Immune * Flashcards
Prevention of infection *
Live attenuated viruses provide broader, longer lived immunity compared to inactivated types
IgG may not ensure local mucosal protection (IgA)
Three schedules for childhood vaccines- 0-6, 7-18 catch up for 4mth-18 years, one schedule for adult 19 and older
ACIP guidelines for vaccine *
Doses may be given 4 days prior/later than specified date
Give live virus vaccine at least 28 days apart
Space vaccine injections 1 inch apart no need to aspirate
Reimmunization is not harmful
Reduced doses should not be given
Recognize response to AE
Vaccine failure can occur with improper transport and storage
May have accelerated schedule for travel
Major contraindications is anaphylaxis
Any dose vaccine not given at recommended age should be given at next encounter
Combination vaccine preferred over separate injections
Dtap/Tdap*
Diphtheria and tetanus toxoid pertussis DTaP-acellular pertussis for those less than 7 years
Tdap-for those greater than 7 years
Controlling pertussis in young infants may depend on giving booster to older children/adults
Tetanus prophylaxis as part of wound care
Inactivated
4-5 doses of DTap, then Tdap at 11-12 years
Booster every 10 years or presence of wound
Tdap to be given during each pregnancy at 27-37 weeks
Polio *
Polio vaccine- only in US, concern for polio resurgence
Inactivated
Haemophilus influenza *
HI type B vaccine-pneumonia, epiglottis
Inactivated
Hepatitis *
Hepatitis A-prevent transmission to adults
Hepatitis B- given at birth/infant
HPV, complete series by 6 months, post vaccine serology 9-12 months of age or 1-2 months post last dose
Hep Bs ag and antihep Bs, may need 3 or 4 doses
Inactivated
HPV*
For females and males
Contraindicated in pregnancy
Inactivated
Influenza vaccine *
Inactivated
Formulation based on epidemiological data, annual
Meningococcal *
Inactivated
For Neisseria meningitis
Pneumococcal- PCV 13 covers 13 serotypes
PCV 23 for children greater than 2 years at high risk
Considerations for inactivated vaccine *
Fever and local reaction may occur within 24-72 hours
Anaphylaxis to prior dose, neomycin, polymyxin B or strepmycin contraindicated in IPV
Allergies to vaccine components/yeast contraindicate for HBV, IPV
Moderate to severe infection contraindicated for HPV/HIB vaccine
Considerations for live vaccine *
Consult with ID if immunocompromised
Cannot given with IGIV therapy
Bacillus calmette guerin vaccine*
Live
To prevent spread of TB not routinely used in US
MMR *
Live
Measles- more responsible for adverse reactions
Mumps
Rubella- given to females greater than 13 years who do not have documented immunity
Children need 2 doses at 12-15 months and 4-6 years
Varicella *
Live
Localized pain, erythema; some may develop rash
Rotavirus *
Live
History of intussusception or SCID is contraindicated