MANAGE IMMUNIZATION PROGRAM Flashcards
BUMEDINST 6230.15 Series
Immunization Program
Adenovirus Types 4 and 7
- Administer to military enlisted basic trainees
- Dosage: 2 tablets, 2 separate oral tablets (1 white/1 peach in color)
- Route: Oral
- Booster: None
Anthrax vaccine
-Administer based on the policy set by the Anthrax Vaccine Immunization Program.
-DOD or US Coast Guard sets the policy for implementation plans
Dosage: 5 shots over 18 months
0.5 mL given at:
1) 0
2) 4 weeks (1 month)
3) 6 months
4) 12 months
5) 18 months
6) Annual booster
Haemophilus Influenzae Type B (HIB)
- Administer HIB vaccine to those who are immunocompromised, have sickle cell disease, or do not have a spleen or a functional spleen.
- Dosage - 1 dose of 0.5 mL given
- Booster - Healthcare provider will determine if second dose is needed.
Hepatitis A
Unless seroimmune administer to trainees and accessions during initial entry training
HEP A
-Havrix (SmithKline Beecham). Dosage
Dosage for: 6 months to 18 years old = 0.5mL
Dosage for 19 years and older = 1.0mL
Give at 0, 6 month interval
HEP A
Vaqta Dosage
6 months -18 years old a) Two doses of 0.5mL. b) Give at 0, 6 month interval Dosage for 19 years and older a) Two doses of 1.0mL. b) Give at 0, 6 month interval
Hepatitis B administer
Unless seroimmune administer to trainees and accessions during initial entry training
Hep B high risk personnel
1) Occupational exposure to blood products, or other body fluids.
2) All healthcare workers.
3) All students in hospital corps and dental technicians school.
4) Any person who contact a sexually transmitted disease.
5) Anyone entering a high-risk area where Hepatitis B is endemic for a significant period of time.
HEP B
Engerix – B (three doses)
Dosage for 0-19 years old
a) 0.5mL
b) Give at 0, 1 month, 8 weeks minimum and at least 16 weeks after dose #1
Dosage for 20 years and older
a) 1.0 mL
b) Give a 0,1 month, 8 weeks minimum and at least 16 weeks after dose #1
HEP B Recombivax HB (3 doses)
Dosage for 0-19 years old 0.5mL
-Give at 0, 1 month, 8 weeks minimum and at least 16 weeks after dose #1
Dosage for 20 years and older 1.0 mL
Give at 0, 1 month, 8 weeks minimum and at least 16 weeks after dose #1
Recombivax HB Immunity should be checked at
1 - 2 months after the completion of the vaccine series.
Hepatitis A/B (Twinrix)
Dosage: 3 doses 1.0mL
0, 4 weeks, 5 months
Influenza
(1) Administer annually
(2) Dosage: 0.5mL
(3) Route: Intramuscular (IM) given over the deltoid
Influenza Contraindications:
-Do not give if they have experienced a serious systemic or anaphylactic reaction to a prior dose
-Those with egg allergy may receive vaccine
depending on medical evaluation
Japanese Encephalitis (JE) administer
Required for personnel going to endemic areas
(a) Personnel should complete the series prior to departure.
(b) If not completed prior to departure, must be started prior to departure and then
completed upon arrival.
Japanese Encephalitis (JE). Dosage
2 Doses
0.5 mL each on day 0 and
between 7-28 days
Measles, Mumps and Rubella (MMR) (live virus)
Administer
- all active duty personnel, unless seroimmune
- ensure healthcare workers have received two documented doses
Measles, Mumps and Rubella (MMR) (live virus)
exceptions
(a) Two documented age appropriate MMR vaccinations
b) Pregnancy (or planned pregnancy within next month
Measles, Mumps and Rubella (MMR) (live virus).
- Dosage: 0.5mL
(a) Given at 0, 4 weeks - Route – Subcutaneous
Meningococcal A/C/W/Y-Inactivated, bacterial polysaccharide conjugate
Administer
Required for all active duty (new accessions) if no evidence of vaccination within the
last 5 years
Meningococcal Dosage, Booster
- single dose of 0.5mL
- Two doses, 2 months apart for adults at high risk
-Booster: People with persistent risk need a booster every 5 years for as long as risk is present
Pneumococcal Conjugate (PCV 13) Administer
Administer to military personnel who are in a high risk category per ACIP recommendations.
Pneumococcal Conjugate (PCV 13) Dosage, Booster
Dosage: (1 dose) 0.5mL
Booster: Administer a second dose to persons without spleens or severely immunocompromised 5 years after initial dose.
Poliomyelitis (Inactivated Poliovirus Vaccine – IPV)
administer, dosage, route
Administer 1 time booster to all active duty personnel during basic training if primary
series was completed.
Dosage - 0.5 mL
Route – Subcutaneous (SQ) or Intramuscular (IM).
Rabies
Dosage
Dosage: (4 doses)
1) Four 1.0 mL of human diploid cell vaccine (HDCV):
a) Doses given on days 0, 3, 7, 14 days
b) If immunocompromised give 5th dose on day 28.
2) Human Rabies Immune Globulin (HRIG):
a) Give with first dose of HDCV
Rabies HRIG dosage
- 20 international units of RIG per kg body weight. If anatomically feasible, infiltrate the full dose around the wound.
- Additional amount IM at site distant from vaccine
Smallpox (live virus) Administer
Vaccinate designated military and civilian personnel based on geographical areas at higher risk for release of small pox as a weapon or in occupational roles
Small pox Training and Education
expected response at the vaccination site, vaccination-site care, risks of spreading vaccinia to close contacts, adverse events following immunizations
Smallpox (live virus) dose
Dose: 15 jabs using bifurcated needle
(a) Assess 6-8 days later for “Major Reaction vs. No Take”.
(b) If “No Take” repeat vaccination procedure in primary vaccinee only once with 15 jabs.
(3) Route- Percutaneous (scarification)
(4) Booster: Every 10 years if repeated or continued exposure
Tetanus, diphtheria, and pertussis – (Tdap)
Dosage: 0.5 mL
Booster - Every 2 years (if repeated or continued exposure to the typhi organism)
Storage Yellow fever
- Store between 36 to 46 ºF (2 to 8 ºC).
- Multi-dose vial of reconstituted vaccine must be discarded after 1 hour of reconstitution.
storage Measles, Mumps and Rubella vaccine
(a) Store in dark place between -58 ºF to 5º F
(b) Discard vaccines if not used within 8 hours following reconstitution.
Storage Varicella
(a) Refrigerator should be between 36° to 46º F
(b) Freezer should be between -58 to 5° F
(c) Must be used within 30 minutes of reconstitution.
Storage All other biologicals
(a) Store between 36 to 46ºF (2 to 8°C)
(b) Store as recommended by manufacturer.
(c) Dispose of if frozen during storage or shipment.
All persons administering vaccines shall be properly trained to include
a) Vaccine Storage and Handing
b) Vaccine Characteristics
c) Recommended Vaccine Schedules
d) Patient Screening
e) Contraindications
f) Vaccine Administration Techniques
g) Treatment and Reporting of Adverse events
h) Vaccine benefit and risk communication
i) Documentation and management
Report all adverse events to ___
Vaccine Adverse Event Reporting System
VAERS
_____must be properly stored and readily available at all vaccination locations along with easy access to telephones/radios to summon emergency medical personnel.
Epinephrine
Yellow fever immunization is required for Navy personnel assigned to Navy units subject
to deployment within 10 days of notification to areas where?
where yellow fever is endemic
During all immunization procedures, an emergency medical treatment cart or
appropriately stocked kit will be immediately available, containing
(a) Oxygen.
(b) Administration apparatus.
(c) Airways.
(d) IV fluid apparatus.
(e) Appropriate medications required for adequate ALS.
(f) Defibrillator/cardiac monitor.
Vaccine administration policies of the Navy Immunization Program must follow the
recommendations of the CDC and the current ACIP recommendations unless
there is a
military relevant reason to do otherwise
Immunizations not given underway
yellow fever
Yellow fever immunizations on IDC ships shall only be conducted
in port during normal working hours after prior notification and concurrence of local Regional Medical Representative (RMR)
unless a Medical Officer is present
Medical Exemptions
- Includes any medical contraindication relevant to specific vaccine. May be temporary (up to 365 days) or Permanent.
- Primary care provider may grant temporary or permanent medical exemptions
Administrative Exemptions
- Separation or retirement 180 days
1) Not currently assigned or deployed in area where the immunization is indicated
2) Not mission essential - Religious
Forms utilized in the record keeping of immunizations
- NAVMED 6230/4 – Adult Health Record Immunization Record
- CDC 731 - International Certificate of Vaccination
- DD Form 2766- Adult Preventive and Chronic Care Flowsheet
Required immunization information
(1) Date
(2) Manufacturer/Name of Immunization
(3) Lot Number
(4) Dose given
(5) Site and route of administration
(6) VIS edition given (if required)
(7) Name, address and title of the person administering the vaccine
(8) MTF or other facility
Typhoid
Administered as a precautionary method for food and water contaminated with salmonella
Dosage: 0.5 mL
Route – Intramuscular (IM).
Booster - Every 2 years (if repeated or continued exposure to the typhi organism)
For short notice travel or deployments
-administer the first dose in a required basic
series.
-Make arrangements to receive additional doses to complete the series as close to the proper schedule as possible.
Providers will only use vaccine information sheets prepared by the ________ and ________
- U.S. Department of Health and Human Services
- Centers for Disease Control and Prevention
Are Routine pregnancy tests required prior to vaccines
no
when can a vaccine be administered to a pregnant female.
Polio and yellow fever vaccine may be administered if risks of contracting illness outweigh potential complications.
What instruction states the immunizations that are not to be given while underway. IDC ship
COMNAVSURFORINST 6000.1
