Vaccines

24 Vaccines


A vaccine is a suspension of dead or disabled organisms that, when ingested or injected, prevents, lessens or treats infections or disease. The most commonly used vaccines in midwifery are rubella (the single antigen vaccine is no longer available in the UK), hepatitis B and BCG vaccine. All women should be offered rubella-screening in early antenatal care to identify the risk of contracting rubella infection; this enables MMR (measles, mumps, rubella) vaccination to be offered following birth and before discharge.


Serological screening for hepatitis B virus should be offered to pregnant women so that effective postnatal intervention can be offered to infected women to decrease the risk of mother-to-child-transmission.


Vaccines are either live attenuated, which usually produce a durable immunity, although not necessarily as long-lasting as immunity resulting from natural infection, or inactivated; a series of injections of vaccine may be administered to produce an adequate antibody response.


The student should be aware of:





BP

Rubella vaccine

Proprietary

Priorix® (GlaxoSmithKline UK) (measles, mumps and rubella – MMR)

Group

Vaccine – live attenuated

Uses/indications

Vaccination where there are low levels of rubella antibodies or none detected

Type of drug

POM

Presentation

Ampoules, powder and solvent for reconstitution

Dosage

Dependant on age of recipient

Route of admin

S.C. or IM

Contraindications

Pregnancy or the intention to become pregnant within 1 month; febrile patients
Systemic hypersensitivity to any component of the vaccine or to neomycin
Extreme care if administered to individuals with egg allergy
Impaired immune function (however, recommend in asymptomatic HIV infection)

Side effects

A mild form of the disease
Rash or swelling at the injection site (use a lesion-free site if eczema)

Interactions

Possible interference from passive antibodies
Can be administered at the same time as the live varicella vaccine (Varilix) but separate injection sites must be used

Priorix® cannot be given at the same time as other live attenuated vaccines; an interval of 4 weeks should be left between vaccinations
In individuals who have received human gammaglobulins or a blood transfusion, vaccination should be delayed for at least 3 months owing to the possibility of vaccine failure due to passively acquired mumps, measles and rubella antibodies
If being given primarily to achieve protection against rubella, the vaccine may be given within 3 months of the administration of an immunoglobulin preparation or a blood transfusion
If tuberculin testing is required, it should be carried out before, or simultaneously, as it has been reported that live measles (and possibly mumps) vaccine may cause a temporary depression of tuberculin skin sensitivity resulting in inconclusive results
If alcohol swabs are used to cleanse the skin, the alcohol must be allowed to evaporate as it may inactivate the vaccine

Pharmacodynamic properties

Induces active immunization against rubella virus infection

Fetal risk

Theoretical risk of teratogenicity and should therefore be avoided unless the need for vaccination outweighs the risk to the fetus

Breastfeeding

Available data suggest that breastfeeding is safe

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Jul 11, 2016 | Posted by in MIDWIFERY | Comments Off on Vaccines

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