Immunizations - Hoffman Flashcards
Intramuscular (IM) Route of Vaccine Administration
Upper thigh in infants, deltoid when muscle mass is sufficient
***Buttock should be avoided due to sciatic nerve damage and inconsistent IM deposition
- Hep A & B
- DTap/Dtap
- Hib
- Strep
- IPV
- Influenza
- Meningococcal
- HPV
Subcutaneous (SQ) Route of Vaccine Administration
Usually “pinch” the skin and inject into fatty tissue under the skin.
MMR & Varicella
Pneumococcal Conjugate Vaccine (PCV) Types
23-valent pneumococcal polysaccharide (23-PS) available (>2 years)
FDA licensed new 7-valent pneumococcal conjugate vaccine (PCV7) - < 2 years
Prevnar 13 – a 13-valent pneumococcal conjugate vaccine (PCV13)
Pneumococcal Conjugate Vaccine (PCV): Contraindications/Precuations
- known hypersensitivity
- moderate to severe illness
Pneumococcal Conjugate Vaccine (PCV): Side Effects
- Local erythema
- Induration
- Tenderness
- Fussiness
- Low grade to moderate fever
MMR Vaccine
Measles, Mumps, Rubella
Administration
- Given subcutaneously
- 1st dose: 12-15 months (minimum age is 12 months)
- 2nd dose: 4-6 years (at school entry)
MMR Vaccine
Measles, Mumps, Rubella
Contraindications & Precuations
Contraindications:
- Anaphylaxis
- Pregnancy
- Immunodeficiency
Precautions:
- Recent immune globulin administration
- History of thrombocytopenia
MMR Vaccine
Measles, Mumps, Rubella
Side Effects:
- Local tenderness/swelling
- Fever 7-10 days after
- Morbiliform rash
Active Immunity
Vaccination with live, live attenuated, or inactivated organisms, their components or their products to stimulate protective immunologic response
Contraindications for All Vaccines
Anaphylactic reaction to previous doses is an absolute contraindication for further doses
Anaphylactic reaction to any component
Moderate to severe illness with or without fever
Rotavirus Vaccine
Pentavalent Rotavirus Vaccine
Adminster three primary doses at 2, 4 and 6 months
***Should not be initiated after age 12 weeks and not to be given at all after 32 weeks of age
Meningococcal Vaccine - MPSV 4
Children age 2-10 in susceptible children
- Complement deficiency
- Anatomic or functional asplenia
- Other high-risk groups
Varicella Vaccine:
**Administration **
- live, attenuated virus
- 1st dose - 12-18 months or teens and adults with no history of natural infection
- 2nd dose – 4-6 years (new for 2007) 95% seroconvert after 1 dose
- >13 years, 2nd dose 4-8 weeks later
Varicella Vaccine:
Side Effects
- Local tenderness
- varicelliform rash within 1 month
Influenza Vaccine
Administration
- First dose: 6 months
- Dose yearly – vaccine typically updated.
- After age 2, option of live-attenuated (nasal spray).
Influenza Vaccine
Precautions
- Avoid in asthma, wheezing past 12 months, underlying medical conditions.
- Avoid if egg allergy.
Injectable Polio Vaccine (IPV)
Administration
- Given intramuscularly
- 2 months, 4 months, 6-9 months, 4-6 years
- Minimum of 4 weeks between 1st and 2nd doses
Injectable Polio Vaccine (IPV)
Side Effects
- VAPP with OPV
- Hypersensitivity
- Guillan-Barre??
Diphtheria, Tetanus and Pertussis Vaccine
DTaP, TDaP, Td
Administration
Diphtheria toxoid; Tetanus toxoid; Acellular pertussis
- Four primary doses and one booster
- Given intramuscularly
- Typically 2, 4, 6 months, and 12-18 months
- Booster at 4-6 years; or if dirty cut and less than 5 year since last booster
Diphtheria, Tetanus and Pertussis Vaccine
DTaP, TDaP, Td
Contraindications & Precuations
Contraindications
- Encephalopathy within 7 days of administration of previous dose
Precuations
- Temperature >40.5° C within 48 hours of previous dose
- Collapse or shock-like state within 48 hrs of previous dose
- Seizures within 3 days of previous dose
- Persistent/inconsolable crying >3 hours within 48 hrs of previous dose
Meningococcal Vaccine - MCV4
- Meningococcal Conjugate Vaccine
- Administer at 11-12 yrs or the 7th grade physical
- A booster is given at college entry
Recombinant Products Vaccines
Hepatitis B
Recombinant Products - A preparation of a weakened or killed pathogen, such as a bacterium or virus, or of a portion of the pathogen’s structure that upon administration stimulates antibody production or cellular immunity against the pathogen but is incapable of causing severe infection
Immunogenic Components of Bacteria Vaccines
Pertussis, Haemophilus influenzae type B, Streptococcus pneumoniae
Toxoids – Diphtheria, Tetanus
Haemophilus influenzae, type B(Hib) Vaccine
Administration:
- Given Intramuscularly
- Can be given with other vaccinations
- 2, 4, and 6 months with booster at 12-15 months
No contraindications and minimal side effects.
Inactivated/Killed Vaccines
Polio, Hepatitis A, Influenza
HPV Vaccine
- Quadrivalent vaccine against HPV Types 6, 11, 16, and 18
- Administer first dose to females/males 11-12 years or before they become sexually active
- Second dose at 2 months
- Third dose at 6 months
Passive Immunity
Trans-placental transfer of maternal antibodies
Administration of antibodies, either as: Immunoglobulin, OR Monoclonal antibody
Heptatis A
- Minimum age is 12 months
- 2 doses, given at least 6 months apart, starting after 1 year of age
- Can be given to older children and adolescents
Common Vaccine Side Effects
- Localized tenderness
- Localized erythema
- Fever
- Fussiness
- Allergic reaction
Other Ingredients in Vaccine
- Suspending Fluids (saline, tissue culture)
- Preservatives
- Stabilizers
- Antibiotics (Prevent bacterial overgrowth)
- Adjuvants to enhance immunogenicity
*All can contribute to local side effects and rarely, can cause anaphylaxis (egg antigens, antibiotics, gelatin)
Hepatitis B Vaccine
Who gets it:
Universal hep B immunizations in infancy as well as children and adolescents who missed immunization during infancy or those who are at increased risk
Hepatitis B Vaccine
Administration
Given IM (intramuscularly)
1st dose – at birth (within 12 hours)
2nd dose – 1-2 months
3rd dose – 6 months
Hepatitis B Vaccine
Contraindications and Side Effects
Contrindications: none
SE: Localized tenderness, rare hypersensitivity, reaction to yeast or vaccine preservatives
Live attenuated vaccinations
Measles, mumps, rubella, varicella
Live Attenuated is the actual viruses – weakened or altered so that the child doesn’t get sick. These vaccines STING!
