Postnatal - Vaccination

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Introduction

Community immunity
Community immunity
Australian Public Health Activities (2007-08)

Although the use of most vaccines during pregnancy is not usually recommended on precautionary grounds, there is no convincing evidence that pregnancy should be an absolute contraindication to the use of any vaccine, particularly inactivated vaccines. The only exception is vaccinia virus (smallpox vaccination), which has been shown to cause fetal malformation. For Australian information see the Australian Immunisation Handbook (June2015)[1]


AIH 10th edition 3.3.2 - Women planning pregnancy "The need for vaccination, particularly for hepatitis B, measles, mumps, rubella and varicella, should be assessed as part of any pre-conception health check. Where previous vaccination history or infection is uncertain, relevant serological testing can be undertaken to ascertain immunity to hepatitis B, measles, mumps and rubella."


Tinycc Vaccination page - http://tiny.cc/Vaccination


Links: Viral Infection | Infectious Diseases School Exclusion


Viral Links: viral infection | TORCH | cytomegalovirus | Hepatitis Virus | HIV | Parvovirus | Polio Virus | rubella virus | Chickenpox | Lymphocytic Choriomeningitis Virus | Zika Virus | rotavirus | vaccination | Environmental
Historic Embryology - Viral 
1941 Rubella Cataracts | 1944 Rubella Defects
neonatal diagnosis

Some Recent Findings

  • Infections in Pregnancy and the Role of Vaccines[2] "Pregnant women are at risk for infection and may have significant morbidity or mortality. Influenza, pertussis, zika, and cytomegalovirus produce mild or asymptomatic illness in the mother, but have profound implications for her fetus. Maternal immunization can prevent or mitigate infections in pregnant women and their infants. The Advisory Committee of Immunization Practices (USA) recommends 2 vaccines during pregnancy: inactivated influenza, and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis during pregnancy. The benefits of MMR, varicella, and other vaccines are reviewed. Novel vaccine studies for use during pregnancy for prevention of illness are explored."
  • Trivalent inactivated influenza vaccine and spontaneous abortion[3] "Our final analysis included 243 women with spontaneous abortion and 243 matched control group women; 82% of women with spontaneous abortion had ultrasound confirmation of fetal demise. ...There was no statistically significant increase in the risk of pregnancy loss in the 4 weeks after seasonal inactivated influenza vaccination."
  • Influenza A/H1N1 MF59 adjuvanted vaccine in pregnant women and adverse perinatal outcomes: multicentre study[4] "This large study using primary data collection found that MF59 adjuvanted A/H1N1 influenza vaccine did not result in an increased risk of adverse perinatal events and suggested a lower risk among vaccinated women. These findings should contribute to inform stakeholders and decision makers on the prescription of vaccination against influenza A/H1N1 in pregnant women."
More recent papers  
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Search term: Vaccination Postnatal Vaccination

Adriana Aguado-Martínez, Afonso P Basto, Shun Tanaka, Lorenz T Ryser, Telmo P Nunes, Luis-Miguel Ortega-Mora, David Arranz-Solís, Alexandre Leitão, Andrew Hemphill Immunization with a cocktail of antigens fused with OprI reduces Neospora caninum vertical transmission and postnatal mortality in mice. Vaccine: 2018; PubMed 30497830

Yu Hasegawa, Britni Curtis, Vernon Yutuc, Megan Rulien, Kelly Morrisroe, Kristin Watkins, Clayton Ferrier, Chris English, Laura Hewitson, Carolyn M Slupsky Microbial structure and function in infant and juvenile rhesus macaques are primarily affected by age, not vaccination status. Sci Rep: 2018, 8(1);15867 PubMed 30367140

Amitinder Kaur, Hannah L Itell, E Peek Ehlinger, Valerie Varner, Soren Gantt, Sallie R Permar Natural history of postnatal rhesus cytomegalovirus shedding by dams and acquisition by infant rhesus monkeys. PLoS ONE: 2018, 13(10);e0206330 PubMed 30356332

Anna Taddio, Vibhuti Shah, Lucie Bucci, Noni E MacDonald, Horace Wong, Derek Stephens Effectiveness of a hospital-based postnatal parent education intervention about pain management during infant vaccination: a randomized controlled trial. CMAJ: 2018, 190(42);E1245-E1252 PubMed 30348739

Aakash Pandita, Astha Panghal, Girish Gupta, Anup Verma, Anish Pillai, Anita Singh, Kirti Naranje Is kangaroo mother care effective in alleviating vaccination associated pain in early infantile period? A RCT. Early Hum. Dev.: 2018, 127;69-73 PubMed 30321774

Neonatal Vaccination

Vaccination of premature infants

A recent study has looked at Wheezing lower respiratory disease hazard ratios (HR) for vaccination of premature infants.[5] Premature infants are at increased risk of wheezing in association with respiratory syncytial virus (RSV) and rhinovirus infections. The study found no evidence of increased WLRD risk following routine vaccinations of premature infants. WLRD risk among non-fragile premature infants appears to be reduced for a few weeks after live attenuated vaccinations.

"Wheezing lower respiratory disease hazard ratios (HR) were not significantly elevated for any vaccine type among non-fragile or fragile premature infants. Among non-fragile infants the 8-14 days HR was significantly reduced for live attenuated MMR (0.68, 0.52-0.88) and Varicella (0.71, 0.53-0.94) vaccines, and similarly but insignificantly reduced for infrequently used live attenuated OPV vaccine (0.70, 0.46-1.06). There was a smaller significant reduction (0.83, 0.69-0.998) in the 15-30 days HR for MMR and a similar but not significant reduction (0.86, 0.71-1.05) in the 31-44 days HR for MMR. Hepatitis B vaccine (HBV), which is not a live vaccine, had significantly reduced 8-14 days (0.84, 0.72-0.98) and 31-44 days (0.88, 0.78-0.98) HRs among non-fragile infants. The apparent protective effect of HBV may be confounded by live vaccines administered simultaneously with the third dose of HBV. Among fragile infants there was a large significant reduction in the 8-14 days HR for live attenuated OPV vaccine (0.40, 0.23-0.70) and smaller significant reductions in the 8-14 days HR for inactivated DTaP (0.82, 0.71-0.95), Hib (0.83, 0.73-0.96), and PCV7 (0.84, 0.70-0.997) vaccines. Delays in vaccinating fragile infants may have made simultaneous administration of live vaccines and third doses of these inactivated vaccines more likely."

Australian Immunisation Handbook

Australian Immunisation Handbook
Australian Immunisation Handbook (2015)

The purpose of The Australian Immunisation Handbook[1] is to provide clinical guidelines for health professionals on the safest and most effective use of vaccines in their practice. These recommendations are developed by the Australian Technical Advisory Group on Immunisation (ATAGI) and endorsed by the National Health and Medical Research Council (NHMRC).

There is a specific section within the handbook for Vaccination of women planning pregnancy, pregnant or breastfeeding women, and preterm infants.


Links: AIH 10th edition (June 2015) | V3.3.2 Vaccination of women who are planning pregnancy, pregnant or breastfeeding, and preterm infants (June 2015) | AIH 9th edition (2008)


Australian Child Immunisation Programs 2013  
Age Vaccine
Birth
  • Hepatitis B (hepB)a
2 months
  • Hepatitis B, diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV)
  • Pneumococcal conjugate (13vPCV)
  • Rotavirus
4 months
  • Hepatitis B, diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV)
  • Pneumococcal conjugate (13vPCV)
  • Rotavirus
6 months
  • Hepatitis B, diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV)
  • Pneumococcal conjugate (13vPCV)
  • Rotavirusb
12 months
  • Haemophilus influenzae type b (Hib)
  • Meningococcal C (MenCCV)

  • Measles, mumps and rubella (MMR)
18 months
  • Varicella (chickenpox)
4 years
  • Diphtheria, tetanus, acellular pertussis (whooping cough) and inactivated poliomyelitis (polio) (DTPa-IPV)
  • Measles, mumps and rubella (MMR)
  Notes: Information provided for educational purposes only. Postnatal - Vaccination | Immunise Australia Program

a Hepatitis B vaccine: should be given to all infants as soon as practicable after birth. The greatest benefit is if given within 24 hours, and must be given within 7 days.

b Rotavirus vaccine: third dose of vaccine is dependent on vaccine brand used.

  Source: Australian Immunisation Handbook 10th edition (April 2013).[6] National Immunisation Program Schedule From 1 February 2013 to 30 June 2013 PDF Immunise Australia Program.

NSW

There have been significant changes to the vaccines offered in the NSW vaccination program over time:

  • 1988, NSW conducted a Bicentennial measles campaign which offered measles vaccine to all child care and primary school age children.
  • 1998 the national Measles Control Campaign, which was the first national mass vaccination program since the 1950s polio campaigns, offered measles, mumps, rubella vaccine to all primary school children laying the groundwork that has resulted in the World Health Organization declaration of measles elimination in Australia
  • 2003 the meningococcal C vaccine was offered to all 1 – 19 year olds over a two year period
  • 2004 a hepatitis B vaccine catch up program was conducted for Year 7 students who had not received a primary course of vaccine and continued until 2013.
  • 2007 the three-dose course of human papillomavirus (HPV) vaccine was offered to female students in Years 10-12 . In 2008 it was offered to female students in Years 7 – 10, and routinely to female students in Year 7 from 2009 and was introduced routinely for male students in Year 7 in 2013 with a catch-up program for male students in Year 9 in 2013 and 2014 only
  • booster dose of diphtheria-tetanus-pertussis (dTpa) vaccine was offered to students in Years 7-12 in 2004, in Year 7 in 2005, in Year 10 from 2009-2012 and has been routinely offered to students in Year 7 from 2010 onwards
  • catch-up dose of varicella (chicken pox) vaccine has been offered to students in Year 7 since 2006

(From NSW Health - Communicable Diseases)

USA Recommended Immunizations for Children

(Birth through 6 years)

USA recommended immunizations for children 2013.jpg


Links: Vaccines | Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedule for Persons Aged 0 Through 18 Years — United States, 2013

References

  1. 1.0 1.1 The Australian Immunisation Handbook 10th edition (2015) Canberra: Australian Government Department of Health. ISBN: 978-1-74241-861-2 Online ISBN: 978-1-74241-862-9.
  2. Fortner KB, Nieuwoudt C, Reeder CF & Swamy GK. (2018). Infections in Pregnancy and the Role of Vaccines. Obstet. Gynecol. Clin. North Am. , 45, 369-388. PMID: 29747736 DOI.
  3. Irving SA, Kieke BA, Donahue JG, Mascola MA, Baggs J, DeStefano F, Cheetham TC, Jackson LA, Naleway AL, Glanz JM, Nordin JD & Belongia EA. (2013). Trivalent inactivated influenza vaccine and spontaneous abortion. Obstet Gynecol , 121, 159-65. PMID: 23262941 DOI.
  4. Rubinstein F, Micone P, Bonotti A, Wainer V, Schwarcz A, Augustovski F, Pichon Riviere A & Karolinski A. (2013). Influenza A/H1N1 MF59 adjuvanted vaccine in pregnant women and adverse perinatal outcomes: multicentre study. BMJ , 346, f393. PMID: 23381200
  5. Mullooly JP, Schuler R, Mesa J, Drew L & DeStefano F. (2011). Wheezing lower respiratory disease and vaccination of premature infants. Vaccine , 29, 7611-7. PMID: 21875634 DOI.
  6. Australian Immunisation Handbook 10th edition (April 2013) Immunise Australia Program


Journals

Vaccine is the journal for those interested in vaccines and vaccination. Homepage | PubMed

Reviews

Bozzo P, Narducci A & Einarson A. (2011). Vaccination during pregnancy. Can Fam Physician , 57, 555-7. PMID: 21571717

Hamlin J, Senthilnathan S & Bernstein HH. (2008). Update on universal childhood immunizations. Curr. Opin. Pediatr. , 20, 483-9. PMID: 18622208 DOI.

Articles

Akinsanya-Beysolow I, Jenkins R & Meissner HC. (2013). Advisory Committee on Immunization Practices (ACIP) recommended immunization schedule for persons aged 0 through 18 years--United States, 2013. , 62, 2-8. PMID: 23364302

Pham H, Geraci SA & Burton MJ. (2011). Adult immunizations: update on recommendations. Am. J. Med. , 124, 698-701. PMID: 21658665 DOI.

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Cite this page: Hill, M.A. (2018, December 15) Embryology Postnatal - Vaccination. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Postnatal_-_Vaccination

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