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P A R T 3  Drugs acting on the immune system

Individual teaching

BOX 18.2

central reporting of adverse effects or suspected adverse effects may help to clarify concerns about reactions to immunisations. Antigens are also processed and injected to help some people who have severe allergic reactions. People who receive allergy shots to help them cope with the signs and symptoms of allergic reactions receive anti- genic proteins that stimulate antibody production to prevent the allergic response by stimulating production of another antibody in the body. VACCINES The word vaccine comes from the Latin word for smallpox, vaccinia. Vaccines are immunisations con- taining weakened or altered protein antigens that stimulate the formation of antibodies against a specific Studies find no link between MMR vaccine and autism There have been theories circulated in the mass media that MMR vaccine has been linked to the development of autism.This has influenced many parents to choose not to immunise their children with detrimental outcomes. The Australian Government Department of Health and Ageing suggest that this has resulted from one study that has since been retracted due to questionable data. From time to time, there have been other myths surrounding Paediatric immunisation It is well-documented that by preventing potentially devastating diseases, society prevents unneeded suffering and death, and saves valuable citizens for the future. Paediatric immunisation has helped to greatly decrease the incidence of most childhood diseases and has prevented associated complications. In Australia and New Zealand, routine immunisation is considered standard medical practice. Ensuring that every child has the opportunity to receive the recommended immunisations has become a political as well as a social issue.The cost of preventing a disease that most people have never even seen may be difficult to justify to families who have trouble putting food on the table. Widespread campaigns to provide free immunisations and health screening to all children have addressed this problem but have not been totally successful. In addition, periodic reports of severe or even fatal reactions to standard immunisations alarm many parents The evidence BOX 18.3

about the risks of immunisations.These parents need facts as well as reassurance about modern efforts to prevent and screen for these reactions. Public education efforts should be directed at providing parents with information about paediatric immunisation and encouraging them to act on that information. Nurses and midwives are often in the ideal position to provide this information, during prenatal visits, while screening for other problems, or even standing in line at the supermarket. It is important for nurses and midwives to be well versed on the need for standard immunisations and screening to prevent severe reactions.The Australian Department of Health and Ageing (www.immunise. health.gov.au) and New Zealand Ministry of Health (www. health.govt.nz/our-work/preventative-health-wellness/ immunisation/new-zealand-immunisation-schedule) offer current information and updates for healthcare providers, as well as teaching materials that can be printed for easy reference.

different vaccines and these have the potential to lead to unnecessary harm. Nurses and midwives have a responsibility to be informed about vaccine safety and to be able to educate parents on factors associated with vaccinations. Source: Australian Government Department of Health and Ageing. (2013). Myths and Realities: Responding to Arguments against Vaccination – A Guide for Providers (5th edn). Canberra: Author.

disease (Figure 18.3). They are used to promote active immunity (see Table 18.1). Vaccines can be made from chemically inactivated microorganisms or from live, weakened viruses or bacteria. Toxoids are vaccines that are made from the toxins produced by the microorganism. The toxins are altered so that they are no longer poisonous but still have the recognisable protein antigen that will stimulate antibody production. The particular vaccine that is used depends on the possible exposure a person will have to a particu- lar disease and the age of the person. Some vaccines are used only in children and some cannot be used in infants. Some vaccines require booster doses—doses that are given a few months after the initial dose to further stimulate antibody production. For example, Box 18.4 discusses the new human papillomavirus (HPV) vaccine, which protects young women from