Immunization is the process by which a Pt's immune system becomes fortified against a perpetrating immunogen. IUTD is a Medical abbreviation for Immunizations Up To Date, and UTD is an abbreviation for Up To Date.

The immunization schedule lists the vaccinations that should be provided from birth to adulthood. Immunizations include:

​Source: NSW Health

Patient information

Wow. There's quite a few. So at birth you get hepatitis B and vitamin K. What do they do?
So the vaccine for hepatitis B, is to help prevent that. We give vitamin K in the right thigh, based on the mnemonic, that it's the "right" thing to do - get it ? The hepatitis B vaccine is therefore given in the left thigh. Hepatitis B is liver inflammation, that is usually transmitted by blood. Vitamin K is needed for clotting blood.

At 2 months, you add dTpa. What does that stand for, and what is it?
Diphtheria, tetanus, and acellular pertussis. So diphtheria is an upper breathing tract infection, that has basically been eradicated because of widespread vaccination. Tetanus is an infection by a bacteria that enters through a skin break, causing muscle spasms. Pertussis is another word for whooping cough, and is a highly contagious disease, involving a coughing fit involving a whooooop sound as the patient breathes in.

At 2 months, we also give haemophilus influenzae type B, poliomyelitis, pneumococcal, and rotavirus. What are they?
Hemophilus influenza is associated with different diseases like respiratory infection, but the biggy we're worried about is meningitis. Polio is an infectious disease, the big problem being muscular weakness. Pneumococcal is just an infection caused by Streppneumoniae, so pneumonias but also meningitis is associated with that. Rotavirus is a common cause of gastroenteritis

At 12 months you add meningococcal C and MMR. What's that? Meningococcal C sounds almost like vitamin C !
Meningococcal are diseases caused by N meningitidis, it's best known being meningitis. MMR is a 3-in-1, measles, mumps, rubella. Measles is a highly contagious infection, that results in, notably, white spots and a red rashes. Mumps is also a highly contagious infection, notably, causing painful swelling of the salivary glands, painful testicular swelling, and a rash. Rubella notably involves pink or light red spots, that are itchy.

At 18 months, you add the V, making it MMRV. What's the V?
Varicella. That's another word for chickenpox, so there's the well known small blisters that are itchy, and eventually scab over.

In the school program, you add HPV for the first time. What's that?
It's a virus that can cause several types of cancers, including cervical cancer.

• Injection is into, in:
  • Infants (<12 mo): the anterolateral thigh
  • Children: deltoid
• Booster dose, which is an extra administration of a vaccine after an earlier prime dose. It is a re-exposure to the immunizating antigen. It is intended ot increase immunity against the antigen back to protective levels, after emory against that antigen has declined through time

When the body is exposed to non-self molecules, an immune response will mount, causing subsequent immunological memory, which is apart of the adaptive immune system. Immunization can occur by:

• Vaccination, which is the administration of a vaccine (antigenic material, that has its infective component inactivated or attenuated) to stimulate an individual's immune system to develop adaptive immunity to a pathogen. It is less risky than risking a milder form of the disease itself. Vacc is shorthand for Vaccination:
  • Inactivated vaccine is where a previously virulent microorganism is destroyed with chemicals, heat, radioactivity or antibiotics. Examples include:
    • Viral, including:
      • Polio vaccine
      • Influenza vaccine
    • Bacterial, including:
      • Typhoid vaccine
      • Pertussis vaccine
  • Attenuated vaccine is where a live/active virus is cultivated under conditions which disable its virulent properties, or a less dangerous subtype is used (e.g. measles, rubella, mumps, TB). Attenuated vaccines provoke a more durable response, but are NOT safe for use in the immunocompromised, and can rarely mutate to a more virulent form. Examples include:
    • Viral, including:
      • MMR, which includes:
        • Measles vaccine
        • Mumps vaccine
        • Rubella vaccine
      • Live attenuated influenza vaccine
      • Chicken pox/Varicella vaccine
      • Oral polio vaccine
      • Rotavirus vaccine
      • Yellow fever vaccine
    • Bacterial, including:
      • BCG vaccine
      • Typhoid vaccine
• Inoculation (from Greek "inoc" meaning "not harmful", is deliberate introduction, to produce a less severe infection than natural acquisition

Patient information

What are the different types of drugs that have their infective component inactivated or decreased?
Well you just said it . So there are inactivated vaccines, which have their infective component removed. Or attenuated vaccines, which have their infective component decreased, so we actually use a live virus, and therefore we can't give it to certain patients. Live vaccines however, are preferred because they create a more durable response.

Who can't we use live vaccines?
In those who have immune system problems. There is also a theoretical risk to the fetus if given to a pregnant woman, so we don't give it then, since we just want to be careful.

Which vaccines are inactivated, and which are attenuated?
Most vaccines are live, i.e. attenuated vaccines, because they create a more durable response. The exceptions that are inactivated, include polio and influenza, and typhoid and pertussis.

• Live vaccines are contraindicated in immunocompromised Pt's, as it can cause severe complications

• It is effective to prevent infectious disease, and widespread immunity is responsible for worldwide erradication of smallpox, and restriction of polio, measles, and tetanus

Paperwork for Immunization registration/consent includes:

• Affix Pt label
• Is the child of Aboriginal or Torres Strait Islander origin? (Tick Yes/No)
• I give permission for my child to receive vaccines specified below, from the standard vaccination schedule, approved by the National Health & Medical Research Council. This consent is subject to discussion of the risks and benefits of immunizations and any concerns that I may have. Followed by Parent/Guardian Name, and Signature
• Office Use Only, indicates includes a Schedule, with the columns Schedule Age, Antigen, Vaccine, Batch No, with the Batch No permitting writing as the last column. Rows include:
  • Birth-7 Days:
    • Antigen Hepatitis B, w/ vaccine HB Vax II
  • 2 months (Can be given as early as 6 weeks):
    • Diphtheria, Tetanus, Pertussis, Hemophilus influenzae type B (Hib), Hepatitis B, Polio, w/ vaccine Infanrix Hexa
    • Pneumococcal, w/ vaccine Prevenar 13
    • Rotavirus, w/ vaccine Rotarix
  • 4 months:
    • Diphtheria, Tetanus, Pertussis, Hemophilus influenzae type B (Hib), Hepatitis B, Polio, w/ vaccine Infanrix Hexa
    • Pneumococcal, w/ vacine Prevenar 13
    • Rotavirus, w/ vaccine Rotarix
  • 6 months:
    • Diphtheria, Tetanus, Pertussis, Hemophilus influenzae type B (Hib), Hepatitis B, Polio, w/ vaccine Infanrix Hexa
    • Pneumococcal, w/ vaccine Prevenar 13
  • 12 months:
    • Hemophilus influenzae type B (Hib), Meningococcal C, w/ vaccine Menitorix
    • Measles, mumps, rubella, w/ vaccine MMR
  • 18 months:
    • Measles, mumps, rubella, varicella, w/ vaccine Priorix-Tetra
  • 4 years (can be given as early as 3.5 years):
    • Diphtheria, tetanus, pertussis, polio, w/ vaccine Infanrix-IPV
    • Measles, mumps, rubella (if child has not had 2 doses of measles, mumps, rubella containing vaccine), w/ vaccine MMR
  • Other, with blank fields for Antigen, Vaccine, and Batch No
• Consent obtained and vaccine administered by: RMO/RN name, Signature, Designation, Date __/__/____
• Clinical comments

Paperwork for the Neonatal Hepatitis B Vaccination, Vitamin K, there is a Consent form:

• Information sheet regarding Vitamin K for newborn, and Hepatitis B
• Vitamin K Election Form (To be completed by parent/guardian of newborn), which states I, ______ (insert name) have read the Vitamin K Newborn Babies; Information for Parents prepared by the National Health and Medical Research Council. Also ticks for the box, stating One injection of vitamin K; three (3) doses Oral Vitamin K (first oral dose will be given soon after birth, second oral dose will be given on Day 3 by either the midwives in the hospital/midwife in the community/by a GP, I take responsibility to ensure that my baby receives the third dose at four (4) weeks of age; or No administration of vitamin K and I am aware of the risks of Vitamin K deficiency bleeding. There is then the Name, Signature and Date of the Parent/Guardian, Witness, and Interpreter
• Hepatitis B Election Form (To be completed by parent/guardian of newborn), which states I, ___ (insert name) have read the Immunization - Understanding Infant Hepatitis B Immunization prepared by the Australian Commonwealth Department of Health and Aged Care. I have discussed Hepatitis B Vaccination with my midwife/nurse/doctor and choose the following. Ticks for either I agree for my baby to receive the first dose of Hepatitis B vaccine, or I choose not to commence Hepatitis B vaccination for my baby. There is then the Name, Signature, date for Parent/Guradian, Witness, and Interpreter

• Route of administration