Vaccinations Flashcards by Sara Fieger

live vaccines

pathogen replicates in host to generate immune responses that mimic those induced by natural infection

typically attenuated, CI in immunocompromised and prego

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inactivated vaccines

can either be WHOLE inactivated agents or specific COMPONENTS

have no ability to replicate in their host, therefore safe in immunocompromised

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whole agent vaccines

whole organism is inactivated and then used in the vaccine

inactivated live vaccine

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engineered vaccine

attenuation (weakened) of agent

oral typhoid, nasal flu, cholera

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toxoid

form of inactivated component that eradicates the toxins that cause disease

reduces pathogenicity but retains immunogenicity

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examples of toxoid vaccine?

diphtheria

tetanus

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whole inactivated vaccine examples

hepatitis A
polio
Rabies

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Examples of classic live attenuated viruses (5)

MMR 
Rotavirus 
Varicella 
Zoster 
Yellow Fever

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Engineered vaccine agents (2)

Intranasal influenza

oral typhoid

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only element of adaptive immune system that can neutralize a virus before it can replicate

Antibodies

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adjuvants

chemicals added to a vaccine to enhance the immune response and induce the immune response

typically uses alum and is more common in live vaccines

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seroconversion

amount of time it takes to generate an immune response to a virus

takes about 2-4 weeks

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what happened if exposed before seroconversion ?

there will be a show of symptoms

give multiple doses to increase seroconversion

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vaccinations in immunocompromised

inactivated vaccines cannot replicate so safe to give (but might not happen if immune system is inactivated)

live vaccines need the immune system so they can’t be used in immunocompromised + their care takers

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immunizations and pregnancy

inactivated are encouraged but activated are contraindicated bc could cause disease to fetus

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vaccination concomitant with immunoglobulin

typically occurs with rabies, can be done

give immunoglobulin and then the live vaccine at a different site to prevent interaction

ex. give Igs at bite site and vaccine in the leg

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herd immunity

protection from the disease because of the numbers

prevention of transmission of disease thru numbers of vaccinated - this protects the members of the community that can not be vaccinated (infants, elderly)

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used in herd immunity

represents how many unprotected peel can be infected by ONE person

higher R# = higher number of people must be vaccinated

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risk of unvaccinated

this alters the herd immunity bc it increases transmission of deadly disease that could infect the immunocompromised who rely on herd immunity

final end goal of immunization programs

eradication

permanent reduction to ZERO of worldwide incidence of infection caused by specific agent as a result of deliberate efforts

getting a disease to a point where vaccination is no longer needed

what is the only eradicated diseases?

smallpox

diphtheria s/s

pseudomembranous tonsils

caused by toxin that paralyzes palate and hypopharynx

diphtheria/tetanus recommendations (primary series + boosters)

primary: 2 mo, 4 mo, 6 mo, 15-18 mo
booster: 4-6y/o, 11-12 y/o, every 10 years later

tetanus s/s

exotoxin that acts on CNS rigidity and convulsive spasms of jaw and neck respiratory compromise, death

tetanus transmission

puncture wound contaminated umbilical cords are common cause for tetanus globally

Hepatitis A

acute fecal oral transmission

Hepatitis s/s

gray BM, increased AST/ALT, RUQ pain fever, fatigue

hepatitis B

can be acute or chronic sexually transmitted

HBsAg+ mother HepB vaccination

baby gets vaccination + immunoglobulins within 12 hrs of birth

HBsAg- mother

vaccine given prior to discharge

Hep B series infants

total fo 3 or 4 given before 18mo.

who is at high risk for Hep B?

health care workers risky sexual activity IV drug users

PO vaccines

rotavirus | typhoid

IN vaccine

live attenuated influenza vaccine

IM vaccines

almost all INACTIVATED vaccine

IM administration sites

vastus lateralis muscle (thigh) deltoid muscle > 12 mo.

where do you avoid IM administration?

buttocks!! could cause risk of sciatic nerve injury

IM delivery

90 degree angle bunch the skin or pull tight

subcutaneous vaccinations list

MMR Varicella Zoster yellow fever all live attenuated virus

SQ vaccine administration

45 degree angle | pinch up fatty tissue (to avoid muscle)

SQ administration sites

thigh | proximal lateral triceps

use of VIS

required to be given to patients gives patient information about vaccination and adverse effects

pink book use

given to medical practitioners comprehensive info on routinely used vaccine and diseases they prevent

local adverse reactions

pain, swelling, redness at site of injury occur within hours of injection (mild and self limited)

what antipyretic should not be given in children

aspirin

anaphylaxis adverse reaction

can be in reaction to antigen, component of vaccine, cell culture material, stabilizer rare but life threatening observe patients for 15-20 minutes after vaccination