51. Immunization (6%) Flashcards
1
Q
With parents who are hesitant to vaccinate their children, what to do? (2)
A
- explore the reasons
- and counsel them about the risks of deciding against routine immunization of their children.
2
Q
Name patients who will specifically benefit from immunization
A
- elderly and children
- immunosuppressed
- travellers
- those with sickle cell anemia (Drépanocytose)
- and those at special risk for pneumonia and hepatitis A and B)
2
Q
A
3
Q
When to immunize? (4)
A
- In infancy
- Before pregnancy
- Before traveling
- When new to the country if not previously immunized
4
Q
Exploring fears and myths about immunizations : Side effects (2)
A
- Most common side effects are mild fever and sore extremity.
- Serious reactions (death, encephalopathy) are so rare that their incidence cannot be calculated.
5
Q
Exploring fears and myths about immunizations : Autism
A
- The original paper in the Lancet publishing this association was recently withdrawn and there have been no definitive cases to support this claim.
- This was originally associated with a preservative agent called thimerosal. The only vaccines in Canada that are given to children and contain thimerosal are the multidose influenza vaccine and Hepatitis B. Both these vaccinations are available in formulations that do not contain thimerosal (ex. Vaxigrip for children and pregnant mothers).
- The only true contraindication to thimerosal is anaphylaxis.
6
Q
Exploring fears and myths about immunizations : Vaccines don’t work
A
- No vaccine is entirely effective. If a vaccine-preventable disease outbreak does occur, some vaccinated individuals will contract the disease.
- However the proportion of unvaccinated individuals who contract the disease will be much higher than the proportion of vaccinated individuals.
7
Q
Exploring fears and myths about immunizations : “Vaccine-preventable diseases no longer exist in Canada “
A
- Certainly some vaccine-preventable diseases are rarely, if ever, seen in Canada and herd immunity for unvaccinated individuals does occur.
- However, unvaccinated individuals may still be exposed in their lifetime given the immigrant population that may not have been vaccinated or if the unvaccinated chooses to travel later in life.
8
Q
Why vaccinate?
A
- To protect yourself from common (HiB, Influenza, Varicella) or serious (Tetanus, Hepatitis, Meningococcemia) preventable infectious diseases.
- To protect individuals in society who are unable to receive vaccinations (newborns, immunocompromised, elderly)
9
Q
When should premature infants receive vaccines?
A
- Premature infants should receive immunizations at the same time (chronological age) as term infants, ie. do not delay vaccinations - in Quebec first vaccines at 2 months old
- Exception: In jurisdictions where Hep B vaccine is given at birth in HbsAg negative mother, delay until infant 2000g or discharged from hospital
10
Q
When to give Pneumococcal 23-valent vaccines ?
A
≥65yo, <65 with specific risk factors
11
Q
A
12
Q
When to give Herpes zoster vaccine ?
A
- ≥60yo (consider 50-59yo), immunosuppressed
- Adults ≥50yo who are known VZV seronegative should be given univalent varicella vaccine rather than herpes zoster (routine testing not recommended)
13
Q
When to give : HPV4 or HPV9 ()
A
- 9-26yo and ≥27yo who are at ongoing risk
- PIQ recommends vaccinating women 9-45yo, men 9-26yo even if previous HPV exposure
14
Q
When to give : Tetanus/Diphtheria (Td) (2)
A
- Primary series for unimmunized, and booster every 10y (Note: In Quebec, current guideline is for one single booster after 50yo)
- Earlier if non-clean/minor wound (if fully vaccinated >5y, if not fully vaccinated needs complete series with Ig)
