JKO Varicella and Herpes Zoster (shingles) Course

Choose the true statement about varicella vaccine.

Previously unvaccinated people 13 years of age and older need only one dose of varicella vaccine.

Choose the true statement about varicella vaccine.

It is recommended that varicella be administered subcutaneously.

Which person should have varicella vaccination delayed?

A 40 year old who received a blood transfusion 10 days ago.

Which person should not receive zoster vaccine today?

48-year-old woman who will be undergoing chemotherapy in two weeks

A healthy, 35-year-old woman was exposed to VZV 16 days ago. Today, she notices maculopapular lesions at her hairline. She is not pregnant. What action is recommended?

Refer her to a healthcare provider to discuss administration of acyclovir.

A susceptible person is infected with VZV. Typically, during which days after exposure could this person be considered infectious?

From day 12 until the day the lesions are crusted

Choose the true statement about varicella vaccine.

Varicella vaccine is a live attenuated vaccine

T/F A healthy adult, born in 1968, who works as a kindergarten teacher lacks written documentation of varicella vaccination, but reports that he had a typical case of chickenpox as a child. This person should be given two doses of Varicella vaccine separated by 4 to 8 weeks.

True

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. An 8-year-old boy with a documented allergy to gelatin.

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. A 34-year-old nurse who is trying to become pregnant.

It Depends

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. A 26-year-old daycare worker with leukemia for which she completed her first round of chemotherapy 4 months ago.

It depends

Which person has a valid contraindication to receiving varicella vaccine today?

An HIV-infected 2 year old with a very low CD4+ T-lymphocyte count

Which person listed should be considered immune to VZV?

A woman born in 1969 who has medical records documenting a case of varicella in 1971, with no documentation of serologic testing or varicella vaccination

An 18-year-old Armed Forces recruit needs varicella vaccination and a PPD. What is a correct way to administer these injections?

Administer the PPD and varicella vaccine simultaneously

A healthy, 40-year-old man who is susceptible to varicella was exposed to VZV 3 days ago. What action is recommended to prevent or reduce the severity of varicella illness if this man is infected with VZV?

Administer a dose of varicella vaccine today, followed by a second dose in 4 to 8 weeks

Choose the true statement about varicella vaccine.

Adults account for approximately 35% of varicella-associated mortality

Varivax is given to adults in two doses, separated by 4 to 8 weeks. What is the recommended amount of vaccine in each dose of Varivax?

0.5mL

Which statement accurately represents information contained in the varicella VIS?

Mild problems after vaccination include soreness or swelling where the shot was given, fever, and mild rash.

A healthy, 18-year-old pregnant woman was exposed to VZV yesterday. She does not know whether she has ever had varicella or varicella vaccine. What action is recommended?

Refer her to a healthcare provider for serologic testing to determine if she has antibodies against VZV.

Varicella Zoster

Herpes virus that causes varicella (chicken pox) Acute

The virus lies dormant in the nerve root ganglia causing Herpes Zoster (shingles)

Communication of Herpes Zoster

A very contagious virus is communicable for 1-2 days before the onset through 4-5 days after characteristic rash

Respiratory transmission or Contact with lesions

Clinical features of Varicella

Generalized rash, consisting of more than a thousand pruritic vesicles

Highest concentration is on the trunk

Lesions appear on the face, scalp, extremities, and mucous membranes

Contain a clear fluid and often rupture. or drain before they dry and develop a crust

Complications of Varicella

Secondary infections with group A Strep. spp. or Staph spp.

Secondary infections are serious leading to clinic visits, hospitalizations, and death

Cerebral ataxia, Encephalitis, pneumonia

Varicella vaccines on the market

Live attenuated virus

Variax
Zostavax (Mayb)
Shingrix (MayB)

Varicella abbreviation

VAR

Target groups for varicella zoster

All Children older than age 12 months of age

Susceptible adolescent and adults

People who do not need to be vaccinated for varicella zoster

Lab evidence of immunity and confirmation of disease

Birth in US before 1980, except women and those that are immunocompromised

Vacerella zoster recommenations

First dose at 12-15 months of age
Second dose at. 4-6. months of age

All. 13 and younger should receive second dose at least 3 months after the first.

All susceptible 13 and older adolescence and adults should receive 2 doses at least 4 weeks apart

Women should be vaccinated at least. one month before conception

Vacerella Zoster Contraindications

People who are immune suppressed should be referred to an allergist

Do not give vaccine to anyone that has had a blood transfusion recently

Can still develop Shingles after vaccination

Herpes Zoster

Reactivation of chicken pox causes nerve pain and a rash on one side of the body
Postherpetic neuralgia (PHN)

PHN

Pain lasting 90 days after injury

Development of more neurological conditions

Shingles/Zoster vaccine abréviation

HZV

Shingles/Zoster vaccine on the market

Zostavax (Live)

Target group for Zoster/Shingles

All adults 60 years or older

Doses of Zoster vaccine

HPV vaccine abbreviation

9vHPV (inactivated)

HPV target groups for vaccination

Children, Adolescence, and adults 9-26, ideally at 11 or 12

HPV doses given for children <15

2 doses given 6 to 12 months apart

HPV doses given for children older that 15

3 doses given where the second dose is given 1-2 months from the first. The third given 6 months after the first

Measles

Contagious virus that is communicable 4 days before and 4 days after the rash appears

-Cough, runny nose, conjunctivitis, koplik spots, maculopapolar rash

Young children and young adults are at higher risk of disease

Paromoxyvirus family

Mumps

Spread by respiratory route but not as contagious as measles
Communicable 3-4 days of onset symptoms
Some people may experience symtoms while some may experience nonspecific symptoms

Most common symtom of mumps is parotitis- inflammation of parotid glands

Member of paromoxyvirus

Rubella

The rubella virus is transported via respiratory route and is communicable 7 days before and 5-7 days after rash appears

Mild and causes few complications

Maculopapular rash appears 2 weeks after exposure

Congenital rubella syndrome (CRS)

If a pregnant women is infected with rubella, fetal harm can occur

Measles, Mumps, Rubella vaccine abbreviation

MMR

MMR vaccine type

Live attenuated

Target groups for MMR

All individuals 12 months and older

Timing of administration for MMR

First dose at 12 to 15 months and second dose at 4 to 6 years

For catch up, 2 doses 4 weeks apart

Pneumococcal vaccine abbreviations

PCV13 and PPSV23

Pneumococcal vaccine type

Inactivated

Timing of PCV13 for children

Children should receive a dose at months:
2, 4, 6, 12 to 15

Pneumococcal vaccine for high risk children

PPSV23 should be given at least 8 weeks after last dose of PCV13 to children 2 and older

Spacing of PPSV23

At least 5 years apart

Pneumococcal vaccine in adults 65 or older

Should receive PCV13 first and wait a year for the next shot of PPSV23
Give 8 weeks apart if immunocompromised
PCV13 only given once in this series
PPSV23 can be given up to 3 times

Meningitis vaccine abbreviations

MenACWY and MenB

Meningitis vaccine type

Inactivated`

Timing of MenACWY

Should be given at age 11-12 and a booster at 16 to 18 years. Must wait at least 8 weeks between doses
For high risk conditions, one dose followed by revaccination every 5 years

Timing of MeB Bexsero vaccinations

MenB given at age 16 to 18 based on clinical discretion
Give second dose at least one month later

Timing of MenB Trumenba vaccinations

Given as 2 doses: Second dose given after 6 months
Given as 3 doses: Second dose given at 1-2 months, Third dose given at 6 months

Hepatitis A vaccine abbreviation

HepA

HepA vaccine type

Inactivated

Timing of administration for HepA

2 doses: The first dose should be given at 1 month of age, and a booster should be given 6-12 months later

Hepatitis B vaccination

HepB

HepB vaccination type

Inactivated

HepB timing of administration for children

3 doses: Given at birth, 1-2 months, 6-18 months

HepB timing for older patients

3 doses: Given at 1 month and 6 months apart

Rotovirus vaccinations

RV1 (Rotarix) and RV5 (RotaTeq)

RV vaccination type

Live

Rotavirus schedule

3 doses total: One dose at 2 months, 4 months, 6 months
or
2 doses: One dose at 2 months of age and 4 months of age

Haemophilus type B abbreviaton

Hib

Dosing schedule for Hib

4 doses (ActHIB, MenHibrix, Hiberix, Pentacel): 2 months of age, 4 months, 6 months, and booster at 12-15 months

3 doses (PedvaxHIB): 2 months of age, 4 months of age, 12-15 months of age

Hib vaccine type

Innactivated

Polio vaccine abbreviation

IPV

Polio vaccine type

Inactivated

Poliovirus vaccination schedule

4 doses: 2 months, 4 months, 6-18 months, 4-6 years