Vaccinations Flashcards
DTaP
Diphtheria, Tetanus, Pertussis DT-Toxoid vaccines Pertussis -Subunit vaccine 5-dose series Administered: 2,4,6, 15-18 months, 4-6 year olds
Tdap or Td
Tdap: Tetanus, Diphtheria, Pertussis
Td: Tetanus-Diphtheria, is given to adolescents and adults
11-19yo: one-time dose Tdap, then Td every 10 years unless injured
Pregnant women should receive Tdap in the third trimester of each of their pregnancies
Adolescents and adults who have close contact with an infant <12 months should receive Tdap
Haemophilus Influenzae type b (Hib)
-Conjugate vaccine- Haemophilus Influenzae type b was a common cause of epiglottitis, meningitis, and bacteremia (bacteria in the blood)
Administered: 2,4,6, 12-15 months
Rotavirus (RV)
Live, oral vaccine 2,4, +/- 6mos 2 vaccines, equal efficacy Rotateq®: 2,4,6 months Rotarix®: 2,4 months
Pneumococcus (PCV13)
13 valent conjugate vaccine
Strep pneumoniae is a primary cause of bacterial disease: pneumonia, meningitis, bacteremia
Strep pneumoniae also a primary cause of otitis media
Administered: 2,4,6,12-15mos
Pneumococcal (PPSV23)
Polysaccharide vaccine
Children 2 and older with specific medical conditions
E.g.: Sickle cell disease, cochlear implant, asplenia, leukemia
All adults 65 and older-one time dose
Adults younger than 65 with specific medical conditions
Residents of nursing homes or long-term care facilities
Adults who smoke cigarettes
Polio (IPV)
Inactivated polio vaccine
Administered: 2,4,6-18mos,4-6yrs
Measles, Mumps, Rubella (MMR)
Administered: 12-15mos, 4-6yrs
Adults born prior to 1957 are considered immune
Adults born after 1957 must have documentation of 1 or more doses or lab evidence of immunity
Varicella (VAR)
Goal is to prevent complications from varicella-zoster virus including: pneumonia, meningitis
Administered: 12-15mos, 4-6 yrs
Teens and adults: 2 doses 4-8 weeks apart if no evidence or prior immunity
Prior to the vaccine 100-150 people died yearly secondary to complications of varicella infection (cdc.gov)
Hepatitis A (HepA)
Inactivated vaccine Hepatitis A: self-limited viral inflammation of liver Source: contaminated food and water Administered: 12mos, 18-24mos Adults at high risk from lifestyle or medical conditions MSM- man sex IVDU- intravenous drug use Research involving Hep A Travel
Hepatitis B (HepB)
Subunit vaccine
Liver disease, in some patients can lead to liver cancer or cirrhosis
Administered: Birth, 1-2mos, 6-18 mos
Adults at high risk from lifestyle, medical conditions, or occupation (health care providers)
Human Papillomavirus (HPV)
Indicated for prevention of cervical cancer
Quadrivalent protects against cervical cancer, genital warts, and cancers of the vagina, vulva, anus
Inactivated subunit vaccine
Recommended for females 11- 26 years and males 11-21 years
Males ages 22-26 may be vaccinated
Schedule: 0, 1-2, 6 months
HPV4: 6,11,16,18 indicated for males and females
HPV2: 16, 18 indicated for females
Meningococcal
MenACWY-D (Menactra)
MenACWY-CRM (Menveo)
Conjugate vaccines
Quadrivalent
Prevents disease by Neisseria meningitidis
Single dose of either Menactra or Menveo at age 11-12 with a booster at age 16
Children with sickle cell disease or other high risk conditions may receive a 4-dose infant series of Menveo
2 doses of Menactra or Menveo at least 2 months apart to adults with asplenia or persistent complement component deficiencies
Menomune is a polysaccharide vaccine
Indicated for adults 56 years and older with certain medical conditions
Influenza vaccine
All persons 6 months and older should be vaccinated annually
Persons 6 mos and older can receive the inactivated influenza vaccine (IIV)
-Recombinant-
Persons 2-49 yo who are healthy, non-pregnant can receive either the live, attenuated influenza vaccine (LAIV) or IIV
Health care workers who care for severely immunocompromised persons should receive IIV
Adults 65 and older can receive the standard dose IIV or high-dose IIV
Influenza Terms
Trivalent=Influenza A (H1N1) virus + Influenza A (H3N2) virus + Influenza B virus
Quadrivalent= Trivalent + additional influenza B strain
How influenza vaccines are made
Egg based Inactivated vaccine Live attenuated Cell based Approved by FDA in 2012 Begins with egg grown viruses Vaccine virus mixed with cultured mammalian cells (not eggs) Recombinant Approved for use in 2013 Virus protein is isolated and combined with another virus that grows well in insect cells Only completely egg free vaccine This type of vaccine production is the fastest Flublok®
Zoster
Zostavax
Live virus vaccine
One single dose is recommended for all adults 60 years and older
Regardless of whether previous episode of herpes zoster is reported
Reduces risk of shingles by 51%
Reduces risk of post herpetic neuralgia by 67%
Contraindication : pregnancy, immune deficiency
Combination Vaccines
Twinrix®: Hep A, Hep B Pediarix®: DTaP, IPV, Hep B Comvax®: Hib, Hep B Kinrix®: DTaP, IPV Pentacel®: DTaP, IPV, Hib Proquad®: MMR, Varivax MenHibrix®: Meningococcal and Hib
Adverse Reactions
Most common are local reactions: pain, swelling, redness at injection site
May occur in up to 80% of vaccine doses
Most common in inactivated vaccines
Systemic reactions: fever, malaise, muscle pain, headache
May be due to vaccine or concurrent viral infection
May occur 7-21 days after live vaccine, often mild fever and rash
Severe, anaphylactic reaction
May be caused by antigen or other vaccine component such as preservative. Rare: less than 1 per ½ million doses
Contradiction and Precautions
Contradiction: a patient condition that greatly increases the risk of a severe adverse reaction
Precaution: a patient condition that might increase the risk or severity of an adverse reaction
Contraindications
Severe allergic reaction to a vaccine component
Encephalopathy within 7 days of a pertussis vaccine
Severe combined immunodeficiency (SCID)
History of intussusception as contraindication to rotavirus vaccine
Pregnancy and immunosuppression: live vaccines
Precautions
Temp 105 0 or higher, hypotonic/hyporesponsive episode, seizure, or inconsolable crying (>3hours) after DTaP
Patient Education: Thimerosal
Thimerosal
Mercury containing preservative
Prevents bacterial contamination of multi-dose vials
Used in some influenza vaccines
No evidence that it causes harm
Patient Education: MMR and Autism
MMR and autism
MMR vaccine first given at 12-15 months
Signs of autism often appear at 12-18 months
Studies have found no association between the MMR vaccine and autism
How vaccines work
Vaccines imitate an infection, but do not cause illness
T-lymphocytes and antibodies are produced
T-lymphocytes and B-lymphocytes will now remember how to fight against the disease
More than one dose of vaccine may be required for the body to produce enough antibodies to fight off an infection
