Immunization in adolescents

                    Immunization in adolescent


Immunization in Adolescents.


Generally majority of population receives vaccination early child hood and infancy. For may vaccines immunity wanes after years. So, this leads to higher risk of vaccine preventable illnesses in adolescents and young adults. Some vaccine preventable diseases are indeed increasing in adolescent population. Many new vaccines were under trial and now available to use in adolescent population. Some of these are Pertussis vaccine, HPV and meningococcal vaccine. They are now easily available and safe to use in adolescents. We will discuss here regarding the important vaccinations that are needed in adolescent population. Other that can be given in adolescents are Typhoid, Japanese encephalitis, MMR, varicella, Influenza vaccine, Pneumococcal vaccines and Rabies vaccine.

So following are vaccines recommended for adolescents : 

Tdap

  • Tdap is a vaccine, a combination vaccine which provides immunity against tetanus, pertussis and diphtheria.
  • Pertussis disease immunity wanes over years so the disease can occur in adolescents and adults who are not vaccinated.
  • Tetanus dose is needed for every one atleast 5 yearly.
  • If the adolescent has not received any single dose of this vaccine previously then doses are needed at 0, 1 months and 6 month interval total 3 doses.
  • If has received vaccination second booster as recommended in UIP then subsequent doses are needed 10 years and 15 years there after 5 yearly.
  • Now a days every TT and Td vaccine shot is to be replaced with Tdap.

HPV



  • Human Papillomavirus is most common sexually transmitted virus.
  • Human Papillomavirus causes various orogenital and anogenital cancers.
  • Two types are vaccines are available bivalent and quadrivalent.
  • They protect from majority of malignant anogenital cancers and also from benign anogenital lesions caused by cancers.
  • Currently this vaccines are recommended in 9 years and above.
  • 3 doses are recommended at 0, 2, 6 months or 0,1,6 months depending on type of vaccine which was selected.
  • Though vaccine is currently costly and may not be affordable to majority of population in developing countries like India, compared to cost of treatment of disease it prevents the cost vaccine is atleast thousand times lesser.

Meningococcal vaccine


  • Meningococcal conjugated vaccine currently recommended for those above 2 years.
  • Additional doses are needed at 12 and 18 years.
  • Adolescents joining college/universities staying in hostels are under increased risk of meningitis and they need the dose.
  • Additionally people travelling in endemic areas those going to Haj yatra should get this vaccine.
  • Adolescents and children needing cochlear implants, splenectomy, affected with AIDS, those with other conditions that decrease immunity need this vaccine.

Influenza vaccine


  • Influenza vaccine protects from the diseases like Swine flu.
  • Every year influenza virus changes its characteristics so that our body can not identify it to fight against it.
  • So vaccine is needed to be taken each yearly.
  • Those with hypertension, diabetes, heart disease, AIDS should get this vaccine on priority.
  • Two types of injectable vaccines are now available trivalent or Tetravalent.
  • It is given intramuscular.

Japanese encephalitis vaccine


  • This vaccine protects from Japanese encephalitis.
  • Those residing in endemic areas should receive this vaccine.
  • Those planning to visit endemic area should receive this vaccine 4 weeks prior to the visit.
  • It is injectable vaccine.

Rabies Vaccine


  • Rabies vaccine protects from deadly disease rabies.
  • Currently rabies has no known treatment.
  • If someone get rabies disease chances of death are 100 percent.
  • Rabies is disease which spreads to human after the mammal animal bites.
  • Dog bite and cat bites are most common cause of rabies.
  • The animal may or may not show the symptoms but can spread the disease by bites.
  • So getting rabies vaccine after bite is important.
  • Also it is given as a prophylaxis to those ho have high risk of getting bites like those working with dogs, zoo and circus.

MMR vaccine


  • MMR vaccine protects from measles, mumps and rubella.
  • It is combination live vaccine.
  • As immunity to mumps wanes after some years the mumps disease is on rise in adolescent population.
  • People getting disease in older age groups the likelihood of complications like orchitis and infertility are more.
  • So additional doses are needed in adolescents.
  • Additionally rubella if affects pregnant woman can lead to congenital rubella syndrome which may not be totally reversible with treatment.
  • So immunizing the adolescents is important to prevent this congenital rubella syndrome possibility. 

Chickenpox vaccine ;

  • Chicken pox though a mild disease complications do occur.
  • The complications are more common with age,
  • Most sever complications and pneumonia and brain involvement.
  • Cornial scarring leading to blindness is also a common complication.
  • Vaccine prevents chicken pox and thus these complications.
  • So the vaccine is given if there was no history of chicken pox in past and person is not vaccinated.
  • Two doses are given subcute 8 weeks apart.

Hepatitis A vaccine

  • This infection protects from hepatitis A.
  • Hepatitis A is a leading cause of liver failure needing liver transplant.
  • This vaccine is given above one year.
  • The adolescents who have not developed immunity to it naturally as detected by absence of Anti hepatitis A antibodies in blood in given this vaccine.
  • As age increases complications of Hepatitis A are increased.
  • Live vaccine single dose is needed in case of inactivated killed vaccine 2 doses are needed 6 months apart.

Hepatitis B vaccine

  • Many countries have included this vaccine in their national immunization program.
  • It protects from Hepatitis B disease.
  • If someone have not received adequate vaccination of hepatitis B 3 doses at 0, 1 and 6 months are to be given.
  • Those working in hospitals, medical labs are given priority as they have increased risk of exposure.
  • At many places this is prerequisite to take Hepatitis B vaccination before joining job.

Typhoid conjugated vaccine 

  • Typhoid conjugated vaccine protects from typhoid.
  • Effect lasts until at least 5 years.
  • Those living in endemic areas should get this vaccine.
  • Those planning to visit endemic area should get this vaccine prior to vitis at least 28 days before.
  • Currently it is recommended between 9 months to 18 year  age.
  • Those who are immunocompromised, those with kidney disease, AIDS affected people may need to take booster dose.





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