Part 3 - Professional Services Chapter 10 - Preventive Health |
Section |
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Purpose | 3-10.1 |
Immunization Information and Clinics | 3-10.2 |
Reference | 3-10.3 |
Interrupted and Completed Immunization Series | 3-10.4 |
Routine Immunization Procedures and Tuberculin Testing | 3-10.5 |
Schedule | 3-10.5A |
BCG Vaccine | 3-10.5B |
Influenza Vaccine | 3-10.5C |
Measles | 3-10.5D |
Pertussis Vaccine | 3-10.5E |
Other Routine Vaccines | 3-10.5F |
Dosage | 3-10.5G |
Parent's Consent | 3-10.5H |
Immunizations for Pregnant Women | 3-10.5I |
Vaccines, Serums & Gloubulins for the Prevention of Specific Diseases | 3-10.6 |
Precautions | 3-10.7 |
Needles and Syringes | 3-10.7A |
Allergic Reactions | 3-10.7B |
Children Six Years of Age and Under | 3-10.7C |
Well Infants and Children | 3-10.7D |
Second Injections of Infants | 3-10.7E |
Use of Aspirin | 3-10.7F |
Contraindications to Immunizations | 3-10.8 |
Respiratory or Other Acute Infections | 3-10.8A |
Neurologic Disorder's, Convulsions, or Cerebral Damage | 3-10.8B |
Children with Eczema or Other Forms of Dermatitis | 3-10.8C |
Tuberculin Test | 3-10.9 |
3-10.1 |
PURPOSE
This chapter brings together-policy statements, standards and guidelines regarding preventive health matters. Each Area and Service Unit will develop manual supplements of local procedures and policies for the control of communicable diseases, especially tuberculosi.5 and venereal diseases. |
3-10.2 |
IMMUNIZATION- INFORMATION AND CLINICS
The Indian Health Area Directors are encouraged to publicize their vaccination program in ways best calculated to reach Indian health beneficiaries and, in addition to immunization at established clinics, consideration should be given to establishing special clinics for this purpose. Immunization is considered a part of general health supervision, especially of infants and children. Such protection is a vital part of hospital and field medical services, and each child should be fully immunized and immunization maintained at all times.
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3-10.3 |
REFERENCES
Each facility should have for reference current copies of "Report of the Committee on the Control of Infectious Diseases" American Academy of Pediatrics, P. 0. Box 1034, Evanston, Illinois 60204; "Control of Communicable Diseases in Man" published by the American Public Health Association, 1790 Broadway, New York, New York 10019; and the current reports of the Public Health Service Advisory Committee on Immunization Practice.
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3-10.4 |
INTERRUPTED AND COMPLETED IMMUNIZATION SERIES
Interrupted Immunization Schedule. If the original series for immunization is interrupted, it is not necessary to start the series over again, provided the past history is known as to which immunizations were given. Although the child is not as well protected during the interval, there is evidence that he gets better antibody response by spacing the immunizations over a longer period of time than the normal six to eight weeks. If the series is interrupted, complete it as soon as possible and continue on with the booster doses as originally scheduled. Completed Immunization Series. Refer to the latest Reports of the Committee on the Control of Infectious Diseases of the American Academy of Pediatrics, the Public Health Service Advisory Committee on Immunization Practice and/or the package insert of the immunizing agent, for 'information as to the number of immunizations that constitutes a completed series for each specific immunization procedure.
For statistical purposes the following will be considered completed immunizations: DPT, 3 injections; DT when used for primary immunization, 3 injections; polio oral vaccine (monovalent
or trivalent) 3 doses; measles live virus vaccine, one injection; influenza, 2
injections; typhoid, 2 injections, smallpox, one vaccination. |
3-10.5 |
ROUTINE IMMUNIZATION PROCEDURES AND TUBERCULIN TESTING
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A. |
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Age | --- | Schedule |
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2 - 3 Months |
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DTP 2/ - Type 1 OPV or Trivalent OPV 3/ |
3 - 4 Months |
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DTP - Type 3 OPV or Trivalent OPV |
4 - 5 Months |
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DTP - Type 2 OPV or Trivalent OPV |
9 - 11 Months |
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Tuberculin Test |
12 Months |
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Measles Vaccine |
15 - 18 Months |
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DTP - Trivalent OPV - Smallpox Vaccine 4/ |
2 Years |
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Tuberculin Test |
3 Years |
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DTP - Tuberculin Test |
4 Years |
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Tuberculin Test |
6 Years |
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TC - Smallpox Vaccine - Tuberculin Test 5/ - Trivalent Test |
8Years |
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Tuberculin Test 5/ |
10 Years |
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Tuberculin Test 5/ |
12 Years |
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TD - Smallpox Vaccine - Tuberculin Test 4/, 6/ |
14 Years |
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Tuberculin Test 5/ |
16 Years |
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Tuberculin Test
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3-10.6 |
VACCINES, SERUMS AND GLOBULINS FOR THE PREVENTION OF SPECIFIC DISEASES
Vaccines and serums for use in specific diseases should be used when medically indicated. |
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3-10.7 |
PRECAUTIONS |
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3-10.8 |
CONTRAINDICATIONS TO IMMUNIZATIONS
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3-10.9 |
TUBERCULIN TEST
Tuberculin Test. If BCG (see 3-10-5B for BCG Vaccine use) has been administered to newborns test infants at two and twelve months of age. If BCG has n& been administered, infants should receive a tuberculin test between three and twelve months of age. In the preschool age group the frequency of retesting depends on the prevalence of tuberculosis in the community; tuberculin testing of preschool children every two years or every year until conversion occurs may be recommended in communities with high prevalence of tuberculosis. All children entering school, not known to be positive reactors, will be tested. If tuberculin positive rate of children in a school is higher than 5 percent, children should be tested annually until conversion occurs. If tuberculin positive rate is less than 5 percent, tuberculin test will be repeated - except in those children known to be positive reactors - in the 6th, 9th and 12th grades. The above schedules may vary depending on local situation. All admissions to pediatric wards will be tuberculin tested. Converters should be placed on INH prophylaxis and their family contacts investigated. PPD intermediate strength - 5 TU, equivalent to 0.0001 mg PPD - is recommended. All reactions 6mm or more of induration should be read as positive. Record the size of all positive reactions, In reporting tuberculin surveys report positive reactors in two groups: a) positive with induration 6 to 9 mm; b) positive with induration 10 mm and over. Skin reactions to be read 3 days later, although it could be read 48 to 72 hours after it is given. If the Tine test is used, it will be read in 48 to 72 hours; a positive reaction will show an induration of 2mm and over. If the Tine test is used and an equivocal reaction is obtained, repeat the test with intradermal PPD, intermediate strength. |