The document discusses vaccines and immunizations. It defines vaccines as suspensions of live attenuated or killed microorganisms that stimulate antibody production against specific pathogens. Vaccines provide active immunity by inducing the body to produce its own antibodies or passive immunity by administering pre-formed antibodies. The document lists many vaccine-preventable diseases and guidelines for childhood and adult immunization schedules. It also discusses nursing considerations for vaccine administration and monitoring.

1. Chapter 36
VACCINES
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2. What are Vaccines?
 Suspensions of live, attenuated
(weakened) or killed (inactivated)
microorganisms
 The weakened form prevents the person
from contracting the disease
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3. Vaccines (cont’d)
 Also stimulate the production of antigens
against a specific antibody
 Vaccinations with live bacteria or virus
provide lifelong immunity
 Vaccinations with killed bacteria or virus
provide partial immunity, and booster
shots are needed periodically
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4. Types of Immunity
 Active immunity
 Body produces
antibodies
 Acquired immunity
 Exposed to antigen
 Passive immunity
 Receives antibodies
from another source
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5. Vaccines
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 Antigen
 Attenuated virus
 Toxoids
 Conjugate vaccines
 Recombinant subunit vaccines
 Adjuvant
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6. Examples of Vaccine Preventable
Diseases
 Anthrax
 Diphtheria
 Haemophilus influenzae
type B (Hib)
 Hepatitis A
 Hepatitis B
 Human papillomavirus
 Influenza
 Japanese encephalitis
 Measles
 Meningococcal disease
 Mumps
 Pertussis
 Poliomyelitis
 Rabies
 Tetanus
 Tuberculosis
 Typhoid
 Varicella
 Yellow fever
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7. Childhood Immunizations
 Centers for Disease Control
and Prevention (CDC)
 Recommendation for childhood
immunizations:
www.cdc.gov/vaccines
 Immunization Action Coalition
 Summary of rules for childhood
immunizations:
www.immunize.org/catg.d/p201
0.pdf
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8. Adult Immunizations
 Centers for Disease Control and Prevention
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(CDC)
 Recommendation for adult immunizations:
www.cdc.gov/vaccines
 Immunization Action Coalition
 Summary of rules for adult immunizations:
www.immunize.org/catg.d./p2011.pdf
 Cocooning ??????? Page 493
 A strategy that focuses on immunizing adults in
close contact with newborns and young infants to
protect the babies from contracting vaccine-preventable
diseases in the months before they
are eligible to receive the vaccine themselves.

9. Adult Immunizations
 Recommended adult immunizations
 Tetanus-diphtheria-pertussis, tetanus-diphtheria
 Influenza-now recommended for EVERYONE
> 6mos old
 Pneumococcal polysaccharide
 Human papillomavirus
 MMR
 Varicella
 Zoster
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10. Immunization Before
Foreign Travel
 All immunizations indicated based on age
and/or immunization history
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 Typhoid
 Yellow fever
 Meningococcal disease
 Rabies
 Japanese encephalitis
 www.cdc.gov/travel
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11. Reporting of Disease and Adverse
Reactions
 All health care providers responsible for
reporting vaccine-preventable diseases
 Contraindications for vaccines
 Report adverse reactions (VAERS)
 http://vaers.hhs.gov/index
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12. Varicella Vaccine
 Pharmacodynamics
 Contraindications
 Mode of action/therapeutic effects
 Drug interactions
 Side effects/adverse reactions
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13. Future of Vaccines
 Anthrax: www.anthrax.osd.mil
 Smallpox
 Pertussis: Adacel, Boostrix
 Herpes zoster: Zostavax
 Rotavirus: RotaTeq
 Human papillomavirus: Gardasil
 Pneumococci: Prevnar
 Neisseria meningitides and Haemophilus
influenza type B: Menhibrix
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14. Practice Question #1
A patient receives a vaccine that contains
components of an inactivated (killed)
microorganism. The nurse identifies the type of
vaccine as
A. traditional vaccine.
B. attenuated virus.
C. toxoid.
D. recombinant subunit vaccine.
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15. Practice Question #2
A physically and medically neglected 15-month-old
child has been placed in foster care. The foster
parents bring the child to the clinic for immunization
updates. They have no idea what, if any, vaccines
the child has previously received. The nurse
anticipates administering which vaccines?
A. No vaccines; assume the child is up to date
B. DTaP #4, Hib #4, and MMR #1
C. MMR, IPV, PCV, hepatitis B, and varicella
D. DTaP, Hib, hepatitis B, MMR, IPV, PCV, and
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varicella
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16. Practice Question #3
The procedure of immunizing adults in close
contact with newborns and young infants to
protect the babies from contracting vaccine-preventable
diseases in the months before they
are eligible to receive the vaccine themselves is
called
A. swaddling.
B. isolating.
C. stabilizing.
D. cocooning.
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17. Practice Question #4
Newborns receive immunities via the transfer
of maternal antibodies across the placenta.
This is known as
A.natural, passive immunity.
B.acquired, passive immunity.
C.natural, active immunity.
D.acquired, active immunity.
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18. Practice Question #5
Before administering the varicella vaccine, it is
most important for the nurse to assess the
patient for a history of allergy to
A. penicillin.
B. eggs.
C. neomycin.
D. milk.
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19. Practice Question #6
Which statement about Zostivax does the nurse
identify as being true?
A. Zostivax is indicated for the treatment of patients at
age 40 years.
B. Zostivax is a live attenuated vaccine.
C. Zostivax should be administered every other year.
D. Zostivax prevented the development of zoster in
90% of the people who received the vaccine.
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20. Practice Question #7
Which is the first vaccine developed to prevent
cancer?
A. RotaTeq
B. Prevnar
C. Menhibrix
D. Gardasil
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1993 by Saunders, an imprint of Elsevier Inc.

21. THE END
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22. Other Vaccines of Interest
 Anthrax
 Smallpox
 Typhoid
 Yellow fever
 FluMist
 Contraindications
 Drug interactions
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23. Future of Vaccines
 New vaccine delivery forms
 New combination vaccines
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24. Nursing interventions, including client teaching,
related to the administration of vaccines
 Assess patient’s health history, medication
history, allergies, pregnancy status
 Assess previous reactions and responses
to immunizations
 Assess for contraindications, including
immunosuppression
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25. Nursing Implications (cont’d)
 Before giving any drug, recheck the
specific protocols for administration and
schedules for administration
 Follow manufacturer’s guidelines for drug
storage, administration, routes, and site of
administration
 Encourage parents of young children to
keep a journal of the child’s immunization
status, with dates of immunizations and
reactions, if any
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26. Nursing Implications (cont’d)
 If discomfort occurs at the injection site,
apply warm compresses and give
acetaminophen
 Do not give aspirin to children
 Monitor for therapeutic responses and
adverse reactions
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27. Practice Question #1
The nurse knows that the following are true
statements about FluMist, except
A. It is recommended for healthy individuals age 5 to
49 years.
B. It is a live vaccine.
C. It is recommended for all healthcare workers.
D. Recipients may spread the disease.
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28. Practice Question #1 (cont’d)
Answer: C
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