Primary Prevention

What is primary prevention?

Precedes disease; includes health promotion through health education and immunizations; many interventions at this level

What is passive strategy of primary prevention?

Individual is inactive
1. Introduction of Vitamin D to milk
2. Sewage systems

What is active strategy of primary prevention?

Individual becomes involved
1. Performing daily exercise
2. Adopting a stress management program

What does the primary prevention of health education do?

Nurtures health promoting habits, values, and attitudes; improves quality of life; *must assess readiness of patient*

What does the primary prevention of immunizations do?

Vaccines protect the body from specific diseases

What happens with no vaccine?

1. First exposure to disease: sickness can occur
2. Antibodies develop
3. Complications
4. Second exposure to disease
5. Patient doesn't get sick

What happens with a vaccine?

1. Vaccine: antigen introduced
2. Antibodies and immunity develop
3. First exposure to disease: patient does not get sick

What is a live-attenuated vaccine? Examples?

Uses weakened form; usually lifetime of immunity.
1. MMR
2. Chickenpox
3. Small pox
4. Rotovirus
5. Flu nasal mist

What is an inactive vaccine? Examples?

Uses the killed version of virus/bacteria. Usually need booster
1. Hepatitis A
2. Flu shot
3. Polio (shot)
4. Rabies

What are mRNA vaccines?

Messenger RNA vaccines teach cells how to make a protein or piece of protein that triggers an immune response; can be created faster than conventional vaccines. Prior to Covid, mRNA vaccines for HIV, rabies, zika, and influenza were in clinical trials

What is the " " for a covid mRNA vaccine?

"Spike"

What is passive immunity? Examples?

Given someone else's antibodies
1. Newborns receive via placenta
2. Injecting blood products with ready made antibodies (no long term immune memory)

What is active immunity? Examples?

Results when own immune system works to produce antibodies
1. Via disease or vaccination: to make the immune system react defensively (provides immune memory)

What are common reactions to vaccines?

1. Redness/swelling
2. Soreness or tenderness
3. Fever
4. Fussiness
5. Fatigue

When would you NOT give a vaccine?

1. Fever 101F or greater
2. Flu, Covid
3. Moderate or severe illness with or without fever
4. Bad reactions to a specific vaccine
5. High steroid doses for 2 weeks
6. Severely compromised immune system
7. COVID

What causes a severely compromised immune system?

1. Leukemia, other cancers
2. AIDS
3. Low platelet count

When would you give a vaccine to COVID patients?

1. Active COVID infection: must be symptom free and finish isolation period
2. Exposure to COVID: must complete CDC's quarantine recommendation before vaccine given

What are some vaccinations?

1. DTaP/Tdap
2. MMR
3. Varicella
4. Polio
5. Meningococcal Disease
6. Hepatitis B/A
7. Flu
8. Pregnant women can and cannot get

How do you talk about vaccines?

Effective, empathetic communication is critical in responding to parents who are considering not vaccinating their children. "A successful discussion about vaccines involves a two-way conversation, with both parties sharing information and asking questions"

What do you say if a parent says "Won't giving my baby so many vaccines overwhelm his/her immune system"?

Infants are colonized with trillions of bacteria, encounter numerous viruses, and face other environmental challenges. The vaccines that children receive in the first two years of life are almost nothing in comparison

What do you say if a parent says "Why don't you recommend spacing out vaccines using an alternative schedule?"

Delaying vaccines increases the time children will be susceptible to serious diseases. Requiring many extra appointments for vaccinations increases the stress for the child and may lead to a fear of medical procedures. There is no evidence that spreading out the schedule decreases the risk of adverse reactions

What do you say if a parent says "Wasn't there a study that proved MMR vaccine causes autism?"

Many large, well-designed studies have found no link between MMR and autism. Autism usually becomes apparent around the same time MMR is given- no causality proven. Autism probably has multiple components, including genetics. The 1998 study by Andrew Wakefield that started this concern was based on 12 children. Retracted the study's interpretation and lost his medical license. The Lancet retracted the paper, research was "dishonest" and "irresponsible" and that he had shown a "callous disregard" for the suffering of children involved in his studies. Deliberate fraud

What do you say if a parent says "Hasn't the mercury in vaccines been shown to cause autism?"

The form of mercury found in thimerosal is ethylmercury, not methylmercury, which is the form that has been shown to damage the nervous system. Although no evidence of harm has been proven, thimerosal was taken out of vaccines as a precaution and "because it can be" taken out (due to single dose vials, other preservative options). Multiple studies have shown that thimerosal in vaccines does not cause autism when comparing vaccinated and unvaccinated children.

What does DTaP cause?

Thick gray coating over the back of the throat. If not treated, this child could die from suffocation.

How is DTaP spread?

Spread via respiratory droplet and open sores

What does DTaP Tetanus cause?

The muscles are in spasm, making it nearly impossible for one to move. Body becomes rigid.

How is DTaP Tetanus spread?

Bacteria found in soil, manure, enters through wound, cut

How can tetanus be spread to newborns?

Infection can occur when the newly cut umbilical cord is exposed to dirt. Most newborns who get tetanus die.

What does pertussis (whooping cough) cause?

Severe coughing spasms, which are often followed by a "whooping" sound. Difficult for him to stop coughing and catch his breath. Broken blood vessels in eyes and bruising on face because of coughing

How is pertussis spread?

Spread via respiratory droplets. Fatal to infants, babies... Big Bad Cough commercial

When is Hepatitis B given?

1st dose: at birth
2nd dose: 1-2 mo
3rd dose: 6-18 mo

When is Diphtheria, tetanus, acellular pertussis given?

1st dose: 2 mo
2nd dose: 4 mo
3rd dose: 6 mo
4th dose: 15-18 mo

When is measles, mumps, rubella given?

1st dose: 12-15 mo
2nd dose: 4-6 yr

When is varicella given?

1st dose: 12-15 mo
2nd dose: 4-6 yr

When is inactivated poliovirus given?

1st dose: 2 mo
2nd dose: 4 mo
3rd dose: 6-18 mo
4th dose: 4-6 yr

What is meningococcal (MenACWY-D, MenACWY-CRM, MenACWY-TT) given?

1st dose: 11-12 yr
2nd dose: 16 yr

What is meningococcal B (MenB-4C, MenB-FHbp) given?

16-18 yr

When is Hepatitis A given?

2 dose series between 12 and 19-23 mo

When is influenza (IIV4) given?

annual vaccination 1 or 2 doses: 6 mo to 7-10 yr
OR
annual vaccination 1 dose only: 7-10 yr to 17-18 yr

When is influenza (LAIV4) given?

annual vaccination 1 or 2 doses: 2-3 yr to 7-10 yr
OR
annual vaccination 1 dose only: 7-10 yr to 17-18 yr

What does polio cause?

Severely deformed leg

How is polio spread?

Spread via respiratory and feces

What does meningococcal septicemia cause?

Subcutaneous hemorrhage

How is meningococcal septicemia spread?

Spread saliva and respiratory droplets

What does Hepatitis B cause?

Chronic infection can lead to liver cancer

How does Hepatitis B spread?

Spread by blood and body fluids

What does Hepatitis A cause?

Jaundice: skin and whites of eyes turn yellow
Other symptoms: loss of appetite, abdominal pain, nausea or vomiting, fever, headaches, and dark urine

How does Hepatitis A spread?

Spread via blood/feces

What are facts and symptoms of influenza?

Abrupt onset of symptoms
1. Fever usually; 3-4 days
2. Aches often severe
3. Chills: common
4. Fatigue weakness: usual
5. Sneezing: sometimes
6. Stuffy nose: sometimes
7. Sore throat: sometimes
8. Cough: common/severe
9. Headache: common

What are facts and symptoms of a cold?

Gradual onset
1. Rare to have fever
2. Maybe slight aches
3. Uncommon to have chills
4. Fatigue/weakness: sometimes
5. Sneezing: common
6. Stuffy nose: common
7. Sore throat: common
8. Cough: mild to moderate
9. Headache: rare

What vaccines are contraindicated in pregnant women, immuno-compromised, and HIV infection with a CD4+ count <200?

MMR, VAR, HZV