Immunization Form and Policy

Hepatitis A
Hepatitis B
Meningitis 
TB test
Tetanus vaccination

www.cdc.gov/travel

Hepatitis A

Definition: Hepatitis A is a highly contagious viral disease that attacks the liver.

Signs and Symptoms:

  • Tiredness
  • Loss of appetite
  • Nausea
  • Vomiting
  • Weakness
  • Stomach discomfort
  • Dark urine
  • Jaundice (yellowing of the skin and/or white part of the eyes).
  • Symptoms generally last 4 to 8 weeks although they may persist for as long as 6 months.

Mode of Transmission: Primarily through fecal-oral route.

Who Should be Vaccinated:

  • Travelers visiting areas such as Africa, Asia (excluding Japan), the Mediterranean Basin, Eastern Europe, the Middle East, Central and South America, Mexico, and parts of the Caribbean
  • Military personnel
  • Native Alaskans and Native Americans
  • People living in endemic areas
  • Those engaging in high-risk sexual activity
  • Illicit injectable drug users
  • Those who may be exposed on the job (day-care workers, lab workers handling Hepatitis A virus, handlers of primates harboring Hepatitis A, institutional workers dealing with developmentally handicapped).

Who Should Not be Vaccinated:

  • Anyone with a febrile illness (illness with a fever) should postpone vaccination unless approved by a physician.
  • Use with caution for persons who have bleeding disorders, are immunosupressed, anyone who has had a previous known hypersensitivity to any component of the vaccine.
  • It should be given to a pregnant woman only if it is clearly needed (the patient must have a written statement from a physician for this clinic).

Side Effects:

  • Soreness at the site of the injection,
  • Headache
  • Fever
  • Fatigue
  • Malaise
  • Anorexia
  • Nausea. 

Rare cases of

  • Rash
  • Vomiting
  • Diarrhea
  • Swollen glands
  • Dizziness
  • Upper respiratory tract infections have been reported.

Side effects are generally mild and don't last long.

Dosage: The vaccination is a series of two intramuscular injections given 6 to 12 months apart. The first vaccination will only give you partial immunity; both are 
required for complete immunity.

Hepatitis B

Definition: A potentially serious, highly contagious viral disease that affects the liver.

Signs and symptoms:

  • Loss of appetite
  • Nausea and vomiting
  • Upper right abdominal pain (liver pain)
  • Fever
  • Headache
  • Dark urine (possibly brown)
  • Light gray stools
  • Jaundice (yellowing of the skin and/or white part of the eyes)
  • Extreme fatigue
  • Skin rashes
  • Swollen glands
  • Muscle and joint pain.

Mode of Transmission:
Hepatitis B is transmitted in blood, saliva, semen and vaginal fluids. It can be transmitted by vaginal, oral, or anal intercourse; through bites, cuts, open sores, or mucous membranes (eyes, nose, moth, vagina, anus, urethra); by sharing needles from drugs, steroids, body piercing, acupuncture, or tattoos; from mother to child; or from an exposure in a health care setting.

Who Should be Vaccinated:
Every one should be vaccinated for Hepatitis B. Death can result from this disease and it is a known causer of chronic liver disease. It is now a requirement for school age children to receive this vaccination.

Who Should Not be Vaccinated:
If you are allergic to yeast or thimerosal or have had a previous allergic reaction to Hepatitis B vaccine, you should notify the nurse. Also, you should tell the nurse about the kind of reaction you had. If you have a serious active infective illness, vaccine should be deferred until you feel well. If febrile seizures have occurred in the past and would cause a serious risk, vaccine should be deferred.

Side Effects:

  • Soreness at injection site
  • Flu-like symptoms with a fever over 100 degrees
  • Stomach virus type symptoms
  • Abnormal liver function tests
  • Sore throat or upper respiratory infection.

Dosage:
Vaccination is performed with a series of three intramuscular injections. The 
1st and 2nd shot are 1 month apart, followed by a 3rd injection 6-12 months 
after the first one. If the series is interrupted for any reason, it should be 
reinitiated as soon as possible. If one of the vaccinations is missed, this 
does not necessarily mean all shots must be repeated.

Meningitis

Definition: Meningococcal meningitis is a bacterial infection that can cause severe swelling of the brain and spinal cord. This disease is potentially very dangerous because it is relatively rare and is often mistaken for a minor cold or the flu, and, as a result, is ignored.

Signs and Symptoms:

  • Headache
  • Fever
  • Stiff neck
  • Extreme fatigue
  • Nausea
  • Vomiting
  • Sensitivity to light
  • Confusion
  • Individuals may also have a purplish red rash of small dots located mainly on the arms and legs

Mode of Transmission: Meningitis is transferred by saliva, nasal mucous, or sputum.

Who Should be Vaccinated:

  • College students, especially those who live in dormitories
  • People who might be affected during an outbreak of certain types of meningococcal disease
  • Anyone traveling to, or living in, a part of the world where meningococcal disease is common, such as West Africa

Who Should Not be Vaccinated:

  • Pregnant women
  • People allergic to thimerosal
  • An individual who has had a serious allergic reaction to a previous dose of the vaccine
  • Individuals with moderate or severe illness should wait until they recover

Side Effects:

  • Tenderness and redness at the injection site for 1-2 days
  • Fever
  • Headaches

Dosage: Vaccination is a single injection. Revaccination should be considered after 3-5 years.

Tetanus

Definition: A potentially fatal infection of the central nervous system (brain and spinal cord).

Signs and Symptoms: irritability, headache, fever, and painful spasms of the muscles resulting in lockjaw; eventually, every muscle of the body spasms.

Mode of Transmission: Tetanus occurs when the bacterium in soil or dust is introduced into the body through a puncture wound, abrasion, laceration, or burn.

Who Should be Vaccinated: Everyone should be vaccinated as a child and then should receive a tetanus booster every 10 years as an adult. If an individual receives a severe wound they should be revaccinated if they have not received a booster in the last 5 years.  Adults 19 and older should receive a TdaP, can be given as soon as two years after last Td.

Who Should Not be Vaccinated: Any one who has had a severe allergic reaction to a previous tetanus vaccination.

Side Effects: Soreness, redness, or swelling where the shot was given.

Very rarely: Serious allergic reaction; deep, aching pain and muscle wasting in upper arm(s).

Dosage: One intramuscular injection every 10 years.


Tuberculosis (TB) Testing

Definition: Tuberculosis (TB) is a disease that can damage the lungs and interfere with a person's ability to breath. If not treated, it can be fatal.

Signs and Symptoms: Chronic coughing, coughing up blood, chest pains, trouble breathing, persistent fatigue, fever, weight loss, poor appetite, night sweats, swollen lymph nodes

NOTE: TB has two forms: latent and active. Latent TB has no signs or symptoms and is not contagious, but it can become active without warning. Active TB shows the above signs and symptoms and can be very contagious.

Mode of Transmission: TB is passed from person to person through the air. Small droplets are transmitted into the air any time a person coughs, shouts, laughs, or sings. Another person breathes in these droplets, thus exposing him or her self to the bacteria.

Who Should be Tested:
People from countries where TB is very common; people with medical conditions that increase the risk of TB; people who work in the medical field, schools, or correctional facilities; alcoholics and IV drug users; people who have signs and symptoms of the disease; people who have been exposed to an individual with active TB.

Who Should Not be Tested: Individuals known to be infected with TB; have had a clearly documented previous positive TB skin test result; have a skin rash that would interfere with reading the test results.

Dosage: The test is administered as an injection just under the skin; a small bubble of medicine is injected forming what is known as a bleb. The individual must return to the clinic in 48 to 72 hours to have the test read.

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