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Vaccination Training

Vaccination Training. Student Run Homeless Clinics Winter 2011. Your Role in Vaccination. Assess if patient is up to date If not, what vaccines are needed Inform the clinic chief Provide vaccine information sheet and go over the side effects and contraindications

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Vaccination Training

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  1. Vaccination Training Student Run Homeless Clinics Winter 2011

  2. Your Role in Vaccination • Assess if patient is up to date • If not, what vaccines are needed • Inform the clinic chief • Provide vaccine information sheet and go over the side effects and contraindications • Bring signed waiver form to attending to be co-signed • Prepare vaccines and necessary supplies • Administer the vaccine

  3. Vaccination Training Video

  4. REMEMBER SAFETY FIRST!!! • WASH YOUR HANDS!!! • USE GLOVES • CLEAN SKIN AREA WITH ALCOHOL • DO NOT RECAP NEEDLES • DISPOSE OF NEEDLES IN SHARPS CONTAINER

  5. Intramuscular (IM) Hep B DTaP, DT, Td Hib IPV PCV Influenza Hep A Subcutaneous (SC) IPV Varicella MMR Injection Method

  6. 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

  7. Adult Vaccines

  8. Pediatric Vaccines

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

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

  11. CDC Vaccine Information Form • Must be provided to parents prior to vaccination • Contains vaccine safety information • Referral information

  12. 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

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

  14. 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 105°F [these kids should just get DT vaccine (no pertussis)] • Should NOT be given to anyone over age of 7

  15. 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

  16. 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

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

  18. 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

  19. 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)

  20. Pneumococcal • Prevents some meningitis, blood infections and ear infections • 2 types: • 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 • 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

  21. 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

  22. Influenza • 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

  23. Other Information

  24. 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

  25. 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

  26. Are Additives Contained in Vaccines Safe? • Additives are thoroughly tested. Tiny amounts are used • Precautions – check manuf. Info., patient hx, and NIP’s 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

  27. 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

  28. Challenges • Few diseases are eradicable • No vaccines are 100% safe or effective • Increased complexity • Universally recommended

  29. National Vaccine Hotline

  30. Immunization Additional Resources • Centers for Disease Control and Prevention website: www.cdc.gov • National Immunization Hotline: 1-800-CDC-INFO • For information on vaccine testing and licensing: www.fda.gov • For information about local health care resources: www.naccho.org or look under “public health” in the blue pages of your local phone book • For information on children’s health insurance: www.insurekidsnow.gov

  31. References • Center for Disease Control Website http://www.cdc.gov/vaccines/default.htm • Basic Vaccine Safety Course, CDC Website: http://www.cdc.gov/vaccinesafety/index.html • Vaccine Information Statements, CDC Website: http://www.cdc.gov/vaccines/pubs/vis/default.htm

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