Vaccines COPY Flashcards
How is the influenza transmitted?
REspiratory droplets primarily
Local reaction symptoms? 3
Pain, swelling, redness
When can you give live vaccine? can they be given together?
Can vaccines usually be given at the same time?
If a vaccine series requires > 1 dose what is important to note about the interval?
Live vaccines can be given together, if they are not though they must be separated by 4 wks
Yes they can be given at the same time
The interval can be increased without restarting
4 specific special populations that should receive Menactra
Travels in mengigitis areas: sub sarahan africa
2 months and older with asplenia, or HIV, sickle cell disease
WHo should get gardasil-9?
Regimens
Females 9-26
Recommended age 11-12
Males 9-21: can be given up to age 21 and up to 26 in immunocompromised pts
If started before 15 2 doses
If started at age 15 or older or if immunocompromised 3 doses
Zostavax
herpes and chingels
Adacel and Boostrix generic name
Tdap
Varivax for chicken pox
Varicella virus vaccine
When do children get Prevnar?
<5 years
Who and what age should get MenB?
>= 10 with high risk
How is shringrix stored?
Refrider not freezer
What symptoms can intranasal influenza cause?
Mild cold like symptoms
Is a severe allergic reaction a contraindication to receiving that vaccine?
Yes
WHo should get Havrix
others but chronic liver disease
How many epinephrine autoinjectors should be available at any time? And what is the dosing?
- 3 adult epipens
- 1-3 doses q5-15 minutes
What vaccine is preferred for pts >50
Shingrix is preferred
Is pneumovax or prevnar given first?
13 comes before 23
How is rotavirus vaccine given?
oral
What does the childrens version of tetanus shot have?
What is the age cutoff for it?
uppercase D
age 7 or younger
Live vaccine contraindications and precautions
Pregnancy: dont attempt to get pregnant until 4 wks after vaccination
Immunocomp:
Precaution: Recent admin of antibody containing blood products
Recommendations for Flu shot?
- Recommended annually
- All pts >= 6 month
- Age 6 months to 8 years (not previouslly vaccinated)
- Give 2 doses 4 wks apart
Tdap wound prophylaxis?
If deep dry wound revaccinate with Td when it has been more than 5 years since vaccine
Adverse reactions that require some type of assistance should be reported where?
Vaccine Adverse event Reporting System
Dtap-IPV/Hib: pentacel who is this given to?
Adults with asplenia
Most vaccines are given IM what 5 are only given SC?
- MMR
- MMRV
- Varicella
- Zostavax
- Yellow fever
Tdap in pregnancy?
- Pregnant or postpartum women should get shot with each pregnancy
- Close contact with infants younger than 12 months should be vaccinated if not upto date
Havrix
Hep A
Live vaccines and TB skin tests
- Live vaccines can cause a false negative result
- Give the live vaccine on the same day as the skin test
- Wait 4 wks after a live vaccine to perform the test
- Admin TB test first and then wait 48-72 hours then give vaccine
In what situations can vaccine can be given? 8
- Mild acute illness (slight fever, mild diarrhea)
- Current antimicrobial tx (some expections)
- Previous local skin rxn (mild/mod)
- Allergies: bird feathers, PCN, allergies to products not in the vaccine
- Pregnancy except live vaccines, breastfeeding, preterm birth
- Recent TB skin test
- Immunosuppressed person in household, recent exposure to disease, or convalesence
- FH of AE to vaccine
What can mild allergic reactions be treated with?
Diphenhydramine, Hydroxyzine
Can inactivated vaccines cause the flu?
No
When can systemmic reactions occur with live vaccines?
3-21 days after
ProQuad
MMRV
What are the 8 live vaccines?
COZY IV RM
- Cholera
- Oral Typhoid
- Zoster (Zostavax)
- Yellow fever
- Intranasal Influenza
- Varicella
- ROtavirus
- MMR
Who should get Engerix-B?
`Children within 24 hours after birth
Adults: healthcare workers, chronic liver disease (including HCV), HIV, DM
What type of flu vaccine should not be given to pregnant pts
Dont give the live flumist
How should proquad be stored?
MMRV
Keep in freezer, store diluents in refrudge or room temp
If there is no evidence of immunity to zoster what vaccine and how much should be given
give Varivax 2 doses
What is the book you can look at for recommendations on vaccines?
Pink Book
How is pneumovax given?
IM or IV
What can interfere with Vorivax and Zostavax
Some antivirals: acyclovir, valacy, famicilovir
65 yo patient with no previous pneumonia vaccine what should they get?
Prevnar and the Pneumovax 12 months later
How should MMR be stored?
Store in the refridgerator or freezer
What pneumonia interval can be used in specific populations?
Immunocompromised pts can reduce interval to 8 wks
Multiple doses of Pneumovax must be separated by 5 years
How long should you monitor a pt after giving them a vaccine?
15 minutes
Rotavirus contrindications and precautions
- Hx of interssusception (part of the intestine slides into an adjacent part of the intestine)
- Precaution: Chronic gastrointestinal disease
Hep B Contraindication?
Hypersensitivity to yeast
When should oral typhoid vaccine be given?
1 wk prior to expected exposure
What is the minimum age for pneumovax?
must be older than 2
Engerix-B, Heplisav-B, Recombivax HB
Hep B
What should a severe allergic reaction be treated with?
Epinephrine
All vaccines contraindications and precautions
- Severe allergic reactions to that vaccine
- Precautions
- illness: if a child or adult has only a mild illness (like a cold) vaccines should be given. Abx treatment is not a valid contra
- If pt has moderate to severe illness it is reasonable to delay
Gardasil 9
Generic name
HPV vaccine
What do MMR and varicella containing vaccines need to be separated from?
Require separation from antibody containing products (blood transfusion, IVIG)
Vaccines 2 wks before antibody containing
Or antibody then 3 months
What are the 2 limitations of live vaccines?
- Immunocompromised pts cannot halt replication
- Circulating antibodies can interfere with vaccine replication
MEnactra generic
MCV4
Diphtheria, tetanus and pertussis vaccines contraindications and precautions
Contraindications for pertussis containing pruducts: Encephalopathy (coma, decreased conciousness, prolonged seizures) that is not attributable to another cause within 7 days
Precautions: GBS within 6 wks of previous vaccine tDap
What are two main contraindications to live vaccines?
Pregnancy and Immunocompromised patients
What flu shots are only indicated for pts >=65
FLuzone high dose
Fluad
When is it recommended to for simulatious vaccine + antibody product?
Certain disease states, postexposure prophylaxis (Hep A, B, rabies and tetanus)
Pts >=65 or immunocompromised pts 6-64 what should they get?
Prevnar 12
Immunocompromised pts age 2-64
- Smokers
- Alcohol abuse
- Liver heart, lung disease
- DM
- Give 1 dose befor age 65
Give two doses before age 65 if immunocompromised, sickle cell, asplenia, HIV, chronic renal failure, malignancy, transplant, immunosuppressive drugs, including steroids
All pats get 1 if older than 65