Public Health Vaccine Preventable Respiratory Diseases

FDA

regulates drug approval process to ensure drug safety and efficacy

CDC

develops vaccination schedules based on recommendations from the advisory committee on immunization practices (ACIP)

Morbidity and Mortality Weekly Report (MMWR)

The CDC publishes timely scientific updates, public health information, and vaccination recommendations

vaccination information sheets (VIS)

These are provided with vaccines to explain their benefits, risks, and what to expect after vaccination

common misconceptions about vaccines

-vaccines do not work and are filled with unsafe toxins

-vaccines can cause disease

-vaccines cause autism

-herd immunity protects me

-vaccines cause long term complications

-vaccines cause reproductive problems

-educate pts and caregivers

-guide patients to reliable sources of med info

-keep the healthcare team informed

-seek out new info regularly

How do we stop misinformation about vaccines?

A, B, C, D

What are the 4 types of influenza virus?

humans and animals

Influenza A effects who?

humans only

Influenza B effects who?

trivalent vaccines

protect against 3 strains (2 influenza A and 1 influenza B strain)

through respiratory droplets produced when an infected individual coughs or sneezes

How is the flu transmitted?

1-4 days

What is the incubation period of the flu?

risk factors for complications of the flu

-< 5 yrs old

->65 yrs old

-pregnant women (2 weeks postpartum too)

-residents of nursing homes and long term care facilities

-immunocompromised pts

-chronic health conditions

Fluzone, Alfuria, Fluarix, FluLaval

-trivalent inactivated influenza vaccine (IIV3)

-egg based

-Fluzone HD ≥ 65 yrs old

FluBlok

Trivalent Recombinant Influenza Vaccine (RIV3)

Flucelax

Cell-Cultured Inactivated Influenza Vaccine (CCIIV3)

FluMist

Trivalent Live Attenuated Influenza Vaccine (LAIV3)

everyone older than 6 months

What age groups should get a flu shot?

no preservative

The CDC recommends using flu vaccines with ______________ for children, pregnant women, and adults.

FluBlok

a flu vaccine made with recombinant technology; It used to be only for people aged 18 and older, but now it's approved for those 9 years and older

pneumonia

-is an inflammation of the lungs which affects millions annually

-can be caused by a variety of bacteria, viruses, fungi, and parasites

streptococcus pneumoniae

What is the most common cause of community acquired pneumonia (CAP)?

respiratory droplets can take 1 to 3 days to incubate

How is pneumonia transmitted?

99%

Since the introduction of pneumococcal vaccinations in 2000, rates of invasive pneumococcal infections has declined by _____ in young children.

co-infection with influenza

remains a leading cause of mortality for pneumonia patients

risk factors for complications with pneumonia

-children < 2

-adults > 65

-chronic illnesses

-immunocompromised

-DM

-chronic heart, liver, kidney, or lung

-alcoholism

-cochlear implants or cerebrospinal fluid leaks

-smoke

dx of pneumonia

-Differential diagnosis

-Otitis Media

-Meningitis

-Sepsis

-Lab work

-Chest x-rays

-Gold standard for diagnosing pneumonia

-CBC

-Check for elevated WBCs

-Cultures may be necessary

2 weeks

How long does it take people to typically recover from pneumonia

pneumococcal conjugate vaccines

CV13 (Prevnar 13), PCV15 (Vaxneuvance), PCV20(Prevnar 20)

Pneumovax 23 (PPSV23)

the surgar component is targeted as an antigen

PCV21 (CAPVAXIVE)

includes 8 additional serotypes

kids < 5

What age of people should get the pneumonia vaccine?

CV 15, PCV 20, or PCV 21

What pneumonia vaccine should you administer if a pt has never received it or its unknown?

PPSV23

If PCV15 is used you should administer a dose of _________ one year later.

no

If you use PCV20 or PCV21 do you need to do a dose of PPSV23?

bordetella pertussis

is a Gram negative exotoxin producing bacteria only found in humans

person-to-person through respiratory droplets or contact with airborne droplets

How is bordetella pertussis transmitted?

6-20 days

Bordetella pertussis is highly contagious, this disease remains communicable through much of the course of the disease with an incubation period of _________

risk factors for complications of bordetella pertussis

-Infants born prematurely

-Infants exposed to unvaccinated adults

-This is especially concerning for newborns prior to vaccination series initiation at 2 months

-Unvaccinated or incompletely vaccinated children younger than 12 months

-Vaccination wears off over time

-pts with cardiac, pulmonary, neuromuscular, or neurologic disease

dx of bordetella pertussis

-an acute cough lasting more than 2 weeks

-At least one of the following symptoms:

-Paroxysms of coughing

-Inspiratory whoop

-Post tussive vomiting

-Apnea with or without cyanosis

Full recovery can often be achieved with supportive care and antibiotics but this can be a slow process

How can bordetella pertussis be treated?

Catarrhal stage

-1 to 2 weeks

-malaise

-rhinorrhea

-lacrimation

-low grade fever

paroxysmal stage

-1-6 weeks (up to 10 weeks)

-high pitched whoop

-cyanosis

-vomiting exhaustion

convalescent stage

-2-3 weeks

-gradual recovery

-less persistent, paroxysmal coughs that disappear in 2-3 weeks

2 months

When do you start vaccines for pertussis?

Diphtheria-Tetanus-acellular Pertussis Vaccine (DTaP) - Daptacel, Pediarix, Infanrix

-4 or 5 dose series given starting at 2 months of age

-Some DTap vaccines also protect against polio

11 years old

Tetanus-diphtheria-acellular Pertussis vaccine (Tdap) - Boostrix and Adacel which is a one life-time dose recommended at what age?

10 years or following wounds

When is a tdap booster recommended?

27-36 weeks

When is a tdap vaccine recommended in preganancy?

COVID-19

-SARS-CoV-2

-Member of the coronavirus family

-Transmission

-Primarily through direct person-to-person respiratory droplets

-Incubation period

-2-14 day

risk factors for complications with COVID-19

-Older adults (65 and older)

-Pre-existing conditions

-CKD

-COPD

-Obesity (BMI of 30 or higher)

-Immunocompromised

-Serious heart conditions (HF, CAD, or cardiomyopathies)

-Sickle cell disease

-Type 2 diabetes

dx of COVID-19

-Differential diagnosis

-Pneumonia, Strep throat, Flu

-COPD or CHF exacerbation

-Nucleic acid amplification testing (NAAT) is used with a reverse-transcription polymerase chain reaction (RT-PCR) assay

-Several specimen collection methods

-Nasopharyngeal, Nasal swab, Oropharyngeal, Saliva

6 months or older

Who can get COVID-19 vaccines?

this year's COVID vaccine

-for people ≥ 65

-people 12-64 who have certain medical conditions

mRNA COVID-19 vaccines (Pfizer and Moderna)

-target the Omicron KP variant

-approved for ages 6 months and up

Novavax (Nuvaxoid)

targets the JN.1 variant

-Direct person-to-person respiratory droplets

-Hard surfaces like door knobs or counters

How is RSV transmitted?

2-8 days

How long is the incubation period of RSV?

risk factors for RSV

-Infants up to 12 months of age

-Children 2 years old or younger

-Older adults 60 years old or older

-Pre-existing conditions

-Asthma, COPD, or lung disease

-Immunocompromised (HIV/AIDS or transplant recipients)

-Serious heart conditions (HF, CAD, or cardiomyopathies)

complications of RSV

-Pneumonia and bronchiolitis

-Congestive heart failure

-Middle ear Infections

-Increased mortality and morbidity

symptoms of babies and toddlers with RSV

-Irritable, decreased appetite, changes to breathing, little interest, fever, or cough

-Severe: blue/gray colored lips, mouth, and fingernails, short/rapid breathing, wheezing, or apnea

symptoms of RSV in adults and children

Running nose, congestion, cough, fatigue, fever, or headache

dx of RSV

-Real time reverse-transcription-polymerase chain reaction (rRT-PCR)

-Antigen testing

prognosis of RSV

-Most patients recover within 7-14 days.

-Infants and older adults are more likely to develop severe RSV

RSV dx

-An acute cough lasting more than 2 weeks

AND At least one of the following symptoms:

-Paroxysms of coughing

-Inspiratory whoop

-Post tussive vomiting

-Apnea with or without cyanosis