临床药物手册( 英文原版)13.pdf

Immunization 3 GENERAL RECOMMENDATIONS ON IMMUNIZATION* Recommendations for immunizing infants, children, and adults are based on char- acteristics of immunobiologics, principles of active and passive immunization, and judgments by public health officials and specialists in clinical and preventive medicine. Benefits and risks are associated with the use of all immunobiologics; no vaccine is completely safe or completely effective. Recommendations for im- munization practices balance scientific evidence of benefits, costs, and risks to achieve optimal levels of protection against infectious diseases. The recommenda- tions in this chapter describe this balance and attempt to minimize the risks by providing information regarding dose, route, and spacing of immunobiologics, and delineating situations that warrant precautions or contraindicate the use of these immunobiologics. These recommendations are for use only in the United States because vaccines and epidemiologic circumstances often differ in other countries. Individual circumstances may warrant deviations from these recom- mendations. Tables 3–1 and 3–2 list the immunobiologics available in the United States. IMMUNOBIOLOGICS The specific nature and content of immunobiologics can differ. When immuno- biologics against the same infectious agent are produced by different manufactur- ers, active and inert ingredients in the various products are not always the same. Practitioners are urged to become familiar with the constituents of the various products. Suspending Fluids. These may be sterile water, saline, or complex fluids con- taining protein or other constituents derived from the medium or biologic system in which the vaccine