Vaccinations for the duration of series Discussion Essay

Vaccinations for the duration of series Discussion Essay

Vaccinations for the duration of series Discussion Essay

Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response. Please use APA 7TH edition, please be sure that response to peers advance the discussion by asking a question.

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Peer Question #1Dana Moore posted

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Hypersensitivity is the bodies response to an antigen that results in disruption to the person. McCance and Huether (2018) noted that it can be broken down into two categories: source and mechanism. They defined the sources as allergy, autoimmunity, and alloimmunity. Allergy indicates the substances in the environment, autoimmunity is the body reacting against itself, and alloimmunity occurs when the body reacts against another, for example the importance of the Rh factor during pregnancy (McCance & Huether, 2018). When describing the mechanism of hypersensitivity reactions, they broke it down into four types: Types I, II, III, and IV.
Type I were described as an immunoglobulin E induced and what occurs as by-products of mast cell stimulation. McCance and Huether (2018) noted that common allergies are considered type I reactions, but not all allergies were type I. Type I reactions could be minor, but also as severe as anaphylaxis. The outcome of the reaction depends on the type of allergen. They noted that foods or medications that are ingested could cause vomiting or diarrhea, whereas inhaled allergens such as pollen could cause runny nose, watery eyes, and other respiratory type symptoms. Type II were described as tissue specific, and they noted that antigens bind to specific cells. An example they mentioned was a mismatched transfusion reaction when RBCs are destroyed. Additionally, they indicated that in a type II reaction the cells may not necessarily be destroyed, but they could malfunction as indicated in graves disease when the antibody affects TSH production. Type III hypersensitivity reactions, as discussed by McCance and Huether (2018), occur when the antigen is released into the circulatory system and binds with the antibody and then are relocated in the wall of a vessel or in tissue. They noted two models of type III reactions: serum sickness and arthus reaction. Raynaud phenomenon is an example they noted as a serum sickness reaction because immune complexes called cryoglobulins precipitate in cooler climates causing decreased or blocked circulation to extremities. Which is when we, as nurses see the pale or bluish fingers/fingertips of an individual which is accompanied by pain. Arthus reaction was described as repeated exposure to an antigen causing an inflammatory reaction such as swelling, redness, bleeding, and damage to the affected area. Discussion: Vaccinations for the duration of series.

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They noted that this type of reaction starts within an hour of exposure and peaks around 6-12 hours. In the case study the infant is experiencing a type III hypersensitivity reaction to the vaccine site received six hours earlier. McCance and Huether (2018) indicated that types I, II, and III are caused by an antibody, but type IV are caused by T lymphocytes. Interestingly, they noted examples of type IV reactions such as type I diabetes mellitus, hashimotos thyroiditis, tissue graft rejection and contact reactions from plants and metals.
In practice I believe we have all dealt with someone who has suffered a hypersensitivity reaction. In practice I have had patients who have had minor to anaphylactic reactions to drugs. I occasionally float to our rheumatology infusion suite, and I think it is very interesting to read about these hypersensitivity reactions and how many of the common autoimmune diseases I see have such different mechanisms. I have always known that rheumatology diseases were very complicated, but I have spent so much of my healthcare career working in cardiology.
According to Centers for Disease Control ([CDC], 2020) immunization schedules, a child around 19 months of age would be most likely receiving boosters of the HepB, DTaP, inactivated poliovirus and HepA. While noting the child’s symptoms of a reaction at the injection site consisting of redness, swelling and pain within 6 hours of receiving a vaccine, the provider would most likely diagnose it as an Arthus reaction. Arthus reactions are a type III hypersensitivity reaction that occurs after receiving a vaccine. This type of reaction can cause pain, swelling, redness and sometimes necrosis at the injection site, typically within 6-12 hours of receiving the vaccine (Peng et al., 2019). Peng et al. (2019) discussed that it was more common to see an Arthus type reaction to DTaP, DTP, DT, and HepB. Additionally, some of their research showed that booster vaccinations were more likely to induce an Arthus reaction. They also noted mild reactions generally did not need any treatment, but the more moderate to severe reactions were treated with diphenhydramine, promethazine and/or cortisone. According to the CDC (2020) vaccine recommendations and guidelines of the Advisory Committee on Immunization Practices (ACIP), an Arthus type reaction would indicate a precaution in proceeding with additional DTaP vaccine. The guidelines state that any vaccine containing a tetanus-toxoid should be avoided for at least 10 years after an Arthus reaction. Discussion: Vaccinations for the duration of series.
As previously noted in a type III sensitivity reaction, it occurs within the circulatory system and is deposited into vessel walls and tissue, as noted with the Arthus reaction leading to pain, erythema and swelling. Repeated exposure, such as receiving booster vaccinations, to an antigen reacts with an antibody and forms immune complexes (McCance & Huether, 2018). This damage to the tissues is caused by an increase in neutrophils and lysosomal enzymes.

Centers for Disease Control and Prevention. (2020, February 3). Immunization schedules. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

Centers for Disease Control and Prevention. (2020, September 28). Vaccine recommendations and guidelines of the ACIP.https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html.

McCance, K., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children. (8th ed.). Elsevier.

Peng, B., Wei, M., Zhu, F.-C., & Li, J.-X. (2019). The vaccines-associated Arthus reaction. Human Vaccines & Immunotherapeutics, 15(11), 2769-2777. https://doi-org.su.idm.oclc.org/11.1080/21645515.2019.1602435

Peer Question #2 Caitlin Dinapoli posted

The immune system is an extensive network performing to protect the host from foreign antigens, chiefly infectious agents. Rote and McCance discuss the role of hypersensitivity as an altered immunological response to an antigen that results in disease or damage to the host (2018, pp.255). The host’s reaction can result with an allergy either with positive or negative effect. Hypersensitivity reactions can be divided into four groups based on reaction- Type 1 hypersensitivity reaction, Type 2 tissue specific, Type 3 immune complex-mediated and Type 4 cell mediated.

Type 1- IgE mediated response; immediate hypersensivity. Type 1 are mediated by antigen specific IgE and the products of the tissue mast cells. This reaction is often termed allergy, which can result in a rapid reaction known commonly as anaphylaxis.

Type 2- IgG or IgM mediated response Tissue-sp Discussion: Vaccinations for the duration of series.