25 - Vaccines Flashcards
What are the 2 types of influenza vaccines?
1) Inactivated virus (effective in 2 weeks, lasts less than 12 months)
2) Live attenuated virus
What is the adult immunization schedule? What diseases does it protect against?
- All adults should receive Tdap (tetanus, diphtheria, and pertussis)
- All adults should receive Td (tetanus and diphtheria) every 10 years
- Adults over 65 y/o should receive the pneumococcal vaccine
- Everyone over 6 m/o should receive the flu shot every year
What can be done to improve influenza and pneumococcal vaccine delivery to high-risk individuals?
- Recommendation by health care provider
- Collaborate w/ pharmacist and specialist physicians to distribute info on benefits and risks
- Advertise in local newspapers, radio, television
- Issue reminders to px and healthcare workers
- Vaccinate on discharged from hospital or ER in fall, w/ home care or at clinics w/ high risk px
- Increase accessibility in institutions and community
What are situations that aren’t CI to vaccines but commonly mislabeled as such?
- Minor acute illness (including upper respiratory infection, diarrhea; exceptions = LAIV, rotavirus vaccine, and oral cholera)
- Antibiotic/antiviral therapy (exceptions = live oral typhoid and LAIV, herpes zoster and varicella)
- Adverse event following previous immunization
- Extensive limb swelling following immunization
- Febrile seizure or syncope after previous immunization
- Inconsolable crying
- Oculo-respiratory syndrome (except influenza vaccine)
- Non-anaphylactic allergies
- Multiple sclerosis
What is done to surveillance vaccine-associated adverse effects?
- During phase 1, 2, and 3 clinical studies
- Passive reporting to provincial health authority
- Active reporting through immunization monitoring program
What are the most common adverse effects of vaccines?
- Local = soreness, swelling, redness
- Systemic = tiredness, irritability, GI, fever, seizures
- Allergic = urticaria, angioedema, rhinitis, bronchospasm, anaphylaxis
What are the principles of effective and informed communication about vaccines and immunization?
- Communicate current knowledge
- Respect difference of opinion
- Represent risks and benefits of vaccines fairly and openly
- Adopt a patient centered approach
- Make the most of each opportunity to present clear, evidence-based messages regarding vaccinations and immunization
Should a 2 y/o w/ no contraindications receive the trivalent/quadrivalent or live attenuated influenza vaccine?
- Can have either
- Parent will likely choose live b/c available in a nasal spray
- If px has asthma, must have TIV
Should a pregnant woman receive the trivalent/quadrivalent or live attenuated influenza vaccine?
Must have TIV
Should a 67 y/o receive the trivalent/quadrivalent or live attenuated influenza vaccine?
Live is only for px aged 2-59, so this px needs TIV
Should a px w/ an egg allergy receive the trivalent/quadrivalent or live attenuated influenza vaccine?
- Can have either
- Egg allergy no longer CI for live
What is zostavax? What does it contain? When is efficacy greatest?
- Vaccine for prevention of herpes zoster (shingles) in px over 50 y/o
- Contains live attenuated varicella-zoster
- Efficacy highest in px 60-69 y/o
Can a px w/ an active case of herpes zoster receive the zoster vaccine?
No, must wait 1 year since last active infection to receive vaccine
What is the primary age group for HPV vaccination?
9-27 y/o females and males
What is the dosing schedule for the HPV vaccine?
Depends on the vaccine (gardasil, gardasil 9, or cervarix)
What is the most common cause of severe gastroenteritis in infants and children?
Rotavirus
When is the rotavirus vaccine recommended?
For infants starting at 6 weeks of age
Is the rotavirus vaccine injected?
No, given orally
What is the benefit to live attenuated vaccines?
Broader, stronger, and longer immunity
What are examples of live attenuated vaccines?
- MMR
- Varicella
- Yellow fever
- Oral typhoid
- Oral cholera
- Influenze (LAIV)
- Rotavirus
What are examples of inactivated vaccines?
- Poliovirus
- Influenza
What are purified or recombinant subunit vaccines? Do they provide better or weaker immunity and what does this mean for dosing?
- Given as protein (ex: toxoid), polysaccharide, or polysaccharide-protein conjugate
- Weaker immunity, so require multiple dose or adjuvant
What are examples of purified or recombinant subunit vaccines?
- DTaP
- Hib
- HBV
- Pneumococcal
- Meningococcal
Which vaccines produce the most adverse effects?
Live vaccines
