PHARMACISTS AS IMMUNIZER (VACCINES)

influenza vaccines

• Inactivated Influenza Vaccine (IIV)

• Live Attenuated Influenza Vaccine (LAIV)

Inactivated Influenza Vaccine (IIV)

• flucelvax

• flublok

• fluzone high dose

• fluzine id

• afluria

Live Attenuated Influenza Vaccine (LAIV)

flumist

Flucelvax

year

(2012)

Flucelvax

• For 18 years old and up

• egg-free

Flucelvax

age

18 years old and up

FluBlok

• recombinant influenza vaccine

• trivalent

• produced without using virus

FluBlok

age

• for 18-49 years old

Fluzone High Dose

year

(2009)

Fluzone High Dose

age

65 years and up

Fluzone High Dose

4x as much hemagglutinin vs. regular adult vaccine

Fluzone ID

year

(2011)

Fluzone ID

age

18-64 years old

Fluzone ID

different formulation vs other IIV

Afluria

YEAR

(2014)

Afluria

Pharmajet Stratis 0.5 mL Needle-free Jet Injector

Afluria

age

18-64 years old

Flumist

year

(2003)

Flumist

• contains same virus as in IIV

• Single dose sprayer unit designed to deliver half a dose in each nostril

Flumist

age

• Non-pregnant, 2-49 years old

Inactivated Influenza Vaccine (IIV)

flucelvax, flublok, fluzone high dose, fluzone id, afluria ADR

• Soreness

• erythema

• induration (1-2 days)

Inactivated Influenza Vaccine (IIV)

flucelvax, flublok, fluzone high dose, fluzone id, afluria CONCERN

• Egg-allergy (epinephrine)

Live Attenuated Influenza Vaccine (LAIV)

flumist ADR

Increased rate of cough, runny nose, nasal congestion, sore throat, and chills

PNEUMOCOCCAL  VACCINES

• Pneumococcal Polysaccharide Vaccine (PPSV)

• Pneumococcal Conjugate Vaccine (PCV)

Pneumococcal Polysaccharide Vaccine (PPSV)

pneumovax 23

Pneumococcal Conjugate Vaccine (PCV)

prevnar 13

Pneumovax 23 

• Contains phenol; single dose vial or syringe and a 5-dose vial

• Not effective <2 years old

• Decreased response with immunodeficiency and chronic illness

Prevnar 13

• More robust

• For all patients >50 years old

Prevnar 13 ADR

Local reactions – pain swelling or erythema

Pneumovax 23 ADR

Local reactions – pain swelling or erythema

TETANUS, DIPHTHERIA, PERTUSSIS VACCINES

• tetanus toxoid

• diptheria toxoid

• pertussis vaccine

• Combination Vaccine with DTaP

Tetanus Toxoid

 Tetanus toxin that is inactivated by

formaldehyde

Tetanus Toxoid

• Pediatric Diphtheria-tetanus toxoid (DT)

• Adult tetanus Diphtheria toxoid (Td)

Diphtheria Toxoid

• Pediatric Diphtheria-tetanus toxoid (DT)

• Adult tetanus Diphtheria toxoid (Td)

• Diphtheria toxoid, tetanus toxoid, and acellular pertussis (DTaP or TdaP)

Pertussis Vaccine

Acellular pertussis vaccine:

Purified, inactivated components of B. pertussis cells

Pertussis Vaccine

• Pediatric (DTap)

• Infanrix (DTaP)

• Daptacel (DTaP)

• Boostrix

• Adacel

Pediatric (DTap)

6 weeks – 6 years

Infanrix (DTaP)

3 antigens:

• FH

• PT

• pertactin

Daptacel (DTaP)

5 components:

• FH

• PT

• pertactin

• fimbriae types 2 and 3

• Adolescent and Adult (2005): contains aluminum salts

Daptacel (DTaP)

• Adolescent and Adult (2005):

contains aluminum salts

Boostrix

• 3 pertussis agents but in reduced quantity (TdaP)

• has aluminum salts

Boostrix

age

• 1- years old and up

Adacel

• 5 components but with reduced quantity of PT

Adacel

AGE

• 10 – 54 years old

Combination Vaccine with DTaP

• Pediatrix

• Pentacel

• Kinrix

Pediatrix

• Pentavalent vaccine (5 components) DTaP (infanrix) + hepatitis B (Engerix B) + IPV

Pediatrix

age and dose

• Minimum age is 6 weeks old, given 3 doses at 2, 4 and 6 months

Pediatrix

not approved for

4th and 5th booster dose of DTaP or IPV series; may be used interchangeably with other vaccines

Pentacel

• DTaP + IPV with lyophilized Hib vaccine

• DTaP-IPV solution should NOT BE USED SEPARATELY

Pentacel

age

• 6 weeks to 4 years old

Kinrix

DTaP + IPV indicated for 5th dose of DTaP or 4th dose IPV

TETANUS, DIPHTHERIA, PERTUSSIS VACCINES

notes

• History of severe allergic reaction to a previous dose

• Who developed encephalopathy within 7 days

TETANUS, DIPHTHERIA, PERTUSSIS VACCINES

AE

• Fever of 40.5°C (48 hours)

• Collapse or shock-like state (48 hours)

• Persistent, inconsolable crying for more than 3 hours

• Seizure within 3 days

TETANUS, DIPHTHERIA, PERTUSSIS VACCINES

potential ADR

• Local site reactions

TETANUS, DIPHTHERIA, PERTUSSIS VACCINES

CI

• Severe allergic reaction to vaccine component or prior dose

MEASLES, MUMPS, RUBELLA VACCINES

MMR Vaccine

MMR Vaccine

how many dose

2 doses

MMR Vaccine

– live attenuated vaccine that provides life-long immunity to 95% of the population

MMR Vaccine

the second dose

•  is for those 5 % who did not respond to the first dose

MMR Vaccine

CI

• Hypersensitivity

• Pregnancy

• Immunosuppression

MMR Vaccine

ADR

• Fever

• Rash

• Arthralgia

• Arthritis

Varicella Vaccine

• varivax

• proquad

• zostavax

Varivax

LAV

Varivax

age

12 months and older

Proquad

MMRV

Proquad

age

12 months to 12 years old

Zostavax

VZV with higher tighter

Zostavax

age

for patients 50 years and older

Varicella Vaccine

varivax, proquad, zostavax CI

• Hypersensitivity

• Pregnancy

• Immunosuppression

Varicella Vaccine

varivax, proquad, zostavax ADR

• Fever

• Rash

• Arthralgia

• Arthritis

Herpes Zoster Vaccine

zostavax

Herpes Zoster Vaccine

• HZ (shingles)

• Manifestation of the reactivation of the VZV

Zostavax for varicella

LAV. VZV with higher titer for patients 50 years and older

Zostavax for varicella

CI

• Hypersensitivity

• Pregnancy

• Immunosuppression

Zostavax for varicella

ADR

• Fever

• Rash

• Arthralgia

• Arthritis

Hepatitis A Vaccine

• Inactivated whole virus

• Both have pediatric and adult formulations

Hepatitis A Vaccine

• havrix

• vaqta

Hepatitis B Vaccine

Recombinant HBsAg

Hepatitis B Vaccine

• Recombivax HB

• engerix B

Combination of Hepa A & B

twinrix

Twinrix

• Bivalent vaccine Havrix + Engerix B

Recombivax HB

• Has pedia and adult formulation

• Has aluminum hydroxyphosphate

Engerix B

• Has pedia and adult formulation

• Has aluminum hydroxide

HAVRIX

preservative

Prepared with 2-phenoxyethanol

HAVRIX

2nd dose

6 to 12 months after 1st dose

HAVRIX

pediatric

12 months – 18 years old

HAVRIX

adult

19 years and older

VAQTA

preservative

No preservative

VAQTA

2nd dose

6 to 18 months after 1st dose

VAQTA

pediatric

12 months – 18 years old

VAQTA

adult

19 years and older

Twinrix

Bivalent vaccine Havrix + Engerix B

HEPATITIS VACCINES

CI

• Severe allergic reaction

Meningococcal Vaccine (MCV)

Single-Component Vaccine (menactra, menveo)

Combination Vaccine (MenHibrix)

Meningococcal Vaccine (MCV)

single component

• Menactra (MenACWY-D)

• Menveo(MenACWY-CRM)

Meningococcal Vaccine (MCV)

combination

MenHibrix

(Hib-MenCY-TT)

Menactra (MenACWY-D)

• Meningococcal A, C, W, Y Polysaccharides conjugated with Diphtheria toxoid

Menactra (MenACWY-D)

age

• 9 months – 55 years old

Menveo(MenACWY-CRM)

Men A, C, W, Y Polysaccharides conjugated CRM₁₉₇

Menveo(MenACWY-CRM)

age

• 2 years – 55 years old