Diseases, Disorders information

Meningococcal vaccine is an inactivated polysaccharide vaccine. Contains some of the strains of meningococcus, groups A, C, Y and W135 but does not contain group B, which is quite common. Again, it has local reactions and is indicated at 2 years of age or greater – not less than that because it’s not immunogenic – and to immunocompromised subjects at higher risk of invasive meningococcal disease; those with asplenia, those with terminal complement component deficiencies, and those at increased risk of exposure if there’s an epidemic, and travelers to endemic areas.
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Immunization of household contacts of immunocompromised children. Just to review, no OPV. You should use IPV. Give influenza vaccine. You should know that varicella vaccines may rarely be transmitted person to person. That’s not a reason not to vaccinate. You should still give varicella vaccine in that situation, but it may be transmitted. MMR vaccine, however, is not transmitted person to person.
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I want to talk about some other special circumstances of immunization, with some of the newer vaccines; hepatitis A. You can prevent hepatitis A either with immune globulin and this is efficacious if given within two weeks of exposure. You can also give it pre-exposure and, depending on the dose, protect for 3-6 months after giving a dose of immune globulin. But this does provide relatively short term protection and the supply may be limited. Therefore inactivated hepatitis A vaccine may be given. There are two different vaccines and I’ve listed some of the details regarding the dose and the differences between them. Most important to know, though, is that hepatitis A vaccine may be given as an active vaccination and that it needs to be given at 2 years of age or older. In terms of the inactivated hepatitis A vaccine, 5-15% have mild local reactions, have excellent immunogenicity and you can see a very high rate of efficacy with hepatitis A vaccination. The pediatric indications; should be given 2 years of age and older, to be given to those travelers to endemic areas, if there is a hepatitis outbreak, for those at increased risk of acquiring hepatitis A or those at increased risk from liver disease. So anybody with chronic liver disease, you wouldn’t want them to take another hit by getting hepatitis A and they should be protected.