Immunizations

http://www.ecommunity.com/healthminute/p/should-my-child-get-a-flu-shot/

NURS 126
Natalie Hotta, Carissa Miyahira,
Chelsea Poligratis, Hana Scully

Immunizations are important for infants, children, and

adolescents because they produce antibodies that provide
active immunity against diseases
Immunizations can take several months to be effective, but
are beneficial because they provide long lasting protection
against infectious and contagious diseases

http://www.yourerdoc.com/shingles-vaccine/

www.dailymail.co.uk

Healthy People 2020

IID (Immunizations and infectious diseases)-7
Achieve and maintain effective vaccination
coverage levels for universally recommended
vaccines among young children.

http://www.vdh.state.va.us/epidemiology/immunization/datamanagement/HealthyPeop
le2020.htm

Why is this important?

Immunizations can save your

childs life
Vaccination is safe and effective
Immunization protects others you
care about
Immunizations can save your
family time and money
Immunization protects future
generations
Outbreaks of preventable
diseases occur when parents
decide not to vaccinate their
child

www.wisegeek.org

Diseases reappear when coverage

drops

Reasons Why People Choose Not To

Get Immunizations

Religious reasons
It isn't natural
The diseases don't exist
anymore
Vaccines don't work
Overload of childs
immune system
childhood diseases are
not serious
vaccines cause autism

wakeup-world.com

How we can reach this goal

Education (correcting unscientific misconceptions)

Many celebrities such as Jenny McCarthy who are huge public figures use their celebrity to
spread unscientific personal beliefs about vaccinations with no evidence to prove what they are
saying.
Making vaccination affordable
For those low income or uninsured, there should be more free clinics in the
McCully/Manoa/Moiliili area as we found no free clinics.
Easily accessible
We found that in Manoa there was a shortage of pediatric offices and of those, none took free
medical insurance. In all, there were very few places within our areas that provided care for all
types of income families.
Raise awareness and advertise
We found that there was very limited media exposure for vaccinations. We think that some
helpful ways to advertise are on TV, bus advertisements, radio and social media.
Time constraints
We realize that the average person is busy and does not have a lot of time to take off to
vaccinate their children. Places like the minute clinic were very time efficient places to get
vaccinated because the wait was less than 10 minutes a person. other places we reached out to
required an appointment and took up to a week to get an appointment.
Mail reminders
We feel that reminders should be sent through the mail to get vaccinations before they are
due similar to the kind you get from the dentist when your check up is close!

Is this objective obtainable by 2020?

We believe that with implementation of our goals,

it is achievable! But without those measures,
people who are choosing not to be vaccinated in
the Manoa/ Moiliili/ McCully area will not seek to
be vaccinated. The media and current outbreaks
have raised awareness about the importance of
vaccines and we hope that by raising the
awareness, more people will choose to vaccinate
their children.

Diseases for which vaccination is routinely

recommended
Diphtheria
Haemophilus influenzae type b (Hib)
Hepatitis A
Hepatitis B
Herpes zoster (shingles)
Human papillomavirus (HPV)
Influenza
Measles
Meningococcal disease
Mumps
Pertussis
Pneumococcal disease
Polio
Rotavirus
Rubella
Tetanus
Varicella (chickenpox)

Immunization Schedule

Diphtheria, tetanus, and acellular

vaccine (DTaP)

4 doses of diphtheria
tetanus, acellular
pertussis by 19-35
months.

2,4,6, and 12-15 months

and again at 4 to 6 years
of age.

Tetanus and diphtheria

(Td) booster- One dose
every 10 years following
DTaP.

Side effects- Local

reaction at the injection
site, fever and irritability,
crying that cannot be
consoled and last over 3
hours, seizures,

Contradiction- a history
of seizures within 3 days
of immunization, a
temperature of 40.5 C
(105 F) within 48 hours
of immunization

Manifestations

Diphtheria- causes a covering in the back of the

throat, which can lead to respiratory and heart
failure.

Tetanus- (lockjaw)

Pertussis- (whooping cough) coughing problems

that are so severe the child has difficulty eating,
breathing, and drinking.

www.healthline.com

http://kckidsdoc.com/whooping-coughvaccine.html

www.aap.org

Healthy People 2020 Statistics

Baseline:
84.6 percent of children aged 19 to 35 months in
2008 received 4 or more doses of the combination of
diphtheria, tetanus, and acellular pertussis antigens
Target:
90.0 percent

Haemophilus influenzae type B

(Hib)

3-4 doses by age 19-35

months

2 months, 4 months, 6
months , 15-18 months

Cause: bacteria spread

by respiratory
secretions.
Can lead to pneumonia,
severe throat swelling,
infections, and death.

Side Effects- Mild local

reactions and a low grade
fever.

Contradictions- child less

than 6 weeks of age.

Contraindicated- for people

with an egg allergy

Contraindicated-for people
who have experienced a
severe life threatening allergy
to a prior dose.

Manifestations

Pneumonia

Bacteremia

Meningitis
www.vaccineinformation.org

textbookofbacteriology.net

Healthy People 2020 Statistics

Baseline:
54.8 percent of children aged 19 to 35 months in 2009
received 3 or more, or 4 or more doses of Hib antigen,
depending on product type received
Target:
90.0 percent

Hepatitis B Vaccine

3 doses by the age of

19-35 months

Intramuscular injections.
The first one is within 12
hr after birth, 2nd vaccine
is given one month after
the first dose, 3rd vaccine
is given six months after
the first dose.

Insurance companies
usually will cover the
cost of the vaccines.

Side effects:
local reaction at
injection site
Headache
Tiredness
Sore throat
nausea
diarrhea
loss of appetite
dizziness

Manifestations
nausea
vomiting
diarrhea
anorexia
headaches
loss of appetite
Jaundice
http://www.whale.to/vaccine/hepb_february_02.html

Healthy People 2020 Statistics

Baseline:
93.5 percent of children aged 19 to 35 months
in 2008 received at least 3 doses of the
hepatitis B antigen
Target:
90.0 percent

Measles, Mumps, Rubella (MMR) Vaccine

1 dose by age of 19-35 months

Doses at 12 to 15 months & at 4-6 years.

Side effects- local reactions (mild rash, fever, swollen

glands in the neck and jaw), joint pain, and risk for
anaphylaxis and thrombocytopenia. Rare severe
problems include deafness, long-term seizures, coma,
lowered consciousness, and permanent brain damage

Contraindications- allergy to gelatin, history of

thrombocytopenia purpura, immunosuppression, and
recent blood transfusions.

Manifestations

www.riversideonline.com

childhooddiseases.info

www.historyofvaccines.org

Healthy People 2020 Statistics

Baseline:
92.1 percent of children aged 19 to 35 months
in 2008 received at least 1 dose of measlesmumps-rubella (MMR) vaccine
Target:
90.0 percent

Poliovirus Vaccine

3 doses of polio by age 19-35 months.

Doses at 2, 4, and 6-18 months and again at 4-6 years.

Side effects- usually mild like temporary redness and a

sore spot where the shot was given

Contradiction- allergy to neomycin

Manifestations
Most people who get infected with
poliovirus do not have any
symptoms.
Some people will have flu-like
symptoms that usually last 2 to 5
days then go away on their own.
In rare cases, poliovirus infection can
be very serious causing weakness
or paralysis in the arms, legs, or
both that can last a lifetime.
www.vaccineinformation.org

Healthy People 2020 Statistics

Baseline:
93.6 percent of children aged 19 to 35 months
in 2008 received at least 3 doses of polio
vaccine
Target:
90.0 percent

Varicella Vaccine

1 dose by age 19-35

months

One dose at 12- 15 months

and again at 4-6 years.

Side effects- a vesicle like

rash on the body

Contraindication-cancer of
blood and lymphatic
system, allergy to
neomycin and gelatin,
immunosuppression, and if
the child is receiving
corticosteroids.

embarrassingbodieskids.channel4.com

www.tesco-baby.com

Healthy People 2020 Statistics

Baseline:
90.7 percent of children aged 19 to 35 months
in 2008 received at least 1 dose of the
varicella antigen
Target:
90.0 percent

Pneumococcal Conjugate Vaccine

(PCV)

Doses should be
administered at ages 2,
4, 6, and 12-15 months.

Side effects- mild local

reactions and fever.

http://www.cdc.gov/pneumococcal/about/sympto
ms-complications.html

Healthy People 2020 Statistics

Baseline:
80.1 percent of children aged 19 to 35 months
received at least 4 doses of pneumococcal
conjugate vaccine in 2008
Target:
90.0 percent

Hepatitis Vaccine A

Two doses 6 months

apart after 12 months of
age.

Side effects- local

reaction at injection site,
anaphylaxis

www.newkidscenter.com

Healthy People 2020 Statistics

Baseline:
40.4 percent of children aged 19 to 35 months
in 2008 received 2 or more doses of hepatitis
A vaccine
Target:
85.0 percent

Rotavirus (RV)

Available in two forms

RotaTeq- 3 doses beginning at

age 6 weeks, with additional
doses at 4- 10 weeks apart.
The vaccination should be
completed before 32 weeks .

Rotarix- 2 doses. One

beginning at 6 weeks and the
second one four weeks later.
All doses should be completed
by 8 months of age

Side effects- diarrhea,

vomiting, and possible ear
infection

Healthy People 2020 Statistics

Baseline:
43.9 percent of children aged 19 to 35 months in 2009
received 2 - 3 or more doses of rotavirus vaccine by
age 19 to 35 months, depending on the form received.
Target:
80.0 percent

Without insurance

http://www.cvs.com/minuteclinic/services/price-lists

Vaccines for Children Program

The Vaccines for Children Program offers vaccines for infants and
children to parents or caregivers who do not have insurance or cannot
afford vaccines
There is no charge for any vaccines for children who are eligible for
VFC
The child can get vaccinated at public health clinics
Contact your state VFC coordinator to find out what clinics offer VFC
vaccinations

THERES ALWAYS A WAY!

http://www.cdc.gov/vaccines/programs/vfc/index.html

Nursing Care

Obtain parental consent

Note date, route, and site

Give intramuscular vaccinations

in the vastus lateralis or
ventrogluteal in infants and
children. The deltoid muscle
may used for older children and
adolescents

Encourage the parents to use

comfort techniques( cuddling,
pacifier, etc)
Document the administration of the
vaccine. Date, route, site, type,
manufacturer, expiration date
Have emergency medications and
equipment on standby

Provide a distraction

driverlayer.com

www.skepticalraptor.com

Parent Care

Use comforting measures such as

cuddling and pacifier

After the procedure, apply a cool

compress to the site and allow
gentle movement of the extremity

Provide praise afterward

Observe for adverse effects and

notify the provider if any side
effects occur.

shotofprevention.com

Maintain scheduled immunizations

for the child.

Avoid giving aspirin to the child to

treat fever or infection. Can lead to
Reye's syndrome.

Premedicate child with

analgesics/antipyretics prior to
immunizations and the next 24
hours. Use acetaminophen for
infants (2-6 months) and ibuprofen
starting at 6 months age.
Apply a topical anesthetic before
the injection.

References
ATI, . (2011). Immunizations . PN Nursing Care of Children(8.0 ed., pp. 389-39). ATI.
Centers for Disease Control and Prevention. CDC - VFC About the Program - Vaccines for Children
Program - Vaccines. Retrieved February 9, 2015, from
http://www.cdc.gov/vaccines/programs/vfc/about/
Centers for Disease Control and Prevention. VFC Program: Vaccines for Uninsured Children |
Features | CDC .Retrieved February 05, 2015, from http://www.cdc.gov/features/vfcprogram/
Centers for Disease Control and Prevention. Immunization schedules. Available at
http://www.cdc.gov/vaccines/schedules. Accessed February 6, 2015.
Centers for Disease Control and Prevention. Vaccine safety and adverse events. Available at
http://www.cdc.gov/vaccines/vac-gen/safety/default.htm. Accessed February 6, 2015.
Hawaii Pacific Health. Pediatrics. Retrieved February 5, 2015, from
http://www.hawaiipacifichealth.org/services/pediatrics/