Immunizations Flashcards
Zoster:
Single dose ≧ 60 years of age
*must have had chickenpox perviously
Contraindicated in Pregnancy
Prevents: Neuralgia, scarring, ocular abnormalities
ADRs for “Varicella”
**Do not give salicylates for 5 weeks: Risk of Reye’s Syndrome
**Maculopapular rash 5-26 days after vaccination; usually only 2-5 lesions.
Varicella: Post-Exposure prophaysis
Vaccine - 90% effective if administered within 3-5 days
Varicella Zoster immunogloblin (VZIG)
Varicella: Combination
MMR + V or MMRV
higher risk of febrile seizures
Measels Mumps Rubella (MMR)
Given at ≧ 12 months
Live Vaccine
No evidence of MMR with Autimsm
MMR why?
Measles: Upper respiratory and neruologic
Mumps: sterilization of adult male
Rubella: taratogenic disease
Meningococcal: Contraindications
Allergy to any component of the vaccine including diptheria and tetanus toxid
Special indications: Meningococcal
Requires Booster q 5years
Asplenia
Sickle cell
Microbiologists??
Meningococcal: AE
GBS (rare)- higher in adolescent males
Syncope
Meningococcal: Preventes
Menigotilus infections
Meningococcal: Adminstration
ages ≧ 2 mo to 10 years if at risk
first dose at 11-12 years then booster at age 16
one dose if given at 12-18
can catch up dose at 19-21
Human Papillomavirus Vaccine (HPV):
Contraindications
Allergy to any component of the vaccine
Immediate hypersensitivy response to yeast
HPV2 vaccine - latex allergy
HPV: AE
rare: Gullian-Barre Syndrome (GBS)-Thromboembolic disorder w/other risk factors
Common: HA, N, local rxn, Synocope–Patient must sit or lie down for 15 minutes.
HPV: Dosing - Administration Schedule
3 doses between 9 - 26 years:
between 1st and 2nd -> 1-2 months ( mim, interval 4 wks)
between 2nd and 3rd- 12 wks
between 1st and 34d –> 6 months
Should women with HPV still recieve vaccine?
Yes, if already infect there are still other stains which the patient can catch.
HPV4
Gardasil: all 4 types: 6,11,16,18
Types 6,11 associated with?
Genital Warts
Tyeps 16 and 18 associated with?
Vaginal, cervical, and penile cancers (leisons)
HPV2 - Bivalent vaccine
Cervarix: 16,18
Only approved for woemn
HPV- 9
Covers 9 strians
approved for males 9-15
females 9-26
HPV: indications
All females at 11-12 yrs up to 26
Males: Recommend 11-12 years
Immunize all males 13-21 years
May immunized 22-26 years
Why immunize Pneumococcal?
bacterial disease not only causes pneumonia.
Symptomatic: Septicemia, and meningitis
non-invasive: pneumonia, sinus infections, otitis media
Incident greatest in adults > 65 years
Pneumococcal Vaccines:
Conjugate -> PCV-13
Polysaccharide - > PPSV23
Pneumococcal indications: children
4 doses of PCV-13 if < 2 years
one dose if PCV-13 if < 5 years and did not recive first series
PCV13 + PPSV23:
Patients with anatomical functional asplenia including patient with sickle cell disease.**
CSF Leak**
Cochlear implants***
Pneumococcal indications: Adults
1 dose each at age ≧ 65
PCV13 -recommended if immuncompormeed
PPSV23 - recommended in all adults ≧ 65
Pneumococcal: Special populations
PPSV23 + Booster: all immunocomporomised
PCV13 + PPSV23: CSF leak, cochler implants
PCV13 + PPSV23+ booster: Sickle cell, ESRD, aslenia, nephrotic syndrome
Pneumococcal: Timing
if both indicated: PCV-13 first then PPSV23 ≧ 8 weeks later
Do not administer both at same visit
if already received PPSV23 must wait 1 year to get PCV13
If patient require revaccination with PPSV23 the second dose is administered 5 year after first
What immunize Diptheria, Tentanus, pertussis vaccines?
D: Myocarditis, neuritis , death
T: Muscle ridgity
P: whooping cough, asfriction
DTP: Capital letter
Higher dose for vaccination
DTP: lower case letter
lower for boosters
DTP: DTaP
Children < 7 years
DTP: DT
< 7 years with contraincicattion to pertussis component
DTP: Td
People ≧ 7 years, decrease AE
DTP: Tdap
booster=> also givin in 3rd trimester
Adminster on dose of Tdap in adolescetn 11 or 12 years of age.
Boostrix for ≧10 years (good for people passed 64 years)
Adacel for ages 11-64 years - backup
Tdap dosing schedule
one time for all adults
Tdap dosing: pregnacy
one dose in each pregnancy (preferred 27-36 weeks of gestation) -regardless of interval
Interval: Tdap
Tdap can be given at any interval to Td dose
DTP: AE
common: rxn on site
3-5% fever
Pertussis (rare) : high fever, febrile seizure, hypotonic hypo-responsive episode, persistant cry spells, encephalopathy with 7 days of vaccine
DTP: contraincation
Severe allergy to components
Encophalophaty within 7 days of vaccine of Pertussis vaccine (rare)
DTP: precaustions
uncontolled seizures (pertussis)
Chaning neruologi condtions
LIve Atteunated vaccines
Mr.V.Z Mapsy”
Replicate normal infectoins
Measles/Mumps/Rubella Rotavirus oral Oral typhoid capsules Varicella(chicken pox) Herpes Zoster (shingles) Yellow fever
Recumbivent influenza: RIV3
Flublok
approved 18-64 years
High dose influenza vaccinee
Fluozone ≧ 65 yr
Live Attenuated Vaccine (LAIV)
Flu Mist
Cold adapted vaccine
Intranasel
Inactivated and Live influenza: Adult and Children ≧ 9
one dose
Inactivated and Live influenza: Childern < 9
use two doses the first year
who have not been vaccinated in past, given 4 wks apart
IIV
inactivated
LAIV
Live
IIV influenza: Route
IM
LAIV influenza: Route
Intranasal
IIV influenza: age
≧ 6 months
LAIV influenza: age
2-49 years
IIV influenza: contraIND
- -Egg Allergy (See section on Egg Allergy)
- History of GuillainBarré Syndrome (GBS)
LAIV influenza: contraIND
–Egg Allergy (See section on Egg Allergy)
- History of GuillainBarré Syndrome (GBS
High risk condition
Children receving asprin
pregnant women,
immunosuppreed
Egg allergy
O