Chelsea Garza

CPCO 4/27/2021
Immunizations for Special Populations
 Vaccines can usually be given at the same appointment
 Multiple live vaccines should be given the same day or spaced at least 4 weeks apart
 You can INCREASE the time frame between vaccines in a series, but you cannot DECREASE
 In Ohio, we can provide CDC recommended vaccines to anyone over the age of 13 without a prescription, and
those ≥ 7 years old with the annual flu vaccine
 Severe allergic reactions to the vaccine, or a vaccine component IS a contraindication
 Live vaccines should not be administered during pregnancy, or to immunocompromised patients
 Mild acute illness, previous injection site reaction, recent TB skin test, family hx of AEs with vaccines, Pregnancy
(except live vaccines), breast feeding, recent exposure, immunocompromised household member, allergies to
products not in the vaccine, and current antimicrobial treatment (exceptions: Varicella, Zoster, and Typhoid) are
NOT contraindications to receive vaccines

Types of Available Vaccines

Vaccine Type Description Examples
Inactivated Vaccines uses the killed version of the germs that cause the disease; may Hepatitis A
require repeat doses to “boost” immunity Flu
Polio
Rabies
Live-attenuated uses a weakened form of the germ that causes the disease; MMR
Vaccines produces a stronger immune response than most inactivated Rotavirus
vaccines. Smallpox
Chickenpox
Yellow Fever
Messenger RNA makes proteins to trigger immune response COVID-19 (Pfizer,
(mRNA) Vaccines Moderna)
Recombinant, these vaccines use specific pieces of the germ (i.e., Protein, Hib Disease
Polysaccharide, and sugar, or capsid), to provide a strong immune response targeted Hepatitis B
Conjugate Vaccines for that specific part of the germ. These can be used on almost HPV
everyone, including many immunocompromised patients; may Whooping cough
require a “booster”. Pneumococcal
Meningococcal
Shingles
Toxoid Vaccines uses a toxin made by the germ that causes the disease. This Diphtheria
creates an immune response to the PARTS of the germ that cause Tetanus
the disease, instead of the germ itself. May require a “booster”
Viral Vector Vaccines uses a modified version of a different virus as a vector to deliver COVID-19 (J&J)
protection.

Resources
1. Vaccines and Immunizations. Centers for Disease Control
and Prevention. https://www.cdc.gov/vaccines/.
Published February 11, 2021. Accessed April 24, 2021.
2. Immunization Action Coalition. Immunization Action
Coalition. https;//immunize.org. Published October 22,
2020. Accessed April 24, 2021
3. Shapiro K, Bombatch C, Garrett SD, Veverka A.
RxPrep Course Book: 2021 Naplex Course Book. El
Segundo, CA: RxPrep, Inc.; 2021.
 What Vaccines should I recommend?

Annual Quadrivalent flu vaccine Annual HD ≥ 65 YO

Tdap should be given every 10 years Each pregnancy at weeks 27‐36 Tdap every 10 years

One dose of PPSV23 should be given prior to 65YO PPSV23 ≥ 65 YO

Hep B ≥ 19 YO Hep A and B HepA & B if at risk for infection
or severe outcome from
infection during pregnancy
PCV13 optional
HepA if in group homes,
or non‐residential day
care facilities

VAR and MMR if no evidence of immunity MMR & other live vaccines VAR and MMR if no
contraindicated during evidence of immunity or
pregnancy born between 1963‐1967

Shingrix ≥ 50 YO
Vaccine Administration Schedule*adapted from the CDC website
Vaccines Abbreviations Trade names Schedule

Hepatitis A vaccine HepA Havrix® Vaqta® 2 doses, 0 & 6-12

Hepatitis A and hepatitis B vaccine HepA-HepB Twinrix® 3 doses, 0, 1 & 6

Hepatitis B vaccine HepB Engerix-B® 3 doses, 0, 1, & 6
Recombivax HB® *if completed w/in 4 months + booster in 1Y
Heplisav-B® 2 doses, 0 & 1
Human papillomavirus vaccine HPV Gardasil 9® <15YO 2 doses, 0 & 6 -12
≥15YO  3 doses, 0, 1-2, & 6
Influenza vaccine (inactivated) IIV Many brands Annually for indicated form
Influenza vaccine (live, attenuated) LAIV4 FluMist® Quadrivalent
HD recommended for those ≥ 65YO
Influenza vaccine (recombinant) RIV4 Flublok® Quadrivalent
Measles, mumps, and rubella vaccine MMR M-M-R II® 2 doses ≥4w apart
Meningococcal serogroups A, C, W, Y vaccine MenACWY-D Menactra® Number of doses and timing dependent on age and
MenACWY-CRM Menveo® specific risk, refer to CDC website
MenACWY-TT MenQuadfi®
Meningococcal serogroup B vaccine MenB-4C Bexsero® 2 doses, 0 & 1
MenB-FHbp Trumenba® 2 doses, 0 & 6
Pneumococcal 13-valent conjugate vaccine PCV13 Prevnar 13® 1 dose
Pneumococcal 23-valent polysaccharide PPSV23 Pneumovax 23® If repeated ≥ 5 years apart
vaccine
Tetanus and diphtheria toxoids Td Tenivac®
Tdvax™ Q10Y
Tetanus and diphtheria toxoids and acellular Tdap Adacel® With traumatic injury if > 5Y ago
pertussis vaccine Boostrix®
Varicella vaccine VAR Varivax® 2 doses, give 4-8 weeks apart
Zoster vaccine, recombinant RZV Shingrix 2 doses, 0, & 2-6