Immunization Background + Principles Flashcards
Routine vaccinations are recommended for…
Everyone - children, adolescents, + adults against vaccine-preventable diseases
Additional vaccines are usually recommended for…
Individuals at high-risk
Primary goal of immunization programs is to…
Protect individuals + communities from disease
Prevent, control +/- eliminate transmission
Canadian guidelines + recommendations for immunizations are made by…
National Advisory Committee on Immunization - NACI
SK - Saskatchewan Immunization Manual (SIM)
Good times to check in with patients regarding immunization is…
Annual flu/COVID vaccination
Medication reviews
New diagnosis that requires immunosuppressive therapy
Pregnancy
Dispensing medication for an infection
Also travel
An immunogen/antigen is…
The substance that stimulates/triggers an immune response
An immunuoglobulin/antibody is…
Protein produced in response to antigens, which protect the body from disease
The definition of a vaccine is…
A highly regulated, complex, biological product designed to induce a protective immune response
The adaptive immune system develops…
As a result of infection, or following immunization
Immunology memory
The innate immune system…
Does not produce immunologic memory - 1st line of defense
Herd immunity is required to…
Prevent person-to-person transmission of infectious diseases
Different types of vaccines include…
Monovalent - one immunizing antigen
Bivalent, trivalent, quadrivalent - multiple immunizing antigens to cover for multiple serotypes of a disease
Combination of immunizing antigens against 1+ vaccine preventable disease
An attenuated (live) vaccine is defined by…
Whole, weakened bacteria/virus that replicates, to induce an immunologic response
Because attenuated vaccines replicate bacteria/virus, there is a small risk of…
Infection - contraindicated/cautioned in immunocompromised patients
Inactivated vaccines are defined by…
Whole/parts of an inactivated bacteria/virus, or toxoids given to induce immunologic response - NON-replicating
Safe for immunocompromised patients
This type of vaccine requires boosters to maintain adequate titres after the primary series…
Inactived vaccines
These vaccines are replicating (attenuated):
MMRV, rotavirus, typhoid
An adjuvant…
Increases immunogenicity/antigenicity and prolongs antigen absorption
Does cause patient to feel more ill/sting more
Factors that may affect vaccine response include…
Viability of antigen, antigen dose
Patient age + immune status
Route + site of administration
Timing
Vaccine storage
Vaccine route of administration are given via..;.
IM, SC, PO
Multiple vaccinations can be given in the same visit. However, live vaccines…
Need to be given on the same day, or separated by 4 weeks between live vaccines
Regarding vaccine interchangeability, we should ideally…
Complete vaccine series with the same product - however most vaccines can be used interchangeably to complete series if vaccine is not available
EXCEPTIONS: Pneumococcal, meningococcal
Consider special populations (pregnancy, dialysis)
If a vaccine schedule is interrupted…
The series does not need to be restarted, regardless of time between doses
Contraindications to receiving immunizations includes…
Anaphylaxis to previous vaccine, or to egg
GBS syndrome within 6 weeks of immunization
Live vaccines - pregnancy, immunocompromised
If someone is sick, can they receive their immunizations?
Okay to give vaccine if mild URTI +/- fever
Expected AE’s from immunizations that are local include…
Tenderness
Redness
Swelling
Injection site pain
Expected AE’s from immunizations that are systemic include…
Fever
Irritability/fussiness (children)
Drowsiness, lethargy
Decreased appetite
Syncope
Pain management strategies for immunizations may include…
Topical anesthetics
Sucrose
Breastfeeding
Evidence of analgesics for immunization pain management…
No evidence of benefit to reduce pain if taken prior/at injection. Potential concern of reducing immune response; but may give 4 hours post vaccine, for first 1-2 days
Inactivated immunizations should be coordinated with immunosuppressants…
Try to give 2+ weeks before starting therapy if possible, but safe if given while on therapy
Live immunizations should be coordinated with immunosuppressants…
Give 4+ weeks before starting therapy, or delay until after treatment is discontinued +/- waiting period
Replicating = infection risk
If someone is on antithrombotics and wants an immunization…
Caution - bleeding risk
