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PHRX 3060: Skills > 3: MMR, Varicella and Zoster, Rotavirus > Flashcards

3: MMR, Varicella and Zoster, Rotavirus Flashcards

1
Q

Which patients are at risk for rotavirus related disease?

A

below 5 years old (if unvaccinated)

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2
Q

Explain why patients are recommended to get the rotavirus vaccine?

A

asymptomatic, diarrhea, dehydration, fever, and vaccine can provide 80-90% efficacy against any rotavirus gastroenteritis

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3
Q

What dose is rotavirus given?

A

Rotateq (RVS): 3 - 2ml dose series @ 2, 4, 6 months old

Rotarix (RVI): 2 - 1ml dose series @ 2 and 4 months

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4
Q

What age range is rotavirus given?

A

Rotateq (RVS): older than 6 weeks but younger than 32 weeks

Rotarix (RVI): older than 6 weeks but younger than 24 weeks

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5
Q

What is the difference between rotateq (RVS) and rotarix (RVI)?

A

RVS - oral live human bovine virus vaccine

RVI - oral live human rotavirus
LATEX ALLERGY

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6
Q

What would you do if a baby spits up their rotavirus vaccine?

A

count it the original dose (DONT REPEAT DOSE)

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7
Q

What are the adverse effects of rotavirus?

A
  • irritability
  • diarrhea
  • vomiting
  • intussusception
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8
Q

Contraindications of rotavirus

A
  • severe allergic reaction to a vaccine component (including latex)
  • history of intussesception
  • severe combined immunodeficiency (SCIDS)
  • history of uncorrected congenital GI malformations
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9
Q

Who is at risk for varicella related diesase?

A
  • infants
  • adults
  • pregnant –> congenital varicella syndrome (birth defects)
  • immunocompromised
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10
Q

What does varicella virus cause?

A

acute infection (Chickenpox) and persists in latent (hidden) form in ganglionic nerve fibers (which may reactivate)

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11
Q

What are symptoms of chickenpox/varicella virus?

A
  • fever
  • itchy rash
    VERY CONTAGIOUS
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12
Q

Name adverse effects of varicella vaccine and MMRV.

A

varicella: injection site reactions, fever

MMRV: fever, febrile seizure, and rash

(safer for MMR and varicella to be given seperately)

severe adverse effects in patients with T-cell dysfunction – uncontrollable disease

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13
Q

What is the dose for MMRV and varicella vaccine?

A

0.5 ml per dose
2 doses - 28 days apart

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14
Q

How is MMRV and varicella stored?

A

live - frozen between -58 and 5 degrees

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15
Q

Specifications of MMRV vaccine

A

ONLY approved for 1-12 years old WITHOUT HIV
- NOT recommended for children with a hsitory of seizures

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16
Q

Describe varicella immunity

A

if NOT pregnant or a healthcare provider, being born before 1980 will make you immune.

17
Q

How/when would you vaccinate a non-immunized adult for varicella?

A

give 2 doses. seperated by 4-8 weeks

during a varicella outbreak
- second doses have been used to control outbreak

18
Q

Contraindications of varicella vaccine

A
  • moderate to severe disease
  • allergy to components of vaccine
  • pregnant
  • immunosupressed
  • patients on medications that will interfere with vaccine
19
Q

What is herpes zoster?

A

Shingles

20
Q

Shingles patients can develop…

A

post herpetic neuragia (PHN)

21
Q

What population is at high risk of herpes zoster?

A
  • Immunocompromised patients (more severe)
  • older patients with shingles (>50)
22
Q

How is the zoster vaccine administered?

A

INACTIVATED
2 - 0.5ml IM
- healthy patients seperated by 2-6 months
- immunocompromised patients (1+ months)

23
Q

How is the zoster vaccine stored?

A

refrigerated

24
Q

What are adverse effects of RZV (Shingrix)

A
  • pain
  • tiredness
  • headache
25
Q

Who is the zoster vaccine recommended to?

A
  • immunocompetent adults 50+
  • immunocompromised adults 19+
26
Q

Contraindications of shingrix (RZV)

A
  • severe allergy to any component of vaccine
  • no data to say if its safe for pregnancy or lactation
27
Q

Serious health effects of getting measles.

A
  • fever, cough, runny nose
  • rash that starts from the hairline and desends
  • pneumonia
  • encephalitis
  • SSPE (subacute sclerosing panencephalitis)

VERY CONTAGIOUS

28
Q

What are health effects of getting mumps?

A
  • parotitis
  • inflammation of the testes
  • inflammation of the ovaries
29
Q

What are health effects of getting rubella?

A
  • rash that starts from the hairline and descends
  • fever, headache
30
Q

How is the MMR vaccine stored?

A

MMR - live in the refrigerator or freezer
MMRV - in the freezer

31
Q

How is the MMR vaccine administered?

A

2 - 0.5ml SC @ 12-15 months and 4-6 years

32
Q

What ages do patients usually get caught up with MMR?

A

1) 11-12 years old
2) women of childbearing age (cannot vaccinate when pregnant)
3) healthcare workers

33
Q

Which populations are considered high risk?

A
  • school age children
  • college students
  • healthcare personnel
  • international travelers
34
Q

What to do if you are planning to travel to a measles endemic area?

A

if unimmunized or under immunized, one dose of MMR (min. 6 months old)

IF recieved a dose between 6 and 11 months, it doesn’t count -> will have to recieve 2 additional doses of MMR/

35
Q

What to do if an unimmunized patient has been exposed to measles?

A
  • if within 72 hrs of exposure, give 1 dose of MMR vaccine (min. 6-12 months old)
  • if they cannot get the MMR, give IGIM to persons younger than 12 months or >12 months and cannot recieve MMR (within 6 days of exposure)
  • if they cannot get the MMR, give IVIG to pregnant non-immune women and severely immune suppressed patients (within 6 days of exposure)
36
Q

Which disease is recommended to receive a 3rd dose of the MMR vaccine if outbreak has occurred?

A

Mumps

37
Q

Can MMR be given at the same time as other live vaccines?

A

Yes, it should be given the same time or seperated by 28 days.
Also do the tuberculin skin test the same time if needed.

38
Q

What are some adverse effects of the MMR?

A
  • high fever
  • rash
  • in post-pubertal females: transient arthragia and arthritis
  • rare: thrombocytopenia
39
Q

What are contraindications of the MMR vaccine?

A
  • severe allergic reaction (gelatin + neomycin + eggs)
  • moderate to severe illness OR active TB
  • pregnant
  • immunosuppressed
  • recent receipt of antibody containing products
  • individuals who cannot handle a fever
  • thrombocytopenia

PHRX 3060: Skills (2 decks)

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