IMMUNIZATION MEDICATION CHART: THORPE/TUNSTALL
VACCINE
INDICATION
ADVERSE
REACTIONS
NURSING INTERVENTIONS
Education on importance of
immunization while in the hospital
along with series of immunizations
at 1, 2, and 6 months of age
Hepatitis B
Prevent the contraction
of Hepatitis B
Site irritation
Rotavirus
Prevention of the
rotavirus
Uncommon. Child may
become irritable
Education on importance of
immunization, prevention of virus,
and proper handwashing
Diphtheria, Tetanus, &
acellular pertussis
(DTaP)
Recommended for the
prevention of
diphtheria, tetanus, and
pertussis
fever, site irritation, and
soreness at injection
site. Rare: seizures and
change in LOC
Determination if children is able to
get vaccination or if vaccination is
contraindicated at that time.
Booster every 10 years.
Determination of length and size of
needle.
Pertussis droplet precautions.
Haemophilus influenza
type B (HiB)
Protection against
numerous serious
infections caused by H.
influenza type B (i.e.:
bacterial meningitis,
epiglottitis, bacterial
pneumonia, and sepsis)
irritation at injection
site, fever, and fainting
Educational resources on
importance of vaccine, prevention
of spread of infection, and
determination of appropriate needle
Pneumococcal
conjugate (PCV13)
Protection against
pneumococcal disease
(13 types)
At risk population
should receive vaccine:
fainting, soreness at
injection site, severe
allergic reactions are
rare
Proper location of injection site,
education to at risk populations,
determination of size and length of
needle.
SITE OF
INJECTION
vastus lateralis (IM)
Orally
vastus lateralis (IM)
vastus lateralis (IM)
Infants and young
children: VASTUS
LATERALIS
sickle cell, nephrotic
syndrome, CRF, DM,
HIV,
immunosuppression,
CHF, Cystic Fibrosis,
Asthma, liver disease,
cardiomyopathy
Older children and
adults: DELTOID
Inactivated poliovirus
Protects individuals
from polio
Uncommon. Site
irritation may occur
Education. Evaluate if the patient is
sick (may need to reschedule
vaccination).
Assess allergy to neomycin
Influenza
Reduce the risk of
contracting the “flu”
mild – same as all other
vaccines. More severe:
Guillian-Barre
Syndrome (nerve cell
damage- paralysis)
Education during peak season.
Correct site location, needle size,
and needle length. Watch for
adverse side effects.
Assess allergy to eggs
IM or SQ (depends on
age and doctor order)
Children: vastus
lateralis (IM)
Older children and
adults: deltoid (IM)
Nasally live virus
Subcutaneously
Measles, Mumps,
rubella (MMR)
Prevention against the
viral diseases: Measles,
Mumps, and Rubella.
Not given to pregnant
women. Soreness,
swelling, seizures, low
platelet count, rash, and
deafness (rare).
Educate women not to receive
while pregnant or 28days after
receiving vaccination. Correct site
of administration, needle length,
and size.
Children: smallanterolateral aspect of
thigh.
Older childrenposterior triceps
Adults: posterior
triceps (may require
one more dose)
Varicella
Prevent against
contracting
“chickenpox” if patient
has not had the infection
soreness and irritation.
Uncommon: rash,
seizure, meningitis, and
pneumonia.
Obtain adequate history on
patient’s exposure or vaccination
history. Provide education to
patient/family. Administer
SUBCUTANEOUS.
Posterior tricep
or is not a reliable
historian.
Hepatitis A
Prevention of Hepatitis
A
injection in appropriate site with
appropriate needle.
Soreness at site lasting
1-2 days
Provide proper education on
importance of vaccine. Ensure
patient is not sick at time of
administration. Administer
vaccination via appropriate needle
and location site.
IM
Children: vastus
lateralis
Older children and
adolescents: deltoid
Adults: deltoid
Reminders:
*General contraindication for ALL immunization is a severe febrile illness, because increases the risk for a serious adverse reactions. The presence
of MINOR ILLNESS, like the common cold is not a contraindication for immunizations.
*Do NOT give live virus to immunocompromised, presence of acquired passive immunity through blood transfusions/immunoglobulin or allergic
response to a previously administered vaccine or substance in vaccine. Must wait 3 months to receive vaccine after any treatment that causes
acquired passive immunity.
*Documentation of Vaccines: date given, vaccine manufacturer name, vaccine lot number, expiration date, person administering, location (clinic),
parent consent, vaccine information sheet (VIS) provided to parent, Route and Site of vaccine administer and any adverse reactions if apply