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Japanese encephalitis virus vaccine Japanese encephalitis virus vaccine (Ja-pan-ees en-se-fa-li-tes vak-seen) japaneseencephalitisvirusvaccine, Ixiaro (trade name) Classification Therapeutic: vaccines immunizing agents Pregnancy Category: B
IndicationsActive immunization against disease caused by Japanese encephalitis virus (JEV) in persons ≥17 yr.ActionAn inactive form of the virus induces antibodies that neutralize live JEV.Therapeutic effectsPrevention of disease caused by JEV.PharmacokineticsAbsorption: Absorption follows intramuscular administration.Distribution: Unknown.Metabolism and Excretion: Unknown.Half-life: Unknown.Time/action profile (antibody production)ROUTE | ONSET | PEAK | DURATION |
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IM | unknown | within 10 days | unknown |
Contraindications/PrecautionsContraindicated in: Serious hypersensitivity to a previous dose; Serious hypersensitivity to protamine.Use Cautiously in: Immunocompromised patients (may have ↓ response); Obstetric / Lactation: Safety and effectiveness not established; Pediatric: Safety and effectiveness not established.Adverse Reactions/Side EffectsCentral nervous systemLocal- pain (most frequent)
- tenderness (most frequent)
- edema
- pruritus
MusculoskeletalInteractionsDrug-Drug interactionConcurrent use of immunosuppressives including antineoplastics and corticosteroids may ↓ antibody reponse and ↑ risk of adverse reactions.Route/DosageIntramuscular (Adults ≥17 yr) 0.5 mL, repeated 28 days later; series completed at least 1 wk prior to potential exposure to JEV.AvailabilitySuspension for injection (contains protamine): 0.5 mL single dose syringes Nursing implicationsNursing assessment- Determine if patient has had reactions to previous vaccines.
- Obtain temperature. Vaccine should not be administered to patients with fever >100°F.
Potential Nursing DiagnosesRisk for infection (Indications)
Implementation- Immunization is administered in 2 doses, 28 days apart, completed at least 1 wk prior to exposure to JEV.
- Intramuscular: Store in refrigerator; clear liquid with white precipitation may form during storage. Shake syringe well to obtain a white, opaque, homogenous suspension. Do not administer if discolored or contains particulate matter. Inject into deltoid; do not give intravenously, intradermally or subcutaneously.
Patient/Family Teaching- Inform patient of the purpose of vaccine and that vaccine is non-infectious. If second dose is missed, contact health care professional to determine when to receive second dose. Maximum protection is not achieved until 1 wk after second dose. Advise patient to read Patient Information Sheet prior to vaccination.
- Advise patient of precautions to take to reduce exposure to mosquito bites transmitting virus (adequate clothing, use of repellents, mosquito nets). Vaccine may not fully protect everyone who gets the vaccine, does not protect against other types of encephalitis or other diseases transmitted by mosquito bites.
- Advise patient to tell health care professional what medications they are taking.
- Advise female patients to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.
Evaluation/Desired Outcomes- Protection against Japanese Encephalitis Virus.
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