Other Flashcards
How long after unsafe vaccines is it safe to fall pregnant?
28 days
1 cycle
What immunisations are unsafe during pregnancy?
All live vaccines eg varicella and MMR, cholera, q fever, yellow fever
Which immunisations are recommended during pregnancy?
Influenza and pertussis (DTpa)
What is the most common cause of vaccine damaging in Australia?
Exposure to temp below 2C - freezing is damaging to most vaccines
exposure to temp more than 8C is dmaging to most vaccines
if power failure leave the door of the fridge closed for up to 4 hours, if longer power failure then other cooling alternaticves needs to be sought
What is the technique used for imi immunisations?
23 or 25 g needle slow injection (5s min) minimises pain
if older than 12 months - deltoid preferred area
90 degree angle to the skin of the needle
When shoud you report a fever post immunisation as an adverse event
if more than 40.5C reported to the state or territory government
How does the varicella zoster vaccine differ from the chickepox vaccine?
zoster vaccine is not marketed in Australia
it is 14 times more potent than the chickenpox vaccine
(they are both live attenuated vaccines)
How long does the shingles rash last for? How common is complications?
10-15 days and complications are increased with age
most states in Australia now have a suveilance program to establish the burden of disease as affected by the varicella vaccination program
Which non recommended vaccines would be safe in pregnancy?
non- live ones
rabies
a) The quadrivalent HPV vaccine has a significantly higher efficacy than the bivalent vaccine but is associated with more adverse events
b) The bivalent HPV vaccine has a significantly higher efficacy than the quadrivalent vaccine
c) Both available HPV vaccines have demonstrated an efficacy of approximately 90–100%
d) Both available HPV vaccines have demonstrated an efficacy of approximately 75-85%
Both available HPV vaccines have demonstrated an efficacy of approximately 90–100%
The two HPV vaccines registered in Australia are both designed to prevent initial HPV infection and provided in a three-dose schedule. Both HPV vaccines employ virus-like particles that generate a highly efficacious immune response preventing approximately 90–100% of persistent infection and cervical disease caused by oncogenic HPV genotypes 16 and 18 in women who are seronegative for these genotypes. One vaccine, ‘Cervarix’, is bivalent (for HPV types 16 and 18) and the other, ‘Gardasil’ is quadrivalent (for HPV types 16, 18, 6 and 11). The quadrivalent vaccine additionally protects against external genital lesions caused by the four relevant HPV types with an efficacy of 99% in women who had not previously been infected with the vaccine HPV types. Human papillomavirus types 6 and 11 are associated with more than 90% of genital warts lesions
what is the HPV recommended vaccine shcedule?
The recommended quadrivalent HPV vaccine schedule is 0, 2 and 6 months. When this schedule cannot be followed for the third dose, this final dose should be given at least 3 months after the second dose and every effort should be made to deliver it within 12 months of the initial dose. The quadrivalent vaccine has demonstrated efficacy when all three doses are received within 1 year. Missed doses should be given as soon as possible and earlier doses do not need to be given again.
What are contra-indications to vaccination
- Immunosupression and organ transplant - no live vaccines, safety and effectiveness of others may be suboptimal
- Current febrile (temp > 38,5C) or systemic illness
- Anaphylaxis following a previous dose of the same vaccine planned to be given
- Live attenuated vaccine or BCG vaccine in the past 4 weeks
- Received blood products in past 7 months or IM or IV immunoglobulin in past 12 months- antibodies in these products may interfere with immune response to MMR,MMRV and varicella vaccines
- history of Guillian-Barré syndrome- may be at risk of recurrence following influenza vaccines
- has a bleeding disorder- imi injections may cause haematomas
- has a severe or chronic illness- safety and effectiveness of some vaccines may be suboptimal
- was born preterm- may not mount an optimal immune response to certain vaccines (eg hepatitis B)
- is an infant of a mother that received immunosuppressive treatment during pregnancy- safety and effectiveness of the vaccine may be suboptimal
How many MMR vaccine doses are required and what coverage does this provide?
Two doses of MMR vaccine, at least 4 weeks apart, are required for optimal protection against all three diseases. This regimen achieves 99% immunity to measles.
Can the MMR vaccine be given at the same time as other vaccines, including live vaccines?
The MMR vaccine may be administered at the same time as DTPa (and other live vaccines) but should be given at a different site to the other vaccines. The antibody responses are not decreased by co-administration if it occurs on the same day, and the likelihood of side effects is not significantly increased. A history of measles, mumps or rubella is not a contraindication to the use of MMR vaccine.
How does the anti-D immunoglobulin interact with the MMR vaccine?
Rhesus D immunoglobulin (anti-D) does not interfere with the antibody response to MMR and the two may be given at the same time, with separate syringes at different sites, or at any time in relation to each other; however, seroconversion resulting from vaccination should be checked 8 weeks after MMR vaccination for those who have received Rh (D) immunoglobulin.
