Pregnancy/lactation

women should know if immune to rubella nad varicella

MMR

• 2 doses of MMR recommended and funded for women who are susceptible to MMR

• advised to ensure not pregnant at time of immunisation and for at least 4wks after

  • although no evidence MMR teratogenic

• if mother non immune

  • 2 doses MMR separated by 4 wks should be given after delivery

Varicella

• recommended but Not funded

• 2 doses given 4-8wks apart

Influenza

• recommended and funded

• offered to women at any stage during pregnancy as soon as annual influenza vaccine becomes avaiable

Pertusis

• offered in every pregnancy

  • funded 28-38 wks

  • protect mother

  • antibodies -> baby

• post partum doens’t have benefir of antibodies -> baby

Preterm and low birthweight infants

• vaccination as per schedule - at usual chronological age

Rotavirus

• exception

• vaccinate as they leave hospital

• vaccine virus shed int he stool

influenza

• preterm who develop chronic lung disease

  • influenza vaccien once aged 6mo

infants exposed to HepB (mum has chronic HBV)

• birth dose of hepB and HBIG

Asplenia

• causes:

  • surgical removal

  • functional

    • disease

      • sickle cell

      • thalassaemia

    • congenital asplenia or polysplenia

• at risk of fulminat bactramia

• strep pneumoniae = most common

• vaccines:

  • pneumococcal conjugae and polysaccharide

    • PCV13

    • polysaccahride funded for adults

  • meningococcal conjugate

  • Hib

  • influenza

  • varicella

• elective:

  • ASAP and at least 2wks pre-operatively

• emergency

  • 2wks post-operatively

• antibiotic prophylaxis

  • sickle cell = proven

  • recommended \<5yo

  • monthly benzathine penicillin injections

    • \<5yo

    • older asplenic for at least 2 yrs post splenectomy