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Adv Pharm > Chaper 55: Childhood Immnizations > Flashcards

Chaper 55: Childhood Immnizations Flashcards

1
Q

Immunizations

A

Purpose is to protect against infectious diseases

Most effective method is to create a highly immune population

Universal vaccine is the goal

Vaccines carry risk, but risks of disease are much greater

Research shows universal vaccination is the best way to reduce vaccine preventable diseases

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2
Q

Vaccine

A

Whole or fractionated microorganisms

Vaccination: Any vaccine or toxoid

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3
Q

Live vaccine

A

Live attenuated vaccines are composed of live microbes that have been weakened or completely nonvirulent. Dangerous to immunocompromised patients

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4
Q

Killed vaccine

A

Killed vaccines are composed of killed microbes or components of killed microbes

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5
Q

Toxoids

A

Bacterial toxin that has been changed to a nontoxic form

Causes immune system to produce antitoxins:
Antibodies against whatever the natural bacterial toxin is
Protect against injury from toxins, but do not kill the bacteria that produced the toxins
Ex. Tetanus toxoid and diphtheria toxoid

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6
Q

Immunization

A

Active: Response to infection or to administration of a vaccine or toxoid.

Passive: Conferred by giving a patient preformed antibodies (immune globulins). Unlike active immunity, passive immunity protects immediately but persists only as long as the antibodies remain in the body.

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7
Q

Specific immune globulins

A

Preparations contain a high concentration of antibodies directed against a specific antigen (e.g., hepatitis B virus)

Administration provides immediate passive immunity

Preparations are made from donated blood

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8
Q

Reporting vaccine-preventable diseases

A

Determine whether an outbreak is occurring

Evaluate prevention and control strategies
Ex. COVID-19 travel restrictions, testing, and masking

Evaluate the impact of national immunization policies and practices

Goal is to prevent outback and/or spread

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9
Q

Immunization records

A

National Childhood Vaccine Act of 1986 requires a permanent record of each mandated vaccination
Date of vaccination
Route and site of vaccination
Vaccine type, manufacturer, lot number, expiration date
Name, address, title of person administering the vaccine

If something goes wrong with specific lot, can identify who got that vaccine

Reason for record
To ensure appropriate vaccination
To avoid overvaccination

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10
Q

Adverse effects of immunization

A

Immunocompromised children are at special risk from live vaccines:

Congenital immunodeficiency

Human immunodeficiency virus (HIV) infection

Leukemia

Lymphoma

Generalized malignancy

Therapy with radiation

Cytotoxic anticancer drugs

High-dose glucocorticoids

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11
Q

Target disease

A

Measles
Mumps
Rubella
MMR is a 2 dose live virus vaccine

Diphtheria
Tetanus (lockjaw)
Pertussis (whooping cough)
Diptheria, tetanus, pertussis are toxoids given series of 5 doses then people get boosters

Poliomyelitis (polio, or infantile paralysis)
PM is inactivated vaccine, 4 dose series of injections

Haemophilus influenzae type b
HIB is a bacterial polysaccharide that’s conjugated to a protein. 4 dose series

Varicella (chickenpox)
Varicella is a live virus, 2 doses

Hepatitis B
Hepatitis A
Hep A (2 dose) and Hep B (3 dose) are inactive viral Ag

Pneumococcal infection
Pneumococcal conjugate vaccine is a bacterial polysaccharide that’s conjugated to a protein. 4 dose vaccination

Meningococcal infection
Meningococcal infection vaccine is a bacterial polysaccharide that’s conjugated to a protein. 2 dose vaccine

Influenza
Influenza vaccine is a live vaccine that’s 1 dose annual after age 2.

Rotavirus gastroenteritis
Rotavirus is a live vaccine that’s 3 doses.

Genital human papillomavirus infection
HPV vaccine DNA-free virus-like particle and that’s a 2 dose vaccine

Respiratory syncytial virus
RSV is an experimental vaccine

COVID 19 –not scheduled yet

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12
Q

MMR ADR

A

Glandular swelling in the cheeks, neck, and under the jaw

5-15% of children will develop rash

May run a fever
Can go up to 12 days after vaccine

Mild local soreness, redness, swelling
Really with any vaccine

Tylenol or NSAIDs to help with s/sx after vaccine

Severe ADR: transient thrombocytopenia –rare, anaphylactic reactions –rare.

No causal link between MMR and development of autism, Crohn disease, or any other serious long-term illness

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13
Q

MMR precautions and contraindications

A

Contraindicated in pregnancy
Cautiously in kids with who have had anaphylactic-like reaction to gelatin, eggs, or neomycin
Contraindicated in immunocompromised kids

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14
Q

MMR schedule

A

2 dose live virus vaccine

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15
Q

Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) schedule

A

Full series and booster shots

series of 5 doses then people get boosters

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16
Q

DTaP ADR

A

Moderate reactions are less common –inconsolable crying, 105 or higher fever, 0.6% can develop convulsions with or without fever, but no permanent sequelae afterwards

Very rarely can cause acute encephalopathy
0-10.5 episodes per million doses
Most occur within 3 days of vaccination

Mild reactions are common –fever, drowsiness, anorexia, and some local pain, swelling and redness at the site developed a couple hours after vaccination and gone in a couple days
Can use NAIDs only after vaccine

17
Q

DTaP precautions and contraindications

A

Don’t want to give it to child with moderate-severe febrile illness. It can be given if they have a other one.

Contraindicated if they had anaphylactic reaction to earlier doses or had acute encephalopathy within 7 days of vaccination

18
Q

Poliovirus vaccine schedule

A

Inactivated poliovirus vaccine (IPV, Salk vaccine)

4 dose series of injections

19
Q

Polio vaccine ADR

A

Local soreness can occur

Contains trace amounts of streptomycin, neomycin and bacitracin, so kids with allergies to these drugs have to be monitored

20
Q

H. influenzae type b conjugate (Hib) vaccine schedule

A

4 dose series

21
Q

HIB vaccine ADR

A

Safest of all vaccines

None serious –local swelling, redness, and warmth at the site

Only 1% get a fever and it only hits about 101

22
Q

Varicella virus vaccine schedule

A

Live, attenuated varicella viruses
2 doses

23
Q

Varicella vaccine ADR

A

None serious

Some local redness, soreness, and some swelling at the injection site. Some fever ~102 degrees

~5% of kids with get a varicella-like rash within a month of the injection
Higher incidence with children with leukemia –about ½

24
Q

Varicella vaccine precautions and contraindications

A

Contraindicated in pregnancy, leukemias, lymphomas, pt allergic to neomycin or gelatin. Immunocompromised pt

Children receiving the vaccine should stay away from ASA and other salicylates for 6 weeks –concern of rye syndrome

25
Q

Hep B vaccine

A

Hepatitis B surface antigen (HBsAg), the primary antigenic protein in the viral envelope
Promotes synthesis of specific antibodies directed against hepatitis B virus
Viral component, not live virus; cannot cause disease

26
Q

Hep A vaccine population

A

Recommended for all children living in areas where vaccination programs target older adults due to an increased risk for infection

at least 1 year old travelling to places with high rates of hep A (central American, south America, Mexico, Caribbean islands, Africa, Asia except japan, and southern or eastern Europe), people in communities that have frequent outbreaks of hep A, homosexual men, people who use illegal drugs, chronic liver disease, people who receive clotting factor concentrates, people who work with non-human primates, or work with Hep A in labs, people who are expect to have close contact to international adoptee from a country where Hep A is common

27
Q

Hep A vaccine

A

Inactive form of hepatitis

28
Q

Hep A ADR

A

Mild reactions are common

Soreness in ~1/2 the people and HA in ~14%, fatigue, lack of appetite

Start ~ 3-5 days after the vaccine and last ~ 1-2 days

29
Q

Pneumococcal conjugate vaccine

A

Prevention of invasive pneumococcal disease in infants and children

30
Q

Pneumococcal conjugate vaccine ADR

A

May have drowsiness, loss of appetite, some redness and tenderness at site. ~1/3 od people run a temp below 102.

Vaccination all children under 2y then follow schedule

Common reactions: local pain, HA, fatigue, redness, swelling at the site

31
Q

Meningococcal conjugate vaccine (MCV4) ADR

A

Concerns that MCV4 might cause Guillain-Barre syndrome appear to be unfounded

32
Q

nfluenza vaccine

A

Annual vaccination against influenza, including the H1N1 subtype, is now recommended for all children between 6 months and 18 years of age

33
Q

Human papillomavirus vaccine

A

Gardasil and Cervarix

Prevent cancers, precancerous lesions, and genital warts in males and female

Should be given before individual becomes sexually active

Adv Pharm (76 decks)

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