Test 4 Immunization Flashcards
Difference in polysaccharide and conjugate polysaccharide vaccines in children younger than 2 years
- polysaccharide: not consistently immunogenic in children younger than 2 years
- conjugate polysaccharide: increased immunogenicity in children younger than 2 years
Universal contraindication for all vaccines
Severe allergy (immediate and lifethreatening anaphylaxis) to a vaccine component following a previous dose
False contraindications
- Minor illness
- Allergies to products not in the vaccine
- Allergies that are not immediate and life-threatening
- Pregnancy in the household
- Breastfeeding
- Premature birth (time on actual age, not gestational)
What are other contraindications?
- do not administer live vaccine if patient has received a live vaccine or blood product within the past 28 days
- do not administer live vaccine if patient is pregnant
- do not administer live vaccine if patient is immunocompromised
- do not administer live vaccine if patient is taking high dose of steroid every day (Prednisone dose of 2 mg/kg/day or more or 20 mg/day for 14 days or more)
influenza vaccine target population
- can be given during any time throughout pregnancy
- Children 6 months through 8 years receiving influenza vaccination for the first time need 2 doses, administered at least 4 weeks apart
Tdap target population
- given to every pregnant women after 30 weeks of gestation
- If not given in pregnancy, administer as soon as possible post-partum
- Boostrix (GSK) 10 years or older
- Adacel (Sanofi Pasteur) 11 to 64 years
- 65 years and older, recommend Boostrix but can use Adacel if that’s the olny thing in stock
- get it every 10 years
Dosing of Influenza Vaccine
- get vaccine soon after it is available; no later than October
- 6 months to 35 months: 0.25 mL IM
- 3 years to 9 years: 0.5 mL IM
- 9 years and older: 0.5 mL IM
Pneumovax 23 target population
- All people 65 years and older
- People 19–64 years old who smoke cigarettes
- People 19–64 years old who have asthma
- People at least 2 years old with chronic illness
- For immunosuppressed, asplenia, or sickle cell patients, second dose recommended within 5 years if under 65
- Patients < 65 with cochlear implants or CSF leaks
- Recommend one dose of PPSV23 for patients 65 years and older who received 1 or 2 doses at least 5 years ago
Pneumovax 23 dosing
0.5 mL IM (or SC)
Prevnar 13 target population
- Indicated for ages 6 weeks through 5 years (Routine schedule: 2, 4, 6, 12 to 15 months)
- ACIP recommended in all adults >=65 years
- No additional PCV13 is needed if a dose was given before age of 65
- ACIP recommended in patients with cochlear implants, CSF leaks, immunosuppression, asplenia, sickle cell disease
Pneumovax and Prevnar combination
- if over 65: Give PCV13 followed by PPSV23 one year later
- if vaccinated with PPSV23 at age 65 years or older: Give PCV13 one year after the PPSV23
Varicella Vaccine
- Live attenuated virus vaccine
- against chicken pox
Varicella target population
- Children get varicella at 12 months and again at 4-6 years
- All adults without evidence of immunity to varicella should receive 2 doses at least 4 weeks apart
Zostavax Vaccine
- against shingles
- Live attenuated virus vaccine
Zostavax target population
- for ACIP: >= 60
- FDA approved for prevention in 50 and up
Shingrix Vaccine
- Non-live, recombinant, adjuvanted vaccine
- for shingles
- 2 dose series 6 months apart
Shingrix target population
- adults at least 50 years old
- Recommended in those previously vaccinated w/Zostavax
DTaP vaccine
- Diphtheria and tetanus toxoids and acellular pertussis adsorbed
- inactive toxoid vaccine
Tdap vaccine
- Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
- inactive toxoid vaccine
What is the difference between DTaP and Tdap?
Tdap has lower diphtheria and acellular pertussis dose to avoid local reactions in adults
DTaP target population
younger than 7 years
Hepatitis A vaccine
inactivated vaccine
Hepatitis A target population
- All infants at least 1 year old (For all children 1 to 2 years old)
- People with chronic liver disease
- Men who have sex with men
- Illicit drug users
- People receiving clotting factor concentrates
- Travelers
Hepatitis B vaccine
inactivated vaccine
