Transcript Childhood Immunisations Developmental Milestones

Childhood Immunisations
Developmental Milestones
Dr Tessa Hicks
For GP Small Group Teaching
19 Oct 2011
Learning Objectives
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List diseases included in standard childhood
immunisation programme
Give main contraindications to immunisation
State immunisation schedule
State nature (live/inactivated) of each vaccine
Explain key developmental milestones
State key causes for concern/referral
Practice/Help with AKT questions!!
Starter Quiz!
1. How many diseases vaccinated against
in standard immunisation schedule?
 2. How many times is child seen for
immunisations in standard imm. schedule?
 When can a child say ‘mama’ and ‘dada’
 When can a child use a spoon and fork?
 At what age should you refer a child who
cannot walk?
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Childhood Immunisations (CI)
Purpose - to protect individual and herd
against important infectious diseases:
 ‘DTaP/IPV/Hib’
 Diphtheria
 Tetanus
 Pertussis
 Polio (Inactivated Polio Vaccine)
 Haemophilus Influenza type b
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CI: purpose
Pneumococcal disease
 Meningococcal group C
‘MMR’
 Measles
 Mumps
 Rubella
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Human papilloma virus
CI: purpose
Non-routine?
 Hepatitis B
 Tuberculosis
Pre Immunisation
1. No contraindications
 2. Consent
 3. Patient/parent understands procedure
 4. Patient/parent understands possible
adverse reactions and how to treat
 5. After - Record/document!
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CI: main contraindications - general
All vaccines contraindicated if:
 Previous confirmed anaphylactic reaction
to same antigen or another vaccine
component
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Temporary contraindication for live
vaccines
 - immunosuppressed
 - pregnant (no evidence)
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CI: contraindications - specific
 Egg
allergy
(influenza, yellow fever)
 MMR safe if allergy after ingestion of egg,
under supervision if confirmed
anaphylaxis to egg-containing food
 Latex
In tip cap and/or rubber plunger
Avoid if severe anaphylaxis to latex
CI - deferral
Fever or systemic upset
 Evolving neurological condition
 Recent immunoglobulins (3
weeks/3months)
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Do NOT defer in premature babies (if
born < 28 weeks, need respiratory
monitoring in hospital after initial
immunisations)
CI: ‘AEFI’
= Adverse events following immunisation
 Programme related
 Vaccine induced – common, rare
 Coincidental
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Developmental Milestones
Guide to normal development
 Variations/Bell curve distribution
 Points for concern
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Starter Quiz!
1. How many diseases vaccinated against
in standard immunisation schedule?
 2. How many times is child seen for
immunisations in standard imm. schedule?
 When can a child say ‘mama’ and ‘dada’
 When can a child use a spoon and fork?
 At what age should you refer a child who
cannot walk?
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At what age would the average child
acquire the ability to draw a cross?
A. 18 months
 B. 2 years
 C. 2 ½ years
 D. 3 years
 E. 4 years
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Each of the following vaccines is
given at 3 months except:
A. Haem influenza b
 B. Inactivated polio virus
 C. Pneumococcal conjugate virus
 D. Tetanus
 E. Meningitis C
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Learning Objectives







List diseases included in standard childhood
immunisation programme
Give main contraindications to immunisation
State immunisation schedule
State nature (live/inactivated) of each vaccine
Explain key developmental milestones
State key causes for concern/referral
Practice/Help with AKT questions!!
References
1. Green Book:
http://www.dh.gov.uk/prod_consum_dh/groups/
dh_digitalassets/@dh/@en/documents/digitala
sset/dh_130279.pdf
2. Summary Table (colour)
http://www.dh.gov.uk/prod_consum_dh/groups/
dh_digitalassets/documents/digitalasset/dh_12
2401.pdf
3. Oxford Handbook of General Practice
Starter Quiz!
1. How many diseases vaccinated against in
standard immunisation schedule? 11
2. How many times is child seen for
immunisations in standard imm. schedule? 7
3. When can a child say ‘mama’ and ‘dada’? 9 m
4. When can a child use a spoon and fork? 3 yr
5. At what age should you refer a child who
cannot walk? 18 months