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Vaccine Update and Resources measles


									        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
 Where are low-cost
  immunizations available?
 What can be expected after
  receiving an immunization?
  Healthcare Worker (HCW) Immunization
 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:
       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:
     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
   Additional information:
     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
 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
    Measles, Mumps, Rubella
 Adequate evidence of immunity to measles, mumps,
 rubella for persons who work in health care facilities:
   Measles and mumps:
       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:
  Measles, Mumps, Rubella
 Rubella
    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:
        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
 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
 Diphtheria and pertussis are spread from person to
 Tetanus, Diphtheria, Pertussis
 All adults should get a
  booster of Td every 10
 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
 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
 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 disease
 can lead to serious
 infections of:
   Lungs (pneumonia)
   Blood (bacteremia)
   Brain covering
 Some at greater risk of getting disease:
    65 years and older
    Very young
    People with certain health problems
    People with weakened immune system
    Smokers
 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
   Redness, soreness,
    swelling at injection site
   Varies somewhat by
   Information for each
    immunization available at:
            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
          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
 Low cost immunizations are often available at local
  health departments and nursing services
 Visit Centers for Disease Control and Prevention’s
  (CDC) website: or call them at:
 Visit Colorado Immunization Program’s website at:
 H1N1 questions: CO HELP 1-877-462-2911
 Flu Clinic Locator:
 Contact Rosemary Spence at 303/692/2798 or

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