Postnatal - Vaccination

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Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.

Introduction

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.[1]


Links: Viral Infection | Infectious Diseases School Exclusion

Viral Links: viral infection | TORCH | cytomegalovirus | hepatitis | HIV | parvovirus | polio | rubella virus | chickenpox | Lymphocytic Choriomeningitis Virus | Zika virus | human papillomavirus | rotavirus | West Nile virus | varicella virus | vaccination | zoonotic infection | environment
Historic Embryology - Viral 
1941 Rubella Cataracts | 1944 Rubella Defects

neonatal diagnosis

Some Recent Findings

  • Trivalent inactivated influenza vaccine and spontaneous abortion[2] "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[3] "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."

Neonatal Vaccination

Vaccination of premature infants

A recent study has looked at Wheezing lower respiratory disease hazard ratios (HR) for vaccination of premature infants.[4] 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

The purpose of The Australian Immunisation Handbook 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) | 2.3 Groups with Special Vaccination Requirements (July 2009) | Vaccination of women planning pregnancy, pregnant or breastfeeding women, and preterm infants (July 2009) | 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).[1] National Immunisation Program Schedule From 1 February 2013 to 30 June 2013 PDF Immunise Australia Program.

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 Australian Immunisation Handbook 10th edition (April 2013) Cite error: Invalid <ref> tag; name "AIH10" defined multiple times with different content
  2. <pubmed>23262941</pubmed>
  3. <pubmed>23381200</pubmed>
  4. <pubmed>21875634</pubmed>


Journals

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

Reviews

<pubmed></pubmed> <pubmed></pubmed> <pubmed>21571717</pubmed> <pubmed>18622208</pubmed>

Articles

<pubmed></pubmed> PMID 23364302 | MMWR Recomm Rep. <pubmed>21658665</pubmed>


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Cite this page: Hill, M.A. (2020, April 8) Embryology Postnatal - Vaccination. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Postnatal_-_Vaccination

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© Dr Mark Hill 2020, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G