Immunizations: Overview Flashcards
(20 cards)
Vaccine Resources
-FDA: approved indication for vaccine (based on safety/efficacy)
-ACIP: recommendations for vaccine administration
-CDC: approves ACIP recommendations and publishes them in the CDC Morbidity/Mortality Weekly Report and the PINK Book
-Immunize.org provides vaccine info and education materials for providers
The Pink Book
Epidemiology and Prevention of Vaccine-Preventable Diseases
Reliable Vaccine Information for Patients
Federal law requires that a VIS be handed to the patient (or parent) before a vaccination is administered
VISs can be found on the CDC website and Immunize.org
Active vs Passive Immunity
-Active: person’s own immune system produces antibodies to fight an infection/response to vaccine
-Passive: antibodies are provided from someone else (mother to baby, when given IVIG)
Live Attenuated Vaccines
-Produced by modifying a disease-producing (“wild”) virus or bacteria
-They have the ability to replicate and produce immunity, but do not cause illness usually
-Most similar to disease and produce a strong immune response
-BUT contraindicated in IC and pregnant patients
-Multiple live vaccines can be given on the same day, or spaced 4 weeks apart (if not given on the same day)
Inactivated Vaccines
-Composed of either killed whole virus or bacteria, or fractions of either
-Immunity can diminish over time and supplemental booster doses may be required to increase immunity
-Cannot replicate or cause disease
-LESS affected by antibodies than live vaccines
List of LIVE Vaccines
-MMR
-Intranasal influenza
-Cholera
-Rotavirus
-Oral Typhoid
-Varicella
-Yellow Fever
-TB (BCG)
-Dengue
-Smallpox
-Ebola
= LIVE VICTORY MEDS
Vaccine Given In A Series
-Increasing the interval between the doses of a vaccine
given in a series does not diminish the effectiveness of the
vaccine after completion of the series, but it may delay
complete protection
-Decreasing the interval between doses of a vaccine can interfere with the antibody response and is generally avoided (shortened only for high risk patients in some cases)
Interval for antibody-containing product and MMR/Varicella
MMR, Varicella = Varivax or MMRV
Minimum of 3 months and can be up to 11 months
MMR and varicella-containing vaccines require separation from antibody-containing products (e.g., blood transfusions, IVIG)
The recommended spacing is:
1. Vaccine → 2 weeks → antibody-containing product
2. Antibody-containing product → 3+ months → vaccine
Live Vaccines in Infants
LIVE Vaccines:
-Withheld until 12 months of age (when maternal antibodies have depleted)
-EXCEPTION: rotavirus vaccine (given to infants)
Inactivated Vaccines:
-Given at any time
-Started when 2 months old (except hep B = at birth)
Live Vaccines and TB Test
Live vaccines can cause a false TB test (TST, PPD)
Reduce risk by:
-Give live vaccine the same day as TST
-Wait 4 weeks after a live vaccine to perform TST
-Do TST first, wait 24+ hr, then give the live vaccine
Vaccine Adverse Reactions
Can range
-Local: soreness, redness, itchiness, pain, swelling
-Systemic: fever, malaise, myalgia, headache, mild illness
-Severe: anaphylaxis
Should be monitored for 15 min at least after vaccination
Report to FDA’s Vaccine Adverse Event Reporting System (VAERS) if AE requires assistance
Live Vaccines and Systemic Rxns
Can occur 3-21 days after vaccine is given
True Allergic Reactions to Vaccines
Mild:
-diphenhydramine, hydroxyzine
-resolve quickly
-not a contraindication for future vaccines
Severe:
-anaphylaxis, urticaria (hives), swelling of throat, difficulty breathing
-IgE mediated
-within 30-60 min
-call EMS and give epinephrine (at least 3 adult, 0.3 mg, auto-injectors should be available as most adults need 1-3 doses)
-can also give diphenhydramine
-supine (back) position
Only Contraindications to Vaccines
Live: IC or pregnancy
Severe/anaphylaxis reaction (cannot give any subsequent doses of that same vaccine)
Illness and Vaccines
For all vaccines
-if a child/adult has a mild illness (cold), vaccines should be given still
-treatment with abx is not a valid reason to delay vaccines
-for moderate/severe illness: can delay
Hypersensitivity to Yeast
-Hepatitis B vaccines
-Human papillomavirus vaccine (HPV)
History of Intussusception
(part of the intestine slides into adjacent part, blocking fluid/food)
Rotavirus vaccines
Severe allergic reaction to eggs
Yellow Fever Vaccine
Severe allergic reaction to gelatin or neomycin
Varicella Vaccines
