Vaccines

Important Info

  • HBsAg-positive birthing parents → infant needs hepB & HBIG within 12hrs of birth

  • Recommended vaccines:

    • 1 month → hepB

    • 2 months → IPV, DTaP, Hib, PCV, RV

    • 4 months → DTaP, Hib, IPV, PCV, RV

    • 6 months → HepB, DTaP, Hib, IPV, PCV, RV

    • 12-15 months → Hib, PCV, MMR, Hep A, varicella

    • 15-18 months → DTaP

    • 18-33 months → Hep A

    • 4-6 years → DTaP, IPV, MMR, varicella

    • FLU → recommended after 6 years

    • 11-12 years → Tdap, MCV4, HPV

    • 12 years + → COVID 19

Reactions

  • Local Reactions: tenderness, erythema, swelling at injection site, low-grade fever; behavioral changes like drowsiness, unusual crying, and decreased appetite in infants

  • Anaphylactic reactions:

    • GOAL → secure & protect airway, restore circulation, prevent further exposure to the antigen

    • Tx for a mild reaction w/ no resp distress or cardiovascular compromise → subq injection of an antihistamine (diphenhydramine, epi)

    • Tx for a mod-severe response/distress → establish an airway #1; then - CPR, elevate HOB, give epi/fluids/vasopressors, monitor v/s & urine output

Contraindications to Vaccines

  • if pt had previous allergic or anaphylactic reaction to the vaccine or any of it’s components

  • LIVE vaccines cannot be given to ppl who are → immunocompromised, pregnant, or have a severe sensitivity to gelatin

  • If pt is currently ill → given cautiously if it’s mod-severe acute illness w/ or w/o fever

  • Meningococcal vaccine → contraindicated if pt has previously had Guillan Barre

HIGHLIGHTS IN SAUNDERS

  • How long should a pt be monitored for a vaccine reaction after the injection? 15-30 mins

  • Vaccine considerations for children who are born preterm → they should receive the full dose at the appropriate chronological age

  • Guidelines for administering vaccines:

    • informed consent necessary

    • Mild side effects → fever, soreness, swelling, redness at site

    • What can be given to a child for vaccine side effects? age-appropriate dose of acetaminophen or ibuprofen q4-6hrs

  • The nurse should advise the parents to do what for painful & red injection sites? apply a cool compress for the first 24 hrs & then use a warm/cool compress as needed

  • What is required if a vaccine adverse reaction occurs? a vaccine adverse event report and the health department is notified