Transcript Vaccine Update and Resources

Rosemary Spence, RN MA
Adult/Adolescent Immunization Coordinator
Colorado Immunization Program
Home Care Advisory Meeting
November 4, 2009
Presentation Overview
 What immunizations are
recommended for healthcare
workers, and what diseases
are prevented?
 What immunizations are
recommended for patients,
and what diseases are
prevented?
 Where are low-cost
immunizations available?
 What can be expected after
receiving an immunization?
Healthcare Worker (HCW) Immunization
Recommendations
 Hepatitis B vaccine
 Influenza (both seasonal and H1N1) vaccines
 MMR (measles, mumps, rubella) vaccine
 Varicella (chickenpox) vaccine
 Td or Tdap (tetanus, diphtheria, pertussis-aka
“whooping cough”) vaccine
Hepatitis B
 Serious disease that affects liver
 Caused by hepatitis B virus (HBV)
 Can cause acute (short-term) illness:
 Loss of appetite
 Tiredness
 Diarrhea and vomiting
 Jaundice (yellow skin or eyes)
 Muscle, joint, and stomach pain
Hepatitis B
 Some develop chronic HBV infection
 Chronic HBV infection often leads to:
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Liver damage (cirrhosis)
Liver cancer
Death
 Those infected can spread HBV to others, even if they
don’t appear sick
 HBV is spread through contact with blood or body
fluids of an infected person
Hepatitis B
 Hepatitis B vaccine can
prevent hepatitis B
 Hepatitis B vaccine is
usually given as a series
of 3 or 4 immunizations
Seasonal Influenza
 Caused by influenza virus, which can be spread by
coughing, sneezing, or nasal secretions
 Can occur any time from November through May
 Influenza can cause:
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Fever
Cough
Sore throat
Chills
Muscle aches
Fatigue
Headache
Seasonal Influenza
 For most people, influenza lasts only a few days
 Some people, such as infants, older adults, and those
with certain health conditions, can get much sicker
 Can cause high fever and pneumonia, and make
existing medical conditions worse
 Influenza vaccine can prevent influenza
Seasonal Influenza
 Two types of seasonal influenza vaccine:
 Inactivated vaccine or “flu shot”
 Live, attenuated (weakened) influenza vaccine is sprayed into
nostrils and may be given to non-pregnant, healthy HCWs
ages 49 years and younger
 These vaccines do not protect against H1N1 influenza
 Influenza vaccines are updated every year and an annual
immunization is recommended
 It takes up to 2 weeks for protection to develop after
immunization and protection lasts for up to a year
 Can’t get influenza from influenza immunization
H1N1 Influenza
 Very contagious-appears to be spreading from human
to human more easily than typical seasonal influenza
 Symptoms include:
 Fever
 Cough
 Sore throat
 Body aches
 Headache
 Chills
 Fatigue
 Diarrhea (in some people)
H1N1 Influenza
 May make underlying chronic medical conditions worse
 Risk for infection among people 65 years or older less than
risk for younger age groups
 Priority groups when vaccine first becomes available:
 Pregnant women
 Caretakers of children younger than 6 months of age
 Healthcare and emergency medical services personnel
 People 6 months-24 years of age
 People 25-64 years with chronic health disorders or
compromised immune systems
LAIV Questions
 Can contacts of people with weakened immune systems get
the nasal-spray flu vaccine LAIV (FluMist®)?
 People who are in contact with others with severely weakened
immune systems when they are being cared for in a protective
environment (for example, people with hematopoietic stem cell
transplants), should not get LAIV (FluMist®). People who have
contact with others with lesser degrees of immunosuppression (for
example, people with diabetes, people with asthma taking
corticosteroids, or people infected with HIV) can get LAIV
(FluMist®).
 Additional information:
http://www.cdc.gov/FLU/about/qa/nasalspray.htm
Measles, Mumps, Rubella
 Measles, mumps, and rubella are serious diseases
 Measles virus causes rash, cough, runny nose, eye
irritation, and fever
 Measles can lead to:
 Ear infection
 Pneumonia
 Seizures (jerking and staring)
 Brain damage
 Death
Measles, Mumps, Rubella
 Mumps virus causes fever, headache, and swollen
glands
 Mumps can lead to:
 Deafness
 Meningitis (infection of brain and spinal cord covering)
 Painful swelling of testicles or ovaries
 Death (rarely)
Measles, Mumps, Rubella
 Rubella (German Measles) virus causes rash, mild
fever, and arthritis (mostly in women)
 If a woman gets rubella while she is pregnant, she
could have a miscarriage or her baby could be born
with serious birth defects
 Measles, mumps, and rubella spread from person to
person through the air
 Measles, mumps, rubella vaccine can prevent these
diseases
Measles, Mumps, Rubella
 Adequate evidence of immunity to measles, mumps,
rubella for persons who work in health care facilities:
 Measles and mumps:
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Documented administration of 2 doses of live virus measles
and mumps vaccine or
Laboratory evidence of immunity or laboratory confirmation
of disease or
Born before 1957 (caveats apply and are available at:
http://www.cdc.gov/vaccines/recs/provisional/default.htm)
Measles, Mumps, Rubella
 Rubella
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Documented administration of one dose of live rubella virus
vaccine or
Laboratory evidence of immunity or laboratory confirmation
of disease or
Born before 1957 (except women of childbearing age who
could become pregnant)((caveats apply and are available at:
http://www.cdc.gov/vaccines/recs/provisional/default.htm)
Varicella (Chickenpox)
 Usually mild, but can be serious, especially in young
infants and adults
 Causes rash, fever, and tiredness
 Can lead to:
 Severe skin infections and scars
 Pneumonia
 Brain damage
 Death
Varicella (Chickenpox)
 Can be spread from person to person through air, or by
contact with fluid from chickenpox blisters
 Person who has had varicella can get painful rash
called “shingles” years later
 Varicella vaccine can prevent varicella
Varicella (Chickenpox)
 Anyone who is not fully
vaccinated, and never
had varicella, should
receive 1 or 2 doses of
varicella vaccine
Tetanus, Diphtheria, Pertussis
 Tetanus (lockjaw) causes painful muscle spasms,
usually all over the body
 Tetanus can lead to tightening of the jaw muscles so
the victim can’t open his mouth or swallow
 Diphtheria causes a thick covering in the back of the
throat
 Diphtheria can lead to breathing problems, paralysis,
heart failure, and even death
 Pertussis (whooping cough) causes severe coughing,
vomiting, and disturbed sleep
Tetanus, Diphtheria, Pertussis
 Tetanus enters body through cuts, scratches, or
wounds
 Diphtheria and pertussis are spread from person to
person
Tetanus, Diphtheria, Pertussis
 All adults should get a
booster of Td every 10
years
 Adults under 65 who
have never gotten Tdap
should substitute it for
next booster dose
 HCWs under 65 who
have direct patient
contact should get Tdap
Immunization Recommendations for Older
Adults
 Zoster (shingles) vaccine
 Pneumococcal vaccine
 Seasonal influenza vaccine
 Tdap (tetanus, diphtheria, pertussis) vaccine
Zoster (Shingles)
 Shingles-painful skin rash, often with blisters
 Rash usually appears on 1 side of face or body and lasts
from 2 to 4 weeks
 Other symptoms:
 Fever
 Headache
 Chills
 Upset stomach
Zoster (Shingles)
 Rarely, shingles infection can lead to pneumonia,
hearing problems, blindness, brain inflammation, or
death
 Post-herpetic neuralgia: severe pain continues even
after rash disappears
 Chickenpox virus stays in body and can reappear many
years later to cause shingles
 Can’t catch shingles form another person with shingles
Zoster (Shingles)
 More common in people 50 and older
 More common in people whose immune systems are
weakened due to cancer, etc.
 Single dose of shingles vaccine is indicated for adults
60 year of age or older
Pneumococcal
 Pneumococcal disease
can lead to serious
infections of:
 Lungs (pneumonia)
 Blood (bacteremia)
 Brain covering
(meningitis)
Pneumococcal
 Some at greater risk of getting disease:
 65 years and older
 Very young
 People with certain health problems
 People with weakened immune system
 Smokers
Pneumococcal
 Usually only 1 dose of
pneumococcal vaccine is
needed for those 65 and
over, but under some
circumstances a second
dose may be given
After Immunizations
 Common events after
receiving an
immunization:
 Redness, soreness,
swelling at injection site
 Varies somewhat by
immunization
 Information for each
immunization available at:
http://www.immunize.org
After Immunizations
 Unusual events after receiving an immunization:
 Signs of serious allergic reaction can include:
Difficulty breathing
 Hoarseness or wheezing
 Hives
 Paleness
 Weakness
 A fast heart beat
 Dizziness
 Usually occur within first few hours after immunization
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After Immunizations
 If an unusual event occurs:
 Call doctor or get person to doctor right away
 Tell doctor what happened, date and time it happened,
and when immunization was given
Resources
 Low cost immunizations are often available at local
health departments and nursing services
 Visit Centers for Disease Control and Prevention’s
(CDC) website: www.cdc.gov/vaccines or call them at:
1-800-CDC-INFO
 Visit Colorado Immunization Program’s website at:
http://www.cdphe.state.co.us/dc/immunization/
 H1N1 questions: CO HELP 1-877-462-2911
 Flu Clinic Locator: www.immunizecolorado.org
 Contact Rosemary Spence at 303/692/2798 or
[email protected]