Immunizations Flashcards
FDA approves the indication of a vaccine based on
demonstrated safety and efficacy
Who provides recommendations for vaccine administration?
ACIP
Who approves ACIPs recommendations? Where can you find them?
CDC approved
Publishes on Morbidity and Mortality Weekly Report (MMWR) and The Pink Book
Where can you find VISs
CDC and Immunization Action Coalition websites
Medical term for antibody
Immunoglobulin
Active immunity
A persons own immune system creates antibodies
Vaccine, infection
Passive immunity
Maternal immunity
IVIG products
Live vaccines
MICROVY
MMR
Intranasal influenza
Cholera
Rotavirus
Oral typhus
Varicella
Yellow Fever
Polysaccharide vaccines should not be used in
Children <2 years old (do not produce good response)
Example- Pneumococcal Polysacharide vaccine (Pneumovax 23)
Conjugate vaccines
Conjugation increases the immune response in infants
-Pneumococcal conjugate vaccine (Prevnar 13)
-Meningococcal Conjugate Vaccine (Menactra)
Interval between an antibody containing product (IVIG) and MMR or varicella vaccine
3-11 months
Which inactivated vaccine is started at birth?
Hepatitis B
The rest are started at 2 months old
Live vaccines and the TB skin test
1.) Give live vaccine on the same day of TST
2.) Wait 4 weeks after live vaccine to perform TST
3.) Administer TST, wait 48-72 hours to read, then give live vaccine
Vaccine spacing
- Multiple vaccines can be given on the same day or spaced 4 weeks apart
- If vaccine series requires >1 dose, intervals can be extended but should not be shortened
Recommended spacing of live vaccines and antibody products
Vaccine –> 2 weeks–> antibody product
Antibody product–> 3 months–> vaccine
How long should a pt be monitored after a vaccine?
At least 15 minutes
When do systemic reactions occur with live vaccines?
Can occur 3-21 days after the vaccine is given
Intranasal flu vaccine can replicate
mild cold
How many epi pens should be available when administering vaccines?
at least 3
Influenza vaccine is recommended for
Annually for all patients >/= 6 months
Shingles vaccine is recommended for
All adults >/= 50
>/= 19 if immunosuppressed
2 dose series, second dose given 2-6 months after
Pneumococcal vaccine recommended for
19-64 to with AUD, cigarette smoking, DM, chronic heart, lung, or liver disease, asplenia, HIV, malignancy, transplant, CKD,or taking immunosupressive drugs
Age >/=65 in all patients
-PCV20 x1
-PCV15 x 1 followed by PPSV23 >1 yr later
Hepatitis B is recommended for
All adults 19-59 and patients >/= 60 with RF
HPV is recommended for
Adults </= 26 who did not complete the series
Meningococcal vaccine is recommended for
all adults
2 vaccines, adults need 1 or both
-Serogroup B vaccines
Conjugate Vaccines
Vaccines for infants/children
3 dose hep B at birth
2 months old- PCV13, DTaP, Hib, polio, rotavirus
Live vaccines at >1 year- MMR, varicella
Adolescents and young adults vaccines
Meningococcal vaccine (Menactra, Menveo, Menquadfi)
-2 doses 1 at 11-12 yo and 1 at 16 yo
-1 extra dose as 1st year college student in dorms
HPV at 11-12 yo
Tdap at >11
Vaccines for older adults
Shingles >50
Pneumococcal >65
-PCV20x1
-PCV15x1 then PPSV23 >12 months later
Vaccines to give for patients with DM
Pneumococcal (19-64)
-PCV20x1
-PCV15x1 then PPSV23 >12 months later
Hepatitis B
Vaccines to give to HCP
Annual influenza vaccine
Hepatitis B
Tdap
Varicella
MMR
Vaccines to give in SCD or asplenia
H. influenza type B (HiB) vaccine
Pneumoccocal vaccine
-PCV20x1
-PCV15x1 then PPSV23 >8 weeks later
Meningococcal vaccines
-Conjugate AND Serogroup B (Bexsero or Trumenba)
Vaccines to give in immunodeficiency
Pneumococcal
-PCV20x1
-PCV15x1 then PPSV23 >8 weeks later
HIV- meningococcal conjugate, hepA, hepB
Haemophilus influenza Type B (HiB) vaccine
Given to adults with asplenia
Havrix
Hep A vaccine
VAQTA
Hep A vaccine
Pediarix
DTaP, HepB, IPV
HPV vaccine regimens
Start before age 15- 2 doses
Start after age 15- 3 doses
Influenza A surface antigens
Hemagglutinin
Neuraminidase
Aged 6 months to 8 years not previously vaccinated for flu
Give 2 doses 4 weeks apart
Patients with egg allergy and flu vaccine
Can get any inactivated flu vaccine
Flublok is egg free for >18
Flucelvax is egg free >12
Which flu vaccines are for patients >/= 65 years old
Fluzone High dose Quadrivalent
Fluad Quadrivalent
ProQuad
MMR + Varicells
MMR storage
fridge or freezer
ProQuad storage
Freezer
Diluents for MMR vaccines
Store at RT or in fridge
Menveo admin
Both vials contain vaccine
MenB vaccines are for
> /=10 years old with asplenia
Children <5 receive which pneumococcal vaccine as part of routine vaccination?
PCV13 (prevnar 13)
PPSV23 admin
IM or SC
Rotavirus vaccines are given
orally
RabAvert
1 dose rabies immune globulin with the first dose of vaccine
2 doses needed
Oral typhoid vaccine
Complete at least 1 week prior to exposure
Store in fridge
Take on empty stomach with cold or lukewarm water
Typhoid vaccine injection
At least 2 weeks prior to exposure
Yellow fever vaccine is contraindicated in
severe (life-threatening) allergy to eggs or gelatin
Cholera vaccine storage
Freezer
Can you place vaccines in fridge doors?
no
Temperature logs for vaccines
Read at least twice per work day
Keep for 3 years
Vaccines stored in the freezer
Varicella
MMRV
Oral cholera
SC only vaccines
MMR
MMRV
Varicella
Yellow Fever
PO vaccines
Typhoid (Vivotif)
Cholera
Rotavirus
SC administration
5/8” needle at 45 degree angle in the fatty tissue over the triceps
IM administration
90 degree angle into the deltoid muscle
IM needle length- 1 inch
If <130 lbs use 5/8-1 and if very overweight use 1 1/2 “
