Candidate for PPSV23?
  • produced by weakening the virus or bacteria to reduce the likelihood that it can cause diseaseend to produce more persistent, longer-lasting immunity than inactivated vaccinesmust replicate in order for the body to produce an immune responsecould cause disease in immunocompromised patientsCirculating antibodies may interfere with a live attenuated vaccine's ability to replicate.
  • The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.*Pure polysaccharide vaccines do not activate B cells.
  • All adults 65+ yearsImmunocompromised (alcoholism, chronic liver; heart; lung disease, diabetics, cochlear implants, CSF leak) patients ages 19-64 Children with asthma only if theyre treated with high dose corticosteriods
  • are produced by killing the virus/bacteriaincludes polysaccharide vaccines (conjugated [protein altered] or unconjugated), toxoids, or cellular vaccines
HPV vaccine is recommended for..
  • immediate hypersensitivity with itching, hives, redness, or symptoms of anaphylaxis
  • Tdap, after 20 weeks of pregnancy
  • Both males and females ages 9-26 years*routinely recommended for 11 or 12 years of age
  • The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.*Pure polysaccharide vaccines do not activate B cells.
Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated?
  • Diphtheria
  • Rabies*it affects the CNS
  • Td or Tdap
  • One dose of MCV4
Occurrence based screening to identify people at risk for vaccine-preventable diseases:
  • takes advantage of an event, such as a hospital admission, clinic visit, or emergency department visit to identify people who need to be vaccinatedex: discharge counseling
  • 2 dose series at 12-15 months and 4-6 years*no additional doses neededMMR is a live vaccine, not recommended until 12 months oldAdults w/o immunity evidence (being born before 1957, documentation of MMR vaccine, lab evidence of disease) should receive one dose Healthcare professionals should receive 2 doses
  • No minimum interval between doses*IIV is inactivated HZV is liveinactivated do not interfere with live
  • 1-4 days
There should be a flat hard surface in the area where vaccines will be administered to ensure:
  • fever, GI upset, red eyes, neurological events
  • there is space to perform CPR
  • 11 or 12 year olds*if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months*if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed
  • every 10 years
Live attenuated vaccines..
  • produced by weakening the virus or bacteria to reduce the likelihood that it can cause diseaseend to produce more persistent, longer-lasting immunity than inactivated vaccinesmust replicate in order for the body to produce an immune responsecould cause disease in immunocompromised patientsCirculating antibodies may interfere with a live attenuated vaccine's ability to replicate.
  • HZV (Zostavax) contains 14 times more antigen than varicella vaccinethe greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox
  • 11 or 12 year olds*if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months*if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed
  • Should be quarantined in fridge/freezer and marked "do not use" and contact manufacturer for further instructions*RPh should document each step anytime theres a break in the cold chain
Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations?
  • PPSV23HPVInfluenza if flu season*PCV13 is for immunocompromised not asthma
  • Immunizations should become part of the patient's permanent record and should be kept for the patient's lifetime.
  • Inactivated is killed so cannot cause influenzaintranasal is live but modified so cannot cause diseaseNo vaccine is 100% effectiveIf illness does occur its often less severe in those who were vaccinatedNo evidence that Thimerosal has caused any short or long term harmSeveral vaccines on the same day in immunocompetent people will not overload their immune systempeople are exposed . to more antigens every day from food or bacteria than from vaccines
  • Immunization stakeholders collaborate to meet community immunization needs.
How do vaccines evoke an immune response?
  • CholeraHZVLAIVMMRMMRVRotavirusTB (BCG)Typhoid (Ty21a)Vaccinia (smallpox)VaricellaYellow Fever*all others are inactivated
  • HZV is a live vaccine so its contraindicated in immunocompromised patients, pregnant women, and those who have experienced a severe allergic reaction to the vaccine components (neomycin, gelatin)
  • it strengthens the response to the antigen and the immune response is much greater because the adjuvant results in an inflammatory response*adjuvants are added to recombinant vaccines
  • The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.*Pure polysaccharide vaccines do not activate B cells.
Viruses associated with the development of cancer:
  • every 10 years
  • HPV and Hep B
  • Td or Tdap
  • 15min of vaccination
The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases?
  • Diphtheria
  • HPV
  • smallpox
  • MMR
Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb?
  • 11 or 12 year olds*if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months*if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed
  • IM at 90 degrees*weight of patient is irrelevant in regards to route of administration
  • because the temperature in the middle does not fluctuate as much.
  • smallpox
True regarding varicella-containing vaccines:
  • HZV is a live vaccine so its contraindicated in immunocompromised patients, pregnant women, and those who have experienced a severe allergic reaction to the vaccine components (neomycin, gelatin)
  • HZV (Zostavax) contains 14 times more antigen than varicella vaccinethe greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox
  • The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.*Pure polysaccharide vaccines do not activate B cells.
  • All adults 65+ yearsImmunocompromised (alcoholism, chronic liver; heart; lung disease, diabetics, cochlear implants, CSF leak) patients ages 19-64 Children with asthma only if theyre treated with high dose corticosteriods
What vaccine should women get every pregnancy?
  • once a year at the end of January or early February
  • The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.*Pure polysaccharide vaccines do not activate B cells.
  • Lower than expected efficacy in 2013-2016
  • Tdap, after 20 weeks of pregnancy
What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines?
  • Fixed 1-inch needles are acceptable for patients weighing 60 kg (132 lb) or less.
  • 6 weeks
  • Pertussis
  • Assess
Minimum interval for inactivated vaccines and antibodies
  • 4 weeks
  • no minimum
  • 2 weeks
  • 28 days
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