C H A P T E R 1 8
Vaccines and sera
285
IMMUNE SERA
As explained earlier, passive immunity can be achieved
by providing preformed antibodies to a specific antigen.
These antibodies are found in immune sera, which may
contain antibodies to toxins, venins, bacteria, viruses or
even red blood cell antigenic factors. The term
immune
sera
, or
immunoglobulin, is usually used to refer to sera
that contain antibodies to specific bacteria or viruses.
The term
antitoxin
refers to immune sera that have anti-
bodies to very specific toxins that might be released by
invading pathogens. The term
antivenin
is used to refer
to immune sera that have antibodies to venom that might
be injected through spider or snake bites. These drugs
are used to provide early treatment following exposure
to known antigens. They are very specific for antigens to
which they can respond (see Table 18.2).
Therapeutic actions and indications
Immune sera are used to provide passive immunity to
a specific antigen, which could be a pathogen, venom
or toxin. They may also be used as prophylaxis against
specific diseases after exposure in individuals who are
immunosuppressed. In addition, immune sera may be
used to lessen the severity of a disease after known or
suspected exposure (see Figure 18.3 for sites of action of
immune sera and antitoxins). Table 18.2 lists the various
available immune sera, antitoxins and antivenins, as
well as usual indications.
Pharmacokinetics
No pharmacokinetic data are available for these
biologicals.
information handy for easy reference. She should also be
encouraged to record any adverse effects that occur after
each immunisation. If reactions are uncomfortable, it is
possible to split doses of future immunisations.
The nurse should give S.D. a chance to vent her
concerns and fears. First-time parents may be more anxious
than experienced ones when dealing with issues involving
a new baby. To alleviate S.D.’s anxiety, the nurse should
provide a telephone number that S.D. can call if the baby
seems to be having a severe reaction or if S.D. wants to
discuss any questions or concerns. She should feel that
support is available for any concern that she may have.
Because this interaction is likely to form the basis for future
interactions with S.D., it is important to establish a sense of
respect and trust.
CARE GUIDE FOR S.D.’S BABY: VACCINES
Assessment: History and examination
Allergies to the serum base, acute infection,
immunosuppression
General: temperature
CV: pulse, cardiac auscultation, blood pressure, oedema,
perfusion
Respiratory: respirations, adventitious sounds
Skin: lesions
Joints: range of motion
Implementation
Ensure proper preparation and administration of vaccine
within appropriate time frame.
Provide supportive and comfort measures to deal
with adverse effects: anti-inflammatory/antipyretic,
local heat application, small meals, rest and a quiet
environment.
Provide parent teaching regarding drug name, adverse
effects and precautions, and warning signs to report.
Provide emergency life support if needed for acute
reaction.
Evaluation
Evaluate drug effects: serum titres reflecting immunisation
(if appropriate).
Monitor for adverse effects: pain, flu-like symptoms, local
discomfort.
Evaluate effectiveness of parent teaching program.
Evaluate effectiveness of comfort and safety measures.
Evaluate effectiveness of emergency measures if needed.
TEACHING FOR S.D.
• This immunisation will help your baby to develop
antibodies to protect her against diphtheria, tetanus
and pertussis. The baby will develop antibodies to these
diseases, and this will prevent the baby from contracting
one of these potentially deadly diseases in the future.
• The injection site might be sore and painful. Heat applied
to the area may help this discomfort and speed the baby’s
recovery.
• Adverse effects that the baby might experience include
fever, muscle aches, joint aches, fatigue, malaise, crying
and fretfulness. Paracetamol may help these discomforts;
check with your healthcare provider for the correct
dose to use for the baby. Rest, small meals and a quiet
environment may also help the baby to feel better.
• The adverse effects should pass within 2 to 3 days. If they
seem to be causing undue discomfort or persist longer
than a few days, notify your healthcare provider.
• Booster immunisations are required for this immunisation.
Your baby should receive a booster immunisation at your
next scheduled checkup. Keep a written record of this
immunisation.
• Please contact your healthcare provider if you have any
questions or concerns.
