Immunizations Flashcards
How much time must elapse before giving a live vaccine to a patient who received a product containing antibodies
wait 3 months or longer before giving vaccine - MMR and varicella containing vaccine (except zoster) consult pink book for blood product/vaccine timeline
How much time must elapse before giving antibody containing products after a live vaccine is given
wait 2 weeks before giving antibody
Which vaccines( polysaccharide or conjugate) do not consistently produce an effective immune response in children under 2
polysaccharide
Live vaccines are withheld until what age
12 months of age - due to mother’s antibodies
Age at which inactivated vaccines can be started and exception
2 months (except Hepatitis B - at birth)
Which diseases is simultaneous administration of antibody and vaccine recommended as post exposure prophylaxis
hepatitis A, hepatitis B, rabies, tetanus
Which vaccines shouldn’t be administered simultaneously?
PCV 13 and Menactra (meningococcal conjugate) - seperated by at least 4 weeks
If live vaccines are not given together, how far should they be seperated?
at least 4 weeks
Which vaccines are Live vaccines
MMR, MMRV, varicella, zoster, yellow fever, LAIV
Effect of increasing the dosing interval in a vaccination series
delayed protection - no decrease in effectiveness
effect of decreasing the dosing interval in a vaccination series
may decrease effectiveness
Live vaccines and PPD timeline
give on the same day or if vaccine given first wait 4 weeks before placing PPD, if PPD given first wait until after reading to give vaccine
Most common vaccine adverse reactions
local reactions - pain, sweling, and redness of injection site - up to 80%, most common with inactive vaccines
Systemic adverse reactions to vaccines
fever, malaise, myalgias, headache, loss of appetite, mild manifestations of the disease being protected against, - mild and occurring within 7-21 days of the vaccine
Are minor allergic reactions a contraindication to repeat vaccination
no
When do anaphylactic allergies occur after a vaccine (timeframe)
minutes to hours
S/s of anaphylactic reaction
urticaria, swelling of the mouth and throat, difficulty breathing, wheezing, abdominal cramping, hypotension, shock
Amount of corticosteroids to get systemic steroid induced immunosuppression
20+ mg/day prednisone x 14+ days, 2+mg/kg/day prednisone x 14+ days
Contraindications to live vaccines
pregnancy, immunosuppression
How long after chemotherapy to be able to give live vaccines
at least 3 months after discontinuation of chemo
Which vaccines are contraindicated in HIV with a CD4 count
MMR, Varicella
Asplenic patients should received which vaccines
PCV13 AND PPSV23. can receive live vaccines if indicated
optimum time for Tdap vaccination during pregnancy
27 and 36 weeks
Which vaccines are recommended for health care professionals
Hepatitis B, Flu, MMR, Varicella, Tdap
DTaP brand names
Daptacel, Infanrix
DTaP-IPV brand name
Kinrix
DTaP - HepB-IPV brand name
Pediarix
DTaP-IPV/Hib brand name
Pentacel
DTap series given to who
children
DTaP dosing
5 doses at age 2, 4, 6, 12-18 months and 4-6 years. followed by Tdap at 11-12 years
Hib vaccine brand names
ActHIB, Hiberix, PedvaxHIB
MenCY-Hib vaccine brand names
Menhibrix (Meningococcal serogroups C and Y - Hib)
When is Hib vaccination given
children, sometimes adults after splenectomy Menhibrix - high risk infants 6 weeks - 18 months
Hep A vaccine brand names
Havrix, Vaqta
Hep B vaccine brand names
Engerix B, Recombivax HB
Hep A / Hep B vaccine brand name
Twinrix
Who gets Hep A vaccination
children at 1 year of age (2 doses); adults: men who have sex with men, IVDU, chronic disease, travelers to countries with high incidence
Who gets Hep B vaccination
3 dose series at 0, 1, and 6 months for all children and adolescents and adults (HCP, men who have sex with men, sex with multiple partners, IVDU, ESRD, chronic liver disease, diabetics between 19-59)
HPV2 vaccine brand name
Cervarix (female only)
HPV4 vaccine brand name
Gardasil
HPV9 vaccine brand name
Gardasil
Who gets HPV vaccination
females 9-26 years old. starting 11-12 or age 9, catch up 13-26 years old. males 9-26 years old. 3 doses (0, 1-2, and 6 months)
LAIV brand name
Quadrivalent nasal spray FluMist
Flustmist indication
healthy people age 2-49
Quadrivalent IIV grown in eggs brand names
Fluarix, Flulaval, Fluzone
Trivalent IIV grown in eggs brand names (IIV3)
Afluria, Fluarix, Flulaval, Fluvirin, Fluzone
Trivalent IIV grown in cell culture brand names (ccIIV3)
Flucelvax
Trivalent high dose IIV grown in eggs brand name
Fluzone high dose
Age range for fluzone high dose
65+
Trivalent, recombinant egg free IIV brand name
Flublok
Precautions to flu vaccinations:
Defer if moderate-severe acute illness; Guillain-Barre within 6 weeks of a prior flu vaccine;
Management of influenza vaccine and egg alllergy
if pt can tolerate lightly cooked eggs or only gets hives - give vaccine and monitor for 30 minutes.
MMRV brand name
ProQuad; 12 months to 12 years of age
Who gets MMR vaccine
children and non-immune adults;
MMRV storage
freezer, diluents in refrigerator
MCV4 brand name
Menactra, Menveo
MPSV4 brand name
Menomune
who is high risk for meningococcal revaccination
HIV, asplenia, complement component deficiencies (MCV4 preferred)
MenB-4c vaccine brand name and age range
Bexsero 10-25 years
MenB-FHbp brand name and age range
Trumenba 10-25 year
who gets meningococcal vaccines
1 dose @ 11-12 years, booster at 16-18; 2-55 if high risk
who is high risk to receive meningococcal vaccine
college freshman, asplenia, sickle cell, military service, immunodeficiencies, high risk countries, lab workers with N. meningitidis exposure
Which meningococcal vaccines cover group b strain and must be used in addition to one of the other vaccines
Bexsero or trumenba
PCV13 vaccine brand name
Prevnar 13
Who gets PCV13
children 64. minimum age 6 weeks
PPSV23 brand name
Pneumovax 23
Who gets PPSV23
all adults >64 and some children and adults 2-64. minimum age 2 years.
max lifetime doses of PCV13
1
Max lifetime doses of PPSV23
3; 2 prior to age 65 spaced at least 5 years apart and 1 post 65
Pneumonia vaccination recommendation for all children age 2-15 months
PCV13 - 4 doses ( 2, 4, 6, 12-15 months)
Who gets polio vaccination
ALL children
IPV vaccine brand name
IPOL
RV1 vaccine brand name
Rotarix
RV5 vaccine brand name
RoTeq
Who gets rotavirus vaccine
All infants. do not initiate series after 15 weeks
Td vaccine brand name
Tenivac
DT vaccine brand name
Diptheria and Tetanus Toxoid
Tdap vaccine brand names
Adacel, Boostrix
VAR vaccine brand name
Varivax
ZOS vaccine brand name
Zostavax
Who gets varicella vaccine
children @ 12 months and 4-6 years. adults without immunity 2 doses at least 4 weeks apart. zostavax for 50/60+
Which vaccine cannot be given if allergy to gelatin or neomycin
varicella containing vaccines
Rabies vaccine brand names
RabAvert, Imovax
Who gets rabies vaccine
high risk prophylaxis or post exposure (with rabies IG)
Typhoid vaccine oral capsules brand name
Vivotif Berna (refrigerated)
Live attenuated typhoid brand name
Typhim Vi
Who gets typhoid vaccine
travelers to asia, africa, and latin america at risk
Japanese Encephalitis vaccine brand name
Ixiaro
Who gets japanese encephalitis vaccine
those spending 1+ month in endemic areas during transmission season
Who gets BCG vaccine
infants and small children in countries with higher TB incidence.
When is yellow fever vaccination contraindicated
severe egg or gelatin allergy, immunosuppression, breastfeeding
Length of needle for an IM vaccination
1” 22-25 G
Length of needle for SC vaccination
5/8” 23-25 G
