I messed up! And freaking out! Please help!

Started by Lisochka
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Lisochka

Senior Member
15+ Year Member
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Gave zostavax today to a patient with pneumonia... I asked the patient, 60 year old hispanic female, if she was feeling ok and she said yes...After I gave a shot she started telling me that doctor should call in an antibiotic for her pneumonia...I am freaking out! Have you ever given a zostavax to a sick person?
 
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I doubt her "pneumonia" was that severe if she could come in for a Zostavax shot and it not be noticeable that she was ill. Sometimes people like to self-diagnose or exaggerate. Maybe she did not even see the doctor, but talked over the phone and the doctor agreed to call in an antibiotic just to satisfy her.

I wouldn't be worried.
 
on the release sheet that each vaccine pt has to sign did she check the "NO" box for the question "Are you sick today?" If she did then liability wise you are fine, if she checked yes and you didn't look then just hope that she doesnt get sick. I still think she will be fine though
 
OP, what *specifically* are you 'freaking out' about? If safety, then what adverse effect are you expecting? If efficacy, then explain that to us. It would be easier to help if it were clear what exactly you are worried about.
 
Thank you guys! I looked up and it was not contraindication but the cdc said "Consider delaying vaccination"
I really hope this woman will be ok...God, please help her to be ok!!!!

OP, what *specifically* are you 'freaking out' about? If safety, then what adverse effect are you expecting? If efficacy, then explain that to us. It would be easier to help if it were clear what exactly you are worried about.

I am freaking out that she will get shingles because the vaccine is live and her immune system is weak now so she wont be able to fight against the shingles virus that has been introduced to her through the vaccine....
 
Sigh. Why are some rphs SO Paranoid? I know one Rph who went NUTS when she realized she gave someone vitamin d2 50,000 unit capsules instead of vitamin d3 50,000 unit capsules. She called the patient, called the doctor, filed an incident report. Just wow.
 
Remember, Zostavax is different from other live vaccines, in that the patient ALREADY has the virus in her system. If she had never had chicken pox and you have her Zostavax, then it would be more concerning (concerning, but probably a minor concern given the situation.) If she has had chicken pox, then she already is at risk for shingles at any given time, I'm not aware of any evidence that give the vaccine can possible increase the person's risks for shingles in any way. From what I understand, the concern with giving Zostavax when someone is sick, is that their body is too busy fighting off the other germs they have, and may not have a proper immune response to the Zostavax (ie they won't make more antibodies for it.) In other words, the most likely worst case scenario is that she doesn't get immune protection from the vaccine, not that she could actually have shingles triggered by the vaccine. But if she felt well enough to walk in to get the vaccine, most likely her immune response to it will also be just fine.
 
Lisochka said:
Thank you guys! I looked up and it was not contraindication but the cdc said "Consider delaying vaccination"
I really hope this woman will be ok...God, please help her to be ok!!!!

OP, what *specifically* are you 'freaking out' about? If safety, then what adverse effect are you expecting? If efficacy, then explain that to us. It would be easier to help if it were clear what exactly you are worried about.

I am freaking out that she will get shingles because the vaccine is live and her immune system is weak now so she wont be able to fight against the shingles virus that has been introduced to her through the vaccine....
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Don't worry Zostavax supposedly only prevents 51% of cases. They also don't know how long it is effective for. They will probably start recommending boosters in a few years when they find it doesn't work as well as previously thought. The cases of shingles really went through the roof after 1995 when they began pushing the Varicella vaccine. People were no longer encountering children with chickenpox so they weren't getting dosed often enough to suppress the shingles. So what was the answer? Another vaccine. If you want your customers to get natural immunity which is much safer have them go hang out with some kids with chickenpox. I don't know if that's possible in America. They may have to go to another country where they are less vaccine happy.
 
Unchained said:
Don't worry Zostavax supposedly only prevents 51% of cases. They also don't know how long it is effective for. They will probably start recommending boosters in a few years when they find it doesn't work as well as previously thought. The cases of shingles really went through the roof after 1995 when they began pushing the Varicella vaccine. People were no longer encountering children with chickenpox so they weren't getting dosed often enough to suppress the shingles. So what was the answer? Another vaccine. If you want your customers to get natural immunity which is much safer have them go hang out with some kids with chickenpox. I don't know if that's possible in America. They may have to go to another country where they are less vaccine happy.
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you are really going there again?
 
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Unchained said:
Don't worry Zostavax supposedly only prevents 51% of cases. They also don't know how long it is effective for. They will probably start recommending boosters in a few years when they find it doesn't work as well as previously thought. The cases of shingles really went through the roof after 1995 when they began pushing the Varicella vaccine. People were no longer encountering children with chickenpox so they weren't getting dosed often enough to suppress the shingles. So what was the answer? Another vaccine. If you want your customers to get natural immunity which is much safer have them go hang out with some kids with chickenpox. I don't know if that's possible in America. They may have to go to another country where they are less vaccine happy.
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I have a great aunt with natural immunity to polio now. She can't walk well. How is that much safer than a shot?
 
npage148 said:
Who even stocks the d3 50000? OTC and not covered. Everyone gets d2 where we work regardless.
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OT, but I saw a doctor freak out when told the D3 50,000 was back-ordered, she refused to OK the D2 and said she figure out something else for her pt. Granted, I've seen a study showing that D3 is supposed to be better absorbed, but c'mon, I doubt that it will make any clinical difference in the majority of patients.
 
BidingMyTime said:
OT, but I saw a doctor freak out when told the D3 50,000 was back-ordered, she refused to OK the D2 and said she figure out something else for her pt. Granted, I've seen a study showing that D3 is supposed to be better absorbed, but c'mon, I doubt that it will make any clinical difference in the majority of patients.
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It looks like the Decara reps have been working hard cause I had to explain this D3 vs D2 difference many times this past month to several OBGYNs and NPs.
 
BidingMyTime said:
OT, but I saw a doctor freak out when told the D3 50,000 was back-ordered, she refused to OK the D2 and said she figure out something else for her pt. Granted, I've seen a study showing that D3 is supposed to be better absorbed, but c'mon, I doubt that it will make any clinical difference in the majority of patients.
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Seriously at that dose who cares about small difference is BA. Im not really believing the idea that they majority of the population is suddenly vit D deficient and needs high dose therapy She probably the type of doctor that writes for Mentax and gets mad when it is not covered
 
npage148 said:
Seriously at that dose who cares about small difference is BA. Im not really believing the idea that they majority of the population is suddenly vit D deficient and needs high dose therapy She probably the type of doctor that writes for Mentax and gets mad when it is not covered
Click to expand...

Yup, I think you are right! She is a DO who is big into nutritional/alternative treatments.
 
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