Vaccines

Question 1

How are vaccines approved

Answer 1

FDA approved them

Advisory Commitee on Immunizations (ACIP) provides the recommendations

CDC approves the recommendations and distributed them

PINK BOOK: Epidemiology and prevention of vaccine preventable diseases

Vaccine Information Statement (VIS) information for patients prepared by the CDC federal law requires that these be given to all patients before vaccination

Question 2

Live vaccines

COZY IV RM

Answer 2

• CHolera
• Oral typhoid
• Zoster (Zostavax)
• Yellow Fever
• Intranasal influenza
• Varicella
• Rotavirus
• MMR

Question 3

Timing and Spacing for vaccines

Answer 3

• Vaccines can usually be given at the same time
• Multiple live vaccines can be given at the same time or spaced 4 wks apart
• If series requires more than one dose the interval in between doses can be extended without restarting the series but they cannot be shortened

Live vaccines and Antibody

• MMR and varicella containing vaccines not zoster, require separation from antibody containing products (blood transfusion, IVIG),
  
  • Vaccines –> 2wks–> from antibody containing products
  • Antibody containing products–> 3 months or longer–> vaccine
• Live vaccines are held until the child is 12 months

Question 4

Live Vaccine and TB tests

Answer 4

• Give live vaccine on the same day as the skin test
• Wait 4 wks after live vaccine to perform skin test
• Admin skin test get results in 48-72 hours then get vaccine

Question 5

Vaccine Adverse Reactions

Answer 5

• Monitor pt for at least 15 minutes after
• Vaccine Adverse Event Reporting System (VAERS)

Question 6

Systemic and True Allergic Reactions from vaccines

Answer 6

• The flu shot is inactive and cannon cause the flu
• With live vaccines mild systemic reactions can occur 3-21 days after the vaccine is given
• Intranasal flu can give cold symptoms
• Minor Allergic reactions can be treated with OTC diphenhydramine or hydroxyzine
• Severe allergic reactions (rare) IgE mediated and occur within minutes after the vaccination: Hives swelling of the airways: epinephrine should be given

Question 7

Epinephrine dosing and use for anaphylaxis

Answer 7

.01 mg/kg max o.5 mg per dose up to 3 times