Vaccination Training

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Vaccination Training

• Student Run Homeless Clinics
• September 10, 2007

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Your Role in Vaccination

• Assess if child is up to date
• If not, what vaccines are needed
• Inform the Chief
• Give parent VIS sheets and go over the side
  effects and contraindications
• Administer the shot

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Common Reactions

• Mild to moderate fever (up to 1-3 days)
• Soreness, tenderness, redness and swelling at
  injection site
• Fussiness
• Vomiting
• Tiredness

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Severe allergic reactions parents should be
warned about (these reactions are VERY
rare)(Usually occur within minutes to hours
after shot given)

• High fever (up to 1 week)
• Unusual behavior
• Weakness
• Paleness
• Dizziness
• Nonstop crying (over 3 hours)

• Difficulty breathing
• Hoarseness
• Wheezing
• Fast heart beat
• Seizures (up to 1 week)

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CDC Vaccine Information Statements

• Public Health law requires them to be provided to
  parents at each visit
• Contains Vaccine Safety information
• Referral information

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Routine Vaccines for Children

• Hepatitis B
• Diptheria, Tetanus, Pertussis (DTaP or DT)
• Haemophilus Influenzae type B (Hib)
• Inactivated Poliovirus (IPV)
• Measles, Mumps, Rubella (MMR)
• Varicella
• Pneumococcal (PCV)
• Influenza

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Hepatitis B

• Need 3 doses
• May be given at the same times as other vaccines
• CONTRAINDICATIONS
• Life threatening allergic reaction to Bakers
  Yeast OR to previous dose of Hep B vaccine
• Moderately or severely ill children should
  reschedule for a later date

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Diptheria, Tetanus, Pertussis(DTaP)

• 5 Doses
• 2 months, 4 months, 6 months, 15-18 months, and
  4-6 years
• If has cold, CAN be vaccinated but should
  reschedule if child has moderate to severe
  illness
• CONTRAINDICATIONS
• Any of the following reaction to pervious DTaP
  severe life threatening allergic reaction,
  seizure, collapsed, cried nonstop for over 3
  hours, or fever over 105F these kids should
  just get DT vaccine (no pertussis)
• Should NOT be given to anyone over age of 7

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Diptheria, Tetanus (Td)

• For age 7 or older
• Tetanus booster
• Lacks pertussis component
• Used as a booster every 10 years after 3rd dose
  of DTaP/DTP/or DT
• Severe Problems
• Deep, aching pain and muscle wasting in upper
  arms, starting 2 days to 4 weeks after shot and
  lasting many months

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Haemophilus influenza type b

• 4 Doses given before age 5
• 2 months, 4 months, 6 months, and 12-15 months
• Given to some immunocompromised when over 5 years
  old
• Prevents bacterial meningitis, pneumonia, severe
  swelling of throat, infections of joints, blood,
  or bone

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Inactivated Polio Vaccine

• 4 doses of IPV
• 2 months, 4 months, 6-18 months
• Booster at 4-6 years
• Adults who have never been vaccinated will need 3
  doses
• Adult vaccination if in certain high risk groups
• OPV no longer given in US because can cause Polio
  (1 in 2.4 million)

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Inactivated Polio Vaccine

• CONTRAINDICATIONS
• Prior severe allergic reaction to streptomycin,
  neomycin or polymyxin B

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Measles, Mumps, Rubella

• Children need 2 doses
• 12-15 months and 4-6 years of age ( or at least
  28 days after 1st dose)
• Some adults also require MMR
• CONTRAINDICATIONS
• Severe life-threatening allergy to gelatin,
  neomycin, or a previous dose of MMR
• Pregnant women (females should wait 3-4 weeks
  before getting pregnant)
• Other Reactions
• Mild rash, swelling of glands in cheek or neck

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Varicella

• One dose between 12 and 18 months of age or at
  any age after that if they have never had the
  chicken pox
• If 13 years or older will need 2 doses, 4-8 weeks
  apart
• CONTRAINDICATIONS
• Severe life-threatening allergy to gelatin,
  neomycin, or a previous dose of varicella
• Pregnant women (females should wait 3-4 weeks
  before getting pregnant)
• Other reactions
• Mild rash that may be contagious to others (very
  rare)

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Pneumococcal

• Prevents some meningitis, blood infections and
  ear infections
• 2 types (we only offer PCV at WTU)
• 1. Pneumococcal Conjugate Vaccine (PCV)
• 4 doses for children under 2 years of age
• 2 months, 4 months, 6 months, and 12-15 months
• Children ages 2-5 with certain high risk
  conditions
• Sickle cell, asplenic, HIV, diabetes, Cancer,
  chemotherapy, etc

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• Pneumococcal Polysaccaride Vaccine (PPV)
• All adults 65 years or older
• Anyone over 2 years of age with long term health
  problem
• Anyone on long term steroid treatment,
  chemotherapy, or radiation
• One dose is sufficient but some circumstances
  require 2nd dose
• No facts about PPV and pregnancy yet

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Influenza

• 2 types Inactivated and activated
• Yearly dose
• Children younger than 9 getting the vaccine for
  1st time should have 2 doses at least 1 month
  apart
• CONTRAINDICATIONS
• Egg allergy (vaccine grown in eggs)
• Guillan-Barre Syndrome
• Children and adolescents on long term aspirin
  syndrome (risk of Reyes syn)
• Season
• Best time is from October to November

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• Inactivated Influenza Vaccine (shot)
• All children ages 6-23 months
• 65 years or older
• Women who will be pregnant during flu season
• Anyone at high risk
• Live, attenuated influenza vaccine (Intranasal
  spray)
• Healthy children and adults ages 5-49
• CONTRAINDICATIONS
• Pregnant women
• Younger than 5, or older than 50,
  immunocompromised, long term health problems

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SAFETY FIRST!!!

• WASH YOUR HANDS!!!
• USE GLOVES
• CLEAN SKIN AREA WITH ALCOHOL
• DISPOSE OF NEEDLES IN SHARPS CONTAINER

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Injection Method

• Intramuscular (IM)
• Hep B
• DTaP, DT, Td
• Hib
• IPV
• PCV
• Influenza
• Hep A

• Subcutaneous (SC)
• IPV
• Varicella
• MMR

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Intramuscular Method

• Needle goes through the skin and into the muscle
• Deltoid, thigh, hip, upper outer quadrant of
  gluteus muscle
• Supplies
• Alcohol pad, sterile gauze, needle and syringe
  with medicine

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Subcutaneous Method
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Video on proper techniques
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Autism and Vaccines

• Theory posed that MMR vaccine might play a role
  in autism
• Weight of scientific evidence does not support
• American Academy of Pediatrics Review and
  Institute of Medicine Review conclude no
  association

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Mercury and Vaccines

• Federal Act to reduce mercury exposure
• Thimiserol -mercury based preservative
• Vaccine schedule prior to 1999 for some infants
  could exceed 1 federal mercury guideline
• No evidence of harm
• US vaccines now virtually mercury-free

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Are Additives Contained in Vaccines Safe?

• Additives are thoroughly tested. Tiny amounts are
  used
• Precautions check manuf. Info., patient hx, and
  NIPs Guide to Contraindications
• Additives Used
• a. adjuvants enhance immune system
  response
• b. antibiotics prevent bacterial fungal
  growth
• c. stabilizers maintain effectiveness in
  face of adverse conditions
• d. preservatives prevent spoilage

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Can vaccines overload the immune system?

• Giving multiple vaccines at the same time is safe
• People are exposed daily to hundreds of antigens
• Multiple vaccines work with the immune system to
  boost it
• Simultaneous vaccination
• protects against several diseases quickly
• Combo vaccines reduce discomfort and costs

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Challenges

• Few diseases are
• eradicable
• No vaccines are 100 safe or effective
• Increased complexity
• Universally recommended

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National Vaccine Hotline
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Additional Resources

• Centers for Disease Control and Prevention
  website www.cdc.gov. Click Vaccines
  Immunizations, then click NIP Home Page in the
  right column or go directly to www.cdc.gov/nip
• National Immunization Hotline [phone]
• Parents Guide to Childhood Immunization
  Publication available online at
  www.cdc.gov/nip/publications/
• For information on vaccine testing and licensing
  www.fda.gov
• For information about local health care
  resources www.naccho.gov or look under public
  health in the blue pages of your local phone
  book
• For information on childrens health insurance
  www.insurekidsnow.gov

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References

• Center for Disease Control Website
  http//www.cdc.gov/nip/recs/child-schedule.htmPri
  ntable
• Basic Vaccine Safety Course, CDC Website
• www.cdc.gov/nip/vacsafe/trg/trg-and-educ.htmBasi
  c
• 3. Vaccine Information Statements, CDC Website
  http//www.cdc.gov/nip/publications/VIS/default.ht
  mdtap