219 Vaccinations

SBAR?

Situation, background, assessment, recommendation

Allergies to vaccines from:

Eggs (most), yeast (hep B)

When to hold a patient after vaccine:

Severe allergic reaction, pregnancy (for live), Severe acute illness, blood thinners, Guillain-Barré syndrome

Injection in thigh?

Vastus Lateralis (infants/toddlers)

Injection in upper arm?

Deltoid (older kids and adults)

Injection in hip?

Ventrogluteal

Subq injections?

MMR and Varicella only, goes in fat not muscle!

Protects against tetanus, diphtheria, and pertussis. IM. Given at months 2,4,6,15-18, and 4-6 years old

DTaP

Tetanus, diphtheria, acellular pertussis. 11 yrs old, repeat every 10 yrs. IM.

TDaP

Given at 2,4,6-18 months and 4 yrs. IM. Can spread by person-to-person contact.

Polio (IVP)

First dose at 12 months, second dose 6-12 months after that. Live. IM.

Hepatitis A

What does IM stand for?

Intramuscular injection

With a live vaccine, what is the earliest age they’ll get it?

12 months

Given at birth, 1-2 months, and 6 months. IM. Can spread by blood/body fluids.

Hepatitis B

Oral, 3 dose series given at 2,4,6 months( RotaTeq) OR could have 2 dose series given at 2,4 months (Rotarix). PO. Live. Hold for hx of intussusception.

Rotavirus

3 or 4 dose series (provider choice). 2,4,6,12-15 month OR 2,4,12-15 month. IM. Is responsible for three million serious illnesses and about 386,000 deaths per year.

Haemophilus Influenzae B (Hib)

2,4,6,12-15 month. IM. Kills more people in the US each year than all other vaccine preventable diseases combined.

Pneumococcal pneumonia

Given at 12 months and 4 years. SQ. Live. After two dose administration, over 99% children have protective antibody levels.

Varicella

Subq. Given at 12 months and 4 years. Live. A rash 4-6 weeks after vaccination is normal.

MMR (measles, mumps, rubella)

Recommended annually for ages 6 months and older. Will need booster dose if first vaccination is between 6 months & 9 yrs. IM. Can do nasal spray for some older kids.

Influenza

Given at 11 yrs (or as early as 9). Before sexually active. 2nd dose needed 2 months after the first. 3rd (if needed) is 6 months after the first. IM. For all genders up to age 45.

Human Papillomavirus (HPV)

11-12 yrs and 16 yrs. IM. College students high risk. Spread by droplet.

Meningococcal (ABCWY)

Which injection site is no longer used?

Dorsogluteal