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LAIV4: Contraindications (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Nursing Influenza and Pneumococcal Vaccination.pdf
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      Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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    00:01 I bet you won't forget that picture of the patient receiving the LAIV4 up their nose.

    00:08 Well, because it's a special administration dose.

    00:10 I wanted to stand out in your mind and that's why I wanted you to see a picture because there's also some special contraindications or certain patients that shouldn't receive this form of the vaccine.

    00:22 If they have a history of allergies to the flu vaccine or any component of the vaccine.

    00:27 If they're young children, particularly age 2 to 4, and they've had a diagnosis of respiratory problems wheezing or asthma they should not get this vaccine.

    00:37 If the patient is immunocompromised or the person is around people who are immunocompromised.

    00:44 This is not a good choice.

    00:45 So if the immunosuppression comes from medications or comes from a disease process, it's the same result.

    00:52 These patients should not take this form of the vaccine if I'm a caregiver or a family member somebody who's in close contact with somebody immunosuppressed you do not want this option.

    01:04 Now the last one seems like why are we looking at this? Well, I want you to keep in mind the seems like nobody would do this, right? You would think no one would do this, but sometimes it happens if you've already gotten the flu vaccine within the last 48 hours, then you don't want this option.

    01:23 Now I do have one more category and it's pretty unusual, but I wanted to leave it for the very bottom of the slide.

    01:30 So we've talked about people who have allergies or allergic reactions to the vaccine.

    01:36 Little guys too who have a respiratory diagnosis of asthma or wheezing, immunosuppressed people or people that are around the immunosuppressed people crazy people that walk in and want another flu vaccine and the last category is pregnancy.

    01:51 Okay. So there you have a full list and a way to kind of chunk this information.

    01:56 I've got extra words on the slide for you, but if you listen to those main categories were walking through this together that will help it stick.

    02:04 So if you heard about the connection between eggs in the flu vaccine.

    02:08 Well historically, flu vaccines were required by the FDA to be grown in chicken eggs.

    02:15 Now the FDA allows viruses to be grown in cells too.

    02:19 So the viruses are then killed, right there deactivated their purified before becoming part of the vaccine.

    02:26 So the injectable flu vaccine cannot cause the flu.

    02:30 Got it? This is how you can explain it and I don't have to worry about an egg allergy anymore because they're no longer forced to be created in eggs.

    02:39 So let's talk about that connection one more time.

    02:43 Used to have to grow flu vaccines in chicken eggs.

    02:46 Now you do not have to do that anymore.

    02:49 Once the virus has grown its killed, its deactivated.

    02:54 That's why it cannot give someone the flu.

    02:57 So it's not the vaccine that gave the patient the flu.

    03:00 It was some type of contact, right? Some type of droplet involvement that cause that patient to get the flu before the antibodies or the right antibodies could be developed by their body.

    03:13 So before if a patient had a severe egg allergy, they thought it could trigger an allergic reaction to the flu vaccine.

    03:20 Now, we know we don't have to worry about that and research really did not support that.

    03:25 So only 10 people out of 7.4 million vaccine cases had anaphylaxis, and most of those didn't even have an egg allergy.

    03:36 So you may have been taught that in nursing school.

    03:38 That is no longer current.

    03:40 So you don't have to ask if the patient has an egg allergy anymore.

    03:44 That's not a contraindication for receiving the flu vaccine.

    03:48 Now in 2016 the CDC eliminated the special requirements for patients with egg allergies, including those with a history of anaphylactic reaction to eggs.

    03:57 So this has been a done deal since 2016.


    About the Lecture

    The lecture LAIV4: Contraindications (Nursing) by Rhonda Lawes, PhD, RN is from the course Influenza and Pneumococcal Vaccination (Nursing).


    Included Quiz Questions

    1. Children aged 2-4 years diagnosed with asthma within the last year
    2. Clients that are diagnosed with HIV
    3. A caregiver that cares for a person receiving chemotherapy
    4. History of severe allergic reaction to any medication
    5. History of influenza within the last year
    1. The vaccine is safe for people with egg allergies.
    2. You can only safely receive the LAIV4 vaccine.
    3. The vaccine most likely safe, but you will need to be closely monitored in hospital for 12 hours.
    4. Anyone with an egg allergy should not get the flu vaccine.

    Author of lecture LAIV4: Contraindications (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN


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