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Orientation to Immunizations
     for Medical Personnel
 who are new to working with vaccines


                  Module #1
Introduction to Vaccine Preventable Diseases

                Carolee Besteman, RN MS
                    Clinical Consultant
             Michigan Primary Care Association

                   Updated March 2010

                                                 1
Introduction
• This Introductory Course
  – Gives information to
     • Work as a team (e.g., medical assistant and provider)
  – Does NOT give enough information
     • For medical assistant (MA) to assess for needed
       immunizations on your own
     • To make decisions
         – About medical care
         – About specific contraindications or precautions
  – Expectations are that you will:
     • Continue to learn about vaccines and immunizations
     • Participate in yearly inservices from LHD or MDCH
         – To teach you additional details
         – To let you know what is new

                                                               2
Module #1 Vaccine-Preventable Diseases
    Why do we give immunizations?
• Prevention
• Immunity
   – Antibodies
      • Proteins the
        body makes
        that protect us
        from diseases
   – Do NOT confuse
     with Antibiotics
      • Medicines that
        fight disease
        after infection
        has begun


                                        3
Why Immunize?
• Vaccines prevent specific communicable diseases
• Why learn about these diseases?
   – All of these communicable diseases
       • Spread easily (usually - but not always - from person to person)
       • May be very serious
           – Cause pain and suffering
           – May be deadly
       • Are vaccine-preventable diseases
• To work with vaccines, MA does NOT need to recognize
  or diagnose the diseases
• But the diseases all need to be real
   – To you
   – To your patients & families
• You must recognize the names of the diseases if you
  hear they are spreading in your state or town
• Sometimes the disease and vaccine are called by the
  same name
   – Ask if this becomes confusing to you                                   4
Vaccine-Preventable Diseases
• Many are spread by
  talking, coughing, or
  sneezing
• One is spread in the dirt
  (Tetanus)
• Some are spread in other
  ways
   – Blood or body fluids
     (Hepatitis B)
   – Sexual activity (Human
     Papillomavirus & Hep B)
   – Contaminated food or
     water (Hep A)

                                5
Vaccines-Preventable Diseases
Hepatitis B
• Virus which infects the
  liver
• Spread by blood and
  other body fluids
• Symptoms may include
  yellow eyes & skin,
  tiredness, loss of appetite
  & nausea
• Or may cause no
  symptoms that we
  can see

                                6
Vaccine-Preventable Diseases
Hepatitis B (cont)
• Can lead to different
  kinds of liver disease
   – Cirrhosis
   – Liver cancer
• Some people become
  carriers
   – Which means they never
     get rid of the virus in their
     liver
   – Will have life-long liver
     problems
   – Can spread virus to other
     people without being
     aware of it

                                     7
Vaccine-Preventable Diseases
Hepatitis A
• Hep A virus and Hep B
  virus both infect the liver
• However, Hep A disease is
  caused by a different virus
  than the Hep B virus
• Usually spread by food or
  water that is contaminated
  with stool from another
  person with disease
• Causes the same
  symptoms as Hepatitis B
  which we may or may not
  be able to see

                                8
Vaccine-Preventable Diseases
Diphtheria
• Disease has several types
• One type forms thick gray
   coating over back of
   throat.
• Coating can eventually
   cover the airway and
   suffocate the patient
•Can also effect one’s heart
• Kills 1 of 10 people
   infected with it

                                9
Vaccine-Preventable Diseases
Tetanus
• Lives in the dirt and feces
  of some animals
• Enters the body through
  cuts, abrasions, and
  puncture wounds
• Muscles become rigid &
  the patient cannot open
  mouth or swallow
• May not be able to
  breathe
                                10
Vaccine-Preventable Diseases
Tetanus (cont)
• Causes painful
  contractions &
  spasms
• Spasms may break
  the patient’s bones
• Kills 3 in 10 people
  infected with it


                                11
Vaccine-Preventable Diseases
Pertussis
  (Whooping Cough)
• Horrendous cough that
  can last 6-9 months
• With great amounts of
  mucus and choking
• May turn blue from lack of
  oxygen while coughing
• Blood vessels in eyes
  and face may break from
  coughing
                                12
Vaccine-Preventable Diseases
Hib (Haemophilus
  influenza type b)
• Disease can take many
  forms
   – This child’s facial tissue is
     infected with Hib
   – Hand is gangrene from
     sepsis with Hib
   – Can also cause
     pneumonia, arthritis
• In past, was a major
  cause of meningitis
• However, do not call it
  “meningitis vaccine”
                                     13
Vaccine-Preventable Diseases
Polio
• Disease which cripples
  and paralyzes many of
  its victims
• Before vaccine,
  outbreaks terrified
  whole towns and states
• Many patients did not
  look or feel sick but still
  spread the disease
• Now rarely seen in the
  US but still a problem in
  some parts of the world

                                14
Vaccine-Preventable Diseases
          Polio   cont




                               15
Vaccine-Preventable Diseases
Pneumococcal
 disease
• Again, disease can take
  many forms
• Leading cause of
  meningitis
• Causes 10% of ear
  infections in the US
• But do NOT call it the
  “ear infection” vaccine
• Child can still get ear
  infections from other
  causes

                                16
Vaccine-Preventable Diseases
• Meningococcal disease
  – Often affects the brain and spinal cord (meningitis)
  – Spreads by
     •   sneezing
     •   coughing
     •   kissing
     •   sharing food and drinks with infected person
  – In places where people are in close contact
    (such as college dorms)
  – Common early symptoms include
     •   fever
     •   headache
     •   confusion
     •   stiff neck

                                                           17
Vaccine-Preventable Disease
Meningococcal
 Disease (cont)
• Can also affect other
  parts of body & cause
   –   Loss of arms or legs
   –   Deafness
   –   Nervous system problems
   –   Mental retardation
   –   Seizures
   –   Strokes


                                 18
Vaccine-Preventable Diseases
Rotavirus
• One major cause of
   – Vomiting
   – Diarrhea
   – High fever
• Child becomes severely
  dehydrated very quickly
• Vaccine does not prevent
  all rotavirus illness but
  does give 98% protection
  against severe disease
                                19
Vaccine-Preventable Diseases
Measles
• Begins with red, watery
  eyes and runny nose
• Then patient develops
  rash over whole body
• May lead to severe
  complications such as
   – Pneumonia
   – Deafness
   – Miscarriage if the woman is
     pregnant
   – Premature birth

                                   20
Vaccine-Preventable Diseases
Measles (cont)
• Disease is still a
  problem world wide




                                21
Vaccine-Preventable Diseases
Mumps
• Causes painful swelling
  under the jaw and in
  front of the ear
• Can cause painful
  swelling of the testicles
  in men which can make
  them sterile
• Can also cause
   – Meningitis
   – Brain damage
   – Deafness

                                22
Vaccine-Preventable Diseases
Rubella
• Rash especially on face
  and neck.
• Slight fever
• Patient may not feel very
  ill
• Teach patients to call
  diseases “measles” and
  “rubella”
   – Do NOT allow confusion to
     develop with names like
     “German measles,”
     “rubeolla”, “3-day measles”


                                   23
Vaccine-Preventable Diseases
Rubella (cont)
• Very serious if pregnant
  woman becomes infected
   – She can pass disease on
     to unborn baby
   – May cause miscarriage
   – May cause stillbirth
• Or she may give birth to
  child with Congenital
  Rubella Syndrome
   – Physical problems, such as
      • cataracts or blindness
      • hearing loss or deafness
      • heart damage
   – Mental retardation
                                   24
Vaccine-Preventable Diseases
Chickenpox
 (Varicella)
• Itchy rash that forms
  blisters
• Often mild but can be
  very serious
• Before vaccine, 50-
  100 people died each
  year from chickenpox
  disease in US
                                25
Vaccine-Preventable Diseases
    Chickenpox (Varicella)   cont




                                    26
Vaccine-Preventable Diseases
Human Papillomavirus
• Infection that causes
   – Genital warts
   – Cervical cancer
• Passed from person to
  person by sexual activity
• Virus is very, very common
• Most people with infection
  do not know they have it
• But certain strains, over a
  period of time, can cause
  cervical cancer
                                 27
Vaccine-Preventable Diseases
Shingles (Herpes Zoster)
• Varicella (chickenpox) virus
  has been dormant in body
• Now emerges again and
  causes shingles
• Most common in people 50
  years of age and older
• But may affect children also
• Causes clusters of blister-
  like rash
   –   In a strip-like pattern
   –   On one side of the body
   –   Itching or numbness
   –   Severe pain that can last
       for weeks, months, or
       years
                                   28
Vaccine-Preventable Diseases
Influenza (“flu”)
•   Respiratory infection
     – That begins suddenly
     – May include
         •   Aching all over
         •   Fever
         •   Runny nose
         •   Sore throat
         •   Cough
•   But is NOT a
     – “Stomach problem”
         • Is NOT vomiting
         • Is NOT diarrhea
•   Can be very severe with
    many possible complications


                                   29
Vaccine-Preventable Diseases
• ALL of these diseases:
   – Are preventable!!
   – With vaccines!!
• But to give protection, vaccines must be:
   – Administered correctly
   – Handled and stored correctly
   – Documented correctly
• Your patients must be:
   – Assessed correctly for contraindications and precautions
   – Taught about
      • Which vaccines they are given
      • Which vaccines they will need next
      • When they will need next vaccines

                                                                30
Vaccine-Preventable Diseases
• If you need more information about the
  vaccine-preventable diseases
  – Read Vaccine Information Statements (VIS)
     • VIS have information on
        –   Disease
        –   Vaccine
        –   Side effects from vaccine
        –   AND much more!
  – Check out The Pink Book from Centers for
    Disease Control (CDC)
     • Online at www.cdc.gov/vaccines/pubs/pinkbook
                                                      31

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Workshop #1 intro & diseases

  • 1. Orientation to Immunizations for Medical Personnel who are new to working with vaccines Module #1 Introduction to Vaccine Preventable Diseases Carolee Besteman, RN MS Clinical Consultant Michigan Primary Care Association Updated March 2010 1
  • 2. Introduction • This Introductory Course – Gives information to • Work as a team (e.g., medical assistant and provider) – Does NOT give enough information • For medical assistant (MA) to assess for needed immunizations on your own • To make decisions – About medical care – About specific contraindications or precautions – Expectations are that you will: • Continue to learn about vaccines and immunizations • Participate in yearly inservices from LHD or MDCH – To teach you additional details – To let you know what is new 2
  • 3. Module #1 Vaccine-Preventable Diseases Why do we give immunizations? • Prevention • Immunity – Antibodies • Proteins the body makes that protect us from diseases – Do NOT confuse with Antibiotics • Medicines that fight disease after infection has begun 3
  • 4. Why Immunize? • Vaccines prevent specific communicable diseases • Why learn about these diseases? – All of these communicable diseases • Spread easily (usually - but not always - from person to person) • May be very serious – Cause pain and suffering – May be deadly • Are vaccine-preventable diseases • To work with vaccines, MA does NOT need to recognize or diagnose the diseases • But the diseases all need to be real – To you – To your patients & families • You must recognize the names of the diseases if you hear they are spreading in your state or town • Sometimes the disease and vaccine are called by the same name – Ask if this becomes confusing to you 4
  • 5. Vaccine-Preventable Diseases • Many are spread by talking, coughing, or sneezing • One is spread in the dirt (Tetanus) • Some are spread in other ways – Blood or body fluids (Hepatitis B) – Sexual activity (Human Papillomavirus & Hep B) – Contaminated food or water (Hep A) 5
  • 6. Vaccines-Preventable Diseases Hepatitis B • Virus which infects the liver • Spread by blood and other body fluids • Symptoms may include yellow eyes & skin, tiredness, loss of appetite & nausea • Or may cause no symptoms that we can see 6
  • 7. Vaccine-Preventable Diseases Hepatitis B (cont) • Can lead to different kinds of liver disease – Cirrhosis – Liver cancer • Some people become carriers – Which means they never get rid of the virus in their liver – Will have life-long liver problems – Can spread virus to other people without being aware of it 7
  • 8. Vaccine-Preventable Diseases Hepatitis A • Hep A virus and Hep B virus both infect the liver • However, Hep A disease is caused by a different virus than the Hep B virus • Usually spread by food or water that is contaminated with stool from another person with disease • Causes the same symptoms as Hepatitis B which we may or may not be able to see 8
  • 9. Vaccine-Preventable Diseases Diphtheria • Disease has several types • One type forms thick gray coating over back of throat. • Coating can eventually cover the airway and suffocate the patient •Can also effect one’s heart • Kills 1 of 10 people infected with it 9
  • 10. Vaccine-Preventable Diseases Tetanus • Lives in the dirt and feces of some animals • Enters the body through cuts, abrasions, and puncture wounds • Muscles become rigid & the patient cannot open mouth or swallow • May not be able to breathe 10
  • 11. Vaccine-Preventable Diseases Tetanus (cont) • Causes painful contractions & spasms • Spasms may break the patient’s bones • Kills 3 in 10 people infected with it 11
  • 12. Vaccine-Preventable Diseases Pertussis (Whooping Cough) • Horrendous cough that can last 6-9 months • With great amounts of mucus and choking • May turn blue from lack of oxygen while coughing • Blood vessels in eyes and face may break from coughing 12
  • 13. Vaccine-Preventable Diseases Hib (Haemophilus influenza type b) • Disease can take many forms – This child’s facial tissue is infected with Hib – Hand is gangrene from sepsis with Hib – Can also cause pneumonia, arthritis • In past, was a major cause of meningitis • However, do not call it “meningitis vaccine” 13
  • 14. Vaccine-Preventable Diseases Polio • Disease which cripples and paralyzes many of its victims • Before vaccine, outbreaks terrified whole towns and states • Many patients did not look or feel sick but still spread the disease • Now rarely seen in the US but still a problem in some parts of the world 14
  • 16. Vaccine-Preventable Diseases Pneumococcal disease • Again, disease can take many forms • Leading cause of meningitis • Causes 10% of ear infections in the US • But do NOT call it the “ear infection” vaccine • Child can still get ear infections from other causes 16
  • 17. Vaccine-Preventable Diseases • Meningococcal disease – Often affects the brain and spinal cord (meningitis) – Spreads by • sneezing • coughing • kissing • sharing food and drinks with infected person – In places where people are in close contact (such as college dorms) – Common early symptoms include • fever • headache • confusion • stiff neck 17
  • 18. Vaccine-Preventable Disease Meningococcal Disease (cont) • Can also affect other parts of body & cause – Loss of arms or legs – Deafness – Nervous system problems – Mental retardation – Seizures – Strokes 18
  • 19. Vaccine-Preventable Diseases Rotavirus • One major cause of – Vomiting – Diarrhea – High fever • Child becomes severely dehydrated very quickly • Vaccine does not prevent all rotavirus illness but does give 98% protection against severe disease 19
  • 20. Vaccine-Preventable Diseases Measles • Begins with red, watery eyes and runny nose • Then patient develops rash over whole body • May lead to severe complications such as – Pneumonia – Deafness – Miscarriage if the woman is pregnant – Premature birth 20
  • 21. Vaccine-Preventable Diseases Measles (cont) • Disease is still a problem world wide 21
  • 22. Vaccine-Preventable Diseases Mumps • Causes painful swelling under the jaw and in front of the ear • Can cause painful swelling of the testicles in men which can make them sterile • Can also cause – Meningitis – Brain damage – Deafness 22
  • 23. Vaccine-Preventable Diseases Rubella • Rash especially on face and neck. • Slight fever • Patient may not feel very ill • Teach patients to call diseases “measles” and “rubella” – Do NOT allow confusion to develop with names like “German measles,” “rubeolla”, “3-day measles” 23
  • 24. Vaccine-Preventable Diseases Rubella (cont) • Very serious if pregnant woman becomes infected – She can pass disease on to unborn baby – May cause miscarriage – May cause stillbirth • Or she may give birth to child with Congenital Rubella Syndrome – Physical problems, such as • cataracts or blindness • hearing loss or deafness • heart damage – Mental retardation 24
  • 25. Vaccine-Preventable Diseases Chickenpox (Varicella) • Itchy rash that forms blisters • Often mild but can be very serious • Before vaccine, 50- 100 people died each year from chickenpox disease in US 25
  • 26. Vaccine-Preventable Diseases Chickenpox (Varicella) cont 26
  • 27. Vaccine-Preventable Diseases Human Papillomavirus • Infection that causes – Genital warts – Cervical cancer • Passed from person to person by sexual activity • Virus is very, very common • Most people with infection do not know they have it • But certain strains, over a period of time, can cause cervical cancer 27
  • 28. Vaccine-Preventable Diseases Shingles (Herpes Zoster) • Varicella (chickenpox) virus has been dormant in body • Now emerges again and causes shingles • Most common in people 50 years of age and older • But may affect children also • Causes clusters of blister- like rash – In a strip-like pattern – On one side of the body – Itching or numbness – Severe pain that can last for weeks, months, or years 28
  • 29. Vaccine-Preventable Diseases Influenza (“flu”) • Respiratory infection – That begins suddenly – May include • Aching all over • Fever • Runny nose • Sore throat • Cough • But is NOT a – “Stomach problem” • Is NOT vomiting • Is NOT diarrhea • Can be very severe with many possible complications 29
  • 30. Vaccine-Preventable Diseases • ALL of these diseases: – Are preventable!! – With vaccines!! • But to give protection, vaccines must be: – Administered correctly – Handled and stored correctly – Documented correctly • Your patients must be: – Assessed correctly for contraindications and precautions – Taught about • Which vaccines they are given • Which vaccines they will need next • When they will need next vaccines 30
  • 31. Vaccine-Preventable Diseases • If you need more information about the vaccine-preventable diseases – Read Vaccine Information Statements (VIS) • VIS have information on – Disease – Vaccine – Side effects from vaccine – AND much more! – Check out The Pink Book from Centers for Disease Control (CDC) • Online at www.cdc.gov/vaccines/pubs/pinkbook 31