VaxSH1 Flashcards
All vaccines can be given on same day however
Separate if you want to separate live vax must separate by 28 days
Influenza
Everyone ≥ 6 months old
IIV : inactivated influenza vaccine
TIV: trivalent vaccine
RIV4 : quadrivalent
FLuzone HD / FLuad ≥ 65
Recombinant influenza vaccine : RIV4
LAIV4
Live attenuated influenza vaccine
Approved for ages 2- 49
Preservative free
Optimal administration
No later than the end of October
Abs develop in about 2 weeks
In general not live vax is IM
T
If live generally is subq
If 6 months to 8 years/old
If previously unvaccinated, should receive 2 doses separated by ≥ 4 weeks then once yearly
Adults and kids > 8 y/o : 0.5 mL IM once yearly
After 8 y/o just one dose
When is the 3rd trimester?
27 to 38 weeks
You want to give Tdap in 3rd trimester to protect infant from pertussis
MMR
Live ( SUB Q 5/8th inch 23-25 gage
Fridge or freezer ( only vax fridge or freezer )
Measles: spots in mouth rash cough fever
Mumps: salivary glands enlargement and/or testicles
Rubella: German measles
May cause abortion, stillbirth or birth defects
Give at 1 years old. No earlier. 2 doses 2nd dose at 4 to 6 y/o
2 doses 28 days apart
Contraindications: pregnant, immunocompromised, neomycin/gelatin allergy
If HIV+ if CD4 count is 300 you can give MMR. Yes. If CD4 count is <200 ( AIDS ) cannot give MMR. If > 200 then yes
ProQuad
MMR & Varicella combo
Varicella is only in freezer therefore this powder is in freezer
Polio and ppsv23
Can be given SubQ and IM. Most just give IM
IPOL - what allergies do we worry about?
Neomycin
Neomycin and gelatin allergy
Varicella and MMR
Neomycin allergy
Varicella, MMR , and IPOL
Kinrix/ quadracel
Combo vax
DTaP- IPOL
4- 6 y/o
Haemophilus influenza type b ( Hib)
Vax to prevent 1) meningitis 2) pneumonia 3) epiglottitis ( severe airway infection in the larynx )
2 months to 5 years
And adults who are not vaccinated and are at high risk ( asplenia, sickle cell, stem cell transplant, or planned splenectomy
ActiHIB, Hiberix, PedvaxHIB
HIB
PedvaxHIb is 2 doses , others are 4
Meningococcal vaccine
College freshman : close quarters:
CONJUGATED VACCINES:
MCV-4 : conjugated. 4 for 4 valents. MEN A C Y W
•Menveo : 2 months to 55 years
- 4 doses start @ 2 months, 2 doses if 7-23 months and 1 single dose if 2 y/o to 55 years old
• Menactra 9 months to 55 years
2022 Now D/C and they have now released MenQuadfi ≥ 2 y/o single dose ( give the college freshman this one dose ) if still in dorms then every 3 to 5 years
•Trumenba/ Bexero : MenB
Only protects against meningitis B. Not a replacement for MenACWY. Used for high risk patients asplenia
ACIP: all adolescents aged 11-18 years first shot Men ACWY
High risk patients then 2 month and older
High risk: asplenia, sickle cell, HIV, etc
Gardasil
Ages 9- 45 FDA approval
CDC: says 11 to 26; 27 to 45 is a shared clinical decision.
If you get it from 9 to14 only need 2 doses. 6 to 12 months apart. Earlier the better it works
Age 15-45 now you need to 3 doses ( 0, 2, 6 ) [ recall hep B was 0, 1, 6 )
Shingrix
RZV
Recombinant zoster vaccine ( 2 doses 2-6 months 2nd)
Ages 50 and above.
If immunocompromised ≥ 18 y/o
Use immediately after reconstitution or refrigerate for 6 hours and use within that time
Can you pass shingle to someone else? No but you can pass chicken pox to someone else
Rotavirus
Most common cause of viral Gastroenteritis in young children usually ages 6 months to 2 years old
RV1: live vaccine. Oral vaccine. : ROTARIX. 2 dose series completed by 6 months.
RV5: live vaccine. Oral. ROTATeq. 3 doses.
Oral. Refrigerated. Live. After reconstitution good for 24 hours.
Ixiaro
Japanese Encephalitis Vaccine
JEV: mosquito borne flavivirus.
These are in NON- URBAN areas in Asia.
2 doses IM 28 days apart
ACIP : only recommends travelers try to reduce mosquito bites. JE-VC is not recommended for short term travelers whose visit will be restricted to urban areas.
Typhoid vaccine
Caused by bacteria salmonella typhi
Not needed in US.
2 vaccines
1) inactivated ( killed ) IM Typphim Vi:
2) live attenuated ( weakened ) : 4 doses q other day ( VIVOTIF Berna)
- for patients ≥ 6 years old
- complete at least 1 week prior to exposure.
- may consider revaccination every 5 year in high risk patients
* take 1 hour before a meal or 2 hours after a meal. With cold or lukewarm water
Yellow Fever
YF-VAX— LIVE ( attenuated ) —- SUBQ
Travelers vaccine: tropical regions of South America and Africa
Transmitted through mosquitos.
Avoid egg allergy!! : never give with egg allergy
Avoid in pregnant and thymus disease
Rabies
What animal carries the most rabies? Bats.
Pre-exposure prophylaxis: RabAvert, Imovax rabies
2 doses. Day 0 and day 7 1 mL per dose
Post exposure: rabies immune globulin - HRIG ( Kedrab ) ( passive immunization ) and then vaccinate w/ 4- 5 doses over 14 - 28 days
TwinRix
Hep A + B
> 18 y/o
ProQuad
MMR + Varicella
Must be in freezer
SubQ live vax
We start at age 1 2nd dose 4 - 6 years old
Kinrix/ Quadracel
DTap + IPV
Pediarix
DTaP + Hepatitis B + IPV
Pentacel
DTaP + IPV + Hib
Avoid live vax if patient on
Chemo, immune modulators
If patient on chemo how long after can they have a live vaccine?
3 months after stopping chemotherapy
If patient on immune modulator ( remicade, Enbrel ) or high dose corticosteroid ( ≥ 20 mg of prednisone daily for 14 days or longer ) how long do they have to wait before they can have a live vaccine?
1 month
Post Splenectomy ( asplenia ) or sickle cell disease
If you dont have a spleen you must be protected from encapsulated organisms.
The only clearance of bacteria with capsular polysaccharides from the bloodstream is by the spleen. Asplenic / splenectomy / sickle cell patients should be vaccinated to reduce risk of overwhelming post splenectomy sepsis ( OPSS ) due to
*encapsulated organisms :1 ) streptococcus pneumonia ( pneumococcus ) - pneumococcal vaccine
2) Haemophilus influenzae type B ( Hib) - Hib vaccines
3) Neisseria meningitidis ( Meningococcus ) - meningococcal vaccine
Travelers
hep A/ B
Meningococcal
Typhoid
Yellow Fever
Japanese encephalitis
Freezer temp range?
-58° F ( -50°C ) to 5 ° F ( -15° C )
Fridge temp range?
36°F ( 2° C ) to 46° F ( 8° C )
When to give pregnant patients Tdap?
3rd trimester
27 to 36 weeks of gestation
All patients less than 60 years old should get hepatitis B vax?
T
VAERS
Vaccine adverse events reporting system
COVID
mRNA : mod/ pfi
Adenovirus vector vacccines: janssen
HIV life cycle
CD4 a type of T lymphocyte and T lymphocyte is a type of white blood cell. HIV virus is a single stranded RNA virus. Has a viral envelope. Also has 2 surface markers ( it uses to bind CD4 host cell.
The 2 markers: glycoprotein 41 ( gp41) and gp 120
Host cell receptor CD4 and CCR5
First process is entry
Binding and fusion
During binding: gp41 and gp120 bind
