Immunization Refresher

and Allergy Awareness

Yarelis Diaz, Student Pharmacist
Kelly Desir, Student Pharmacist
Dominique Davis, Pharm.D.
Melissa Milfort, Pharm.D., PGY-1 Community-Based Pharmacy Resident
Erika Zwachte, Pharm.D., PGY-1 Community-Based Pharmacy Resident
Why should I get immunized?

● Protect myself and those around me

● Vaccines are the first line of protection
against preventable diseases:
○ Varicella
○ Shingles
○ Hepatitis
○ Influenza
○ Others
Why do we immunize?

● Commitment with the community

● Pharmacists are the most accessible health care professionals
● Student Pharmacists can educate and make an impact
Vaccines during COVID-19
● May 2020 Centers for Disease Control and Prevention (CDC)
report found a troubling drop in routine childhood
immunizations as a result of families staying at home.

● The U.S. department of health and human Services (HHS)

○ Expanded access to childhood vaccines during COVID-19 by 3 rd

amendment

○ Authorizing state-licensed pharmacists to order and administer

vaccines to individuals ages 3 years and up
Influenza “Flu” Season

● Year-round incidence in the

United States
● More common during Fall
and Winter
● Activity increases in October
● Activity peaks between
December and February
Why do we want to prevent the Flu?
● Highly contagious respiratory illness
● Caused by a virus
● Could result in hospitalization
○ Even death
● EVERYONE is at risk
○ Populations at higher risk:
■ Elderly
■ Pregnant women
■ Children under 5yo
■ Patients with chronic conditions (asthma, diabetes, heart disease)
How does it spread?
● Person to person
○ Coughing, sneezing talking
○ Touching a contaminated surface then
touching your own mouth, nose or eyes
● Most contagious in the first 3-4 days
after illness begins
● Can be transmitted before knowing that
you are sick
Common Flu Symptoms
● Fever ● Sometimes vomiting and
● Cough diarrhea
● Sore throat ● More common in children
● Runny or stuffy nose ● Complications:
● Muscle or body aches ○ Sinus and ear infections
● Fatigue ○ Pneumonia
● Headache ○ Death
What can I do to prevent myself from catching
the Flu and to prevent it from spreading?

● The best way to prevent the flu is by getting vaccinated yearly

● Other measures:
○ Avoid contact with people who are sick
○ Cover your mouth and nose with a tissue
○ Wash hands with soap and water
○ Avoid touching your eyes, nose or mouth
○ Disinfect frequently touched surfaces
 “Vaccines
cause autism”
“I don’t want to get
vaccinated because my
neighbor told me that it
caused him the Flu”
Minimal side effects

● Soreness, redness and swelling in the injection site

● Fever
● Muscle aches
● Headache
● The vaccine does NOT cause influenza
○ Patient might have gotten in contact with the virus in the waiting
room or 1-2 days before getting the vaccine
● Allergic reactions
Why do we get
allergies?
Our immune system is meant to protect us from and
help eliminate foreign bodies such as:

● Bacteria
● Viruses
● Parasites

When our body detects a foreign substance our

immune system will produce antibodies.

Antibodies help our body to identify, react to and

destroy antigens from foreign molecules that may be
harmful
What are the signs you should look for?
What should you do in the event of an Allergic
Rxn or Anaphylaxis?
What should you do if you witness an
Anaphylactic Rxn
● Administer epinephrine: this is the only medication for the treatment of anaphylaxis
● Call 911 immediately, let them know the person is having a severe allergic reaction (DO NOT
CALL TO ASK IF YOU SHOULD ADMINISTER EPINEPHRINE, EVERY SECOND COUNTS!)
● Epinephrine last about 10-20 minutes; symptoms may recur which requires a second dose
● Hospital will monitor for up to 4hrs
Epinephrine
● Administer to everyone: IN AN
EMERGENCY THERE IS NO EXCLUSION TO
WHO CAN GET IT
○ Anaphylaxis is LIFE THREATENING,
other issues can be wealth with at
the hospital
● Use the medication even if it is expired if
you have nothing else
○ The manufacturer says it expires in
18 months, but studies have shown
it may still be potent up to 4 years
from the expiration date
EPIPEN Administration
● Blue to the sky orange to the thigh
● Remove the blue cap located at the TOP
● Swing the needle into the outer thigh, no need to remove clothing as the needle will go
through
○ Must be sitting/ laying down
○ If vomiting, be sure to lay on side (not back)
● Hold in place for 3 seconds (3 Mississippi‘s), can count to 5
● Rub area for 10 seconds
● The syringe contains a needle that comes out of the ORANGE END, watch your fingers; getting
poked requires a trip to the ER for you!
 Before administering the vaccine...
● Set up supplies:
○ Vaccine for injection
○ Alcohol swabs
○ Cotton swabs or gauze
○ Adhesive bandages
○ Syringe and needle
○ Gloves
○ Sharps container
○ Sterile pad
Before administering the vaccine...
● Use a needle that is
appropriate for the patient
● Make sure that you and the
patient are both sitting
comfortably
● Make sure that the patient
read the Vaccine Information
Statement (VIS)
Before administering the vaccine...
● Prepare syringe for injection:
○ Review vial containers
○ Remove plastic cap from vial
○ Swab top of vial with an alcohol swab in one swift motion
○ Fill syringe with air equivalent to the amount you will be drawing
○ Insert needle through vial stopper and push plunger
○ Invert the syringe and vial and withdraw the amount of vaccine desired
○ Remove any large air bubbles
○ Remove needle and syringe from the vial
■ If not injecting right away, place protective cap on the needle
Prepare to inject!

● Put on gloves
● Expose injection site
○ Middle and thickest part of the
deltoid muscle in upper arm
● Swab the injection site with
alcohol and allow to dry
Administering an intramuscular injection

● Insert the needle at a 90 degree angle

in one quick thrust, all the way to the
hub of the needle
● Press down the plunger in one smooth
and coordinated manner
● Remove needle in one quick motion
and place protective cap
● Throw the syringe into the sharps
container
After administering the injection...
● Place a cotton swab or gauze on the injection site
● Place adhesive bandage
● Remove gloves
● Disinfect hands before and after administering a vaccine
● Document the injection given
● Provide patient counseling
Resources
References
● Centers for Disease Control and Prevention. (2019, June 11). Influenza (Flu). Retrieved from https://www.cdc.gov/flu/index.htm
● APhA [aphapharmacists]. (2018, July 20). APhA Injection Technique Video 2018 [Video file]. Retrieved from
https://www.youtube.com/watch?time_continue=86&v=1H7LnK0CpOY
● The Hygiene Hypothesis. (2016, May 13). Retrieved January 15, 2018, from http://fightthecauseofallergy.org/page/hygiene-
hypothesis
● Anaphylaxis. (2017, December 07). Retrieved January 15, 2018, from http://acaai.org/allergies/anaphylaxis
● Kids with Food Allergies. (n.d.). Retrieved January 15, 2018, from
http://www.kidswithfoodallergies.org/page/what-is-anaphylaxis.aspx
● Cantrell, F. L., Cantrell, P., Wen, A., & Gerona, R. (2017, June 20). Epinephrine Concentrations in EpiPens After the Expiration Date.
Retrieved January 15, 2018, from
http://annals.org/aim/article-abstract/2625390/epinephrine-concentrations-epipens-after-expiration-date
● Jimison, R. (2017, May 08). EpiPens still potent 4 years after expiration date, study says. Retrieved January 15, 2018, from
http://www.cnn.com/2017/05/08/health/expired-epipen-safety-study/index.html
● AAFA. (n.d.). Retrieved January 15, 2018, from
http://www.aafa.org/page/types-of-allergies.aspx?gclid=Cj0KCQiAv_HSBRCkARIsAGaSsrDmintfzwchgi2drcirDD8N9gQjV9iBaDwpvkHF
HCixrEXTTgRJ7LMaAoztEALw_wcB
● https://www.cdc.gov/healthyschools/foodallergies/index.htm
● https://www.foodallergy.org/sites/default/files/migrated-files/file/emergency-care-plan.pdf
● U.S. Department of Health and Human Services. (2020, August 19). HHS Expands Access to Childhood Vaccines during
COVID-19 Pandemic. Retrieved September 08, 2020, from
https://www.hhs.gov/about/news/2020/08/19/hhs-expands-access-childhood-vaccines-during-covid-19-pandemic.html