Vaccine Types
Live attenuated: MMR, varicella, yellow fever, rotavirus, intranasal influenza, BCG. Contraindicated in pregnancy and severe immunosuppression. Inactivated: IPV, rabies, hepatitis A. Subunit: HBV, HPV, pertussis, pneumococcal, meningococcal. Toxoid: tetanus, diphtheria. mRNA: COVID-19.
Immunization Schedule
Birth: HBV. 2 months: DTaP, IPV, Hib, PCV, RV. 12-15 months: MMR, varicella. 4-6 years: DTaP, IPV, MMR, varicella. 11-12 years: Tdap, HPV, meningococcal. Adults: Td/Tdap q10y, influenza annual, pneumococcal at 65, zoster at 50, COVID. Pregnancy: Tdap each pregnancy.
Nursing Considerations
Contraindications: severe allergic reaction to prior dose/component, severe immunosuppression (live), pregnancy (live), encephalopathy after pertussis. Herd immunity: 85-95% coverage. Educate parents on importance and safety. VAERS for adverse events. Address vaccine hesitancy with empathy and evidence.
Important Notes
- Live vaccines (MMR, varicella, yellow fever) contraindicated in pregnancy and severe immunosuppression.
- Severe allergic reaction to previous dose or component is a permanent contraindication.
Clinical Tips
- Herd immunity requires 85-95% vaccination coverage — unvaccinated put vulnerable populations at risk.
- Tdap with each pregnancy between 27-36 weeks protects newborn from pertussis.
Summary
Vaccines prevent deadly diseases through herd immunity — nurses must know the schedule, contraindications, and address vaccine hesitancy.
