35 Questions
What should the nurse be aware of in terms of vaccine administration?
The immunization history of the child
Why is it important for the child to remain in the clinic under observation for at least 20 minutes after receiving a vaccine?
To monitor for any adverse reactions
What should be available at the clinic for emergencies during vaccine administration?
Epinephrine
What is the purpose of reporting serious adverse events to VAERS?
To monitor vaccine safety
Why should patients be directly observed for 15 to 20 minutes after receiving an immunization?
To ensure immediate treatment for anaphylaxis
Why should reducing pain at the site of injection be considered, especially when multiple injections are required?
To make children more comfortable during vaccination
What is the recommended needle gauge for administering an intradermal injection?
23-25 gauge
Which of the following is NOT a contraindication for live virus vaccine administration?
History of high fever (40.5°C [105°F]) after previous vaccinations
What is the recommended needle length for an IM injection in children aged 4 months to 18 years?
1-¼-inch
What is the recommended spacing between the MMR and Varivax vaccines if not administered on the same day?
28 days apart
In case of an interrupted vaccination series in children, what action is usually recommended?
Continuing the vaccination series without restarting
Which of the following necessitates an individual evaluation by a health care provider before live virus vaccine administration?
Immunocompromised caregiver in the home
Which vaccine must be dispensed in a separate syringe from other vaccines administered at the same clinic visit?
Haemophilus influenzae type b (Hib) vaccine
Which vaccine causes significant tissue irritation if given subcutaneously?
Diphtheria-tetanus–acellular pertussis (DTaP) vaccine
Which organization approves the recommended immunization program in the United States?
CDC
What is essential before a vaccine is administered to a child?
Providing a VIS (Vaccine Information Statement) to the parent, discussing the vaccine, and obtaining consent
What interval is recommended between the administration of an immune globulin and administration of a live virus vaccine?
$3-11$ months
What type of vaccines have been developed to reduce the number of injections required at each clinic visit?
Combination vaccines
Why should epinephrine be on hand during vaccine administration?
To reduce the risk of anaphylaxis
Which organization should be contacted for management of bioterrorism-related incidents?
HHS Bioterrorism Branch
What should a nurse be aware of when administering vaccines to children?
The child's vaccination history and contraindications
Why should appropriate equipment for anaphylaxis treatment be readily available during vaccine administration?
To manage potential adverse events like anaphylaxis
Why is it important to reduce pain at the site of injection during vaccinations?
To improve patient experience and compliance
What is a contraindication to live virus vaccine administration?
History of high fever (40.5° C [105° F]) after previous vaccinations
What is the recommended needle length for an intradermal injection in children?
½-inch
When should a child adhere to a catch-up vaccine schedule?
If they are more than 1 month behind
What type of therapy necessitates individual evaluation before live virus vaccine administration?
Corticosteroid therapy
Why is it important to dispense the Haemophilus influenzae type b (Hib) vaccine in a separate syringe from other vaccines administered at the same clinic visit?
To prevent contamination of the Hib vaccine.
What spacing is required between MMR and Varivax vaccines if not given on the same day?
At least 28 days apart
What is the significance of carefully using intramuscular (IM) technique for the diphtheria-tetanus–acellular pertussis (DTaP) vaccine?
To avoid subcutaneous administration that can lead to tissue irritation.
At what temperature may previous vaccinations have caused a history of high fever as a contraindication to live virus vaccine administration?
$40.5^{\ ext{C}}$ [105° F]
What is the purpose of providing a Vaccine Information Statement (VIS) to parents before administering a vaccine to their child?
To obtain consent for vaccination.
Why should there be a 3- to 11-month interval between the administration of an immune globulin and a live virus vaccine?
To prevent potential interactions that could reduce vaccine effectiveness.
What alternative methods of vaccine delivery are being developed according to the text?
Intranasal and transdermal techniques.
How do combination vaccines impact the number of injections required at each clinic visit?
They reduce the number of injections required.
Study Notes
Vaccine Ingredients and Contraindications
- A list of ingredients found in vaccines can be accessed at https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf
- Some vaccines contain heavy metals, antibiotics, or animal products, which may be a problem for parents with specific cultural beliefs
Nursing Responsibilities in Vaccine Administration
- The nurse must be aware of when vaccines are due to be scheduled for administration
- The nurse must know the immunization history of the child
- The nurse must know the vaccines that can be given together
- The nurse must know the contraindications
- The nurse must know the route of administration
- The nurse must know the proper equipment needed
- Epinephrine should be on hand for emergencies
- The child should remain in the clinic under observation for at least 20 minutes
Reporting Adverse Events and Compensation
- Serious adverse events occurring within a designated time after vaccination should be reported to the national Vaccine Adverse Events Reporting System (VAERS) or by calling 1-800-822-7967
- The National Childhood Vaccine Injury Act of 1986 contains a provision for compensation in some cases of specific vaccine injuries
Reducing Pain and Proper Injection Technique
- Reducing pain at the site of injection should be considered
- The use of vapocoolant sprays or EMLA cream is effective
- Using the proper injection technique for vaccines is important
- The Haemophilus influenzae type b (Hib) vaccine must be dispensed in a separate syringe from other vaccines administered at the same clinic visit
- The varicella vaccine is given subcutaneously, whereas the diphtheria-tetanus–acellular pertussis (DTaP) vaccine causes significant tissue irritation if given subcutaneously
Vaccine Administration and Contraindications
- Informed consent on the potential risks of vaccination and documentation of the immunization are essential
- Contraindications to live virus vaccine administration may include:
- Immunocompromised state
- Pregnancy
- Bacteremia or meningitis
- Immunocompromised caregiver in the home
- Corticosteroid therapy or immunosuppressive drugs
- History of high fever (40.5° C [105° F]) after previous vaccinations
Immunization Schedules and Catch-up
- Children from 4 months to 18 years of age who start the immunization process late or are more than 1 month behind should adhere to the catch-up schedule
- An interrupted vaccination series can usually continue without restarting the entire series
- If the MMR and the Varivax vaccines are not administered on the same day, they must be spaced at least 28 days apart
Test your knowledge about ingredients found in vaccines and nursing responsibilities in vaccine administration. Learn about potential concerns for parents with specific cultural beliefs and the importance of vaccination schedules and immunization history.
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