Immunization Bacille Calmette-Guérin (BCG

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Immunization Bacille Calmette-Guérin (BCG

Puglise, Joe, General Manager has reference to this Academic Journal, PHwiki organized this Journal Immunization Dr.Khalid Hama salih, Pediatrics specialist M.B.Ch.; D. C.H F.I.B.M.S.ped Bacille Calmette-Guérin (BCG Bacille Calmette-Guérin (BCG) is a live strain of Mycobacterium bovis developed by Calmette in addition to Guérin as long as use as an attenuated vaccine to prevent tuberculosis in addition to other mycobacterial infections. The vaccine was first administered to humans in 1921 in addition to remains the only vaccine against tuberculosis BCG is the most widely administered vaccine in the world; it has been given to over 3 billion individuals, principally in the setting of routine newborn immunization (as dictated by guidelines of the World Health Organization) . EFFICACY — BCG vaccine efficacy appears to depend on three factors: the underlying immune status of the recipient, the extent of background exposure to mycobacteria prior to vaccination, in addition to perhaps the potency of the BCG strain used in the vaccine

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Active disease — A widely cited meta-analysis suggests that BCG vaccination reduces the risk of active TB by about 50 percent, Vaccination of newborns in addition to infants appears to confer protection in about 80 percent of cases, The greatest benefit of BCG appears to be diminished risk of tuberculous meningitis in addition to disseminated disease in children (75 to 86 percent efficacy) Dose — The st in addition to ard dose of BCG vaccine is 0.1 mg in 1 mL. Other childhood vaccines can be administered simultaneously with BCG. BCG can be administered intradermally Durability of protection — The duration of BCG induced protection against tuberculosis is generally believed to be approximately 10 to 15 years GROUPS TO CONSIDER FOR VACCINATION — The approach to BCG vaccination policy depends on the regional prevalence of TB in addition to is variable around the world. In countries where the prevalence of TB is moderate to high, neonatal vaccination is recommended by the World Health Organization (WHO) in addition to is administered routinely The WHO does not recommend use of BCG vaccine in the countries meeting the following criteria; 1.Average annual rate of smear-positive pulmonary TB below 5 per 100,000 2.Average annual rate of tuberculous meningitis in children under five years below 1 per 10 million population 3.Average annual risk of TB infection below 0.1 percent

Bacillus CalmetteGuerin Vaccine (BCG) SIDE EFFECTS Local Skin ulceration, regional lymphadenitis Subcutaneous abscess Generalized Anaphylaxis, generalized BCG infection (rare): osteitis Potential factors affecting the rate of adverse reactions include the BCG dose, vaccine strain, in addition to method of vaccine administration Bacillus CalmetteGuerin Vaccine (BCG) PRECAUTIONS & CONTRAINDICATIONS(CI): CIPosative tubercline skine test CI in persons with immunodeficiencies CI during pregnancy Hepatitis B Virus Vaccine Vaccination with hepatitis B virus (HBV) vaccine prevents HBV infection in addition to its complications, which include hepatocellular cancer. Thus hepatitis B vaccinewas the 1st anticancer vaccine The initial strategy of targeting hepatitis B vaccination toward high-risk persons failed to significantly reduce the incidence of HBV infection

STORAGE. The vaccine should arrive at the office with a refrigerant but unfrozen. It should be refrigerated on arrival in addition to stored at 2° to 8° C. The vaccine should not be frozen. The shelf life is up to 3 years ADMINISTRATION: 0.5 1 ML, anterolateral thigh or deltoid IM injection Adminstration: A 3-dose( 0.5 mL) schedule is recommended as long as active immunization. For routine infant immunization, the initial dose should be given to the newborn be as long as e hospital discharge. The minimal intervals between doses are8: Between the 1st in addition to 2nd doses—4 weeks Between the 2nd in addition to 3rd doses—8 weeks Between the 1st in addition to 3rd doses—16 weeks The 3rd dose should be administered no earlier than 24 weeks of age. For infants, children, in addition to adolescents through 19 years of age, the dose is 0.5 mL. adverse effect The most common adverse event after receiving the hepatitis B vaccine is pain at the injection site. Mild systemic complaints, including fatigue, headache, in addition to irritability, occur in fewer than 20% of children. Low-grade fever occurs in up to 6% of children. 3.Serious systemic adverse events in addition to allergic reactions are rare.

CONTRAINDICATIONS AND PRECAUTIONS Administration of hepatitis B vaccine is contraindicated as long as individuals who had a serious (anaphylactic) allergic reaction to a prior dose of hepatitis B vaccine or a vaccine component infants born to women who are HBsAg positive All infants born to women who are HBsAg positive should receive hepatitis B vaccine in addition to HBIg (at a different injection site) within 12 hours of birth, regardless of gestational age or birth weight. For infants weighing less than 2000 g, this birth dose should not be counted as part of the series; that is, 3 additional doses of hepatitis B vaccine should be given, the first of which should be at 1 month of age Infants born to women who were not tested as long as HBsAg should receive an initial dose of hepatitis B vaccine within 12 hours of birth. The mother should be tested immediately, in addition to if she tests positive, then the infant should receive HBIg within 7day. NB/ LOW-BIRTH-WEIGHT INFANTS. Hepatitis B vaccination should be postponed if an infant is born to an HBsAg-negative woman in addition to weighs less than 2000 g. Low-birth-weight infants whose mother’s surface antigen status is positive or unknown should receive immediate vaccination in addition to HBIg, as previously described days

After the hepatitis B immunization series is complete (preferably at 6 months of age), all infants of HBsAg-positive mothers should be tested as long as the presence of anti-HBs in addition to HBsAg at 9 to 15 months of age. Tetanus in addition to Diphtheria component is Toxoid, the pertusis component is whole cellular. PREPARATIONS < 7 years : DTP, DT, DTaP (acellular pertussis vaccine) > 7 years : Td, TdaP

STORAGE DTaP, DTP, or DTP-Hib vaccines should arrive at the office unfrozen in addition to should be refrigerated on arrival at a temperature of 2° to 8° C. The vaccine should not be frozen. The shelf life is up to 1 year. The vials must be shaken vigorously be as long as e withdrawing the individual doses ADMINISTRATION. The vaccine is administered intramuscularly using a dose of 0.5 mL Side effect; . In this vaccine the Pertusis component is acellular. in addition to it has less side effects than the previous vaccine. 1) local reactions of ress, swelling, induration, in addition to tenderness in addition to (2) systemic reactions : drowsiness, vomiting, crying, in addition to low-grade fever. Moderate-to-severe reactions include high fevers of 40.5° C (105° F) or higher, persistent in addition to inconsolable crying of more than 3 hours’ duration, hypotonic-hyporesponsive episodes, in addition to febrile seizure Diphtheria, Tetanus & Pertussis (DTP) CONTRAINDICATIONS (CI) Encephalopathy within 7 days Progressive or unstable neurological disorders Anaphylactic reaction to a previous dose PRECAUTIONS severe systemic reactions such as Temp > 40.50C persistent inconsolable crying > 3 hours Collapse episodes Convulsions NB/ Vaccination should be deferred in the event of a moderate to severe acute illness until the illness subsides

Polio Vaccine Two polio vaccines have been developed: enhanced-potency IPV in addition to OPV PREPARATIONS: (A) Oral (OPV) SABIN(Live attenuated) (B) Inactivated (eIPV) SALK (killed) Routine polio vaccination in the United States is currently accomplished with IPV, which is administered subcutaneously (or intramuscularly) with a dose of 0.5 mL in addition to consists of as long as maldehyde-killed poliovirus. OPV, in contrast, is a live attenuated vaccine that is administered orally. Though still used routinely in many countries STORAGE:opv should be frozen but IPV should arrive at the office unfrozen in addition to should be refrigerated between 2° in addition to 8° C. The shelf life is up to 18 months. ADMINISTRATION: OPV 2 drops orally IPV SC injection PRECAUTIONS & CONTRAINDICATIONS(CI) : (a) OPV pregnancy, immunodeficiency (b) IPV neomycin hypersensitivity ADVERSE REACTIONS: OPV paralytic disease (rare :Haemophilus Influenzae Type B Vaccine In the prevaccination era, 1 in 200 children developed invasive Hib disease by the age of 5 years.31 The most recent surveillance data show that the annual number of cases decreased by 99%

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STORAGE. Hib vaccines should arrive in insulated containers to prevent freezing. They should arrive unfrozen in addition to should be refrigerated immediately in addition to stored between 2° in addition to 8° C. Freezing reduces or destroys potency. Shelf life is up to 2years ADMINISTRATION: im If a child receives different br in addition to s of Hib vaccine at 2 in addition to 4 months of age, then a Hib vaccine dose should be given at 6 should be followed by a booster at 12 to 15 months of age. ADVERSE EVENTS. Adverse events after Hib vaccination are mild in addition to infrequent. Between 5% in addition to 30% will have a local reaction consisting of swelling, redness, or pain. Systemic adverse events such as fever are uncommon CONTRAINDICATIONS AND PRECAUTIONS . The only contraindication to Hib vaccination is a history of severe (anaphylactic) allergic reaction after a prior dose of Hib vaccine or a vaccine component. Vaccination should be deferred in the event of a moderate to severe acute illness until the patient’s health improves

Measles, Mumps & Rubella (MMR) MMR vaccine is a combination of 3 live attenuated vaccines that together protect against measles, mumps, in addition to rubella. The purpose of the measles in addition to mumps vaccines is to protect against these specific diseases; the purpose of the rubella vaccine is to prevent congenital rubella syndrome by preventing the occurrence of rubella, which, itself, is a mild disease, in the general population, thereby preventing its spread to susceptible pregnant women. The incidence of all 3 viruses has declined more than 99% compared with the prevaccination era Measles, Mumps & Rubella (MMR) . STORAGE:It should be refrigerated on arrival in addition to stored between 2° in addition to 8° C (never frozen). The shelf life is up to 2 years; On reconstitution, the vaccine should be stored in a dark place between 2° in addition to 8° C in addition to must be used within 8 hours ADMINISTRATION:. administration of 2 doses of MMR vaccine as long as children; these doses are 0.5 mL delivered subcutaneously. The 1st dose should be given at 12 to 15 months of age in addition to the 2nd be as long as e elementary school entry (4 to 6 years of age :Measles, Mumps & Rubella (MMR) ADVERSE REACTIONS Fever ,rash (7 days post vaccination) Arthralgia , arthritis (rubella) Encephalitis [rare] (measles, mumps) Suppression of PPD skin test (measles) Convulsions in prone children(measles) Thrombocytopenia

Influenza Virus Indications: Sickle cell anemia. Chronic salicylate therapy. Diabetes mellitus. Chronic renal disease. Chronic metabolic disease. immunosuppressive conditions: cancer, HIV etc. Hospital personnel with significant patient contact. Influenza Virus Contraindication: Anaphylaxis to previous dose. Hypersensitivity to eggs. Adverse Reaction: Soreness at injection site. Allergic response. Guillain-Barré Syndrome.

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