6.2 Vaccine-Preventable Diseases, Vaccines, and Immunizations

Immunity and vaccines are crucial for protecting individuals and communities from infectious diseases. Natural, active, and passive immunity work together to defend our bodies, while vaccines stimulate the immune system to produce antibodies against specific pathogens.

Vaccines have dramatically reduced the incidence of many infectious diseases worldwide. They work by introducing antigens that trigger an immune response, preparing the body to fight off future infections. Understanding vaccine mechanisms and development is key to appreciating their role in public health.

Immunity and Vaccines

Types of immunity

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• Immunity enables the body to resist or fight off infections and diseases
  • Natural immunity acquired through exposure to a disease-causing agent
    • Develops after recovering from an infection (chickenpox)
  • Active immunity acquired through exposure to a vaccine or disease-causing agent
    • Stimulates the body to produce antibodies and immune cells
    • Provides long-lasting protection (hepatitis B vaccine)
  • Passive immunity acquired through the transfer of antibodies from another source
    • Obtained through maternal antibodies or the administration of preformed antibodies (immunoglobulins)
    • Provides immediate but short-term protection (rabies immunoglobulin)

Role of vaccines in health

• Vaccines stimulate the immune system to produce antibodies and immune cells against specific pathogens
  • Prepares the body to fight off infections if exposed to the pathogen in the future
• Vaccines protect individuals and communities through herd immunity
  • Herd immunity occurs when a significant portion of a population is vaccinated, reducing the spread of disease
    • Protects those who cannot be vaccinated due to age, health conditions, or other factors (infants, immunocompromised individuals)
• Vaccines have significantly reduced the incidence and mortality of many infectious diseases
  • Eradication of smallpox and near-elimination of polio worldwide

Vaccine development and mechanisms

• Vaccines contain antigens, which are substances that stimulate an immune response
• Adjuvants are added to some vaccines to enhance the immune response and improve immunogenicity
• Edward Jenner pioneered the concept of vaccination by using cowpox to protect against smallpox
• Vaccine efficacy measures how well a vaccine prevents disease in controlled clinical trials

Vaccine-Preventable Diseases and Immunization Strategies

Vaccine-preventable diseases

• Measles causes fever, rash, and potential complications like pneumonia and encephalitis
• Mumps causes swelling of the salivary glands, fever, and potential complications like meningitis and orchitis
• Rubella causes mild symptoms in children but can lead to congenital rubella syndrome in pregnant women
• Pertussis (whooping cough) causes severe coughing fits, especially dangerous for infants
• Influenza causes fever, respiratory symptoms, and potential complications like pneumonia
• Hepatitis B affects the liver, can lead to chronic infection, cirrhosis, and liver cancer
• Human Papillomavirus (HPV) can cause genital warts and various cancers, including cervical cancer

Vaccines vs immunizations

• Vaccines are biological preparations that stimulate the immune system to produce antibodies and immune cells against specific pathogens
  • Contain inactivated, attenuated, or fragments of the pathogen or toxoid
  • Administered through various routes (intramuscular, subcutaneous, oral)
• Immunizations are the process of administering vaccines to protect individuals against infectious diseases
  • Includes the schedule, dosage, and route of vaccine administration
  • Follows recommended guidelines based on age, health status, and other factors

Vaccination recommendations

• Age-based recommendations include routine childhood and adult immunization schedules
  • Measles-Mumps-Rubella (MMR) vaccine for children, influenza vaccine for adults
• Health status considerations include vaccinations for individuals with specific health conditions or risk factors
  • Pneumococcal vaccine for individuals with chronic lung disease, hepatitis B vaccine for healthcare workers
• Travel considerations include vaccinations recommended or required for international travel
  • Based on the destination, duration of stay, and planned activities
  • Yellow fever vaccine for travel to certain African and South American countries, meningococcal vaccine for Hajj pilgrims

Nursing roles in vaccination

• Vaccine administration
  1. Verify the correct vaccine, dosage, and route of administration
  2. Ensure proper storage and handling of vaccines
  3. Obtain informed consent and screen for contraindications
  4. Administer vaccines using proper technique and infection control measures
  5. Monitor patients for immediate adverse reactions
• Patient education
  • Provide information on the benefits and risks of vaccines
  • Explain the potential side effects and how to manage them
  • Emphasize the importance of completing the vaccination series, if applicable
  • Provide written materials and resources for further information
  • Address patient concerns and misconceptions about vaccines
• Maintain the cold chain to ensure vaccine potency during storage and transport

Strategies for vaccine compliance

• Vaccine hesitancy is the reluctance or refusal to receive vaccines despite their availability
  • Caused by factors such as misinformation, personal beliefs, and safety concerns
• Strategies to address vaccine hesitancy
  • Provide evidence-based information on vaccine safety and effectiveness
  • Use motivational interviewing techniques to explore and address patient concerns
  • Collaborate with community leaders and influencers to promote vaccine acceptance
  • Implement reminder and recall systems to improve immunization compliance
  • Offer alternative vaccine schedules or formulations, if appropriate and available
• Educate patients about the importance of booster shots for maintaining immunity

Vaccine side effects and contraindications

• Common side effects include pain, redness, and swelling at the injection site, fever, and mild systemic symptoms
  • Usually mild and self-limited
• Rare but serious side effects include allergic reactions, seizures, and Guillain-Barré syndrome
  • Require immediate medical attention
• Contraindications are conditions or circumstances that increase the risk of a serious adverse reaction
  • Severe allergic reaction to a previous vaccine dose or component, immunosuppression, pregnancy (for certain live vaccines)
• Precautions are conditions that may increase the risk of a vaccine-related adverse event but do not necessarily preclude vaccination
  • Moderate to severe acute illness, recent receipt of antibody-containing blood products

Importance of immunization records

• Immunization records
  • Document the vaccine, dose, date, and lot number for each administered vaccine
  • Provide evidence of immunization status for school entry, employment, and travel
  • Facilitate the tracking of vaccine coverage and effectiveness
• Reporting adverse events
  • Adverse events following immunization (AEFI) are any untoward medical occurrence following vaccination
    • Includes vaccine-related and coincidental events
  • Reporting AEFIs to the Vaccine Adverse Event Reporting System (VAERS) in the United States
    • Helps monitor vaccine safety and identify potential issues
  • Prompt reporting and investigation of serious AEFIs
    • Ensures timely identification and management of vaccine-related problems