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Workshop #2 details, details, details
1. Module #2 Update March 2010
Details, Details, Details
Vaccine Names, Brands, Specific Details
• Vaccines have at least two names
– CDC recommended abbreviations
– Brand names
• Use of CDC recommended abbreviations is
highly recommended!!
– At times we find ourselves referring to vaccines by
their brand name to specifically identify a vaccine
– However, document vaccines with CDC
recommended abbreviations
• These abbreviations stay the same over time
• Brand names of vaccines come & go
• Use of brand names on patient record is extremely confusing
when brand is no longer is use and has become unfamiliar to
us
1
2. The first module focused on the vaccine-preventable diseases.
Now let’s tie those diseases to the vaccines
which are used for their prevention.
• But first, let’s define some vaccine terms used in this
module
– Pediatric vs Adult formulations
• Some (but not all) vaccines
• Have different formulations
• That can be used ONLY for specific age groups
– Do NOT use ½ doses or make other
adjustments on your own
• Use vaccines correctly!!
2
3. Definitions (cont)
– Combination vaccines
• Vaccines which protect against more than one
disease
– Valid vs invalid doses of vaccine
• Immunizations given correctly are said to be “valid”
• Immunizations given incorrectly are said to be
“invalid”
– Invalid doses usually need to be repeated
• Most common errors that make a vaccine dose
invalid are
– Vaccine dose given to a patient before the minimum age
for that vaccine
– Vaccine dose given before the minimum interval between
doses has passed
3
4. Definitions (cont)
• Vaccines for Children Program (VFC)
– A federal program which allows you to
administer vaccines at no charge to children
in specific categories
– Program will be discussed in depth in Module
#8
4
5. Disease: Hepatitis B
Vaccine Abbreviation: Hepatitis B (Hep B)
Two brands: 1) Recombivax HB
2) Engerix-B
Formulations:
1) Recombivax HB
a) Pediatric/Adolescent formulation Use for birth thru 19 yrs of age
b) Adult formulation Use for 20 yrs of age and older
2) Engerix B
a) Pediatric/Adolescent formulation Use for birth thru 19 yrs of age
b) Adult formulation Use for 20 yrs of age and older
5
6. Disease: Hepatitis A
Vaccine Abbreviation: Hepatitis A (Hep A)
Two brands: 1) Havrix
2) VAQTA
Formulations:
1) Havrix
a) Pediatric/Adolescent formulation Use for 1 yr thru 18 yrs of age
b) Adult formulation Use for 19 yrs of age and older
2) VAQTA
a) Pediatric/Adolescent formulation Use for 1 yr thru 18 yrs of age
b) Adult formulation Use for 19 yrs of age and older
6
7. Diseases: Diphtheria, Tetanus, Pertussis
Vaccine Vaccines to prevent these three diseases have been in
Abbreviations: combination since the 1940s. Currently there are
several of these vaccines in use. They are called
diphtheria tetanus containing vaccines.
DTaP
DT
DTP
Td
Tdap
- These vaccines are all different vaccines
- They are not interchangeable
- Each is given at a specific age or for a specific
reason
- Yet each, if valid, can be counted as a dose in
this series of vaccines
7
8. Diseases: Diphtheria, Tetanus, Pertussis (cont)
Work Carefully!
• Capitalized letters vs lower case letters
– Diphtheria Tetanus (with and without Pertussis)
containing vaccines have a very strict use of
• Both capital letters AND lower case letters
• The order in which the letters are written also
indicates a specific vaccine
– You will need to know the difference between these
vaccines. They are NOT the same vaccines!!!
– Memorize them (and the details that follow) now
• DTaP
• DTP
• DT
• Td
• Tdap 8
9. Diphtheria, Tetanus,
Diseases: Pertussis (cont)
Vaccines & Brand Contains these Licensed for this age
Names vaccines group
DTaP Diphtheria, tetanus, 6 weeks thru 6 yrs of age
1) Tripedia pertussis
2) Infanix
3) DAPTACEL
DTP (Currently not used in (Is in use in many other
U.S.) countries of the world)
DT Diphtheria & Tetanus 6 weeks thru 6 yrs of age
Td Tetanus & diphtheria but 7 yrs of age and older
in different proportions
than in DTaP & DT
Tdap Tetanus, diphtheria, &
pertussis but in different
1) ADACEL proportions than in 11 yrs thru 64 yrs of age
DTaP
2) Boostrix 10 yrs thru 64 yrs of age9
10. Disease: Hib (Haemophilus influenza type b)
Vaccine Abbreviation: Hib
Three brand names: 1) ActHIB
2) PedvaxHIB
3) Hiberix
Disease: Polio
Vaccine Abbreviation: IPV (Inactivated Polio Vaccine)
Only one brand IPOL
currently in use in U.S:
IPV and OPV are two OPV (Oral Polio Vaccine) is in
different vaccines but
both prevent the same wide use in other countries
10
disease
11. Disease: Pneumococcal This is a category of
disease diseases which has
types and subtypes
Vaccine These vaccines
Abbreviations are not
interchangeable.
& Brands:
1) PCV7 Prevents 7 types of
Brand name: pneumococcal disease
Prevnar
2) PCV13 Prevents 13 types of
pneumococcal disease
(Newly licensed 2-2010)
3) PPSV23 Prevents 23 types of
Brand name: pneumococcal disease
11
Pneumovax
12. Disease: Meningococcal This is another category of
diseases which has types
disease and subtypes
Vaccine
Abbreviations
& Brands:
1) MCV4 Both brands of MCV4
vaccine protect against the
a) Menactra same 4 types of disease
b) Menveo Newly licensed 2-2010
2) MPSV4 This vaccine protects against
the same four subtypes of
(Menomune) disease as MCV4. However,
it is made in a very different
manner and is not
interchangeable with MCV4
vaccines. 12
13. Work Carefully: conjugate vs polysaccharide
• Two vaccines currently come as Conjugate
vaccines and as Polysaccharide vaccines
– These are two different ways of making vaccines
– Conjugate and Polysaccharide vaccines are NOT
interchangeable
• The “C” identifies pneumococcal & meningococcal
vaccines as conjugate
• The “PS” identifies pneumococcal & meningococcal
vaccine as polysaccharide
– PCV7 Pneumococcal CONJUGATE vaccine
– PCV13 Pneumococcal CONJUGATE vaccine
– PPSV23 Pneumococcal POLYSACCHARIDE vaccine
– MCV4 Meningococcal CONJUGATE vaccine
– MPSV4 Meningococcal POLYSACCHARIDE vaccine
• Pay close attention to which vaccine is ordered
• Give the correct vaccine
• Document the correct vaccine 13
14. Work Carefully: conjugate vs polysaccharide (cont)
• PCV7
- Pneumococcal CONJUGATE vaccine
- Brand name: Prevnar
- Routine childhood vaccine
• PCV13
- Another Pneumococcal CONJUGATE vaccine
- Brand name: Prevnar13
- Newly licensed 2-2010
• PPSV23
- Pneumococcal POLYSACCHARIDE vaccine
- Brand name: Pneumovax
- NOT a routine vaccine for children
- But can be given to high-risk children who are 2
years of age and older
- Generally given to adults 14
15. Work Carefully: conjugate vs polysaccharide (cont)
• MCV4
- Meningococcal Conjugate Vaccine
- Brand names: Menactra & Menveo
- Licensed for ages 2 (two) - 55 years only
- Given routinely to adolescents
• MPSV4
- Meningococcal Polysaccharide Vaccine
- Brand name: Menomune
- NOT given routinely
- Used if patient 56 years old or older
- Used if pt 2-55 yrs old but MCV4 not available
- Used if patient has history of Guillian-Barre syndrome
- NOT on Vaccines for Children program
15
16. Disease: Rotavirus
Vaccine
Abbreviations and
Brand Names:
Abbreviation Brand Name
1) RV5 RotaTeq ®
2) RV1 Rotarix ®
Rotavirus vaccine schedule is not covered in this module but
please be aware that it has a very specific schedule that
must be followed when administering this vaccine
16
17. Diseases: Measles, Mump, Rubella
Vaccine Abbreviation: MMR
History of disease gives immunity.
However, patient must have had
history of all three of these
diseases before vaccine is held
Disease: Varicella (Chickenpox)
Vaccine Abbreviation: Varicella or Var
Again, history of disease gives
immunity & vaccine may be held if
specific criteria are met
17
18. Disease: Human Which causes cervical
Papillomavirus cancer and genital warts
Vaccine Vaccine is licensed only for
Abbreviations & persons age 9 years through
26 yrs
(Brand Names)
1) HPV4 - Licensed for females for
prevention of cervical cancer
(Gardasil) and genital warts
- May be used for males for
prevention of genital warts
2) HPV2 - Licensed only for females
(Cervarix) for prevention of cervical
caner
- Does not prevent genital
warts 18
19. Disease: Shingles
Vaccine (Abbreviation): Zostavax (Zoster)
Vaccine is licensed only for
persons 60 yrs or age and older
Disease: Influenza
Vaccine Types
1) TIV (Trivalent Influenza Injectable vaccine
Vaccine)
2) LAIV (Live Attenuated Intranasal vaccine
Influenza Vaccine)
Influenza vaccines are made each year specifically for the
upcoming influenza season. Products and recommendations vary.
19
20. Combination Vaccines
This is simply a list of current combination vaccines
It is not a complete list of details for their use.
Brand Name Combination contains these vaccines
Pediarix DTaP – IPV - Hep B
Pentacel DTaP – IPV - Hib
Kinrix DTaP – IPV
Comvax Hib – Hep B
Twinrix Hep A – Hep B
ProQuad MMR - Varicella
DTaP, DT, Td, Tdap Discussed previously
MMR Discussed previously
20
21. Additional Definition of Terms
– Presentation
• Term used to describe whether vaccine comes to
you as single dose vial, multi-dose vial, prefilled
syringe, etc.
– Preservative Free (PF)
• Does not contain thimerosol
– Which was frequently used as preservative in the past
– With only a few exceptions, has now been removed from
vaccines
21
22. Additional Definition of Terms (cont)
• Live vs Killed vaccines
– Live vaccines (attenuated)
• Strength has been weakened so germ will begin immune
process in the body but will not give disease if patient’s
immune system is healthy
• Very fragile vaccines
• Do NOT give to pregnant women
• Do NOT give to people whose immune systems are not
normal
• Routine vaccines which are Live
– MMR, Varicella, MMRV, Zoster, LAIV, RV5, RV1
– Killed vaccines (inactivated)
• All other vaccines which are given routinely
• Absolutely impossible for these vaccines to cause the
disease in persons who receive the vaccine
22
23. Additional Definition of Terms (cont)
• Vaccines which come as liquid
– Usually (but not always) are ready to be
administered
• Vaccines which come as powder
– Must be mixed up
• Reconstitute
– Word used for “mixing” the powder & liquid
• Diluent
– Word used for liquid that is mixed with powder
23
24. Additional Definition of Terms (cont)
• Diluents
– You MUST use ONLY the diluent which comes
specifically with each powdered vaccine
– Current vaccines that need to be reconstituted:
• ActHIB
– Comes with its own diluent in the box
• MPSV4 (Menomune)
– Come with its own diluent
• MMR, Varicella, MMRV
– All made by same company – Merck
– Diluent comes in separate box
– Labeled as “Sterile Diluent for Merck Live Virus Vaccines”
– Do NOT freeze diluent
– Do not use any other liquid to mix Merck vaccines
24
25. Screen for contraindications and precautions
• At times there are reasons to NOT give
specific vaccines
– Contraindications
• Permanent conditions that prohibit a patient from
ever getting vaccine
• E.g., Anaphylactic reaction to vaccine
– Precautions
• Temporary conditions that may or may not prohibit
a patient from getting vaccine
• Provider must look at risk of vaccine vs benefit of
vaccine
– Pregnancy
– Moderate – severe illness
25
26. Screen for contraindications and precautions (cont)
• Every patient must be screened
• Every time a vaccine is to be given
• This module will not cover screening in
detail
• Screening must be done by provider or
experienced nurse
26
27. Screen for contraindications and precautions (cont)
• Screening Forms
– One for children and
teens
– Another for adults
– With appropriate
screening questions
– From Immunization
Action Coalition (IAC)
– Updated as necessary
by that agency
– Available in AIM Kit &
on IAC website
27
28. Screen for contraindications and precautions (cont)
• Screening Forms (cont)
– Additional information
on back of form
– For help if patient’s
answer indicates a
potential problem
28
29. Again, Work Carefully:
• Vaccines given in other countries
– Remember: other countries often use
different combination vaccines
– Do NOT assume you can guess which
vaccine is which
– Ask to have vaccine record translated by
someone who knows the language
– E.g., Sarampion in Spanish is Measles
• But a Sarampion vaccine contains only Measles
vaccine
• It does not contain Mumps or Rubella vaccine
29
30. Details, Details, Details
• These are only a few of the details about
working with vaccines
• Always work very carefully with vaccines
• If you are unsure about something, ask
questions from a reliable source before
you make a mistake!
30
31. Games People Play #1
Review of diseases, abbreviations, & brand names
Let’s Practice:
Note to instructor:
• Write names of all diseases, vaccine abbreviations, &
brand names -- one each -- on small pieces of paper
• Put all pieces of paper into a hat
• Attendees at class then
– Draw one piece of paper out of hat
– If disease is written on paper, attendee will give abbreviation of
vaccine, & brand name
– If brand name is written on paper, attendee must give disease
prevented, & abbreviation, etc.
– Repeat
• Go around the room, attendees take turns drawing
• Until all review is completed 31