Immunizations

Minor reactions

-usually occur within few hours -resolve after short period of time/ not dangerous -local (pain, swelling, redness at injection site) -systemic (fever, malaise, muscle pain, headache, no appetite)

HPV: who should receive

-•2 dose schedule for all boys & girls ages 9 to 14 years of age (must wait 6 mos btwn 1st and 2nd dose, if less than 6 mos btwn 2nd dose --> must get 3rd dose) -CDC recommends 3 doses of HPV vaccine for people age 9 - 26 years if they have certain immunocompromising conditions. -3 DOSES FOR:People whose immune responses might be lower, for example due to HIV infection, cancer, transplantation, autoimmune disease, or taking immunosuppressant medications,

Polio: What type is used most commonly today (killed or attenuated)?

INNACTIVAED (KILLED)

Types of reactions according to the CDC

Minor, Severe and Serious

Why are the pneumococcal immunizations different between children and adults?

PCV 13 is mainly for children under the age of 2. And PPSV23 is for adults 65+. -pneumococcus) is the leading BACTERIAL cause of childhood meningitis (50% dev. brain damage, hearing loss & 10% die), sepsis, pneumonia & otitis media. PCV13 protects against 13 strains of pneumococcus bacteria and PPSV23 protects against 23 strains of pneumococcus bacteria. -Both vaccines provide protection against illnesses like meningitis and bacteremia. PCV13 also provides protection against pneumonia. -older adults need 2 pnemococcal vaccines

Varicella (Shingles): What is the difference between the 2 types of varicella immunizations?

Zostavax vs Shingrix -CDC no longer recommends Zostavax unless can't take Shingrix -no max age to take Shingrix, must take even if you'd had shingles, received Zostavax or are not are if your had chickenpox -Pregnant or breastfeeding women CANNOT receive Shingrix

specific immune globulins

contain a high concentration of antibodies directed against a specific antigen ( hepatitis B virus). Provides immediate passive immunity. Preparations are made from donated blood & do not transmit infectious dz.

MMR: Pregnancy or Pre-Pregnancy Recommendations

contraindicated during pregancy if child is severely immunocompromised -give after childbirth; wait 1 month after immunization to try to become pregnant -can receive while breastfeeding

active immunity

develops in response to infection or to administration of a vaccine or toxoid. both produce endogenous antibodies. It takes weeks or months to develop but it long lasting.

Live (attenuated) Vaccine

live microbes that have been weakened or have been rendered completely antivurulent. Be careful with immunocompromised pts.

Why are there more than one type of pneumococcal immunization?

pneumococcal conjugate vaccine (PCV13) protects against 13 strains of bacteria and pneumococcal polysaccharide vaccine (PPSV23) which protects against 23 strains of pneumococcus bacteria. -both vaccines provide protection against menigisits and bacteremia. PCV13 also provides protection against pneumonia

Passive immunity

preformed antibodies (immune globulins). Protection is immediately, but only last as long as the antibodies remain in the body.

Which patient populations should avoid live attenuated immunizations?

pregnant and immunocompromised patients.

Vaccine

preparation containing whole or fractionated microorganisms. Administration causes recipient's immune system to manufacture antibodies directed against the microbe from which the vaccine was made.

Killed Vaccine

whole, killed microbes of isolated micorbial components (the polysaccharide of Haemophilus influenzae type B of the surface antigen of hepatitis B)

Severe reactions

-usually do not result in long term problems -can be disabling -RARELY life threatening -seizures, allergic rxns caused by body rxn to particular component of vaccine

Serious Reactions

-life threatening -anaphylaxis

Which immunizations are live attenuated?

-Measles -Polio (Sabin) -Rotavirus -Varicella zoster (chickenpox) -Yellow Fever

Pnemococcal (conjugate vaccination): which patients should receive this immunization

-all children under the age of 2 -children btwn 2-5 who have not been vaccinated or at high risk

Influenza: Who should recieve?

-all people older than 6 months should receive influenza vaccine

Nursing Implications with Vaccinations

-assess the pt's health history, medication history, allergies, and pregnancy status -assess previous rxns and responses to immunization -assess contraindicatiokns, including immunosuppression -before giving drug, recheck specific protocols for admin and schedules for admin -follow manufacturer's guidelines -encourage pts of young children to keep journal of child's immunizations -if discomfort at injection site, apply warm compress and give acetaminophen -do not give aspirin to children -monitor for therapeutic responses and adverse reactions

Meningococcal: Who should receive?

-college freshmen living in dorms -U.S. military recruits -Travelers where dz is common -anyone w/ injured spleen or spleen removed

DTap (details)

-has replaced the whole-cell pertussis vaccine -tetanus diphtheria (Td) booster shots should be given every 10 years -efficacy: reduces the risk of dz by 80-90%. Protection begins after 3rd dose & persists 4-6 yrs for pertussis and 10yrs for tetanus & diphtheria.

Tetanus (details)

-if someone experiences a deep/puncture wound, or a wound contaminated with dirt, an additional booster dose may be given if the last dose was more than 5 yrs ago -if passive immunization is required, Tetanus Immune Globulin (TIG) (Human) Can be used with exposure

Hepatits B dose required

3 doses required: 1st dose, then 2nd (1 month later) and 3rd (4 month later) -85% protection after 2nd dose, 90% protection after 3rd dose -Protection lasts 5-7 yrs

DTap

Diphtheria and tetanus toxoids and acellular pertussis vaccine; given to infants and children ages 6 weeks through 6 years. In addition, three childhood combination vaccines include DTaP as a component.

DT

Diptheria and tetanus toxoids (no pertussis); given to infants and children ages 6 weeks through 6 years who have contraindications to pertussis

What are the dosing differences between age groups for influenza?

Given IM regular dose: ages 2-49yrs old Fluzone: HIGH DOSE specifically for older adults

Human Papillomavirus (HPV): Why is it important for people to receive?

HPV is associated with cervical, vulvar, and vaginal cancer in females, penile cancer in males, and anal and oropharyngeal cancer in both females and males

Td

Tetanus and diptheria toxoids, given to children and adults ages 7 and older. -Note the small "d" indicates a much smaller quantity of diptheria toxoid than in the pediatric DTap formula.

Vaccination

administration of any vaccine or toxoid only active immunity

Pnemococcal polysaccharide vaccination: who should receive it?

adults 65 yrs or older -people 2-64 yrs with certain medical conditions -adults 19 through 64 years who smoke cigarettes

Toxoid

bacterial toxin that has been changed to nontoxic form. Admninistration cause the pts immune system to manufacture antitoxins (antibodies directed against the natural bacterial toxin). Antitoxins protect against injury from toxins but do not kill the bacteria that produce them (tetanus & diptheria)

HPV: When to admnister

before beginning to have sex

immunization

both active and passive immunity

Antibody Titer

measure of how many antibodies to a given antigen are present in the blood and is used to assess whether enough antibodies are present to protect the body effectively against the particular pathogen. -sometimes levels decline overtime so you need a booster shot

TDap

tetanus and diptheria toxoids with acellular pertussis vaccine; given to adolescents and adults, usually as a single dose -EXCEPTION: pregnant women who should recieve TDap during each pregnancy