Immunizations Flashcards
Influenza vaccines available
IIV4, RIV4 or LAIV4
Influenza recommended ages
> 6 months (IIV4)
18 years (RIV4)
2 to 49 years (LAIV4)
Influenza dosing
1 dose annually during September/October
Children 6 months through 8 years who have only received one or no lifetime doses require 2 doses >4 weeks apart
Influenza efficacy
~50%, reduces symptomatic illness, medical visits, hospitalization, and death.
Immunity delayed 2 weeks after vaccination
Influenza contraindications
IIV4 and LAIV: h/o anaphylaxis
LAIV4 ONLY: Pregnancy, immunocompromise, children aged 2-4 yo w/ asthma, children/adolescents treated w/ aspirin/salicylates (risk of Reye syndrome), treatment with influenza antivirals within past 48 hours
Why is influenza vaccine modified annually?
Antigenic drift
What is antigenic drift
Gradual protein changes
What is antigenic shift
Drastic protein changes
Can you get the flu vaccine with an egg allergy
Heck yeah, get the cell-cultured or recombinant
COVID-19 vaccines available
Pfizer (COMIRNATY)
Moderna (SPIKEVAX)
Novavax
Recommended ages
Pfizer: 6 mo - 4 yo = yellow cap, 5 -11 yo = blue cap, 12+ yo = grey cap
Moderna: 6 mo - 11 yo = green label, 12+ yo = blue label
Novavax: 12+ yo = syringe
COVID-19 vaccine dosing
See dosing chart in notes
COVID vaccine efficacy
~90%
COVID-19 Contraindications
h/o anaphylaxis or an immediate allergic reaction to vaccine ingredients, including PEG
COVID-19 vaccine ADRs
Myocarditis and pericarditis (rare), most common in adolescents and young adult males. Mainly injection site reactions (pain, fever, fatigue).
Pneumococccal vaccines available
PCV15, PCV20, PPSV23
Pneumococcal recommended ages
PCV: >/= 6 weeks
PPSV: >/=2 years
Pneumococcal ADRs
Rare: febrile seizures in children when administered with IIV
Pneumococcal vaccine special considerations
Patients with asplenia are at a higher risk for invasive pneumococcal disease and require vaccination
When administering PCV15 and PPSV23, do the PCV15 first.
Tdap/DTaP contraindications
h/o anaphylaxis to the vaccine/components
*may contain latex, yeast, neomycin, polymyxin B, streptomycin
Encephalopathy of unidentified cause <7 days after vaccination with DTaP/Tdap
Tdap/DTaP Special considerations
Tdap is recommended every pregnancy in the early 3rd trimester (27-36 weeks)
Hepatitis A Contraindications
h/o anaphylaxis to the vaccine/components. Havrix and Vaqta have neomycin and pre-filled syringes contain latex
Twinrix contains yeast and neomycin
mRNA vaccines
Pfizer/Moderna COVID-19
Inactivated vaccines
HepA
IIV4
Pertussis
IPV
Recombinant vaccines
Novavax
HepB
HPV
Zoster
Conjugated vaccines
Hib
Meningiococcal
PCV15 and PCV20
Polysaccharide vaccines
PPSV23
Toxoid vaccines
Tetanus and diphtheria
Live-attenuated vaccines
LAIV4
MMR
Rotavirus
Varicella
Ultracold freezer vaccine
Pfizer COVID-19
Freezer vaccines
Moderna COVID-19
MMR-II
MMRV
Varicella
Room temp vaccines
Pfizer COVID-19
Moderna COVID-19
MMR Priorix
Vaccines to protect from light
Novavax
LAIV4
MMR-II
MMR Priorix
MMRV
Zoster
Vaccines given SQ
PPSV23
IPV
MMR
MMRV
Varicella
Vaccine administered intranasally
LAIV4
Vaccine administered orally
Rotavirus
DTap-IPV vaccine
Kinrix
Quadracel
DTaP-IPV-Hib vaccine
Pentacel
DTaP-IPV-HepB vaccine
Pediarix
DTaP-IPV-Hib-HepB vaccine
Vaxelis
HepA-HepB vaccine
Twinrix
MMRV vaccine
ProQuad
Meningococcal ABCWY vaccine
Penbraya
HepB vaccine contraindications
h/o anaphylaxis to the vaccine or its components like latex.
Twinrix: yeast and neomycin
Pediarix: neomycin and polymyxin B
Vaxelis: neomycin, polymyxin B, streptomycin
HPV vaccine dosing
2 doses age 9-14 years
3 doses age 15-49 years, or if immunocompromised
HPV contraindications
h/o anaphylaxis and during pregnancy
MMRV special considerations
Live attenuated viruses must be given on the same day or at least 4 weeks apart
Delay TST for 4 weeks unless given ont he same day
Administer separately for 12-15 month dose
Rotavirus vs RotaTeq
Rotarix: 2 doses
RotaTeq: 3 doses
Rotarix has latex in oral applicator
