Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants

Vaccines in child has been a controversial topic in the media, and in the public. As health care professionals we usually role our eyes at the topic of parents not vaccinating their children.

DeMeo and colleagues researched adverse effects in low-birth weight infants 3 days before they receive immunizations and after they receive them. Immunizations in low-birth weight patients have shown a positive impact on the child’s immune system through the rest of their childhood, but dangerous adverse effects do occur. This creates a dilemma for physicians: immunizations are very beneficial, but are they beneficial enough to give early on in the life of a low-birth-weight infant to risk death in some low-birth weight infants?

DeMeo and colleagues preformed a multicenter retrospective cohort study that included 13,926 infants that were born at 28 weeks gestation or earlier. The infants were discharged from 348 different neonatal intensive care units from Jan. 1st, 2007 to Dec. 31,2012. Each of these 13,926 patients received one or more immunization between 53 days to 110 days after birth. Their measurements included the appearance of sepsis, increased need for respiratory support, intubation, seizures, and death in the infants. 91.1% of the infants received three or more immunizations and the results from pre-immunizations to post include:

Increase from 5.4 per 1000 days of patient days experiencing sepsis to 19.3 per 1000 days.

Increased respiratory need: 6.6 to 14.0 days per 1000 days

Increased intubation need: 2.0 to 3.6 days per 1000 days

Adverse effects were similar for all immunization types and were even more prevalent in infants born at 23 or 24 weeks. The researches did find that immunizations are causing increased adverse effects in low-birth-weight infants. They did not come to a definite conclusion that patients should not be receiving immunizations or say that the reward is greater than the risk. They suggested further investigation into whether spacing and timing of the immunization administration of the immunizations played a role in the increase of adverse effects.

This article was really interesting because it brought a topic that is controversial and showed some evidence that in some instances immunizations can be harmful. Seeing here that they can cause adverse effects as serious as death is frightening.

JAMA Pediatr. 2015;169(8):740-745.

http://archpedi.jamanetwork.com/article.aspx?articleid=2300376

Pharmacist Education and Inpatient Influenza and Pneumococcal Vaccination Acceptance Rates

The United States is vastly affected by pneumococcus pneumonia, invasive pneumococcal infections, and seasonal influenza each and every year. Although there are vaccines that prevent these diseases, approximately 70 million high-risk adults are vulnerable to pneumococcus by by remaining unvaccinated. The number of deaths related to influenza has been steadily increasing in the United States since 1990. If patients qualify, patients can receive both the influenza and pneumonia vaccinations to protect themselves from these disease, however, less than half of adults 18 years of older were vaccinated during the 2012 to 2013 flu season. It is apparent that pharmacists, as immunizers in the community setting, are increasing the current vaccination rates in the population today.

A study was conducted to determine just how effective pharmacist-driven education programs were at increasing vaccination rates. Patients in a small community hospital who initially rejected vaccinations upon admission were educated by pharmacists and pharmacy interns and reoccurred the vaccination. As a result, 39.2% of patients changed there minds and decided to receive the influence and pneumococcal pneumonia vaccines.

This study proves the importance of patient education. Pharmacists need to provide patients with all the available information in order for patients to make the right decisions in regards to their health care. I am proud to be going in to a profession that has such a big influence on its patient population.

Journal of Pharmacy Practice (2016): n. pag. Web.

Link to article