Vaccines (General Information)

Once vaccine is injected, what does the body do?

It builds up antibodies to fight bacteria or virus they're vaccinated against

Once an individual receives the vaccine, they will be…

Immune to the specific pathogen

Most vaccines are protective in at least _______ of the individuals that receive them

80%

How long do vaccines take to establish adequate immunity?

2 to 3 weeks after receiving final dose

What are the 6 common vaccines?

Live/attenuated, inactivated, subunit, toxoid, RNA

What are live, attenuated vaccines?

Contain a live bacteria or virus to trigger an antibody response. The bacteria/virus is live but weakened or "attenuated"

What are 4 examples of live, attenuated vaccines?

What are advantages of the live, attenuated vaccine?

What are the disadvantages of the live, attenuated vaccine?

Not safe for patients who are immunocompromised or pregnant

What is a inactivated vaccine?

Use a killed version of the disease

What are two examples of inactivated vaccines?

What are advantages for inactivated vaccines?

What are the disadvantages of inactivated vaccines?

What are subunit vaccines?

Use specific pieces of the disease causing organism

Subunit vaccines are considered…

Inactivated since they don't have live components of pathogen

Subunit vaccines require…

Adjuvants or substances to accelerate, enhance, or prolong immune response

What are the 3 types of subunit vaccines?

Polysaccharide, conjugate, and recombinant

What are advantages to subunit vaccines?

Safe for patients immunocompromised or pregnant

What are disadvantages to subunit vaccines?

Weak immune response and multiple doses

What is a subunit, polysaccharide vaccine?

Use polysaccharides, which make up surface of certain bacteria

Whats an example of a subunit polysaccharide vaccine?

Pneumococcal

What is a subunit, conjugate vaccine?

Uses pieces from polysaccharide coat of bacteria AND a carrier protein

What are two positives of adding a protein in the conjugate vaccines?

What are two examples of conjugate vaccines?

What are subunit, recombinant vaccines?

Use genetic engineering to replicate an organism's protein that triggers the immune system response

What are three examples of recombinant vaccines?

What is a toxid?

Toxin that has been inactivated

What are toxoid vaccines?

Vaccines made up of toxoids, which then illicits an immune response

Some diseases are caused by ___________ which are produced by…

Toxins which are produced by bacteria, not the bacteria itself

What are advantages of a toxoid vaccine?

What are disadvantages of a toxoid vaccine?

What are RNA

based vaccines?

What does mRNA of a pathogen do?

Gives cells blueprints to make piece of viral protein, which then triggers antibodies to fight against it

What are two examples of mRNA vaccines?

What are advantages to mRNA vaccines?

Faster to produce than other vaccines, relatively safe

What are disadvantages to mRNA vaccines?

What ate viral vector vaccines?

Separate, modified virus (also called "vector") to deliver important instruccions about how to fight targeted pathogen

What does the "vector" carry?

Genetic instruction for targeted pathogen. Its modifed so it doesn't cause infection

What is one example of a vector vaccine?

Johnson and Johnson COVID 19

What are advantages to vector vaccines?

Relatively safe

What are disadvantages to vector vaccines?

Potential concern whether all patients will mount a proper immune response

What are vaccine excipients?

Small amounts of inactive ingredients added to enhance stability, sterility, and effectiveness, or to assist in the manufacturing process

Vaccine excipients are helpful with what?

To understand why some patient should not receive certain vaccines, may experience side effects, or may have concerns about receiving certain vaccine

What are adjuvants?

Excipients added to non

Examples of adjuvants

Aluminum hydroxide, aluminum phosphate

What are preservatives?

Excipients added to prevent combination and growth of bacteria

Preservatives are used a lot in _________ vials

Multidose vials

Example of preservative

Thimerosal

What are stabilizers?

Excepient added to keep vaccine potent during transport and storage

What are examples of stabilizers?

Lactose, sucrose, gelatin

What are cell culture materials?

Excipients, which are remnants of the environment that vaccines are grown in

What are examples of cell culture materials?

Chicken eggs, yeast

What are inactivating ingredients?

Excipients which are used to kill pathogens or inactivate toxins

What is an example of an inactivating ingredient?

Formaldehyde

What are antibiotics?

Excipients which are added to prevent growth of bacteria during vaccine production

What are examples of antibiotics in vaccines?

Aminoglycoside antibiotics

What are immunization schedules?

Spell out exaclty which vaccines should be administered for people of specific age and with specific condition

Who publishes immunization schedules?

Centers for Disease Control and Prevention (CDC), based on reccommendations by the Advisory Committee on Immunization Practices (ACIP)

When are revisions made to immunization schedules?

Annually and are published within first couple months of the year

What do revisions do?

Add new vaccines, new reccommendations for administration of vaccines, and improve readability

What are 3 contraindications you must consider when giving a vaccine?

Allergies, medical conditions, and current medications

What is a vaccine allergy?

Serious allergy to a previous dose or a component of a vaccine. Could result in anaphylactic reaction

For patients that have a latex allergy, what vaccines must be avoided?

Tdap vaccines, such as Adacel and Boostrix, that come in prefilled syringes. The vials dont have later though

What allergic reactions may come from being exposed to a vaccine with latex?

Mild rxns result in red rash, or itchy, dry, cracked, or scaly skin. Severe lead to anaphylaxis

What are 3 excipients commonly used in vaccines that patients may be allergic to?

Egg, yeast, or antibiotics

When it comes to being vaccinated while being ill, what people can receive vaccines and who can’t?

Can: mild acute illness, such as ear infection, cold, low-grade fever, diarrhea

Can’t: moderate-severe acute illness, such as severe/persistent cough, dehydration, mental confusion, shortness of breath

Pregnant patients (or planning to) should receive which vaccines?

Injectable influenza

Pregnant patients (or planning to) should NOT receive which vaccines?

Live attenuated vaccines, such as varicella, intranasal influenza, etc.

Why can’t pregnant or planning to patients can’t receive live attenuated vaccines?

There’s a chance the weakened organism could cross the placenta and infect the fetus

When should MMR vaccines be avoided before pregnancy?

30 days before

Which type of immunocompromised patients are at greater risk with vaccines?

Chemotherapy patients and patients with advanced HIV

Which vaccines are avoided in immunocompromised patients?

Live attenuated

What is Guillain-Barre Syndrome?

Rare disorder where the body’s immune system attacks the nervous system leading to muscle weakness and sometimes paralysis. Exact cause is unknown

When does GBS develop?

Days or weeks after a respiratory or GI tract, a recent surgery, or recent vaccination

On very rare occasions, when do people develop GBS?

6 weeks after immunization

If a patient has history of GBS and wants to get vaccinated…

The pharmacist will likely defer vaccination and refer them to their prescriber

Most meds _____ with routine vaccines

Dont interfere, but there are few instances where meds and vaccine timing matters

What are 4 meds that affect when vaccines can be administered?

Antivirals, high-dose corticosteroids, blood and immune globulins, and salicylates

Patients must wait 24 hours after their last dose of…before receiving any varicella containing vaccine. Also, they must wait ______ days afyer vaccine before taking them.

Last dose of acyclovir, famciclovir, or valacyclovir. Wait 14 days after receiving vaccine to take them

Live attenuated intranasal influenza vaccine should NOT be administered to patients who have taken…

Oseltamivir, zanamivir within last 48 hours; or baloxavir within 17 days

Antiviral drugs against influenza virus migth reduce the effectiveness of…

Flumist quadrivalent

Patients who need an antiviral med against influenza within _____ days of receiving ________ should be revaccinated.

14 days of receiving Flumist Quadrivalent

Patients who are on _____________ should not receive live attenuated vaccines

Chronic systemic corticosteroids, since they suppress the immune system

While chronic systemic corticosteroids should be avoided with live attenuated vaccines, what ca be taken?

Oral corticosteroids (less than 14 days), use of topical inhaled corticosteroids, or getting a local corticosteroid injection in a joint

Why should patients that receive immune globulins or blood products delay live attenuated vaccines?

Because the immune response to live attenuated vaccines can be reduced, or eliminated, by antibodies in the blood product that are specific to the vaccine organism

What is the minimum time patients receving blood and immune globulins should wait before getting live attenuated vaccines?

At least 3 months

What are exceptions to the 3 month waiting period for blood and immune globuling receiving patients and live attenuated vaccines?

Intranasal flu vaccine, rotavirus, and yellow fever vaccines canbe administered at any time before, with, or after. They are not affected by circulating antibodies

Patients who receive a varicella containing vaccine should avoid what for six weeks? Why?

Salicylates. It reduces the chance of getting Reye’s syndrome

What is Reye’s syndrome?

Rare but serious condition that causes confusion, swelling in brain, and liver damage

While most vaccines don’t interact with each other, what must we be careful with?

Adjuvants (theoretical concerns about side effects if they both have adjuvants), and we should separate live vaccines at least 4 weeks if not given on the same day, due to one getting in way of immune response of other