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11/13/24, 8\:18 PM Guide | Immunisation explanation

Immunisation explanation

Table of contents

Introduction

This guide aims to provide a template of a generic immunisation counselling station which could be applied to any of the
immunisations mentioned (you wouldn't be expected to cover all of the immunisations in this guide in one station). The guide
covers explaining what immunisations are, why we do them and what the process involves.

Opening the consultation

Wash your hands and don PPE if appropriate.
Introduce yourself to the parent(s) including your name and role.
Con
Ask about the ideas, concerns and expectations of the parent(s).
Determine the parent(s) prior knowledge of immunisations.
Example
“ H e l l o , I’ m o n e o f t h e s t u d e n t d o c t o r s w o r k i n g w i t h t h e p r a c t i c e t o d a y . o k a y ? C a n I j u s t c o n
I’ v e b e e n a s k e d t o c o m e a n d s p e a k w i t h y o u , " W h a t a r e y o u r t h o u g h t s a b o u t i m m u n i s a t i o n s ?"
" W a s t h e r e a n y t h i n g y o u w e r e c o n c e r n e d a b o u t ?"
" W h a t w e r e y o u h o p i n g w e' d d o t o d a y ?"
" W h a t d o y o u k n o w a b o u t i m m u n i s a t i o n s ?"
i s t h a t

Explanation

Vaccinations help protect children from serious diseases and also provide protection for society as a whole (known as herd
immunity).
“ T h e v a c c i n a t i o n p r o g r a m m e i s v e r y s a f e , a n d a l m o s t a l l b a b i e s w i l l h a v e t h e m . T h e r e a s o n f o r v a c c i n a t i o n i s b o t h t o p r o t e c t
y o u r c h i l d f r o m h a r m a n d t o p r o t e c t t h e c o m m u n i t y a s a w h o l e .
”
“ G i v i n g a c h i l d a v a c c i n a t i o n a g a i n s t a d i s e a s e d r a m a t i c a l l y l o w e r s t h e r i s k o f t h e m c a t c h i n g t h e i l l n e s s w h i c h c o u l d b e
e x t r e m e l y h a r m f u l t o t h e m b o t h i n t h e s h o r t a n d l o n g-t e r m . B y s t o p p i n g t h e d i s e a s e d e v e l o p i n g i n y o u r c h i l d , w e a l s o s t o p y o u r
c h i l d b e i n g a b l e t o s p r e a d t h e d i s e a s e , s o i t c a n b e c o n s i d e r e d a p u b l i c h e a l t h b e n e
p e o p l e s o t h a t w e c a n s t o p t h e d i s e a s e c o m p l e t e l y – t h i s h a p p e n e d w i t h s m a l l p o x i n s o m e c o u n t r i e s .
”
Check the parent's understanding\:
“ D o e s e v e r y t h i n g I' v e s a i d s o f a r m a k e s e n s e ?"
" D o y o u h a v e a n y q u e s t i o n s ?"
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Routine vaccinations

Below are details on speciroutine vaccination schedule for children in the UK. It's
important to have some understanding of each vaccine and the disease it prevents. You should also be aware of the
di
information and instead highlight only the key points.
Check the parent's understanding after your explanation and provide an opportunity for questions.
Pathogens which are vaccinated against in the UK include\:
Diphtheria
Tetanus
Whooping cough (Bordetella pertussis)
Polio
Haemophilus in
Hepatitis B
Rotavirus
Meningitis B
Pneumococcus
MMR (measles, mumps, rubella)
Flu vaccination
HPV
Meningitis A, C, W and Y

Whooping cough

Organism
Bordetella pertussis
Clinical features
Incubation period\: 6-14 days
Illness typically lasts for 6-8 weeks and has three phases\:
Catarrhal (week 1-2, upper respiratory tract symptoms)
Paroxysmal (usually lasts up to a month\: coughing interrupted by ‘whoop’ stridor)
Convalescent (lasts around 2 weeks, persistent chronic cough)
Complications
Complications can include\:
Encephalopathy
Death (up to 20% mortality in children less than 12 months old)
Type of vaccine
Inactivated bacteria are administered in the vaccine to induce an immune response.

Measles

Organism
RNA paramyxovirus
Clinical features
Symptoms\:
Cough
Low-grade fever
Conjunctivitis
Rash
Complications
7.5% of children experience complications including\:
https\://app.geekymedics.com/osce-guides/counselling/immunisation-explanation/ 2/611/13/24, 8\:18 PM Guide | Immunisation explanation
Pneumonia
Otitis media
Encephalitis (1 in 5000, signi
Type of vaccine
Live attenuated vaccine

Mumps

Organism
Paramyxovirus
Clinical features
Incubation period\: 14-24 days
Symptoms\:
Cervical lymphadenopathy
Malaise
Complications
Complications can include\:
Meningoencephalitis
Orchitis
Pancreatitis
Unilateral deafness
Type of vaccine
Live attenuated vaccine

Rubella

Organism
Common RNA virus
Clinical features
Incubation period\: 14-21 days
Symptoms\:
Cervical lymphadenopathy (typically posterior lymph node chains)
Rash\: initially on the head and neck, before becoming more widespread
Typically causes a mild illness in children
Complications
Complications are rare but potentially serious and include\:
Encephalopathy
Arthritis
Guillain-Barré syndrome
Transmission from mother to fetus can be devastating\:
Sensorineural deafness
General learning disability
Insulin-dependent diabetes
Congenital heart disease
Microcephaly
Cataracts
Pigmentary retinopathy
Type of vaccine
Live attenuated vaccine
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Diphtheria

Organism
Corynebacterium diphtheriae
Clinical features
Incubation period\: 2-5 days and the child is infectious for up to 4 weeks
Symptoms\:
Sore throat
Greyish pseudomembrane on the tonsils/pharynx/nasal cavity
Low fever
Complications
Complications of diptheria can include\:
Paralysis of the palate and hypopharynx
Cranial nerve lesions
Diaphragmatic paralysis
Atrioventricular block
Death (up to 16% of patients)
Type of vaccine
Inactivated bacterial toxin

Tetanus

Organism
Clostridium tetani
Clinical features
Spread via spores in soil, house dust and faeces.
Incubation period\: 3-14 days
Symptoms\:
Spasms in jaw muscles (lockjaw/trismus).
Late symptoms include widespread spasms, tetany, drooling, hyperhidrosis and dysphagia.
Type of vaccine
Inactivated bacterial toxin

Polio

Organism
Single-stranded RNA virus
Clinical features
Faecal-oral transmission
Incubation period\: 3-21 days
Typically a
Symptoms\:
Progressive paralysis (replicates in motor neurones)
Type of vaccine
Inactivated virus

HiB

Organism
Haemophilus in
https\://app.geekymedics.com/osce-guides/counselling/immunisation-explanation/ 4/611/13/24, 8\:18 PM Guide | Immunisation explanation
Clinical features
Symptoms\:
Cough
Shortness of breath
Ear pain
Sore throat
Fever
Irritability
Complications
Complications can include\:
Pneumonia
Otitis media
Epiglottitis
Eye infections
Bloodstream infection
Meningitis
Intellectual impairment
Deafness
Seizures
HiB has high morbidity ~11% HiB meningitis su
convulsions.
Type of vaccine
Polysaccharide extract vaccination

What to expect on vaccine day

Explain that the practitioner will administer the injection after screening for contraindications\:
“ W h e n y o u c o m e i n t o t h e c l i n i c , t h e n u r s e w i l l a s k a f e w q u e s t i o n s a b o u t h o w y o u r b a b y i s , i n c l u d i n g w h e t h e r t h e y h a v e b e e n
u n w e l l r e c e n t l y , w h e t h e r t h e y h a v e a n y m e d i c a l c o n d i t i o n s a n d i f t h e y h a v e a n y a l l e r gi e s . T h i s i s t o m a k e s u r e i t i s s u i t a b l e t o
g i v e t h e v a c c i n a t i o n .
”
“ T h e v a c c i n a t i o n w i l l b e g i v e n a s a n i n j e c t i o n , u s u a l l y i n t h e t h i gh .
”
Explain normal reactions (crying, irritability, low fever) and the measures the carer can take to mitigate them\:
“ I t i s n o r m a l f o r y o u r b a b y t o b e a b i t u p s e t b y t h e i n j e c t i o n a n d c r y a t t h e t i m e . Y o u m a y
h o u r s a f t e r w a r d s a n d m a y h a v e a b i t o f a t e m p e r a t u r e . I f t h i s o c c u r s t h e r e a r e a f e w t h i n gs y o u c a n d o t o h e l p i n c l u d i n g gi v i n g
s o m e C a l p o l f o r t h e t e m p e r a t u r e a n d m a k i n g s u r e t h e y a r e s t i l l d r i n k i n g r e gu l a r l y . I n a b o u t 1 i n 1 0 c h i l d r e n , t h e p l a c e o f i n j e c t i o n
c a n b e a b i t r e d a n d s o r e f o r a d a y o r s o – t h i s a ga i n s h o u l d b e r e l i e v e d b y C a l p o l , s o m e r e a s s u r a n c e a n d a c o l d c o m p r e s s m a y
a l s o h e l p .
”
Explain the rare, but more serious reactions which sometimes occur\:
“ I f t h e r e i s a l a r g e s w e l l i n g a t t h e s i t e o f i n j e c t i o n , o r y o u n o t i c e a n y r a s h e s o r s w e l l i n g e l s e w h e r e ( e s p e c i a l l y a r o u n d t h e l i p s a n d
m o u t h ) i t i s i m p o r t a n t t o c o n t a c t t h e d o c t o r u r ge n t l y . V e r y o c c a s i o n a l l y , a c h i l d m a y h a v e a n a d v e r s e r e a c t i o n t o t h e v a c c i n e a n d
m a y h a v e a t e m p e r a t u r e t h a t d o e s n o t r e s p o n d t o C a l p o l . C h i l d r e n s o m e t i m e s c a n e x p e r i e n c e s e i z u r e s w h e n t h e y h a v e a
r a i s e d t e m p e r a t u r e a n d i f t h i s h a p p e n s y o u s h o u l d s e e k m e d i c a l r e v i e w .
”
“ C o m p l i c a t i o n s o f v a c c i n e s a r e v e r y r a r e ( l e s s t h a n 1 i n 1 0 0 0 , w i t h t h e c h a n c e o f a n a p h y l a x i s b e i n g l e s s t h a n 1 i n 5 0 0 ,0 0 0 ) .
C o m p l i c a t i o n s o f t h e d i s e a s e s w h i c h w e a r e v a c c i n a t i n g a g a i n s t a r e m o r e c o m m o n a n d o f t e n m o r e s e r i o u s , a n d t h a t i s w h y w e
f e e l i t i s f o r t h e b e s t t o i m m u n i z e c h i l d r e n .
”
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MMR concerns

Explain the study which was conducted, and the new evidence that has come to light since\:
“ T h e r e w a s a p i e c e o f r e s e a r c h p u b l i s h e d a n u m b e r o f y e a r s a go , c l a i m i n g a l i n k b e t w e e n M M R a n d a u t i s m . S i n c e i t s r e l e a s e i t
h a s b e e n d i s c r e d i t e d – t h e r e s e a r c h w a s o n a v e r y s m a l l g r o u p o f i n d i v i d u a l s a n d t h e o u t c o m e s w e r e b i a s e d b y s e v e r a l f a c t o r s .
T h e r e s e a r c h h a s s i n c e b e e n w i t h d r a w n a n d t h e r e s e a r c h e r s h a v e b e e n s t r u c k o
”
“ G i v i n g t h e M M R a s o n e i n j e c t i o n r a t h e r t h a n 3 s e p a r a t e o n e s i s s h o w n t o b e j u s t a s s a f e , f o r y o u r b a b y .
”
a n d a r gu a b l y r e s u l t s i n l e s s d i s c o m f o r t

Closing the consultation

Summarise the topics covered\:
“ J u s t t o s u m m a r i s e – w i t h y o u r c o n s e n t , y o u r c h i l d w i l l h a v e ….v a c c i n a t i o n ( s ) . T h e r e a s o n f o r t h e v a c c i n a t i o n i s t o r e d u c e a n y
p o t e n t i a l h a r m t o y o u r b a b y f r o m s p e c i
v a c c i n a t e d . V a c c i n a t i o n s a r e s a f e , b u t m a y h a v e s o m e m i n o r s i d e-e
u s u a l l y b e m a n a g e d w i t h C a l p o l a n d s o m e r e a s s u r a n c e . I f y o u t h i n k y o u r b a b y i s e x p e r i e n c i n g a m u c h r a r e r s e v e r e r e a c t i o n o r
t h e r e i s a n y t h i n g y o u a r e w o r r i e d a b o u t , w e a d v i s e y o u t o c o n t a c t a d o c t o r s t r a i gh t a w a y .
”
Check parental understanding and elicit any concerns\:
w o u l d l i k e t o a s k ?”
“ D o e s t h a t a l l s e e m t o m a k e s e n s e ? A r e t h e r e a n y q u e s t i o n s y o u
O
Arrange follow-up appointments for speci
Thank the parent(s) and child (if relevant).
Dispose of PPE appropriately and wash your hands.
Source\: geekymedics.com
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