Vaccination precautions

Household contacts of immunocompromised persons should have all routine vaccines as scheduled, including yearly influenza vaccination. Children in the household may receive live virus vaccines without special precautions however, if a rash develops following varicella vaccination, contact should be avoided with the immunocompromised host until the rash resolves. 

A single dose of zoster vaccine is recommended for adults aged >60 years regardless of whether they report a prior episode of herpes zoster. Persons with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition. 

If an outbreak occurs, the first step would be to properly isolate those with the disease. Health officials should be diligent regarding use of adequate isolation facilities and precautions. If they are at all uncertain about correct procedures for isolating patients, they should contact the state or local health department or CDC. All the contacts of the patients should be vaccinated as soon as possible. In the event that there are many cases in a city vaccinations may be given to the entire population of that city. 

Airborne precautions using correct ventilation including negative air-pressure rooms with high-efficiency particulate air filtration should be initiated for hospitalized confirmed or suspected smallpox patients, unless the entire facility has been restricted to smallpox patients and recently vaccinated persons. 

Although personnel who have been vaccinated recently and who have a demonstrated immune response should be fully protected against infection with smallpox virus, they should continue to observe standard contact precautions including using protective clothing and shoe covers when in contact with smallpox patients or contaminated materials to prevent inadvertent spread of variola virus to susceptible persons and potential self-contact with other infectious agents. 

There is no vaccine available for glanders In countries where glanders is endemic in animals, prevention of the disease in humans involves identification and elimination of the infection in the animal population. Within the heaEth care setting, transmission can be prevented by using common blood and body fluid precautions. 

CDC, Update vaccine side effects, adverse reactions, contraindications, and precautions reommendations of the advisory committee on immunization practices (ACIP), MMWR, 45(RR12 001), September 6,1996. 

A wise precaution is to seek professional medical advice and institute a vaccination programme to protect staff against as wide a range of identified risks as possible. 

Processing steps after harvesting may be carried out simultaneously in the same production area provided that adequate precautions are taken to prevent cross-contamination. For killed vaccines and toxoids, such parallel processing should only be performed after inactivation of the culture or after detoxification. 

Substantially less is known about the cost of R D for particular vaccines and for improvements to existing vaccines. To a lesser extent, there is also insufficient information in the public domain about the marginal cost of producing vaccines, especially reflecting actual and optimal safety precautions in the production process. We also know too little about consumer demand for vaccines, including the role of price and nonprice factors. There are insufficient data on coverage of vaccines by private health insurance currently. For this reason, it is not possible to precisely predict market responses to any specific proposal. 

Infliximab should not be given to individuals with known hypersensitivity to murine proteins. As with etanercept, precautions for the prevention of serious infections must be taken, and live virus vaccines are contraindicated. 

However, since then there has been a major resurgence of drug resistant-tuberculosis, associated with the AIDS pandemic, and this has caused increasing concern over the past decade. BCG vaccination of medical and nursing personnel involved in these areas has now become an accepted precaution since there is no other approved vaccine available and any acellular vaccine, for example, will probably not receive regulatory approval for at least another decade, if at all. 

Botulinum toxin is extremely poisonous to humans. Coats, gloves, face shields, and protective cabinets are recommended for handling botulism specimens. Ideally, laboratory personnel should be vaccinated with C. botulinum antitoxin. Universal precautions should be used when caring for patients suspected of botulism. Isolation is not necessary but droplet precautions should be instituted (Arnon et al., 2001). 

Pulmonary Dyspnea CNS Cranial nerve deficits are universal Descending symmetric paralysis Gastrointestinal Constipation (later in course) OTHER FORMS OF BOTULISM ISOLATION/DECON PRECAUTIONS Droplet precautions Extensive precautions for laboratory personnel VACCINE Botulinum toxoid vaccine available but restricted in use to military and laboratory personnel. POSTEXPOSURE PROPHYLAXIS None... 

Live measles vaccine should not be given to pregnant women. This precaution is based on the pnrely theoretical risk of fetal infection (134). 

The amounts of thiomersal in the UK schedule of childhood vaccination are lower than in the USA. No specific action has been recommended in the vaccination program. European and American regulatory authorities have recommended that vaccine manufacturers should phase out their use of thiomersal whenever possible as a precaution (SEDA-25, 278). 

Patients having a febrile prodrome and either one other major criterion or at least four minor criteria are at moderate risk for smallpox. For patients at moderate risk, physicians should alert infection control and immediately institute contact precautions and respiratory isolation. If possible, they should obtain dermatology and/or infectious disease consultation and obtain digital photographs of the lesions. Given a moderate risk situation, the appropriate clinical diagnosis is essential, and physicians must rule out varicella or complication of vaccinia (smallpox vaccine). Therefore, for moderate risk patients, the history is essential, specifically the history of clinical varicella infection, history of vaccination for varicella and history of possible exposure to vaccinia (smallpox) vaccine. 

In addition to vaccinating health care workers against hepatitis B, other infection control practices are important in preventing transmission of the virus because up to 10% of people do not develop an adequate antibody response to the vaccine. The most important infection control measure is the use of universal precautions. These precautions prevent exposure to blood and blood-derived body fluids via use of a variety of barrier precautions, measures to prevent needlesticks, environmental control measures, and good hand-washing techniques. However, if a worker is exposed to material that potentially contains HBV, recommendations for percutaneous exposure to HBV should be followed (see Table 40-7). ... 

Premature infants should be vaccinated at the same chronologic age using the same schedule and precautions as full-term infants. The full recommended doses of vaccines should be used, regardless of... 

Evidence as to the use of human volunteers in experiments at Porton Down is harder to come by. Service volunteers were regularly requested during the fifties and sixties, but they are said to have been used only for the testing of defensive precautions like vaccines. 

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