Vaccination Exam

Antibody for anaphylaxis

IgE

What do helper T cells do?

Produce cytokines

Stimulate B cells to make antibodies

What do B cells do?

Make antibodies

Passive immunity

Immediate protection

Short lasting

Active immunity

Develops in response to infection or vaccine

Long lasting

Live attenuated vaccines

Weakened versions of the wild type

More than one can be given at the same time

Must be separated by 28 days after initial visit

Measles vaccine contraindications

Pregnancy, severe allergic reaction

Live vaccine contraindications

Received a live vaccine less than 28 days ago

Taking 20 mg or more daily of prednisone for more than 2 weeks

Does increasing the interval between multi-dose vaccines change the effectiveness?

No. Ensure interval is not too short

Live attenuated influenza vaccine contraindication

Pregnancy. Use inactivated influenza instead

Egg allergies and vaccines

May administer even if patient has an egg allergy. No additional precautions needed

Cold chain

Maintaining appropriate storage and handling conditions throughout transport and at provider facility

Freezer for vaccines

Must be a stand alone freeze, not combination fridge/freezer

How should vaccines be stored in in the fridge?

In the center of the fridge to prevent freezing

Varicella vaccine storage

Freezer

Best practices for vaccine preparation

Syringe should be administered immediately (unless manufacturer filled)

Multi-dose vials can be used until expiration date

Multiple syringes should not be prepped

Manufacturer filled must be discarded at the end of the day if the sterile seal is broken

Freezer temperature

-58 to 5 F

Fridge temperature

35 to 46 F

What do you do if the vaccine storage unit is out of temperature range?

Notify the vaccine coordinator

Do NOT throw out or move the vaccines

RZV diluent

AS01B adjuvant suspension

How to prevent vaccine storage problems

Place water labeled “do not drink” to stabilize temp

Do NOT plug fridge and freezer into one outlet or into a power strip

Do NOT use extension cords

What are Vaccine Information Statements?

Provide information about vaccines in patient friendly language

Must be provided to ALL patients (or guardians)

Should be given before immunization

What should be included on an immunization record?

Type of vaccine

Date

Site

Manufacturer/lot number

VIS publication date and date given

Initials and title of administrator

Where are the recommendations for prevention of vaccine preventable diseases made by the Advisory Committee on Immunization Practices (ACIP) published?

Morbidity and Mortality Weekly Report

Federally mandated blood borne pathogen training must be completed how frequently?

Annual retraining is required

Do pharmacies need a bloodborne pathogen exposure plan?

Yes, however it is a low risk activity for exposure. Hep B vaccination must be offered to these health care worker

How should sharps be disposed of?

Follow local guidelines

Why are vaccines held to a higher safety standard than most other medications?

They are administered to healthy people to prevent disease rather than ill people to cure disease. They are administered to more people than other medications

What does the Countermeasures Injury Compensation Program do?

Provide benefits to individuals seriously injured as a result of certain antivirals

When should a provider report to the Vaccine Adverse Event Reporting System (VAERS)?

After ANY clinically significant adverse event after vaccination

Who can submit to Vaccine Adverse Event Reporting System (VAERS)?

Any provider

Patient

Vaccine manufacturer

What is the Vaccine Injury Compensation Program?

They provide financial compensation to individuals who are found to have been injured by a vaccine. They provide liability protection for manufacturers and providers

What is the goal of the Clinical Immunization Safety Assessment (CISA)?

To be a vaccine safety resourse for consultation on clinical vaccine safety issues

How long should a patient be observed after receiving an immunization?

15 minutes

What symptom of anaphylaxis does epinephrine treat?

HypOtension

What is the onset time of anaphylaxis?

Within minutes of exposure

What are signs of syncope?

Loss of consciousness

Loss of vision

Falling for no reason

Light-headness

What are signs of anaphylaxis?

Swelling of the face

Difficulty breathing

Flushing

Itching

What symptoms of anaphylaxis does diphenhydramine treat?

Itching and hives

Why do you give a second dose of measles vaccine for college students with no evidence of immunity?

To give another opportunity to develop immunity for those who didn’t with the first dose

It is NOT a booster

What qualifications does an individual need to get a routine MMR vaccine?

First dose: age 12-15 months

Second dose: age 4-6 years

College student with no evidence of immunity

What qualifications does an individual need to get a routine influenza vaccine?

Yearly dose

Initial vaccination: 2 doses (12-15 months, then 4-6 years)

If a patient has never received, should get 2 doses

What qualifications does an individual need to get a varicella vaccine?

1 year old or older

LIVE VACCINE

Contraindicated in pregnant patients

Must be separated from other live vaccines by 4 weeks unless given simultaneously

What qualifications does an individual need to get HPV vaccine?

Ages 11-12 for routine vaccination

Ages 9-45 approved

2 doses if first dose between 9-14

3 doses if first dose between 15-45 OR immunosuppressed

What qualifications does an individual need to get a zoster vaccine?

Age 50 and older OR 19 and older if immunocompromised

Rotavirus transmission route

Fecal-oral route

Heplisav-B

2 dose series for 18+ years

All other HepB vaccines are 3 doses

What ages are indicated for ROUTINE meningococcal vaccine?

First dose: ages 11-12

Second dose: 16 years

Which vaccine has pediatric and adult formulations?

Hepatitis A

Rotavirus route of administration

Oral

MMR (Priorix) route of administration

Subcutaneous

Zoster virus (Shingrix) route of administration

Intramuscular

HPV (Gardasil) route of administration

Intramuscular