Immunizing Pharmacist

Cards (75)

  • A vaccine is a biologically derived substance designed to produce a protective immune response when administered to humans
  • Vaccination is the act of introducing a vaccine into the body to produce a desired outcome of having immunity against a specific infection or disease
  • Immunization is the process by which the vaccination confers protection to the individual
  • Vaccine Efficacy is the extent to which the vaccine prevents disease, and possibly also transmission, under ideal and controlled conditions
  • Vaccine Effectiveness is the extent to which the vaccine provides beneficial results under real-world conditions
  • Vaccine Efficacy can be measured through randomized clinical trials
  • Vaccine Effectiveness can be measured through observational studies
  • The effectiveness percentage can be lower than efficacy due to real-world unpredictability
  • Pharmacy-based immunization allows public access to vaccines, especially when doctors' clinics or health centers are inaccessible due to work hours or location
  • FDA Advisory No. 2014-067 states that the FDA-DOH and PPhA plans to train and authorize FDA-licensed community pharmacists to administer adult vaccines and other immuno-products
  • RA 10918 states that pharmacists are allowed to administer adult vaccines given that they undergo training and should hold a certification of training granted by the PRC
  • Adult vaccines refer to cervical cancer, flu (influenza), pneumococcal, other pre-exposure prophylactic vaccines to be administered to patients aged 18 years old and above
  • The Philippine Pharmacists Association, Inc - IPCP is an innovative and interactive practice-based educational program that provides Filipino pharmacists the skills necessary to become primary sources for vaccine advocacy, education, and administration
  • The roles of pharmacists as immunizers are to be an educator, facilitator, and immunizer
  • Immunity is the ability of the body to tolerate the presence of material indigenous to the body (self) and to eliminate foreign material (non-self)
  • Immunity is the ability to provide protection from infectious diseases, usually indicated by the presence of an antibody
  • Active immunity is produced by the person's own immune system
  • Passive immunity can be transferred from another person or animal
  • Active Immunity is permanent while Passive Immunity is temporary
  • Active Immunity occurs after infection or vaccination through the production of immunologic memory
  • Passive Immunity can come from transplacental, blood products, homologous pooled human antibodies, plasma products, etc.
  • Naturally acquired active immunity involves exposure to the organism
  • Artificially acquired active immunity develops upon exposure to the antigen during vaccination
  • Naturally acquired passive immunity includes transfer of IgG antibodies from mother to fetus during pregnancy or the transfer of IgA antibodies from mother to baby during breastfeeding
  • Artificially acquired passive immunity involves IV injection of immunoglobulins or antibodies
  • Live attenuated vaccines
    • weakened form of the wild virus or bacteria
    • must replicate to be effective
    • immune response similar to natural infection
    • usually effective with one dose
    • severe reactions are possible
    • interference from circulating antibody
    • heat labile
  • Inactivated vaccines
    • cannot replicate, and not live
    • minimal interference from circulating antibody
    • not as effective as live vaccines
    • require multiple (3 to 5) doses
    • antibody titer falls over time requiring booster doses
  • Subtypes of inactivated vaccines
    • Whole cell vaccines - from whole organisms that have been inactivated by chemical, thermal, or other means
    • Fractional - from components of the whole organism
    • Toxoids - inactivated toxins of toxin-producing bacteria
    • Polysaccharide vaccines - polysaccharide is linked to proteins to increase effectiveness
  • Live attenuated vaccines
    • Viral: measles-mumps-rubella, varicella, herpes zoster, yellow fever, oral polio, influenza nasal spray, rotavirus, dengue virus
    • Bacterial: bacille calmette-guerin, oral typhoid
  • Inactivated whole cell
    • Viral: influenza, polio, rabies, hepatitis A, japanese encephalitis
    • Bacterial: pertussis, typhoid, cholera
  • Fractional
    • Viral: hepatitis B, influenza, acellular pertussis, human papillomavirus
    • Bacterial: typhoid vaccine
  • Toxoid
    • Diphtheria toxoid, tetanus toxoid
  • Conjugate polysaccharide
    • Pneumococcal, meningococcal, Haemophilus influenzae type b (Hib)
  • For multi-dose vaccines, vaccine doses administered less than or equal to 4 days prior to minimum interval are considered valid -- this is known as grace period
    Exception: rabies vaccine
  • Doses of any vaccine administered greater than or equal to 5 days earlier than minimum interval or age are invalid and should be repeated as age appropriate
    The repeat dose should be spaced after the invalid dose by the recommended minimum interval
  • Simultaneous administration of vaccines refers to the administration of more than one vaccine on the same clinic day, at different anatomic sites and not combined in the same syringe
  • Simultaneous administration of vaccines increases the probability that the patient will be fully vaccinated
  • Any inactivated vaccine can be administered either simultaneously or at any time before or after a different inactivated or live vaccine
  • Two live vaccines should always be administered on the same day. Otherwise, the live vaccines should be separated by at least 4 weeks to minimize the potential risk for interference
    If separated by less than 4 weeks, the second vaccine becomes invalid and the dose should be repeated at least 4 weeks later
    Exception: yellow fever vaccine (can be given less than 4 weeks after MMR or univalent varicella vaccine)
  • Inactivated vaccines interfere less with antibody-containing products