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News to Use
To Use
By Tina Thornhill
Tdap in Pregnancy
A new study found that when the Tdap vaccine is given during pregnancy, the occurrence of infant pertussis is reduced. The Centers for Disease Control (CDC), with support from the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives, recommends that women between 27 (preferred) and 36 weeks of pregnancy receive the Tdap vaccine. The aim is to provide the infant with some shortterm protection against whooping cough. The antibodies produced by the mother when the vaccine is given in the third trimester was thought to bridge protection for the infant until they can receive their immunization at the age of two months. In the retrospective analysis, there was a 75% reduction of pertussis hospitalizations and a 46% reduction of any pertussis cases. Some previous immunological studies reported that mothers receiving the vaccine have a less effective response to their own pertussis vaccine series; however, this most recent study did not find this to be the case. The incidence of pertussis is increasing leading to an increase in infant mortality. The CDC recommends the Tdap vaccine with every pregnancy. The side effects are minimal, but may include injection site reactions, headache, body aches, and fatigue. Reference: https://www.ajpmonline.org/article/S07493797(18)31696-9/pdf
Analysis of the National Health and Nutrition Examination Surveys (NHANES) data revealed that one out of every three children and adolescent uses dietary supplements. Products most commonly used are: multivitamins, iron, calcium, vitamin D, body-building supplements, melatonin and omega-3 fatty acid supplements. Boys were more likely to take body-building and omega-3 supplements. Since these products report some benefit to cognition and sleep, researchers attributed the rise in melatonin and omega-3 fatty acid use especially in those with attention-deficit hyperactivity disorder (ADHD). The researchers warn about the use of these and other supplements that have potentially adverse cardiovascular side effects (e.g., arrhythmias) – especially when combined with ADHD products. Reference: Qato DM, Alexander GC, Guadamuz JS, et al.Prevalence of Dietary Supplement Use in US Children and Adolescents, 2003-2014. JAMA Pediatrics; Published online June 18, 2018.
Vaccination Errors – the 2017 Report from ISMP
The Institute for Safe Medication Practices (ISMP) reported that errors related to vaccinations remain a problem – especially in outpatient medical and public health clinics where over half of the errors occurred. A third of errors occurred in physician offices. The most frequently cited errors were the administration of the wrong vaccine, the wrong dose, and using expired or contaminated vaccines. Pharmacies accounted for 2% of the errors, the lowest incidence cited. The vaccinations with the most errors were Hepatitis A, DTaPIPV, and Influenza. The ISMP has developed a teaching tool that can be used to increase awareness and reduce the number of errors made. Pharmacists can be an excellent education resource to medical and nursing staff and help with policy and procedure development that may reduce the incidence of vaccination errors.
(https://www.ismp.org/sites/default/files/attachments/2018-06/ Teaching-table.pdf).
Tina Thornhill, PharmD, FASCP, CGP
