Vaccines
VFC Abbreviation
Vaccine For Children
Oral vaccine
What is Rotarix - 2 parts!!! Must mix together and administer in feeding position. Usually give first prior to injectables.
Aseptic technique should be done prior to drawing up vaccine from vial?
Cleanse rubber stopper with an alcohol wipe
VFC Eligibility Criteria
Uninsured
Underinsured - insurance doesn't cover vaccine
Medicaid/Badgercare
Alaska Native or Native American
Angle and location of administration of TB skin test
45 degree angle, bevel up, 2-4 inches from antecubital space (elbow)
Use left arm for 1st step and right arm for 2nd step
Live vaccines administered SQ
What are MMR and Varicella
Verify these before vaccine administration (in addition to the 5 rights)? (3 things)
What is Lot number, expiration dates, answers to screening questions
Vaccine stored in vaccine freezer
Varicella
A 65 year old female comes to our clinic for a Shingles vaccine, can we administer the vaccine?
No, we do not offer the Shingles vaccine.
Appropriate size wheel you should expect to get after placement of TB skin test?
8-10 mm
Vaccines recipients should wait 15 minutes after receiving (non-Covid)
HPV
Menveo
Men B
*Risk for fainting r/t to age
Vaccine that can be administered SQ or IM?
What is Polio (IPV) - only multi-use vial 0.5 cc/ml
3 vaccines require dilution (non-Covid)?
MMR, Varicella, Rotarix
Regulator of VFC Program and Eligiblity
CDC
Interval between a live vaccine and TB skin test placement
4 weeks. Can co-administer live vaccine and 1st step TB skin test on the same day.
Resource for vaccine questions, considerations, counterindications
Pink Book
VFC Policy and Procedure Manual
Age of child to begin using deltoid (vs vastus) muscle
What is 36 months (age 3)
Use up to 2 nurses for multiple vaccines for poke at the same time, give consideration to site of admin (1" between injection into same muscle). Consider order of administration (more painful vaccines last - MMR/Varicella, HPV).
Acceptable Range of vaccine Storage
36-46 degrees F
>46 F / 8 C or >5 F freezer - too warm
<36 F / 2 C - too cold
A 15 year old with Medicaid insurance presents to our clinic for a Tdap, can they receive it through us?
Yes, Medicaid is an eligible category to receive VFC vaccine through our clinic
Interval between placement of a 2nd step TB skin test?
7 days after reading of the 1st test
Example: Placed on Tuesday 2/1 - Read on Friday 2/4. Place 2nd Step (earliest Friday 2/11).
Number of vaccines we offer
21
Menveo, HPV, Men B, Tdap, Td, Hep B Adult, Hep B Peds, Pfizer Jr, Janssen, Pfizer Tris, Dtap, Kinrix, Varicella, MMR, Polio, Havirix, Kinrix, Influenza, Hib, Rotarix, Prevnar 13
On the vaccine questionnaire an egg allergy is noted. What would your next steps be?
Which vaccine would this be a consideration for?
Consult with vaccine counterindications of administration reference in vaccine binder. If egg allergy is not a contraindication to administration of vaccine, move forward with administration.
Influenza
Process of vaccine excursion
Notify supervisor, move vaccine to back-up cooler if not in current range, mark vaccine to not use, pull temperature data off of logger, complete temperature excursion report, contact vaccine manufacturer regarding excursion and use. Send temperature excursion to DHS/VFC program.
A 19 year old without insurance presents for HPV vaccine, can we administer.
Yes
Process of measuring a PPD - when is it considered positive?
Palpate area of placement. Redness and bruising are normal - measuring a hard raised area. Read from 9-3 (clock). Can use a pen to come along the skin to identify boarders. Use measuring tool for induration measurement. Record results on card. Positivity depends on risk category - refer to chart in TB skin test room. Assist with setting up physician evaluation if indicated.