Immunizations Flashcards
Diptheria
Agent: Formalin-inactivated diptheria toxin
Route: IM with tetanus toxoid as DTap, DT, Td, or Tdap
Indications: Childhood immunization?
Schedule: As DTaP
dose 1 at 6 weeks
dose 2 at 4 months
dose 3 at 6 months
dose 4 at 15-18 months
dose 5 at 4-6 yrs
Booster: 11-12 years old if 5 years since last dose, then every 10 years
Side Effects: Local reactions, uncommonly systemic symptoms (fever, HA, n/v, diarrhea, stomach ache, joint pain, rash). Severe systemic are rare.
CI: Severe allergic reaction to vaccine component or following prior dose. Severe adverse reaction… Same as TDaP
Tetanus
Agent: Formalin inactivated tetanus toxin
Route: as diptheria, part of tdap
Indications: Haven’t had a booster in 10 yrs. Pregnant women begin after 20 weeks. Booster after exposure to tetanus.
Schedule: 5 doses, booster every 10 years
Side effects: Local effects, same as diptheria?
CI: Same as TDaP
Pertussis
Agent: acellular
Route: Same as TDaP
Indications: childhood immunizations. Pregnant women each pregnancy
Schedule: TDaP schedule
Side effects: 90% fewer in acellular. Local pain and erythema. At least one booster from Tdap formulation
CI: Same as TDaP
Haemophilus Influenzae b
Agent: Polysaccharide-based conjuage vaccine
Route: Pointy needle?
Indications: Adults and over 5 yrs if they have sickle cell, HIV/AIDS, asplenia, bone marrow transplant, immunocompromised cancer tx.
Schedule: 1st dose 6 weeks
2nd dose 4 mos.
3rd dose 6mos.
Booster 15-18 mos.
Side effects: Local effects. Systemic, rash, fever, anorexia, diarrhea, vomiting.
CI: Allergic reaction to vaccine
Adverse reaction to vaccine
Children less than 6 wks old
MMR
Agent: Live attenuated
Route: SubQ
Indications: Susceptible kids and adults without documented immunity. Non pregnant women of childbearing age, specifically borne outside the U.S.
Schedule: 1st dose 12-18 mos.
2nd dose 4-6 yrs
Side effects: Local effects?
CI: Pregnancy, allergic reaction to vaccine, allergic reaction to neomycin, immunosuppression.
Varicella
Agent: Live attenuated vaccine (Varivax)
Route: SubQ
Indications: Sure, let’s have some.
Schedule: 1st dose 12-15 mos.
2nd dose 4-6 yrs, or sooner, as long as its more than 3 months between shots.
Side effects: Local effects, rash, uncommon systemic reactions.
CI: Pregnancy, allergic reaction to vaccine, immunosuppression,
Zoster
Agent: Live attenuated vaccine (Zostavax)
Route: SubQ
Indications: Routine vaccination of all pts. over 60 yrs old, including ones with previous episode of zoster.
Schedule: Single dose?
Side effects: Local effects, rash uncommon systemic reactions.
CI: Pregnancy, allergic reaction to vaccine, immunosuppression,
Hepatitis A
Agent: Inactivated whole virus. Pediatric and adult formulations.
Route: IM
Indications: All children between 1st and 2nd birthdays.
international travelers. Men who have sex with men. Illegal drug users. People with occupational risk. People with chronic liver disease.
Schedule: 1st dose 12-23 mos. 2nd dose separated by 6-18 mos.
Side effects: Local effects. Systemic malaise, fatigue, fever
CI: Severe allergic or adverse reaction to vaccine or dose
Hepatitis B
Agent: Inactivated vaccine Route: IM Indications: Routine for children. At risk populations; Non monogamous sexually active persons, male homosexual sex, people seeking tx for an STI, IVDU, contact with hep-b positive people, residents and staff in facilities serving dd population. Occupational exposure, people with end stage renal disease, International travelers, HIV infected people. Schedule: 1st dose birth 2nd dose 6 weeks 3rd dose 6-18 mos. Adult: 0, 1 month, 6 months Side effects: Local effects? CI: Severe allergic/adverse reaction to vaccine/dose
Influenza
Agent: Injectable inactivated vaccine. Intranasal Live vaccine
Route: IM, nasal
Indications: Recommended yearly. 6 mos. to 8 yrs should get 2 doses the first year they are vaccinated
Schedule: Yearly vaccinations, try to begin in October.
Side effects: Inactivated- Local effects, fever malaise, allergic reactions, neurological. Live- nasal problems, HA, sore throat. Rare-anaphylaxis, Guillain-Barre syndrome, Bell’s palsy, asthma.
CI: Inactivated-Severe allergic reaction to vaccine component, (egg) or following a dose of vaccine. Live-Immunosupression, pregnancy, children younger than 2, older than 50. anaphylactic egg allergy. Hx Guillain-Barre syndrome.
Pneumococcal
Agent: Conjugate or polysaccharide
Route: IM, SubQ
Indications: Over 65 yrs old. 2-64 yrs and immunocompromised or chronic medical conditions. 19-64 yrs old smoker or has asthma.
Schedule: PPSV 1 dose, 2 if 65yrs or older and got 1st dose more than 5 yrs ago. 2-64yrs old immunocompromised.
Side effects: Local effects, fever, myalgia
CI: Severe allergic reaction to vaccine or following a dose. Moderate or severe acute illness.
Meningococcus
Agent: Conjugate vaccine (Menactra) and polysaccharide vaccine (MPSV4)
Route: IM
Indications: 2 doses for adolescents 11-18 yrs old. 3 doses for same demographic with HIV
Schedule: 1st dose 11-12 yrs
booster at 16
OR 2 doses 2 mos apart at 11-12 and booster at 16 for HIV
Side effects: Local effects, Systemic: HA, malaise, fatigue.
CI: Severe allergic reaction to vaccine component or dose
Human Papillomavirus (HPV)
Agent: Quadrivalent (Gardasil) Bivalent (Cervarix)
Route: IM?
Indications: All adolescents 11-12 yrs old. Catch up for 13 to 26 yrs old.
Schedule: 0, 2, 6 months 3rd dose follow first by at least 24 weeks. Accelerated schedule not recommended.
Side effects: Local effects. Fever.
CI: Severe allergic reaction to component of following a dose. Should not vaccinate during pregnancy.
Rotavirus
Agent Live attenuated. (Rotateq) (Rotarix)
Route: Oral
Indications: Childhood immunization
Schedule: 1st 6 wks., 2nd 4 mos., 3rd 6 mos. minimum interval 4 wks.
side effects: Vomiting, diarrhea, irritability, (probably because of the diarrhea), Fever. Intussusception.
CI: Severe allergic reaction to a vaccine component or prior dose.
Polio
Agent: Inactivated virus
Route: IM?
Indications: Get it so you don’t kill us all you fool! Children under 18.
Schedule: 6 wks, 4 mos., 6-18 mos., booster at 4-6 yrs.
Side effects: Local effects.
CI: ? Allergic reaction.
