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13 th Annual Medical Assistant Immunization Update

13 th Annual Medical Assistant Immunization Update. CENTRAL VALLEY IMMUNIZATION COALITION. Tom Booth, RN, BSN, PHN Supervising Public Health Nurse County of Fresno Department of Public Health Immunization Program (559) 600-3550 tbooth@co.fresno.ca.us. Disclosures.

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13 th Annual Medical Assistant Immunization Update

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  1. 13th Annual Medical Assistant Immunization Update CENTRAL VALLEY IMMUNIZATION COALITION

  2. Tom Booth, RN, BSN, PHN Supervising Public Health Nurse County of Fresno Department of Public Health Immunization Program (559) 600-3550 tbooth@co.fresno.ca.us

  3. Disclosures • The speaker has no financial conflict with manufacturers of any product named in this presentation. • The use of trade names and commercial sources during this presentation is for identification only, and does not imply endorsement by the presenter, the Central Valley Immunization Coalition, Vaccines for Children, or the County of Fresno.

  4. SINCERE THANKS TO: • ANTHEM BLUE CROSS • CDPH- CAIR TEAM • CDPH- IMMUNIZATION BRANCH • CHDP • FRESNO COUNTY IMMUNIZATION PROGRAM • GLAXOSMITHKLINE • HEALTH NET • KINGS COUNTY IMMUNIZATION PROGRAM • MADERA COUNTY IMMUNIZATION PROGRAM • MEDIMMUNE • MERCK • NOVARTIS • PFIZER • SANOFI-PASTEUR • TULARE COUNTY IMMUNIZATION PROGRAM • TULARE COUNTY PROFESSIONAL DEVELOPMENT CENTER • UNITED HEALTH CENTERS • VFC

  5. Resources • Central Valley Immunization Coalition http://centralvalleyiz.org/ • Vaccines for Children (EZIZ) http://eziz.org/ • Immunization Action Coalition http://www.immunize.org/ • The Pink Book onlinehttp://www.cdc.gov/vaccines/pubs/pinkbook/index.html

  6. USA Childhood and Adolescent Vaccine Recommendations • National (federal) recommendations are developed and harmonized by American Academy of Pediatrics (AAP), American Academy of Family Practice (AAFP) and the Advisory Committee on Immunization Practices (ACIP) • ACIP Meetings and recommendations • Schedule published yearly (February) • Requirements are state specific • child care • school laws

  7. Vaccines in the Office

  8. Vaccine Quality Office Management • Vaccines and vaccine management should be a part of all office staff meetings • Many new vaccines and preparations • More coming! • Competency in all aspects of immunization should be documented for all staff • Don’t assume anything!

  9. Vaccine Management • The right storage equipment 2009 VFC storage equipment requirements • For questions, check with VFC reps. • Staff education • Involve everyone in the office • Storage temperatures • Monitoring protocols or policies (twice a day documentation) • Thermometer maintenance • Plan to handle storage problems

  10. Refrigerator 35°- 46° F (2°-8° C) Freezer Varicella, MMR, MMRV + 5°F (-15° C) or colder Recommended Vaccine Storage Temperatures 32° is freezing

  11. Be Prepared! Have anEmergency Vaccine Plan If the patient has a reaction to a vaccine… • Call for MD • Call 911 • Simple medical protocol

  12. Materials

  13. Organized!

  14. Freezers • Inexpensive • Available in a variety of sizes

  15. New Separate Temp Logs

  16. Monitor Temps Twice Daily

  17. Patient Encounter • Have an exact vaccine order in writing • Order must be written • Check and double check! • Prepare vaccines carefully • Stay focused and undisturbed, set it up as a quiet room • Read labels and expiration dates • Ask someone if you do not understand • When using new vaccines all staff need education before using the vaccine

  18. Quiz: Which are Contraindications? • MILD UPPER RESPIRATORY INFECTION • CURRENT ANTIBIOTIC TREATMENT • TEMPERATURE OF 100 F • MILD DIARRHEA

  19. False Contraindications • Mild illness • Low grade fever • Antibiotics “Get them while you’ve got them”

  20. Parent Education/Concerns http://www.cdc.gov/vaccinesafety/Concerns/Index.html • Autism? • Mercury in thimerisol? • Won’t all these shots overwhelm the immune system? ASK PARENTS: TO WHICH DISEASES DO YOU WANT YOUR CHILD LEFT VULNERABLE???

  21. Number of Vaccines in the Routine Childhood and Adolescent Immunization Schedule 2008 Measles RubellaHep B Varicella Mumps Diphtheria Pneumoccal Influenza Tetanus Meningococcal Pertussis HepA Polio Rotavirus Hib (infant) HPV 1995 Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Hib (infant) Hep B Varicella 1985 Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio 7 16 10

  22. Read your vials and syringes!

  23. Make sure the vaccine order matches the vaccine

  24. Read the vial or syringe

  25. Check expiration dates Month/Day/Year Day/Month/Year

  26. The Five Rights • RIGHT PATIENT • RIGHT ROUTE • RIGHT DOSE • RIGHT TIME • RIGHT MEDICATION

  27. Organized!

  28. Are you using these? You should it is Federal Law http://www.immunize.org/vis/

  29. ORGANIZED! ORGANIZED!

  30. ORGANIZED!

  31. www.CAIRweb.org 1-800-578-7889

  32. 2012 SCHEDULE 0-6 YEARS

  33. Schedule Using Combinations

  34. 2012 SCHEDULE 7-18 YEARS

  35. 2012 ADULT SCHEDULE FIGURE 1. Recommended adult immunization schedule, by vaccine and age group1— United States, 2012 Centers for Disease Control and Prevention. Recommended adult immunization schedule—United States, 2012. MMWR 2012;61(4).

  36. 2012 ADULT SCHEDULE FIGURE 2. Vaccines that might be indicated for adults, based on medical and other indications1 — United States, 2012 Centers for Disease Control and Prevention. Recommended adult immunization schedule—United States, 2012. MMWR 2012;61(4).

  37. Adult Patients • Annual Flu Vaccine • Tdap (new baby) • Pneumococcal • Hepatitis A and/or Hepatitis B • Shingles • Vaccines for Foreign Travel

  38. 2012 SCHEDULE 0-6 YEARS

  39. 2012 SCHEDULE 0-6 YEARS

  40. Two Rotavirus Vaccines THREE DOSE 2,4,6 Months TWO DOSE 2 & 4 Months

  41. Many DTaP, Tdap containing products Know how to read the vials and syringes

  42. Replaced by …,.. COMPANY WHO MAKES THE VACCINE PFIZER (WYETH)

  43. Prevnar 13 (PCV 13) Complicated catch-up recommendationsAll children under 4 years and 6 months should have at least one dose of PCV 13

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