Class 8 - vaccines preventable diseases Flashcards
define herd immunity
refers to the immunity of a population against a specific infectious disease. The resistance of the population to the spread of an infectious disease is based on the percentage of people who are immune and the probability that those who are still susceptible will come into contact with an infected person
How many people are required to be immune to reach herd immunity
- Depends on several factors
- important one being the transmissibility of the infectious agent either from a symptomatically infected person or from an asymptomatically colonized person
In which situations do we initiate immunizations?
- once passive immunity from mother is lost
- communicable disease are a real risk to the infant
- immune system capable of an adequate response
- prematurity (> 28 wks is regular schedule, <28wks dependable)
Are immunization schedules the same across Canada?
Technically no; NACI provide suggestions to provinces, and provinces will take suggestion and create their guidelines accordingly
What are examples of vaccines not covered under Manitoba Health
- RSV
- Shingles
What does informed consent look like for immunizations
- public education (S&S, use, etc)
- legalities of consent (mature minor, language/culture)
- documentation (consent form, vaccine name, manufacture, lot #, site/route, date + time)
- health care provider/client communication
What is considered a special population for immunizations
- children (infants + school setting)
- people with disabilities/chronic illness
- uniformed & unwilling
What are ways to prevent adverse reactions from vaccines
know the potential contraindications:
- anaphylaxis to a component of the vaccine
- significant immunosuppression (live vaccine only)
- pregnancy (live only)
- review vaccine ingredient-specific contraindications in advance
Examples of contraindications for vaccines
- anaphylaxis to a component in the vaccine
- egg allergy (varies)
- febrile seizures
- pregnancy
What are common symptoms of an anaphylactic shock
- sneezing, coughing
- itchiness
- “pins & needles” sensations
- flushing
- facial edema
- hives
- respiratory difficulties
- shock/collapse
- anxiety
What are common symptoms of a syncopal episode
- pallor
- slow pulse
- saliva
- nausea
- vomiting
- sweating
What are the treatment steps in case of an anaphylactic shock
- activate EMS (dial 911)
- place person in supine position (feet elevated)
- admin adrenaline IM into large muscle (avoid site of injection), up to 3x
- monitor vitals
- admin diphenhydramine IM
- transport to hospital
- documentation (AEFI)
What are the treatment steps in case of a syncopal episode
- lowering head
- raising feet
- deep breaths
- responds quickly…
Define natural immunity
acquired from exposure to the disease organism through infection with the actual disease
Define acquired immunity
immunity you develop over your lifetime. It can come from:
- vaccine
- exposure to an infection or disease
- another person’s antibodies (infection-fighting immune cells)
Define active immunity
- results when exposure to a disease organism triggers the immune system to produce antibodies to that disease
- can be acquired through natural immunity or vaccine-induced immunity
Define passive immunity
provided when a person is given antibodies to a disease rather than producing them through his or her own immune system
Who is eligible for influenza vaccine
- 6 month of age or older
- (high-dose) 65 years of age and older
- international student and out-of-province visitors
Which vaccine preventable disease has been eliminated in Canada? (2019)
- polio
Which diseases do we continue to see excess of 1,000 cases per year?
- mumps
- Hep B
- Pertussis
Which vaccines are the most cost effective
- influenza for >65yr = $45
- MMR for kids = $16
- pneumococcal >65yr = $8
- DTaP for kids = $6
National guidelines for immunization, guidelines (1-8)
1) Immunization services should be readily available.
2) facilitate timely receipt of vaccine and eliminate unnecessary prerequisites
3) screen for needed vaccines and administer all vaccine doses for which a vaccine recipient is eligible at the time
4) communicate current knowledge about immunization using an evidence-based approach.
5) should inform, in specific terms, about the risks and benefits of vaccines
6) recommend deferral or withholding of vaccines for true contraindications only
7) vaccinations are accurately and completely recorded
8) maintain easily retrievable summaries of immunization records
National guidelines for immunization, guidelines (9-16)
9) report clinically significant adverse events following immunization (AEFI) promptly
10) report all cases of vaccine-preventable diseases
11) adhere to appropriate procedures for the storage and handling
12) maintain up-to-date, easily retrievable immunization protocols
13) properly trained and maintain ongoing education
14) errors and immunization-related incidents should be reported to local jurisdiction
15) operate an immunization tracking system
16) Audits should be conducted to assess the quality of records and the degree of coverage.
To be considered interchangeable, the vaccines should:
- be authorized with the same indications and with equally acceptable schedules,
- be authorized for the same population,
- contain comparable type and quantity of antigen,
- be similar in terms of safety, reactogenicity, immunogenicity and efficacy.
Should one aspirate when immunizing?
Aspiration prior to injection of vaccine is not recommended
What is the cold chain and why is it important?
- process used to maintain optimal conditions, particularly temperature, during the transport, storage and handling of vaccines, (from manufacturer to administration)
- Monitoring of vaccines’ cold chain is required to ensure that these products have been stored and transported at recommended temperatures and in correct conditions.
What are negative consequences of breaks in the cold chain
- exposed to temperatures above the recommended temperature range may experience some loss of potency with each episode of exposure
- vaccines containing an aluminum adjuvant experience a permanent loss of potency due to adjuvant clustering when subjected to freezing and thawing.
- Freezing of a vaccine or diluent may cause cracks in the container which may lead to contamination of the contents.
Why/How does blood products, or human IG impact timing of immunization
can interfere with the immune response to parenteral live virus vaccines if given concomitantly with or shortly before or after the vaccine
DTap-IPV-Hib (5 in 1) =
diphtheria, tetanus, pertussis, polio, HID
Tdap =
tetanus, diphtheria, pertussis
Td =
tetanus, diphtheria
