vaccines Flashcards
types of vaccine
-Live vaccines
-Attenuated live vaccines
-Inactivated (killed vaccines)
-Toxoids
-Polysaccharide and polypeptide (cellular fraction) vaccines
-Surface antigen (recombinant) vaccines:
-mRNA vaccine
-Viral vector vaccines
categorize the vaccines
-LIVE
-nasal flu
-small pox
-LIVE ATTENUATED:
-Chicken pox-Varicella zoster
-MMR- Mumps, Measles, Rubella
-Yellow fever
-Rotavirus
-Polio - ORAL
-Flu (some flu vaccines, particularly nasal spray)
-oral cholera
-BCG
-oral typhoid
-typhus
-KILLED INACTIVATED:
-Polio (Salk)
-Flu (IM)
-IM cholera
-pertussis
-IM typhoid
-rabies
-TOXOIDS:
-Diphtheria
-Tetanus (TDAP)
-CELLULAR FRACTION
-pneumococal polysaccaride
-meningicoccal
-hepatitis B
-RECOMBINANT
-hepatitis B
-mRNA
COVID
-VIRAL VECTOR
COVID
what is the ACIP (advisory committee on immunization practices)
-comprises medical and public health experts who develop recommendations on the use of vaccines in the civilian population of the United States. The recommendations stand as public health guidance for safe use of vaccines and related biological products.
Concerns may arise during vaccination process and providers must address them to make sure pt and family are well informed.
-providers must navigate numerous issues, such as
-CDC recommends routine vaccination to prevent the 17 vaccine-preventable diseases that occur in infants, children, adolescents, or adults
issues:
-timing of each vaccine dose
-screening for contraindications and precautions
-number of vaccines to be administered
-educational needs of patients and parents
-interpreting and responding to adverse events.
-Above all else, providers need to help pts be informed of decisions
which adult vaccination does everyone need
-not just for children
-Protection from some childhood vaccines can wear off over time.
-If you travel, your age, your job, or your health can put you at risk
-immunizations Adults need Annually:
-seasonal Flu (influenza)vaccine every year (Especially pt with chronic health conditions, pregnant, older adults)
-Tdap once if they did not receive it as an adolescent to protect against pertussis (whooping cough), and then aTd(tetanus, diphtheria) or Tdap booster shot every 10 years
-women should get Tdap each time they are pregnant ->27 - 36 weeks.
benefits of vaccination
-better to prevent ds than to treat it
-vaccine is highly effective, safe, and easy way to keep healthy.
-timing of vaccination based on how child’s immune system responds to vaccine at various ages and how likely the child may be exposed to ds
-Vaccines are tested to ensure safety and efficacy for kids to receive at recommended ages.
contraindications vs precautions of vaccination
-Contraindication:
-Severely immunocompromised pts shouldnt get live vaccines
-Pregnant pts should not receive live, attenuated vaccines
-h/o encephalopathy after pertussis- vaccine administration, which out a valid cause, should not receive pertussis containing vaccines.
-h/o intussusception contraindication for rotavirus vaccine.
-Precautions-
-Patient with an illness, pt with fhx of seizures or encephalopathy
list of vaccine preventable ds
+ whooping cough
-17 preventable diseases
birth-18 yo immunization schedule
19-65+ immunization schedule
NEW adult immunization practice standards
-Stresses that all providers, including those that don’t provide vaccine services, have a role in ensuring patients are up-to-date on vaccines
-Acknowledges that:
-Adult patients may see many different healthcare providers, some of whom do not stock some or all vaccines
-Adults may get vaccinated in a medical home, at work, or retail setting
-Aim is to avoid missed opportunities and keep adult patients protected from vaccine-preventable diseases
adult immunization practice standards
-“Call to action” for healthcare professionals
-Assess immunization status of all patients in every clinical encounter.
-Strongly Recommend vaccines that patients need.
-Administer needed vaccines or Refer to a provider who can immunize.
-Document vaccines received by patients, including entering immunizations into immunization registries.
components of successful vaccination programs
-Strategies shown to improve vaccine uptake in healthcare settings:
-Patient education (e.g. email reminders from providers plus provider recommendations)
-Use of standing orders
-Use of reminder-recall systems
-Efforts to remove administrative barriers
-Provider and practice assessment of vaccination and feedback
-Use of immunization registries
how to address parents about vaccination
-Tips to talking to parents:
-be respectful, patient, and understanding.
-Explain the positive effects vaccines have on public health.
-Provide evidence of safety and effectiveness.
-Address any of their concerns and provide information to access correct information online
-Provide personal stories or work experience to instill confidence.
genetics and vaccination
-Genetics play important role in how bodies respond tovaccines and booster shots -> suggests that protective responses elicited byvaccination could be more effective with personalization.
-Other factors influencing observed heterogeneity for immune responses induced by vaccines are gender, age, co-morbidity, immune system, and genetic background.
-Vaccines that are affected by genetic factors include:
-MMR
-hepatitis B
-varicella
-HPV
-genetic makeup can influence how well they respond to these vaccines and may also determine their risk of developing certain SE
US preventive services task force (USPSTF)
works to improve the health of people nationwide by making evidence-based recommendations on effective ways to prevent disease, promote health, and prolong life
-Why do Primary Care Practitioners need to know the recommendations?
-Every time PCP sees pt, it’s an opportunity to prevent disease and promote good health.
-Collab with USPSTF allows practitioners an index to see evidence-based recommendations.
What is the difference between USPSTF and sub-specialty organization health screening recommendations?
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-USPSTF uses evidence-based guidelines to make its recommendations, while sub-specialty organizations typically rely on their own clinical experience and expertise to make recommendations.
-USPSTF recommendations are more general and cover a broader population, while the sub-specialty organizations’ recommendations may be more specific to the population they serve.
-USPSTF considers the benefits and harms of screening, while sub-specialty organizations may focus more on the benefits of screening.
-Ex. American Urological Association- Prostate Cancer
USPSTF doesn’t recommend annual PSA AUA recommends annual with DRE.
up to date USPSTF recommendations for health screening
Re-screening intervals
women aged 40 and older should receive a mammogram every 1-2 years
Adults 50 and older should receive a colonoscopy every 10 years.
skin cancer screening once a year,
women aged 30 and older should receive an HPV test every 5 years
PSA not on the list. Too many false-positives with unnecessary potentially harmful procedures.
warning signs for cancer to remember in family practice
CAUTION:
- change in bowel or bladder
- a SORE THAT DOES NOT HEAL
-UNUSUAL BLEEDING OR DISCHARGE
- THICKENING
- indigestion or dysphagia
- obvious mole or WART change
- nagging cough/hoarseness
disparity in cancer screening
-Access to healthcare
-Comfortability visiting practitioners
-Lack of knowledge from practitioners
-Limited education
-Poor insurance coverage
-Cultural beliefs that restrict preventative screenings
what is the rationale behind not screening certain populations?
-risk-benefit ratio
-Evaluates the population to ascertain the benefit to an invasive or non-invasive health screening.
-For older patients and those with multiple chronic conditions, the risks of screening may outweigh the benefits, as the chance of developing cancer may be low and the potential harms of screening may be greater.
-Additionally, for patients with multiple chronic conditions, the potential harms of screening (such as overdiagnosis) may be greater due to the overall burden of disease.
-important to consider pts age and co-morbidities when determining if cancer screening is appropriate.
group 1
-no live vaccines bc immunocompromised
-flu (IM)
-covid19
-meningicoccal
-HIV
-no MMR or
-4th dose of polio
-if bone transplant -> needs renew vaccine
-needs 2 years after bone transplant to reget the vaccines after eval risk and benefit
-milestones
-mental health
group 2
-start screening at age 40 (10 years prior to dx) and repeat every 5 years
-STI screenings
-drugs use
-flu, tdap
-send for titers
-covid
group 3
-BRACA 1 and 2 gene
-intimate partner violence
-TDAP COVID
-after 26 HPV vaccine based on CDM
-HPV screen
group 5
third dose of hep b
-anemia
-education
-schedule third dose bc it wont line up with well visits
