Nura 107 - Immunizations

Front 1

General Immunization Guidelines

Back 1

Children should begin immunizations at birth.
Those who miss a dose do not have to start over, just get the missed doses.
If suspicion that parent will not attend follow ups, any of the vaccines may be given simultaneously.

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General Immunization Contraindications/Precautions

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Contraindicated for previous anaphylactic rxn to vaccine or its components.
Contraindicated in severly immunocompromised, gelatin sensitivity, pregnant women.
Caution with moderate or acute illness.
Premature should get full dose at appropriate chronological age.

Front 3

Nursing Actions for Vaccine Administration.

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Verify prescription. Obtain immunization history and assess for allergies. Provide info to parents about vaccine. Obtain parental consent. Check lot number & exp date. Select appropriate administration site. Administer the vaccine. Document the administration and site, lot number, and exp date. Provide vaccination record to the parents.

Front 4

Hepatitis B Vaccine (Route, Dosing, Contraindications, Precautions)

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IM route. First dose after birth & before discharge. Second dose at 1-2 mos. Final dose 24 mos or older. Contraindicated in allergic reaction to vaccines or yeast, aluminum hydroxide. Caution in infants under 2000g (4.4 lbs).

Front 5

Hepatitis B Vaccine (HBsAg positive mothers and those with unknown status)

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Infants of positive mothers need the vaccine and Hep B Immunoglobulin, and should be tested for HBsAg after completion of HepB series. Unknown mothers should be tested ASAP and follow above if positive.

Front 6

Rotavirus Vaccine (At risk, administration, contraindications)

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Rotavirus is most serious in 3-24 mos. Given oral route due to needing to replicate in gut. Contraindicated in infants with severe vomiting or diarrhea.

Front 7

Rotavirus Vaccine (Types, dosing)

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RotaTeq - 3 doses: 6-14 wks, then 4-10 wks later, then 4-10 wks after 2nd.
Rotarix - 2 doses: 6-14 wks and 4 wks after first dose.

Front 8

Diptheria, tetanus, acellular pertussis (DTaP) Vaccine (Administration, Contraindications, Dosing, Complications)

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IM route, 2,4, and 6 mos. then between 15-18 mos and 4-6 yrs. Contraindications: encephalopathy within 7 days of prev dose, severe allergic rxn to previous dose or vaccine component. Encephalopathy is a complication.

Front 9

Diptheria, tetanus, pertussis vaccine for Adolescents

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Tdap, recommended at 11-12 yrs for children whohave completed DTaP but have not received Td booster. 13-18 yrs who have not had Tdap should receive.

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Haemophilus influenzae type B conjgate vaccine (Agent/Protects Against, Route, dosing, contraindications)

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H. influenzae type b. Protects against meningitis, bacterial pneumonia, septic arthritis, sepsis. IM route. 2,4,6 mos and 12-15 mos. Contraindications: severe allergic rxn to a previous dose or vaccine component.

Front 11

Inactivated poliovirus vaccine (IPV) (Route, dosage, contraindication)

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Sub Q route, can also be IM. 2,4, 6-18 mos, and 4-6 yrs. Contraindications: Severe allergic rxn to previous dose or vaccine component (formalin, neomycin, streptomycin, or polymyxin B)

Front 12

Measles, mumps, rubella (MMR) vaccine (Route, dose, contraindications)

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Sub Q route. 12-15 mos & 4-6 yrs. Children who have not completed the second dose previously need the complete schedule at 11-12 yrs. Contraindications: Severe allergic rxn to vaccine or components (gelatin, neomycin, eggs), pregnancy, immunodeficiency, received immunoglobin in last 3-6 mos.

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Varicella vaccine (Route, dosing, contraindications)

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Sub Q route. 12-15 mos and 4-6 yrs. Children 13 or older who do not have vaccine or chickenpox need 2 doses at least 28 days apart. Contraindications: Severe allergic rxn to vaccine or component (gelatin, bovine albumin, neomycin), significant suppression of cellular immunity, pregnancy. Avoid aspirin (Reye's syndrome)

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Pneumococcal conjugate vaccine (PCV) (Route, dosing, at risk groups, contraindications)

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IM Route. 2,4,6,and 12-15 mos. Recommended for children with chronic illnesses. Contraindicated in those with severe allergic rxn to previous dose or vaccine component.

Front 15

Hepatitis A vaccine (Route, Dosing, Contraindications)

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IM Route. 2 doses 6 mos apart. Contraindicated in those with severe allergic rxn to a previous dose or vaccine component.

Front 16

Meningococcal vaccine (MCV) (Route, dosing, contraindications)

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IM Route. All children 11-12 and college freshmen living in dorms. Revaccination if still at increased risk after 3 years. Contraindicated in children with a history of Guillain-Barre syndrome.

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Human papillomavirus vaccine (HPV) (Dosing, side effects, contraindications)

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Most effective if given before sexually active. 3 injections for girls at 11-12 yrs, 2 mos after, then 6 mos after. Given to boys at 9-18 yrs. Can cause pain, swelling, itching and redness at injection site. Contraindicated in individuals with a rxn to prev injection and pregnant women.