Immunizations- Final.docx - 1 Immunizations Kenna Robertson...

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1 Immunizations Kenna Robertson Chamberlain College of Nursing NR 566: Advanced Pharmacology for Care of the Family Dr. Brian Mountain April 3, 2021
2 Immunizations Immunizations for infants, children, adolescents, and adults are vital for the prevention of communicable diseases that are exist within the United States. Various vaccinations are recommended, with this paper discussing the hepatitis B and the measles, mumps, and rubella vaccinations. We will discuss the vaccine, contraindications, precautions and common adverse reactions, along with the typical administration schedule, dosage, and special situations. This paper will also discuss the barriers to vaccines and interventions that may be utilized by the nurse practitioner. Hepatitis B Vaccine The Hepatitis B vaccine, also known as Recombivax HB, is a recombinant vaccination used to prevent infection of hepatitis B (FDA, 2018). A recombinant vaccine is one that is genetically engineered and are “produced by insertion of a segment of the respective viral gene into the gene of a yeast cell or virus” (CDC, 2020a, para. 37). Contraindications to the Recombivax HB vaccine include those who have had a severe reaction after a previous dose of any hepatitis B vaccine or in those severely allergic to yeast. Per the package insertion, the precautions include those with a latex allergy as the vial stopper contains a latex rubber. They also mention that providers should use precaution in premature infants as there have been reports of apnea post-administration of the vaccine; clinical judgement should be utilized to determine the benefit/risk of receiving the vaccine. Adverse drug reactions in infants and children include fever, irritability, diarrhea, decreased appetite, and rhinitis (FDA, 2018). There is no minimum age at which infants should receive the first dose of the vaccine as it is typically administered at birth. The Recombivax HB vaccine is administered in a three-dose series, with the first dose being administered at birth; the second dose is typically administered
3 between one and two months of age; and the third dose administered between six to 18 months of age (CDC, 2020a; FDA, 2018). Special situations exist, such as infants whose mother is HBsAg-positive, infants weighing less than 2,000 grams, and those with immunocompromised states or receiving hemodialysis. In infants whose mother is HBsAG-positive, the vaccine should be administered with a hepatitis B immune globulin (IG) within the first 12-hours of birth (CDC, 2020a). In infants weighing less than 2,000 grams, the Recombivax HB vaccine should be

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