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Clinical - Winter > 25 - Vaccines > Flashcards

25 - Vaccines Flashcards

1
Q

What are the 2 types of influenza vaccines?

A

1) Inactivated virus (effective in 2 weeks, lasts less than 12 months)
2) Live attenuated virus

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2
Q

What is the adult immunization schedule? What diseases does it protect against?

A
  • All adults should receive Tdap (tetanus, diphtheria, and pertussis)
  • All adults should receive Td (tetanus and diphtheria) every 10 years
  • Adults over 65 y/o should receive the pneumococcal vaccine
  • Everyone over 6 m/o should receive the flu shot every year
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3
Q

What can be done to improve influenza and pneumococcal vaccine delivery to high-risk individuals?

A
  • Recommendation by health care provider
  • Collaborate w/ pharmacist and specialist physicians to distribute info on benefits and risks
  • Advertise in local newspapers, radio, television
  • Issue reminders to px and healthcare workers
  • Vaccinate on discharged from hospital or ER in fall, w/ home care or at clinics w/ high risk px
  • Increase accessibility in institutions and community
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4
Q

What are situations that aren’t CI to vaccines but commonly mislabeled as such?

A
  • Minor acute illness (including upper respiratory infection, diarrhea; exceptions = LAIV, rotavirus vaccine, and oral cholera)
  • Antibiotic/antiviral therapy (exceptions = live oral typhoid and LAIV, herpes zoster and varicella)
  • Adverse event following previous immunization
  • Extensive limb swelling following immunization
  • Febrile seizure or syncope after previous immunization
  • Inconsolable crying
  • Oculo-respiratory syndrome (except influenza vaccine)
  • Non-anaphylactic allergies
  • Multiple sclerosis
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5
Q

What is done to surveillance vaccine-associated adverse effects?

A
  • During phase 1, 2, and 3 clinical studies
  • Passive reporting to provincial health authority
  • Active reporting through immunization monitoring program
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6
Q

What are the most common adverse effects of vaccines?

A
  • Local = soreness, swelling, redness
  • Systemic = tiredness, irritability, GI, fever, seizures
  • Allergic = urticaria, angioedema, rhinitis, bronchospasm, anaphylaxis
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7
Q

What are the principles of effective and informed communication about vaccines and immunization?

A
  • Communicate current knowledge
  • Respect difference of opinion
  • Represent risks and benefits of vaccines fairly and openly
  • Adopt a patient centered approach
  • Make the most of each opportunity to present clear, evidence-based messages regarding vaccinations and immunization
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8
Q

Should a 2 y/o w/ no contraindications receive the trivalent/quadrivalent or live attenuated influenza vaccine?

A
  • Can have either
  • Parent will likely choose live b/c available in a nasal spray
  • If px has asthma, must have TIV
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9
Q

Should a pregnant woman receive the trivalent/quadrivalent or live attenuated influenza vaccine?

A

Must have TIV

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10
Q

Should a 67 y/o receive the trivalent/quadrivalent or live attenuated influenza vaccine?

A

Live is only for px aged 2-59, so this px needs TIV

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11
Q

Should a px w/ an egg allergy receive the trivalent/quadrivalent or live attenuated influenza vaccine?

A
  • Can have either

- Egg allergy no longer CI for live

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12
Q

What is zostavax? What does it contain? When is efficacy greatest?

A
  • Vaccine for prevention of herpes zoster (shingles) in px over 50 y/o
  • Contains live attenuated varicella-zoster
  • Efficacy highest in px 60-69 y/o
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13
Q

Can a px w/ an active case of herpes zoster receive the zoster vaccine?

A

No, must wait 1 year since last active infection to receive vaccine

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14
Q

What is the primary age group for HPV vaccination?

A

9-27 y/o females and males

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15
Q

What is the dosing schedule for the HPV vaccine?

A

Depends on the vaccine (gardasil, gardasil 9, or cervarix)

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16
Q

What is the most common cause of severe gastroenteritis in infants and children?

A

Rotavirus

17
Q

When is the rotavirus vaccine recommended?

A

For infants starting at 6 weeks of age

18
Q

Is the rotavirus vaccine injected?

A

No, given orally

19
Q

What is the benefit to live attenuated vaccines?

A

Broader, stronger, and longer immunity

20
Q

What are examples of live attenuated vaccines?

A
  • MMR
  • Varicella
  • Yellow fever
  • Oral typhoid
  • Oral cholera
  • Influenze (LAIV)
  • Rotavirus
21
Q

What are examples of inactivated vaccines?

A
  • Poliovirus

- Influenza

22
Q

What are purified or recombinant subunit vaccines? Do they provide better or weaker immunity and what does this mean for dosing?

A
  • Given as protein (ex: toxoid), polysaccharide, or polysaccharide-protein conjugate
  • Weaker immunity, so require multiple dose or adjuvant
23
Q

What are examples of purified or recombinant subunit vaccines?

A
  • DTaP
  • Hib
  • HBV
  • Pneumococcal
  • Meningococcal
24
Q

Which vaccines produce the most adverse effects?

A

Live vaccines

25
Q

What is passive immunity?

A

Immune globulin w/ performed antibodies for protection

26
Q

What are advantages and disadvantages to combination vaccines?

A
  • Advantages = easier storage and administration, potential increase in vaccine uptake, reduced exposure to adjuvants/additives
  • Disadvantages - more complex pre-approval, difficult to determine component responsible for adverse event, increased cost
27
Q

Where are ID injections injected?

A

Flexor surface of forearm

28
Q

Where are SC injections injected?

A

45 degrees into upper triceps area of arm

29
Q

Where are IM injections injected?

A

90 degrees into deltoid muscle in 1 year and older

30
Q

What should be done if more than 1 injection is needed?

A
  • Use both arms

- More than 2 injections = use 2 arms and third injection should be more than 1 inch from previous injection

31
Q

Can vaccinations be given before or after their recommended schedule?

A
  • Shouldn’t be given sooner than recommended b/c may cause less than optimal antibody response and shouldn’t be counted
  • Can be given after w/o having to restart series
32
Q

Hepatitis B vaccine is administered at 0, 1, and 6 months. What would you do if the 3rd dose was given at 3 months?

A

Ignore that dose and give another at 6 months

33
Q

Which 2 vaccinations are commonly recommended to be administered simultaneously?

A

Pneumococcal and influenza

34
Q

Can vaccines for the same disease be given simultaneously?

A

No, must be separated by at least 8 weeks

35
Q

Can 2 live vaccines be given on the same day?

A

Yes or can be separated by 4 weeks

36
Q

What should be done after administration of a vaccine?

A

Keep px nearby for 15 minutes

37
Q

What are some contraindications to both inactivated and live vaccines?

A
  • Anaphylaxis after previous dose of the vaccine
  • Proven immediate or anaphylactic hypersensitivity to any component of the vaccine or its container
  • Guillain-Barre syndrome w/in 6 weeks of receiving the vaccine (not immediate CI for influenza vaccine)
38
Q

What are some contraindications to only the live version of a vaccine?

A
  • Severe asthma
  • Congenital malformation of GI tract, uncorrected (rotavirus is CI)
  • Immunocompromised (can weigh risk vs. benefit in milder cases)
  • Immunosuppressive therapy (ex: cancer tx, monoclonal antibodies)
  • Pregnancy
  • Active, untreated TB (MMR, MMRV, univalent varicella, herpes zoster, and BCG vaccines CI)
39
Q

When are egg allergies CI for immunizations?

A
  • Yellow fever
  • Tick-borne encephalitis vaccine
  • Some rabies vaccine

Clinical - Winter (24 decks)

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