| Subject: Leave this on the kitchen table so your sibling finds it |
Author:
Tim
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Date Posted: Tuesday, August 06, 2019, 06:19: am
Me and my girlfriend left this letter on the kitchen table and watched her two 13 year old daughters freak out reading it....LOL
Hepatitis A/B & Adolescent Vaccination Notice
______________________________________________
August 1, 2019
Draft 49018.16
Recommendations of the Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP), the American Academy of Family Physicians
(AAFP) and the American Medical Association (AMA)
The following CDC staff members prepared this report:
Francisco M. Averhoff, M.D., M.P.H.
Walter W. Williams, M.D., M.P.H.
Stephen C. Hadler, M.D.
Epidemiology and Surveillance Division
National Immunization Program
Notice Regarding Mandatory Hepatitis A/B Vaccination
For Upcoming School Year
Recommendations of the Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP), the American Academy of Family Physicians*
(AAFP) and the American Medical Association* (AMA)
This statement on adolescent immunization is a supplement to the "General Recommendations on Immunizations" of the Advisory Committee on Immunization Practices (ACIP). This statement presents a new strategy to improve the delivery
of vaccination services to adolescents and integrate recommendations for immunization with other preventive services provided to adolescents.
Dear ____________________________________,
This letter is being sent to you to provide important information regarding the new State Mandated Hepatitis A/B Vaccination Requirement; Starting this year 2019, all children between the ages of 10 and 18 MUST receive these vaccinations within 30 days or you will not be allowed to attend class. This letter will:
(1) Provide information about the Hepatitis A/B infection.
(2) Provide information regarding the administration of the Hepatitis vaccine.
(3) Help you cope with the pain of the Hepatitis A/B injection.
In the United States, most persons acquire Hepatitis A/B virus (HBV) infection as adolescents or young adults. HBV is primarily transmitted through sexual contact, use of injection drugs, and household contact with a chronically infected person, or occupational exposure. However, over one-third of persons with acute Hepatitis A/B do not have a readily identifiable source for their infection (8).
An immunization visit at age 10-18 years, during adolescent high-risk behaviors, is an ideal time to initiate the Hepatitis A/B immunization. In addition, older unvaccinated adolescents with identified risk factors for HBV infection should also be vaccinated (9). To achieve complete immunization, providers may offer Hepatitis A/B vaccine to all adolescents in their practice as recommended by the AAP (12). The Hepatitis A/B immunization is different from any other Hepatitis immunization you may have already received.
Your child will have to receive three doses of Hepatitis A/B vaccine given in schedules of: 0, 1, and 9 months; or in certain cases 0, 0, and 6 months. If the vaccination schedule is interrupted, it is not necessary to restart the vaccine series. Although studies have not examined all possible variations, studies of "off schedule" vaccination indicate the following approach if the series is interrupted after the first dose: 1) another dose should be given as soon as possible and the third dose should be separated by an interval of at least 6 months, and 2) if only the third dose is delayed, it should be administered as soon as possible. Intervals of up to nine months between the first and third doses have been found to result in excellent antibody responses and studies are in progress to evaluate longer intervals (16).
**The entire series normally takes 9 months to complete. If given in less than 9 months, 2 doses will be required at the first visit; these being considered doses 0 and 1. It will then be necessary for the physician to administer two separate injections during the initial visit. The third dose must be administered no later than 6 months from the first two.
**Since the State mandate requires that all students be fully immunized by January 1, 2020, it will be necessary for you to use the alternate vaccination schedule of 0, 0 and 6 months. This will mean that your child will be receiving the first two doses at the initial visit and the third dose six months later.
Administration of the Hepatitis A/B vaccination is intramuscular and is administered in the buttocks. In the case of multiple injections at first visit, the nurse or doctor will alternate sides of the buttocks for each injection. A nurse or parent should be present to assist in holding you steady to prevent any movement during the injection.
Because the Hepatitis A/B vaccine is recombinant (a mixture), the dosage is large and the serum is thick. The serum is also caustic (it burns), as there is some degree of tissue damage when coming in contact with muscle tissue. The duration of the injection usually takes between 2 and 3 minutes. It is important that your child remain still during this period. The serum must reach the inner most part of the muscle and must be administered in the buttocks. It cannot be given in the upper arm or thigh. Up until 2017, it had been administered in the upper arm. However, this was found to lose effectiveness. Further studies have shown this to be true.
The Hepatitis A/B injection is painful. Your child should lay on their stomach in a relaxed position with their toes pointing inward toward each other. This will allow the physician or nurse to directly administer the injection safely. It is recommended that a nurse or parent hold your child steady to prevent any movement due to pain.
When the injection is administered, your child will feel a sharp stick from the insertion of the needle. They will then feel the needle go deeper into the inner muscle. This does hurt. You may want to hold your child’s hand to ease some of the pain. It is important for them to hold still during this period even though it is painful. After the needle is fully inserted, your child will feel a very intense burning sensation as the serum is injected. This will last and perhaps increase, for the duration of the injection; between 2 and 3 minutes. They should hold still during this period.
The needle used is between 2 and 2 1/2 inches long and is 18 gauge in diameter to reach the necessary part of the inner muscle. Therefore, the physician or nurse will insert it with a strong jabbing motion. It is okay for your child to scream or cry if that will help them stay still. When the needle is removed, there will be another sharp pain. At this point, the physician or nurse will quickly swab the area with alcohol to prevent infection.
Due to the long duration of the injection and the thickness of the serum, the site of injection will remain sore. This will last anywhere between 1 to 2 weeks. If the pain does not subside after this period, contact your physician.
As mentioned earlier, it is okay to scream or cry if that allows your child to remain still. They should not feel embarrassed, for this is common among anyone receiving these injections.
The consideration of the mandatory Hepatitis A/B vaccination, while painful, has been made in order to protect your child from a very debilitating disease. Although it is a painful experience when receiving the Hepatitis A/B injections, the long-term benefits are many.
Some schools will have immunization clinics set up in their auditoriums. These will be set up starting August 16, 2019. These clinics will offer these vaccines at no charge. Parents should talk to their children beforehand to prepare them for the injections and explain the importance of them.
Again, these immunizations are required “prior” to the start of school this year or your child will be prevented from attending classes. It is okay for your child to take Tylenol to ease some of the pain associated with the injections.
The above recommendations for each vaccine are consistent with the current ACIP.
Hepatitis A/B Virus Infection: Adolescent Information
American Academy of Pediatrics
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