3: MMR, Varicella and Zoster, Rotavirus Flashcards
Which patients are at risk for rotavirus related disease?
below 5 years old (if unvaccinated)
Explain why patients are recommended to get the rotavirus vaccine?
asymptomatic, diarrhea, dehydration, fever, and vaccine can provide 80-90% efficacy against any rotavirus gastroenteritis
What dose is rotavirus given?
Rotateq (RVS): 3 - 2ml dose series @ 2, 4, 6 months old
Rotarix (RVI): 2 - 1ml dose series @ 2 and 4 months
What age range is rotavirus given?
Rotateq (RVS): older than 6 weeks but younger than 32 weeks
Rotarix (RVI): older than 6 weeks but younger than 24 weeks
What is the difference between rotateq (RVS) and rotarix (RVI)?
RVS - oral live human bovine virus vaccine
RVI - oral live human rotavirus
LATEX ALLERGY
What would you do if a baby spits up their rotavirus vaccine?
count it the original dose (DONT REPEAT DOSE)
What are the adverse effects of rotavirus?
- irritability
- diarrhea
- vomiting
- intussusception
Contraindications of rotavirus
- severe allergic reaction to a vaccine component (including latex)
- history of intussesception
- severe combined immunodeficiency (SCIDS)
- history of uncorrected congenital GI malformations
Who is at risk for varicella related diesase?
- infants
- adults
- pregnant –> congenital varicella syndrome (birth defects)
- immunocompromised
What does varicella virus cause?
acute infection (Chickenpox) and persists in latent (hidden) form in ganglionic nerve fibers (which may reactivate)
What are symptoms of chickenpox/varicella virus?
- fever
- itchy rash
VERY CONTAGIOUS
Name adverse effects of varicella vaccine and MMRV.
varicella: injection site reactions, fever
MMRV: fever, febrile seizure, and rash
(safer for MMR and varicella to be given seperately)
severe adverse effects in patients with T-cell dysfunction – uncontrollable disease
What is the dose for MMRV and varicella vaccine?
0.5 ml per dose
2 doses - 28 days apart
How is MMRV and varicella stored?
live - frozen between -58 and 5 degrees
Specifications of MMRV vaccine
ONLY approved for 1-12 years old WITHOUT HIV
- NOT recommended for children with a hsitory of seizures
Describe varicella immunity
if NOT pregnant or a healthcare provider, being born before 1980 will make you immune.
How/when would you vaccinate a non-immunized adult for varicella?
give 2 doses. seperated by 4-8 weeks
during a varicella outbreak
- second doses have been used to control outbreak
Contraindications of varicella vaccine
- moderate to severe disease
- allergy to components of vaccine
- pregnant
- immunosupressed
- patients on medications that will interfere with vaccine
What is herpes zoster?
Shingles
Shingles patients can develop…
post herpetic neuragia (PHN)
What population is at high risk of herpes zoster?
- Immunocompromised patients (more severe)
- older patients with shingles (>50)
How is the zoster vaccine administered?
INACTIVATED
2 - 0.5ml IM
- healthy patients seperated by 2-6 months
- immunocompromised patients (1+ months)
How is the zoster vaccine stored?
refrigerated
What are adverse effects of RZV (Shingrix)
- pain
- tiredness
- headache
Who is the zoster vaccine recommended to?
- immunocompetent adults 50+
- immunocompromised adults 19+
Contraindications of shingrix (RZV)
- severe allergy to any component of vaccine
- no data to say if its safe for pregnancy or lactation
Serious health effects of getting measles.
- fever, cough, runny nose
- rash that starts from the hairline and desends
- pneumonia
- encephalitis
- SSPE (subacute sclerosing panencephalitis)
VERY CONTAGIOUS
What are health effects of getting mumps?
- parotitis
- inflammation of the testes
- inflammation of the ovaries
What are health effects of getting rubella?
- rash that starts from the hairline and descends
- fever, headache
How is the MMR vaccine stored?
MMR - live in the refrigerator or freezer
MMRV - in the freezer
How is the MMR vaccine administered?
2 - 0.5ml SC @ 12-15 months and 4-6 years
What ages do patients usually get caught up with MMR?
1) 11-12 years old
2) women of childbearing age (cannot vaccinate when pregnant)
3) healthcare workers
Which populations are considered high risk?
- school age children
- college students
- healthcare personnel
- international travelers
What to do if you are planning to travel to a measles endemic area?
if unimmunized or under immunized, one dose of MMR (min. 6 months old)
IF recieved a dose between 6 and 11 months, it doesn’t count -> will have to recieve 2 additional doses of MMR/
What to do if an unimmunized patient has been exposed to measles?
- if within 72 hrs of exposure, give 1 dose of MMR vaccine (min. 6-12 months old)
- if they cannot get the MMR, give IGIM to persons younger than 12 months or >12 months and cannot recieve MMR (within 6 days of exposure)
- if they cannot get the MMR, give IVIG to pregnant non-immune women and severely immune suppressed patients (within 6 days of exposure)
Which disease is recommended to receive a 3rd dose of the MMR vaccine if outbreak has occurred?
Mumps
Can MMR be given at the same time as other live vaccines?
Yes, it should be given the same time or seperated by 28 days.
Also do the tuberculin skin test the same time if needed.
What are some adverse effects of the MMR?
- high fever
- rash
- in post-pubertal females: transient arthragia and arthritis
- rare: thrombocytopenia
What are contraindications of the MMR vaccine?
- severe allergic reaction (gelatin + neomycin + eggs)
- moderate to severe illness OR active TB
- pregnant
- immunosuppressed
- recent receipt of antibody containing products
- individuals who cannot handle a fever
- thrombocytopenia
