9 Months, 3 Hours, & 28 Days (9 Hours... Book 1)
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Immunity following live vaccines is long-lasting, and booster doses are not necessary. For inactivated vaccines, the first dose administered at the recommended age usually does not provide protection hepatitis A vaccine is an exception. A protective immune response may not develop until the second or third dose.
For inactivated vaccines, antibody titers may decrease wane below protective levels after a few years. This phenomenon is most notable for pertussis vaccine; tetanus and diphtheria vaccine immunity also wanes. An additional dose is given to raise antibody back to protective levels. Not all inactivated vaccines require boosting throughout life.
For example, additional doses of Hib vaccine are not required after completion of the infant primary series and month old booster dose because Hib disease is very rare in children older than 5 years of age. Top of Page.
9 Months, 3 Hours, & 28 Days (9 Hours Book 1) by June West
Vaccines are intended to produce active immunity to specific antigens. Adverse reactions are also called vaccine side effects. A vaccine adverse event refers to any medical event that occurs following vaccination. An adverse event could be a true adverse reaction or just a coincidental event, with further research needed to distinguish between them. Acute vaccine adverse reactions fall into three general categories: local, systemic, and allergic.
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The most common type of adverse reactions are local reactions, such as pain, swelling, and redness at the site of injection. Local adverse reactions generally occur within a few hours of the injection and are usually mild and self-limited.
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On rare occasions, local reactions may be very exaggerated or severe. Some of these reactions, referred to as Arthus reactions, are most frequently seen with diphtheria and tetanus toxoids. Arthus reactions are not allergic reactions. Arthus reactions are believed to be due to very high titers of antibody, usually caused by too many doses of toxoid. Systemic adverse reactions are more generalized events and include fever, malaise, myalgias muscle pain , headache, loss of appetite, and others.
These symptoms are nonspecific; they may occur in vaccinated persons because of the vaccine or may be caused by something unrelated to the vaccine. Systemic adverse reactions were relatively frequent with DTP vaccine, which contained a whole-cell pertussis component. However, comparison of the frequency of systemic adverse events among vaccine and placebo recipients shows they are less common with inactivated vaccines currently in use, including acellular pertussis vaccine. Systemic adverse reactions may occur following receipt of live attenuated vaccines.
Live attenuated vaccines must replicate in order to produce immunity. The adverse reactions that follow live attenuated vaccines, such as fever or rash, represent symptoms produced from viral replication and are similar to a mild form of the natural disease. Systemic adverse reactions following live vaccines are usually mild, and occur days after the vaccine was given i.
LAIV replicates in the mucous membranes of the nose and throat, not in the lungs. As a result, LAIV may cause upper respiratory symptoms like a cold but not influenza-like symptoms. A third type of acute vaccine adverse reactions are allergic reactions. Allergic reactions may be caused by the vaccine antigen itself or some other component of the vaccine, such as cell culture material, stabilizer, preservative, or antibiotic used to inhibit bacterial growth.
Severe allergic reactions anaphylaxis may be life-threatening. Fortunately, they are rare. The risk of an allergic reaction can be decreased by good screening prior to vaccination. All providers who administer vaccines must have an emergency protocol and supplies to treat anaphylaxis. Providers should report any clinically significant adverse event that occurs after the administration of any vaccine licensed in the United States to the Vaccine Adverse Event Reporting System VAERS , which includes reporting from both public and private sectors.
Providers should report a clinically significant adverse event even if they are unsure whether a vaccine caused the event. VAERS accepts reports of adverse reactions through their online system. Contraindications and precautions to vaccination generally dictate circumstances when vaccines will not be given. Many contraindications and precautions are temporary, and the vaccine can be given at a later time.
Days, Weeks, Months and Years
A contraindication is a condition that increases the likelihood of a serious adverse reaction to a vaccine for a patient with that condition. If the vaccine were given in the presence of that condition, the resulting adverse reaction could seriously harm the recipient. For instance, administering MMR vaccine to a person with a true anaphylactic allergy to gelatin could cause serious illness or death in the recipient.
In general, vaccines should not be administered when a contraindication condition is present. A precaution is a condition in a recipient that might increase the chance or severity of a serious adverse reaction, or that might compromise the ability of the vaccine to produce immunity such as administering measles vaccine to a person with passive immunity to measles from a blood transfusion. Injury could result, but the chance of this happening is less than with a contraindication. In general, vaccines are deferred when a precaution condition is present. However, situations may arise when the benefit of protection from the vaccine outweighs the risk of an adverse reaction, and a provider may decide to give the vaccine.
There are very few true contraindication and precaution conditions. Only four of these conditions are generally considered to be permanent contraindications: severe anaphylactic allergic reaction to a vaccine component or following a prior dose of a vaccine; encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination; severe combined immunodeficiency SCID and a history of intussusception as contraindications to rotavirus vaccine. Two conditions are temporary precautions to vaccination: moderate or severe acute illness all vaccines , and recent receipt of an antibody-containing blood product.
The latter precaution applies only to MMR and varicella-containing except zoster vaccines. Two conditions are temporary contraindications to vaccination with live vaccines: pregnancy and immunosuppression.
Short Term Effects
A severe anaphylactic allergic reaction following a dose of vaccine will almost always contraindicate a subsequent dose of that vaccine. Anaphylactic reactions are those that are mediated by IgE, occur within minutes or hours of receiving the vaccine, and require medical attention. Examples of symptoms and signs typical of anaphylactic reactions are generalized urticaria hives , swelling of the mouth and throat, difficulty breathing, wheezing, hypotension, or shock. These reactions are very rare following vaccination and can be further minimized with appropriate screening.
A table listing vaccine contents is included in Appendix B. Persons may be allergic to the vaccine antigen or to a vaccine component such as animal protein, antibiotic, preservative, or stabilizer. The most common animal protein allergen is egg protein found in vaccines prepared using embryonated chicken eggs e.
Ordinarily, a person who can eat eggs or egg products can receive vaccines that contain egg; persons with histories of anaphylactic or anaphylactic-like allergy to eggs or egg proteins should be referred for further evaluation. Asking persons whether they can eat eggs without adverse effects is a reasonable way to screen for those who might be at risk from receiving yellow fever and egg-containing influenza vaccines.
Studies have shown that children who have a history of severe allergy to eggs rarely have reactions to MMR vaccine. This is probably because measles and mumps vaccine viruses are both grown in chick embryo fibroblasts, not actually in eggs. It appears that gelatin, not egg, might be the cause of allergic reactions to MMR.
As a result, in , the ACIP removed severe egg allergy as a contraindication to measles and mumps vaccines. Egg-allergic children may be vaccinated with MMR without prior skin testing.
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Certain vaccines contain trace amounts of neomycin. Persons who have experienced an anaphylactic reaction to neomycin should not receive these vaccines. Most often, neomycin allergy presents as contact dermatitis, a manifestation of a delayed-type cell-mediated immune response, rather than anaphylaxis. A history of delayed-type reactions to neomycin is not a contraindication for administration of vaccines that contain neomycin. Latex is sap from the commercial rubber tree.
Latex contains naturally occurring impurities e. Latex is processed to form natural rubber latex and dry natural rubber. Dry natural rubber and natural rubber latex might contain the same plant impurities as latex but in lesser amounts.
Natural rubber latex is used to produce medical gloves, catheters, and other products. Dry natural rubber is used in syringe plungers, vial stoppers, and injection ports on intravascular tubing. Synthetic rubber and synthetic latex also are used in medical gloves, syringe plungers, and vial stoppers. Synthetic rubber and synthetic latex do not contain natural rubber or natural latex, and therefore, do not contain the impurities linked to allergic reactions. The most common type of latex sensitivity is contact-type type 4 allergy, usually as a result of prolonged contact with latex-containing gloves.
However, injection-procedure-associated latex allergies among diabetic patients have been described. Allergic reactions including anaphylaxis after vaccination procedures are rare. Only one report of an allergic reaction after administration of hepatitis B vaccine in a patient with known severe allergy anaphylaxis to latex has been published. If a person reports a severe anaphylactic allergy to latex, vaccines supplied in vials or syringes that contain natural rubber should not be administered unless the benefit of vaccination clearly outweighs the risk of an allergic reaction to the vaccine.
For latex allergies other than anaphylactic allergies e. The concern with vaccination of a pregnant woman is infection of the fetus and is theoretical.