GENERAL RULES IN VACCINATION APPLICATIONS

Öz

Vaccination is one of the most effective preventive health measures. The vaccination status of every individual who applies to a health institution for any reason should be checked and if there are no contraindications, any missing vaccinations should definitely be done. It is very important for those administering vaccines to understand the vaccination procedure, including how to administer vaccines correctly, how to manage contraindications and how to recognize post-vaccination reactions. All physicians should be aware of the indications, contraindications, situations requiring caution and vaccinations in special cases regarding vaccines. In order to obtain an ideal immune response in vaccinated individuals, vaccines should be administered at the recommended time, with the appropriate dose and method. In addition, minimizing risks during vaccination and ensuring patient safety form the basis of vaccination practices. This review provides basic information about vaccination and points to be considered in vaccination practices.

Anahtar Kelimeler

• Immunization
• vaccines
• vaccine safety

Aşı Uygulamalarında Genel Kurallar

Öz

Bağışıklama en etkili koruyucu sağlık önlemlerinden biridir. Sağlık kurumuna herhangi bir nedenle başvuran her bireyin aşılanma durumu kontrol edilmeli ve herhangi bir kontrendikasyon yoksa eksik aşıları mutlaka yapılmalıdır. Aşı uygulayan kişilerin aşıları doğru şekilde nasıl uygulanacağı, kontrendikasyonların nasıl yönetileceği ve aşılama sonrası reaksiyonları nasıl tanıyacağı da dahil olmak üzere aşılama prosedürünü anlamaları oldukça önem arz etmektedir. Aşılarla ilgili endikasyonların, kontrendikasyonların, dikkatli olunması gereken durumların ve özellikli durumlarda aşılamaların tüm hekimler tarafından bilinmesi gerekmektedir. Aşı uygulanan kişilerde ideal immun yanıtın elde edilebilmesi için aşıların önerilen zamanda, uygun doz ve yöntemle uygulanması gereklidir. Ayrıca aşılama sırasında riskleri en aza indirmek ve hasta güvenliğini sağlamak aşı uygulamalarının temelini oluşturmaktadır. Bu derlemede aşılama ile ilgili temel bilgiler ve aşı uygulamalarında dikkat edilmesi gereken hususlar belirtilmiştir.

Anahtar Kelimeler

• aşı güvenliği
• bağışıklama
• aşılar

Kaynakça

1. 1. T.C. Sağlık Bakanlığı ASIE Genelgesi 2008
2. 2. Amerikan Academy of Pediatrics. Children who received immunizations outside the United States or whose immunization status is unknown or uncertain. In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2024. p.121.
3. 3. Kroger A, Bahta L, Hunter P. General Best Practice Guidelines for Immunization. Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP) Timing and spacing of immunobiologics. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html (Accessed on August 18, 2024)
4. 4. Del Mar CB, Glasziou PP, Spinks AB, Sanders SL. Is isopropyl alcohol swabbing before injection really necessary?. Med J Aust. 2001;174(6):306. doi:10.5694/j.1326-5377.2001.tb143609.x
5. 5. Zhang L, Wang W, Wang S. Effect of vaccine administration modality on immunogenicity and efficacy. Expert Rev Vaccines. 2015;14(11):1509-1523. doi:10.1586/14760584.2015.1081067
6. 6. Beirne PV, Hennessy S, Cadogan SL, Shiely F, Fitzgerald T, MacLeod F. Needle size for vaccination procedures in children and adolescents. Cochrane Database Syst Rev. 2018;8(8):CD010720. Published 2018 Aug 9. doi:10.1002/14651858.CD010720.pub3
7. 7. Groswasser J, Kahn A, Bouche B, Hanquinet S, Perlmuter N, Hessel L. Needle length and injection technique for efficient intramuscular vaccine delivery in infants and children evaluated through an ultrasonographic determination of subcutaneous and muscle layer thickness. Pediatrics. 1997;100(3 Pt 1):400-403. doi:10.1542/peds.100.3.400
8. 8. Taddio A, McMurtry CM, Shah V, et al. Reducing pain during vaccine injections: clinical practice guideline. CMAJ. 2015;187(13):975-982. doi:10.1503/cmaj.150391

9. 9. American Academy of Pediatrics. Vaccine administration. In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2024. p.52.
10. 10. Immunize.org. Ask the experts. Administering vaccines. Available at: https://www.immunize.org/askexperts/administering-vaccines.asp (Accessed on August 18, 2024)
11. 11. Taddio A, Flanders D, Weinberg E, et al. A randomized trial of rotavirus vaccine versus sucrose solution for vaccine injection pain. Vaccine. 2015;33(25):2939-2943. doi:10.1016/j.vaccine.2015.04.057
12. 12. Goveia MG, DiNubile MJ, Dallas MJ, Heaton PM, Kuter BJ; REST Study Team. Efficacy of pentavalent human-bovine (WC3) reassortant rotavirus vaccine based on breastfeeding frequency. Pediatr Infect Dis J. 2008;27(7):656-658. doi:10.1097/INF.0b013e318168d29e
13. 13. Ramani S, Mamani N, Villena R, et al. Rotavirus Serum IgA Immune Response in Children Receiving Rotarix Coadministered With bOPV or IPV. Pediatr Infect Dis J. 2016;35(10):1137-1139. doi:10.1097/INF.0000000000001253
14. 14. Tregnaghi MW, Abate HJ, Valencia A, et al. Human rotavirus vaccine is highly efficacious when coadministered with routine expanded program of immunization vaccines including oral poliovirus vaccine in Latin America. Pediatr Infect Dis J. 2011;30(6):e103-e108. doi:10.1097/INF.0b013e3182138278
15. 15. Guerra FA, Gress J, Werzberger A, et al. Safety, tolerability and immunogenicity of VAQTA given concomitantly versus nonconcomitantly with other pediatric vaccines in healthy 12-month-old children. Pediatr Infect Dis J. 2006;25(10):912-919. doi:10.1097/01.inf.0000238135.01287.b9
16. 16. Staples JE, Gershman M, Fischer M; Centers for Disease Control and Prevention (CDC). Yellow fever vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010;59(RR-7):1-27.
17. 17. Kowalzik F, Faber J, Knuf M. MMR and MMRV vaccines. Vaccine. 2018;36(36):5402-5407. doi:10.1016/j.vaccine.2017.07.051
18. 18. American Academy of Pediatrics. Active Immunization After Receipt of Antibody-Containing Products . In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2024. p.68-70.
19. 19. Englund JA. The influence of maternal immunization on infant immune responses. J Comp Pathol. 2007;137 Suppl 1:S16-S19. doi:10.1016/j.jcpa.2007.04.006
20. 20. Keller-Stanislawski B, Englund JA, Kang G, et al. Safety of immunization during pregnancy: a review of the evidence of selected inactivated and live attenuated vaccines. Vaccine. 2014;32(52):7057-7064. doi:10.1016/j.vaccine.2014.09.052
21. 21. Wilson E, Goss MA, Marin M, et al. Varicella vaccine exposure during pregnancy: data from 10 Years of the pregnancy registry. J Infect Dis. 2008;197 Suppl 2:S178-S184. doi:10.1086/522136
22. 22. Oshman LD, Davis AM. Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). JAMA. 2020;323(5):468-469. doi:10.1001/jama.2019.18411
23. 23. McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS; Centers for Disease Control and Prevention. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP) [published correction appears in MMWR Recomm Rep. 2015 Mar 13;64(9):259]. MMWR Recomm Rep. 2013;62(RR-04):1-34.
24. 24. Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018;67(1):1-31. Published 2018 Jan 12. doi:10.15585/mmwr.rr6701a1
25. 25. Mahadevan U, Wolf DC, Dubinsky M, et al. Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013;11(3):286-e24. doi:10.1016/j.cgh.2012.11.011
26. 26. Julsgaard M, Christensen LA, Gibson PR, et al. Concentrations of Adalimumab and Infliximab in Mothers and Newborns, and Effects on Infection. Gastroenterology. 2016;151(1):110-119. doi:10.1053/j.gastro.2016.04.002
27. 27. American Academy of Pediatrics. Immunization and other considerations in immunocompromised children. In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2024. p.93.
28. 28. Wodi AP, Murthy N, McNally V, et al. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023. MMWR Morb Mortal Wkly Rep 2023; 72:137.
29. 29. American Academy of Pediatrics. Minimum Ages and Minimum Intervals Between Vaccine Doses . In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2024. p.61.
30. 30. Centers for Disease Control and Prevention. Immunization schedules. https://www.cdc.gov/vaccines/schedules/index.html. (Accessed August 17, 2024.)