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Vaccine-Preventable Diseases

Edited by Michelle Asselin

Have you ever wondered which vaccines pharmacists are able to inject? Pharmacists who have successfully completed their injection training have the knowledge, skills, and judgment to safely administer vaccines in pharmacies.* This skill has been especially important during the COVID-19 pandemic, as well as during flu shot season. In addition to the COVID and flu vaccines, pharmacists, pharmacy students, registered pharmacy technicians, and interns can also administer vaccines against 13 other preventable diseases.*

Continue reading if you are interested in refreshing your memory or learning more about these 13 vaccines that pharmacists continue to provide to the community.*

1. Bacille Calmette-Guérin (BCG)

Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. It is transmitted by airborne droplets that mainly affect the lungs. Approximately 33% of the world is infected with TB, while the incidence in Canada is very low. In Canada, TB occurs more commonly among Indigenous and foreign-born individuals. Some of the risk factors for the progression to active TB include immunodeficiencies, diabetes, malnutrition, and smoking. The BCG vaccine has shown to be 51% effective in preventing TB and up to 78% effective in protecting the spread of TB to other areas of the body in newborns. This live vaccine is given as a single injection into the outer layer of the skin and usually leads to redness and swelling in the area, followed by a scar. The BCG vaccine is not recommended for routine use in Canada but is considered for infants in high-risk communities, when there is a high chance of ongoing exposure to TB, and for long-term travellers going to countries where the prevalence of TB is high. The BCG vaccine will not prevent the development of TB in individuals who are already infected.

2. Haemophilus influenzae type B (Hib)

Haemophilus influenzae is a bacterial infection than can cause infections like sepsis (blood infection), meningitis (brain infection), and pneumonia (lung infection). Type B causes 95% of all invasive H. influenzae infections and is therefore targeted through immunization. Hib is spread through coughing, sneezing, or touching contaminated surfaces. Hib occurs worldwide, however infection rates are low in countries with vaccination programs in place. Children under the age of 5 are at the greatest risk of contracting Hib. As a result, vaccination consists of a 3-dose primary series at 2, 4, and 6 months of age with a booster at 12 to 23 months. Following the booster, the vaccine series is 95% to 100% effective against invasive infections. The DTaP-IPV-Hib combination vaccine is commonly used as it provides protection against not only Hib, but also diphtheria, tetanus, pertussis, and polio.

3. Hepatitis A

Hepatitis A occurs worldwide and is one of the most common vaccine preventable diseases. The leading cause of Hepatitis A infection in Canada is international travel. Hepatitis A is a viral infection of the liver and is spread through the faecal-oral route, usually through contaminated food or water. Roughly 25% of adults will become hospitalized, but the mortality rate remains low at 0.5%. Those over 60 years of age, who have pre-existing liver disease or are immunocompromised are at an increased risk for severe illness. The Hepatitis A vaccine (ex. Avaxim, Havrix) is an inactivated virus vaccine administered intramuscularly (into the muscle) as two doses, 6 months apart. The vaccine is nearly 100% effective and is associated with mild fever, soreness at the injection site, and headache. The vaccine is indicated for those 6 months of age or older. To prevent Hepatitis A infection, practicing proper hygiene and avoiding infected water sources, in addition to vaccination, are strongly encouraged.