Immunizations

Question 1

Seasonal Influenza Vaccine

Answer 1

• Seasonal: fall to spring

It takes 2 weeks for protection to develop so take precautions:

• Avoid sick contacts, wash hands frequently
• No protection during this time period
• Immune system is busy making antibody against multiple variants of influenza
• Higher susceptibility to other infections

Side effects (expected):

• Inflammatory/immune responses
• Local inflammatory response at the injection site (local soreness, redness)
• Systemic inflammatory responses (fever, cough, malaise, body aches, vomiting, diarrhea)

IIV: inactivated influenza vaccine: 
Indication:
- everyone older than 6 months & pregnant 
Route: 
- IM/subQ
Contraindication
- age < 6 months
- severe allergy to egg
- Guillain-Barré Syndrome

LAIV: live attenuated influenza vaccine: 
Indication:
- 2-49 years healthy & non-pregnant
Route:
- nasal spray 
Contraindications: 
- pregnancy
- with antiviral
- with aspirin
- egg allergy
- Guillain-Barré Syndrome
- chronic diseases, asthma
- Immunosuppressed
- working with at risk population**
- acute phase of diseases (stuffy nose)
- other vaccines in the last 4 weeks

Question 2

Pneumococcal Vaccine

Answer 2

Pneumococcal polysaccharide vaccine (PPSV23)
- IM/subQ
Indication:
- 2 years to 65 years if (immunocompromised, chronic diseases, smokers, living in long-term care facilities)
- 65 years of age (one dose; if received one before 65 give a booster after 65)
Contraindication:
- pregnancy
- children < 2 years

Pneumococcal conjugate vaccine (PCV13) (used more frequently)
- IM/subQ
Indication:
- 6 months to 65 years if (immunocompromised, chronic diseases, smokers, living in long-term care facilities)
- 65 years of age (one dose; if received one before 65 give a booster after 65)
Contraindication:
- children < 6 months
Off-label use:
- protects children against some ear infections also

Side effects:
- local and systemic inflammatory reactions: injection site soreness, fever, drowsiness, anorexia, malaise