vaccines

subcutaneous vaccines

IPV, MMR, Varicella, MPSV4

•Redness/tenderness/swelling at site

•Low-grade fever

•Fussiness

common vaccine SE

contraindication of vaccines

anaphylaxis

specific conditions

< 7 years

DTaP

> 7 years

Tdap

•Tonsillar/pharyngeal infections

•Pseudomembrane formation

•Cervical edema and lymphadenopathy

•AIRWAY OBSTRUCTION

diphtheria

•AKA Whooping cough

•Bordetella pertussis

•Paroxysmal coughing spells lasting 1-4 weeks

•Booster important for transmission

•Droplet transmission

pertussis

DTaP vaccine

diptheria, tetanus, pertussis

•Fatal neurological disease

•Clostridium tetani

•Spores can live anywhere

•Most severe form will result in generalized tetanus

tetanus

given at :

•2 and 4 months

•6 months (if 4-dose series)

•12-15 months

HIB

can cause life threatening infections:

meningitis

epiglottis

septic arthritis

HIB

•Inactivated vaccine

•Given at:

•2, 4, 6-18 months

•4-6 years

•Oral secretions

•Can cause permanent paralysis

polio

•Given at:

•12-15 months

•4-6 years

•Live attenuated vaccine

•Can be given the same day as other live vaccines

•If not, wait 28 days

MMR

•AKA Rubeola

•Communicable 4 days before and 5 days after onset of rash

•AIRBORNE PRECAUTIONS

measles

•S/S include:

•Maculopapular rash spreading from head to toe

•Cough / Conjunctivitis / Cold symptoms

•Koplik spots

•Complications include encephalitis

measles

•Contagious several days prior and 6-9 days after onset of parotid swelling

•Droplet & Contact precautions

mumps

•S/S:

•Fever

•Parotitis

•Complications include orchitis

mumps

•AKA German measles

•Droplet precautions

•Vertical transmission / TORCH

•Maternal rubella can cause:

•Miscarriage

Congenital malformations

rubella

•Given at:

•Started at 12 months

•2nd dose in 6 months

•Fecal-oral transmission

•Contaminated food/drinking water

•Oral exploratory behavior

hep A

•Given at:

•Birth

•1-2 months

•6-18 months

•Spread through contact with blood or body fluids

•Can spread from infected mother to newborn

Hep B

•Given at:

•12-15 months

•4-6 years

•Live attenuated vaccine

•Can be given with other live vaccines

•If not, wait 28 days for next live vaccine

varicella

•Contagious 1 day prior to macule eruption and until all lesions are crusted

•S/S:

•Fever

•Malaise

•Anorexia

•Macules -> Papules -> Vesicles

AIRBORNE/CONTACT PRECAUTIONS

varicella

causes:

•Pneumonia

•Sepsis

•Meningitis

•Otitis media

pneumococcus

two types of pneumococcal vaccine

PCV 13

PPSV 23

•Inactivated vaccine (IIV) given:

•2 doses 4 weeks apart for first administration for children 6 months to 8 years

•1 dose annually every flu season thereafter

influenza

•Live attenuated vaccine (LAIV) given:

•Intranasal

•Contraindicated if immunocompromised or exposure to immunosuppressed persons

•Children 2 years and older

influenza vaccine

•Given at:

•2 and 4 months (Rotarix)

•2, 4, and 6 months (Rotateq)

•Severe, watery diarrhea

•ORAL vaccine

•Contraindicated with history of SCID or intusseception

rotavirus

•2 doses

•Ages 11-12 years then again in 6-12 months

•Can start as young as 9 years

•3 doses

•Ages 15 and older

•2nd dose in 1-2 months

•3 dose in 6 months

HPV vaccine

•genital warts

•Cervical and head/neck cancer

HPV

•Neisseria meningitidis

•Causes:

•Meningitis

•Meningococcemia

•Bacterial pneumonia

meningococcal disease

•Given at 11-12 years, again at 16 years

•Given at 2 months to 10 years for those at increased risk:

•Anatomical/functional asplenia

•Complement component deficiency

•HIV

serogroup ACWY

•Usually given between 16-18 years

•High risk groups:

•Functional/anatomic asplenia

•First year college students in residence halls

•During outbreaks

serogroup B

•vaccine is the only vaccine currently under EUA for children 5-15 years; full FDA approval for patients 16 years and older

Pfizer

•Given on same schedule as adults - 2 doses 21 days apart; Dose for 5-11 years old is 1/3 of the adult dose.

Pfizer