Download Free Medical Smallpox Vaccine Overview PowerPoint Presentation

Smallpox Vaccine Overview PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Erythema Multiforme, which is titled "Smallpox Vaccine Overview", to get an overview of smallpox.

Tags : Erythema Multiforme, Smallpox Vaccine

Published on : Jul 05, 2021 | Views : 2164 | Downloads : 1

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Smallpox Vaccine Overview Types of Vaccine Administration Contraindications Adverse Reactions
Slide 2-

ppt slide no 2 content not found
Slide 3-

Smallpox Vaccine History Original material used by Jenner was probably cowpox. Cowpox to vaccinia in 19th Century.
Slide 4-

Vaccinia Virus Origin of vaccinia virus unknown. Genetically distinct from cowpox and variola. May be a virus now extinct in nature.
Slide 5-

Smallpox Vaccine
Slide 6-

Smallpox (Vaccinia) Vaccine Dryvax® Lyophilized vaccinia containing calf lymph. Original diluent in separate vial with attached needle (shaker tube) Trace amounts of antibiotics: Polymyxin B. Streptomycin. Chlortetracycline. Neomycin.
Slide 7-

Vaccine Production Liquid vaccine – lost potency in tropical climates. 1909 – Freeze-drying technology. 1950’s – Collier produced vaccine stable at 37o-45o C for 64 weeks. 1970’s – Japanese produce attenuated virus vaccines that are less reactogenic
Slide 8-

Vaccine Production Grown on skin of calves, sheep, water buffalo. Lesions harvested before crusting: Maximizes viral titer. Pulp ground. Mixed with 40%-60% glycerol. Distributed in glass capillary tubes.
Slide 9-

ppt slide no 9 content not found
Slide 10-

Dryvax® Vaccine Storage and Handling (Check Manufacturer’s Instructions) Stable indefinitely at –20°C. Unreconstituted – Stable >1 year at room temperature. Reconstituted – Stable 3 months* at refrigerator temperature. * Recent FDA
Slide 11-

Dryvax Smallpox (Vaccinia) Vaccine Administration Schedule - Occupational Schedule: 1 Successful Dose >18 years of age. Revaccination: 10 Years - nonhighly-attenuated vaccinia and recombinants. 3 Years – highly attenuated orthopoxviruses.
Slide 12-

Smallpox (Vaccinia) Vaccine Administration Schedule – Non-Emergency Schedule: 1 Successful Dose >18 years of age. Revaccination: Unknown.
Slide 13-

Vaccine Administration Surgical needle. Vaccinostyle. Rotary lancet. Jet injector. Bifurcated needle*. *Only administration technique currently in use.
Slide 14-

The Bifurcated Needle
Slide 15-

Fenner F et al. Smallpox and its Eradication, pp 570 Smallpox Eradication Strategy The Bifurcated Needle
Slide 16-

Vaccine Administration
Slide 17-

New Smallpox Vaccines, 2003 Live vaccinia virus produced using cell culture technology. Distributed as a freeze-dried powder. Do not contain antibiotics. Diluent contains glycerin and phenol.
Slide 18-

Contraindications and Screening
Slide 19-

Smallpox Vaccine Vaccine contains live vaccinia virus. Vaccine virus can be transmitted to household and other close contacts. Candidates for vaccination must be carefully screened for contraindications. Certain medical conditions in the person's household contacts must also be considered as contraindications for vaccination.
Slide 20-

Serious allergic reaction to a prior dose of vaccine or vaccine component. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 21-

Smallpox Vaccine Components Dryvax: polymyxin B. streptomycin. tetracycline. neomycin. phenol. New vaccines do not contain antibiotics.
Slide 22-

Serious allergic reaction to a prior dose of vaccine or vaccine component. Immunosuppression in the recipient or household contact. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 23-

Causes of Immunosuppression Diseases Leukemia. Lymphoma. Generalized malignancy. Solid organ or stem cell transplantation. Humoral or cellular immunity disorders. HIV infection.
Slide 24-

Causes of Immunosuppression Therapies Alkylating agents. Antimetabolites. Radiation. High dose corticosteroid therapy: >2 mg/kg/day, OR >20 mg/day for >14 days.
Slide 25-

Screening for HIV Infection Mandatory HIV testing not recommended, but: Recommended for persons who have history of risk factor and do not know status. Should be readily available for anyone concerned who wishes testing.
Slide 26-

Serious allergic reaction to a prior dose of vaccine or vaccine component. Immunosuppression in the recipient or household contact. Pregnancy in the recipient or household contact. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 27-

Screening for Pregnancy In pre-event setting, should NOT be given to: pregnant women. women trying to become pregnant. Educate women of child-bearing age about fetal vaccinia. Advise avoidance of pregnancy for 4 weeks following vaccination.
Slide 28-

Screening for Pregnancy If concerned, administer home test for pregnancy. Establish pregnancy registry for women inadvertently vaccinated.
Slide 29-

Serious allergic reaction to a prior dose of vaccine or vaccine component. Immunosuppression in the recipient or household contact. Pregnancy in the recipient or household contact. Breastfeeding. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 30-

Eczema or atopic dermatitis (current or past history) in the recipient or household contact. Acute, chronic, or exfoliative skin conditions (until improved or resolved) in the recipient or household contact. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 31-

Questions and Information: Have you or member of your household been diagnosed with eczema or atopic dermatitis? Have you had an itchy, red, scaly rash that lasts more than 2 weeks and comes and goes? If you or household member EVER had a rash like this, you should NOT receive smallpox vaccine. Screening for Eczema and Atopic Dermatitis
Slide 32-

Eczema or atopic dermatitis (current or past history) in the recipient or household contact. Acute, chronic, or exfoliative skin conditions (until improved or resolved). Children <12 months of age. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 33-

Eczema or atopic dermatitis (current or past history) in the recipient or household contact. Acute, chronic, or exfoliative skin conditions (until improved or resolved). Children <12 months of age. Moderate or severe acute illness. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 34-

Serious allergic reaction to a prior dose of vaccine or vaccine component. Immunosuppression in the recipient or household contact. Pregnancy in the recipient or household contact. Breastfeeding. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 35-

Eczema or atopic dermatitis (current or past history) in the recipient or household contact. Acute, chronic, or exfoliative skin conditions (until improved or resolved) in the recipient or household contact. Children <12 months of age. Moderate or severe acute illness. Smallpox Vaccine Contraindications and Precautions Non-emergency Situations
Slide 36-

Contents of volunteer pre-clinic screening packet
Slide 37-

Pre-Clinic Screening Materials Participant Advice Letter. Vaccine Information Sheet: Smallpox Vaccine. Immune System Problems. Skin Conditions. Pregnancy. Pre-Clinic Checklist.
Slide 38-

Exposed Persons – NO Contraindications. Unexposed Persons – Same as in Non-Emergency. Smallpox Vaccine Contraindications and Precautions Emergency (Post-Event) Situations
Slide 39-

World Health Organization Issues
Slide 40-

Watch Vaccine Administration Video
Slide 41-

Vaccine Administration Technique Review
Slide 42-

Smallpox Vaccine Reconstitution Diluent and instructions for reconstitution will be supplied with vaccine. Vaccine may be used for 30 days following reconstitution.
Slide 43-

Smallpox Vaccine Administration Use of gloves is recommended. Persons administering smallpox vaccine should be vaccinated. Healthcare workers with a contraindication to vaccination should not handle or administer the vaccine.
Slide 44-

Bifurcated needle
Slide 45-

Vaccination Site Preparation Alcohol, soap and water, or chemical agents are not needed for preparation of the skin for vaccination unless grossly contaminated. If needed, soap and water are the preferred cleaning agents. Skin must be thoroughly dry in order to prevent inactivation of the vaccine.
Slide 46-

Remove needle from sterile packaging.
Slide 47-

Dip the needle into the vaccine.
Slide 48-

Do NOT re-dip the needle into the vaccine solution once it has touched the person’s skin.
Slide 49-

Proper position of hands.
Slide 50-

Smallpox Vaccine Administration Prior to administration of smallpox vaccine, please refer to the package insert for number of bifurcated needle punctures to administer.
Slide 51-

Smallpox Vaccine Administration Apply strokes perpendicular to the skin. Prick the skin in about 3 seconds within an area of 5 millimeters. Apply sufficient pressure to visibly push down the skin.
Slide 52-

Pressure should be sufficient to visibly push down the skin.
Slide 53-

A trace of blood should be present after 10-20 seconds.
Slide 54-

Dispose of used needle immediately into sharps container.
Slide 55-

Cover site with sterile dressing.
Slide 56-

Smallpox Vaccine Administration Vaccinia virus may be cultured from the site of a primary vaccination from 2-3 days after vaccination until the scab separates. Care must be taken to prevent spread of the virus to other parts of the body or other persons. Hands must be washed after every contact with the vaccination site or any materials (clothing, dressing, etc.) that has come into contact with the vaccination site.
Slide 57-

Clinical Response to Vaccination “Jennerian” vesicle at vaccination site. Swelling and tenderness of axillary lymph nodes, usually during 2nd week: 15%-20% of primary vaccinees. 0%-15% of revaccinees. Fever and malaise common.
Slide 58-

Clinical Response to Vaccination *typical response in a nonimmune person
Slide 59-

ppt slide no 59 content not found
Slide 60-

Clinical Response to Vaccination Neutralizing antibody: 10 days after primary vaccination. 7 days after revaccination. Considered fully protected after a successful response demonstrated at vaccination site.
Slide 61-

Clinical Response to Vaccination Major (primary) reaction: Indicates viral replication has occurred and vaccination was successful. Equivocal reaction: Indicates immune suppression of viral replication or allergic reaction without production of immunity. Poor vaccination technique. Inactive vaccine.
Slide 62-

Major Reaction 6-8 Days After Vaccination Primary vaccination: Vesicular or pustular lesion. Area of definite palpable induration surrounding a central crust or ulcer. Revaccination: Less pronounced and more rapid progression. Pustular lesion or induration surrounding a central crust or ulcer.
Slide 63-

Equivocal Reaction All responses* other than major reactions. Caused by immunity, insufficiently potent vaccine, vaccination technique failure. Vaccination should be repeated with another vial, if possible. *Includes accelerated, modified, vaccinoid, immediate, early, or immune reactions.
Slide 64-

Vaccine Efficacy Clinical efficacy estimated in household contact studies. 91%-97% reduction in cases among contacts with vaccination scar. Studies did not consider time since vaccination or potency of vaccine.
Slide 65-

Post-Exposure Vaccine Efficacy Clinical efficacy estimated in household contact studies. SAR 2%-75%, varied by time since exposure. Disease generally less severe (modified type) in those with post exposure vaccination.
Slide 66-

Post-Exposure Vaccine Efficacy
Slide 67-

Adverse Events following Smallpox Vaccination
Slide 68-

Progression of smallpox vaccination site in a non-immune person.
Slide 69-

Common Symptoms Fatigue (50%) Headache (40%) Muscle aches and Chills (20%) Nausea (20%) Fever 37.7 ºC or 100 ºF (10%)
Slide 70-

Clinical Response to Vaccination* Symptom/sign Papule Pustule Maximum erythema Scab Scab separation Time after Vacc 3-5 days 5-8 days 8-10 days 14 days 14-21 days *typical response in a nonimmune person
Slide 71-

Smallpox Vaccine Reactions Among Susceptible Adults About 10% with temperature > 100F. Systemic symptoms (malaise, myalgias). 36% sufficiently ill to miss work, school, or recreational activities or had trouble sleeping.
Slide 72-

Lymphangitis following smallpox vaccination.
Slide 73-

Satellite lesions.
Slide 74-

Allergic reaction to tape
Slide 75-

Robust take with lymphangitis.
Slide 76-

Secondary bacterial infection of vaccination site.
Slide 77-

Smallpox Vaccine Adverse Reaction Rates* *Rates per million primary vaccinations
Slide 78-

Erythema multiforme following smallpox vaccination.
Slide 79-

Erythema Multiforme.
Slide 80-

Inadvertent Autoinoculation Transfer of vaccinia virus to sites other than the intended vaccination site Commonly on mucocutaneous borders (eye, mouth, rectum) Lesions heal spontaneously without specific treatment Highest risk in children 1-4 years Vaccinia Immune Globulin (VIG) may be useful
Slide 81-

Inadvertent autoinoculation
Slide 82-

Inadvertent inoculation.
Slide 83-

Palebral Autoinoculation.
Slide 84-

Generalized Vaccinia Generalized vesicular skin lesions occurring in the absence of eczema or other preexisting skin diseases Believed to result from a viremia with implantations in the skin Fever and systemic signs vary widely but are generally mild VIG may attenuate severity if given early in course of illness
Slide 85-

Generalized vaccinia.
Slide 86-

Generalized Vaccinia Differential diagnosis: Erythema multiforme. Eczema vaccinatum. Inadvertent inoculation at multiple sites. Early progressive vaccinia. Disseminated herpes. Severe varicella.
Slide 87-

Eczema Vaccinatum Generalized spread of vaccinia on skin of patients with eczema or past history of eczema (atopic dermatitis) May result from blood dissemination of vaccinia virus or from direct skin inoculation of vaccinia on broken skin Vaccinia virus readily recoverable from lesions of the rash VIG helpful
Slide 88-

Eczema vaccinatum.
Slide 89-

Progressive Vaccinia Also known as vaccinia necrosum and vaccinia gangrenosa Occurs only in patients with impaired immunologic function Characterized by spreading necrosis at site of vaccination, with or without metastatic necrotic lesions elsewhere on the body Painless, progressive, +/- systemic illness VIG is used to treat
Slide 90-

Progressive vaccinia.
Slide 91-

Post-vaccinial Encephalitis Diagnosis of exclusion. Other infectious or toxic causes of encephalitis should be ruled out. Pathophysiology not well understood. CSF may have increased opening pressure, lymphocytosis, elevated protein.
Slide 92-

Fetal Vaccinia 47 fetal vaccinia cases reported in world literature (as of 1970) Most result from primary vaccination of mother early in pregnancy May results in stillbirth or death of infant soon after delivery VIG may benefit live born infant
Slide 93-

Fetal vaccinia.
Slide 94-

Vaccinia Immune Globulin Antibodies limit viral replication Cangene® intravenous First-line therapy Under IND Available only through CDC Administer as soon as possible after onset Inadvertent inoculation (severe, or underlying illness) Generalized vaccinia (severe, or underlying illness) Eczema vaccinatum Progressive vaccinia Consider for severe ocular complications
Slide 95-

Vistide®, cidofovir Antiviral therapy FDA approved for CMV retinitis in AIDS patients Second-line treatment Not tested in humans against vaccinia Nephrotoxic (probenecid, hydration) Carcinogenic Investigational New Drug (IND)
Slide 96-

Certain images supplied by: Dr. John Leedom Dr. J. Michael Lane Dr. Vincent Fulginiti World Health Organization University of Rochester National Institutes of Health Logical Images, Inc.