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P A R T 3
Drugs acting on the immune system
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
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
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
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 (
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.
Individual teaching
BOX 18.2
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
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.
The evidence
BOX 18.3
