Immunizations (13-15 ques)

Question 1

Contraindications for all vaccines

Answer 1

1. hx of life threatening rxn to previous dose of the vaccine
2. mod to severe acute illness (fever, ear infection)

Question 2

Contraindications for LIVE vaccines

Answer 2

immune suppression (includes chemotherapy)
Live vacc --> MMR, varicella, rotavirus, nasal influenza)

Question 3

Live vaccines

Answer 3

MMR
Varicella
Rotavirus
Nasal influenza

Question 4

When to call provider after vaccination

Answer 4

• s/s of severe adverse rxn
• high fever
• behavioral changes
• unconsolable
• unwakeable

Question 5

Recognizing an adverse reaction

Answer 5

• difficulty breathing
• hoarseness or wheezing
• hives
• pallor
• lethargy
• dizziness
• tachycardia
• typically occur w/in the first few minutes to hours of vaccine admin

Question 6

General rule of vaccination side effects

Answer 6

• teach parents give antipyretic only when needed
• do not pre-medicate
• typically, children experience none or mild SE

Question 7

Side effects of Live Vaccines

Answer 7

• typically occur 2-4 weeks after administration
• mimic the actual disease
• varicella –> vaccine induced rash can be contagious
• rotavirus –> virus is shed in stool for up to 14 days

** avoid contact w/immunocompromised people

Question 8

administration sites

Answer 8

IM injections

• vastus lateralis - up to 18 mos
• deltoid - 18 mos & up (18 mo to 3 yr: use deltoid only if enough muscle - judgement call)

Question 9

MMR administration/contraindication

Answer 9

two doses: 12-15 mos & 4-6 years
Contraindication: <12 mos b/c still have maternal antibodies

BUT - if a measles outbreak, <12 mo can get a dose
DOES NOT COUNT as part of MMR series

Question 10

HPV administration

Answer 10

Given to boys & girls between 11-12 yo (can be given 9-26)

• most effective if given before exposure to HPV
• 2nd dose 6-12 mo after first one