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B Vaccine
Epidemiology and Prevention of VaccinePreventable Diseases
National Center for Immunization and
Respiratory Diseases
Centers for Disease Control and Prevention
Revised May 2009
infected worldwide
Established cause of chronic
hepatitis and cirrhosis
Human carcinogencause of up to
80% of hepatocellular carcinomas
More than 600,000 deaths worldwide
in 2002
Hepatitis B Complications
Fulminant hepatitis
Hospitalization
Cirrhosis
Hepatocellular carcinoma
Death
Hepatitis B Perinatal
Transmission*
Global Patterns of
Chronic HBV Infection
MMWR 2006;55(RR-16):6-7
groups
Vaccination of adolescents
Vaccination of adults in high-risk
groups
Vaksin Hepatitis B
(Engerix-B, Euvax-B,
Hepvac-B)
Hepatitis B Vaccine
Composition
Recombinant HBsAg
Efficacy
Duration of
Immunity
20 years or more
Schedule
3 Doses
Hepatitis B Vaccine
Hepatitis B Vaccine
Routine Infant Schedule
Minimum
Dose+
Usual Age
Interval
Primary 1 Birth
--Primary 2 1- 2 months 4 weeks
Primary 3 6-18 months* 8 weeks**
* infants who mothers are HBsAg+ or whose HBsAg status is
unknown should receive the third dose at 6 months of age
** at least 16 weeks after the first dose
+an additional dose at 4 months is acceptable if the clinician prefers to
use a combination vaccine that contains hepatitis B vaccine
Hepatitis B Vaccine
Adolescent and Adult Schedule
Dose
Primary 1
Primary 2
Primary 3
Usual
Interval
--1 month
5 months
Minimum
Interval
--4 weeks
8 weeks*
birth
Hepatitis B vaccine (first dose) and
HBIG at different sites
Complete vaccination series at 6
months of age
Test for response after completion of
at least 3 doses of the HepB series at
9 through 18 months of age
(generally at the next well-child visit)
Hepatitis B Vaccine
Adverse Reactions
Pain at injection site
Mild systemic complaints
(fatigue, headache)
Infants and
Adults
Children
13%-29%
3%-9%
11%-17%
0%-20%
1%
0.4%-6%
rare
rare
Hepatitis B Vaccine
Varicella and
Varicella Vaccine
Epidemiology and Prevention of VaccinePreventable Diseases
National Immunization Program
Centers for Disease Control and Prevention
Revised March 2002
Average 5 lesions
Systemic reactions uncommon
Varicella Vaccine
Contraindications and Precautions
Pregnancy
Immunosuppression
Moderate or severe acute illness
Recent blood product
Varicella Vaccine
Transmission of Varicella
Vaccine Virus
Asymptomatic seroconversion
Penyimpanan vaksin
Di Tingkat Propinsi : kmr dingin & kmr beku
Suhu kamar dingin: +2 s/d +8 C
Suhu kamar beku: -15 s/d -25 C
Di Kabupaten dan Pelayanan Primer
Jarak lemari es dengan dinding belakang 15 cm
Lemari es tidak terkena sinar matahari langsung
Sirkulasi ruangan cukup
Penyusunan vaksin
Jarak menyusun dos vaksin 1-2 cm atau
satu jari antar dos vaksin
Penyimpanan
BCG
+2 s/d +8C
-15s/d -25C
+2 s/d +8C
1 tahun
1 tahun
2 tahun
Hepatitis
B
TT
+2 s/d +8C
26 bulan
+2 s/d +8C
2 tahun
DT
+2 s/d +8C
2 tahun
OPV
+2 s/d +8C
-15 s/d
-25C
+2 s/d +8C
6 bulan
2 tahun
DPT
Campak
2 tahun
Khusus
DTP / DTPa : ensefalopati dalam 7 hari
pasca vaksinasi DPT/DTPa
Pemeriksaan Fisik
Pemeriksaan umum
Pemeriksaan khusus
Mencari indikasi kontra atau halhal yang perlu diperhatikan
bekas vaksinasi terdahulu
Lokasi vaksinasi yang akan
dikerjakan
Persiapan pemberian
vaksin
Cuci tangan dengan antiseptik
Baca nama vaksin, tanggal kadaluwarsa,
Teliti kondisi vaksin apakah masih layak :
warna indikator VVM,
Vaksin
pernah
beku
Setelah dikocok
Setelah
15
menit
Setelah 30 menit
Penempatan alat
untuk memudahkan vaksinasi
Kotak
pembuangan
jarum bekas
Form R&R
Kota
k
pem
baw
a
vaks
Temp
in
Kursi Kursi
at
pasien vaksinat samp
Ukuran jarum
Intramuskular di paha mid-anterolateral
Neonatus
kurang bulan / BBLR : 5/8 inch (15,8 mm)
: 7/8 inch (22,2 mm)
cukup bulan
: 7/8 1 inch
1 24 bulan
(22,2-25,4 mm)
Intramuskular di deltoid
> 2 thn (tergantung ketebalan otot)
7/8 1,25 inch (22,2 -31,75
mm)
Tungkai anak
dijepit paha ibu
Tangan yg lain
dipegang ibu,
Kemudian
anak dipeluk
Tangan di
Tangan
bebas
Bisa
suntik
meraih
jarum
suntik
Kaki
bebas
Posisi bayi
dalam pelukan
ibu pada
penyuntikan
BCG
Intramusc
Subcutaneous
e.g. hepatitis A an
DTP
Oral
e.g.
poli
Intradermal
BCG
Pencatatan
Pemantauan setelah
vaksinasi