immunization quiz 2 Flashcards
identify patients that are at risk for covid
- age: >65 years and very young children
- conditions: obesity, diabetes, kidney disease, COPD, neurocognitive disorders, heart conditions
- conditions are additive for risk
explain risks of covid
- complications include pneumonia, myocarditis, blood clots, neurologic effects, long-COVID
- reinfection can happen
identify and explain when based on CDC recommendations patients should receive COVID vaccine
- primary series of 2 (or 1 Janssen) recommended. mixing not authorized for primary doses
- Janssen boosters: 1 bivalent booster
- age 12+ booster: 1 bivalent booster
- age 5-11: Pfizer booster (monovalent)
- age 6mo-4yrs: primary series only
- immunocompromised people get an extra dose of primary series (considered separate than booster)
- if patient has received monoclonal antibodies, wait 2 weeks after vaccination and continue with additional doses
identify vaccine specific adverse effects to covid
- injection site pain
- fatigue
- headache
- myalgia
- adverse effects tend to be mild to moderate, happening 1-2 days from vaccine
- can be more frequent and severe after 2nd dose
- kids: injection site pain, fatigue, irritability, drowsiness, febrile seizures possible, also tend to be mild to moderate overall
- myocarditis (but there’s a higher risk with infection than vaccine, most common in males 12-39, increasing intervals between doses may help)
- Janssen also has risk of thrombosis, only recommended if it’s the only option, tell patients to look out for symptoms up to 2 weeks after (shortness of breath, chest pain, leg swelling, persistent abdominal pain, headache, easy bruising)
- very rare anaphylactic reaction
explain dosage, storage, administration technique, and schedule for covid vaccine
- Pfizer age 6mo-4years: 0.2mL
- Pfizer age 5-11: 0.2mL primary series, 0.2mL booster
- Pfizer 12+: 0.3mL primary series, 0.3mL booster
- Moderna 6mo-5years: 0.25mL
- Moderna 6-11: 0.5mL
- Moderna 12-17: 0.5mL
- Moderna 18+: 0.5mL primary series, 0.25mL booster dose
- Janssen 18+: 0.5mL
- Novavax 12+: 0.5mL
- storage depends per vaccine but generally fridge or freezer?, usually ok 12 hrs from opening but varies per vaccine
- all IM
identify contraindications for covid vaccine
- history of severe allergic reaction to previous dose/ to a component of COVID vaccine
- diagnosed allergy to component of COVID vaccine
- Janssen: TTS following previous Janssen COVID vaccine
- Janssen: not recommended if history of immune syndrome related to thrombosis
- Janssen: not recommended if Guillain Barre Syndrome occurs within 6 weeks of previous dose
- Janssen: precaution with any history of GBS
- precaution if history of an immediate allergic reaction to any vaccine other than COVID
- precaution if a non-severe, immediate allergic reaction to a previous dose occurred
- precaution if moderately to severely ill
- precaution if history of MIS-C or MIS-A
- precaution if history of myocarditis or pericarditis after a dose of a COVID vaccine
identify patients that are at risk for HIB related disease
- crowded/ large household
- daycare
- school-aged siblings
- chronic disease (sickle cell, cancer, etc)
- low parental education
- low socioeconomic status
- males have slightly higher risk
- race/ethnicity: African-Americans, Hispanics, Native Americans
explain what is severe/invasive HIB disease
related diseases include:]
- meningitis
- epiglottitis
- pneumonia
- arthritis
- osteomyelitis and bacteremia
- 6% mortality rate
identify and explain when based on ACIP/CDC recommendations patients should receive HIB vaccine
-primary series of 2-3 doses at 2, 4, and 6 months with a booster at 12-15 months
identify HIB vaccine adverse effects
- local swelling, pain, redness
- systemic fever, fussiness
- severe reaction rare
explain dosage, storage, administration technique, and schedule for HIB vaccination
- 0.5mL administered IM
- stored in fridge
- catch up recommended up to 5 years old
identify valid contraindications for HIB vaccine
- no less than 6 weeks old
- evaluate combination vaccine components
- defer if moderate to severe illness
- do not give if there is a known allergy to the vaccine or its components
identify patients at risk for meningococcal disease
- most common in adolescents and young adults
- highest risk groups: <1 and 19-22, college students during outbreak, microbiologists, asplenia increases fatality chance, complement inhibitor, persistent complement deficiency
- host factors: deficiencies in terminal complement, asplenia, chronic underlying illness, genetic, HIV infected
- exposure factors: household exposure, recent viral infection, household crowding, exposure to cigarette smoke, microbiologists
explain serious health effects from becoming sick with meningococcal disease
- very rapid onset
- 10-20% mortality
- common complications when body goes into DIC: loss of limb, scarring, cerebral infarction
- common complications with meningitis in 50% of cases: hearing loss and neurologic damage
- meningococcemia in 40% of cases: high fever, rash, shock (hypotension and multiorgan failure), acute adrenal hemorrhage, death within hours of onset
identify and explain why patients require meningococcal vaccines based on CDC guidelines
- Bexsero (men b): approved for 10-25years
- Trumenba (men b): approved for 10-25 years
- recommended for everyone?
- at risk patients stay up to date on boosters, 1 vaccine lasts 3-5 years
- Menactra (A,C,W,Y): approved for 9mo-55years
- Meveo (A,C,W,Y): approved for 2mo-55years
- Menquadfi (A,C,W,Y): approved for 2+ years
