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NAPLEX > Chapter 20: Immunizations > Flashcards

Chapter 20: Immunizations Flashcards

1
Q

Who provides the recommendations for vaccine administration in children and adults

A

The Advisory committee on Immunization Practices (ACIP)

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2
Q

Who approves the ACIP recommendations and where do these recommendations get published?

A

CDC

CDC’s Morbidity & Mortality Weekly Report (MMWR) & The Pink Book

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3
Q

____ vaccines are produced by modifying a disease-producing (“wild”) virus or bacterium in a lab; they have the ability to replicate (grow) and produce immunity, but usually do not cause illness

A

Live attenuated

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4
Q

Live attenuated vaccines are CI in which populations

A

immunocompromised and pregnant patients

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5
Q

____ vaccines can be composed of either a whole virus or bacterium, or fractions of either. They cannot replicate

A

Inactivated

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6
Q

Polysaccharide vaccines do not produce a good immune response in children < __ years of age

A

2

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7
Q

Key live vaccines

A

Remember: COZY IV RM

  • Cholera
  • Oral Typhoid
  • Zoster
  • Yellow Fever
  • Intranasal influenza
  • Varicella
  • Rotavirus
  • MMR
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8
Q

When can most live or inactivated vaccines be administered

A

Simultaneously

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9
Q

T/F: Increasing the interval between doses of vaccine given in a series does not diminish the effectiveness of the vaccine after completion of the series

A

True

Decreasing the interval between doses of vaccine can interfere with antibody response & protection

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10
Q

Antibodies in some blood products and IVIG can interfere with ______ and a separation period may be required

A

live vaccine replication

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11
Q

Which type of vaccine can be given at any time

A

Inactivated

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12
Q

Inactivated vaccines are started when a baby is 2 months old, except for which vaccine which is given at birth

A

Hepatitis B

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13
Q

Live vaccines can cause a false-negative TB skin test. Options to reduce the risk of a false-negative include:

A
  1. give the live vaccine on the same day as the skin test
  2. Wait 4 weeks after a live vaccine to perform the skin test
  3. Administer the skin test first, wait 48-72 hrs to get the result, then give the live vaccine
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14
Q

Multiple live vaccines can be given on the same day or (if not given on the same day) spaced _____ weeks apart

A

4

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15
Q

T/F: If a vaccine series requires > 1 dose, the intervals between doses can be extended without restarting the series, but they cannot be shortened in most cases

A

True

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16
Q

MMR & varicella-containing vaccines (not zoster) require separation from antibody-containing products (e.g., blood transfusions, IVIG).

  • The recommended spacing if giving a vaccine before antibody containing product is:
  • The recommended spacing if giving an antibody containing product before a vaccine is:
A

Vaccine → 2 weeks → antibody-containing product

antibody-containing product → 3 months or longer → vaccine

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17
Q

Simultaneous administration of vaccine and antibody (in the form of immunoglobulin) is recommended for post-exposure ppx of certain diseases, such as

A

Hep A & B, rabies and tetanus

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18
Q

Adverse reactions that require some type of assistance should be reported to

A

FDA’s Vaccine Adverse Events Reporting System (VAERS)

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19
Q

With live vaccines, mild systemic reactions can occur __ - ___ days after the vaccine is given

A

3-21 days

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20
Q

When does a vaccine become contraindicated in a person (besides being immunocompromised or pregnant with live vaccines)

A

A severe or anaphylactic reaction

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21
Q

T/F: Treatment with antibiotics is NOT a valid reason to delay vaccines

A

True

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22
Q

T/F: If a person has a moderate-severe acute illness, it is not necessary to delay vaccines until the condition has improved

A

False - it is reasonable to delay the vaccine

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23
Q

How often is Tdap or Td given in adults

A

every 10 years

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24
Q

At what age can Shingrex be given

A

> /= 50 years old

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25
Q

T/F: Shingrex should still be given even if a patient has previously had chicken pox

A

True

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26
Q

When is the second dose of Shingrex given

A

2-6 months after the first dose

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27
Q

Pneumovax 23 is given to all adults >/= ___years

A

65

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28
Q

Patients age 2-64 years should get 1 dose of Pneumovax 23 if they have which condition(s)

A

Heart, lung, liver disease, diabetes, alcohol abuse, smokers

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29
Q

Patients age 2-64 years should get 2 doses of Pneumovax 23 if they have which condition(s)

A

Immunocompromised (e.g, SCD, asplenia, HIV, chronic renal failure, malignancy, transplant, immunosuppressive drugs including steroids)

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30
Q

T/F: Prevnar 13 is optional for adults age >/= 65 years

A

True

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31
Q

Any patients >/= 6 years old who are ____ should receive Prevnar13

A

immunocompromised

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32
Q

Which meningococcal vaccines are serogroup B

A

Bexsero, Trumenba

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33
Q

Which adult populations should receive Meningococcal serogroup B vaccines

A

complement component deficiency, taking aculizumab (Soliris), asplenia, microbiologist with exposure to Neisseia Meningitidis, serogroup B meningococcal vaccine exposure

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34
Q

Which meningococcal vaccines are conjugate vaccines

A

Menactra and Menveo

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35
Q

Which adult populations should receive Meningococcal conjugate vaccines

A

Same groups as serogroup B: complement component deficiency, taking aculizumab (Soliris), asplenia, microbiologist with exposure to Neisseia Meningitidis, serogroup B meningococcal vaccine exposure

PLUS: HIV, Sickle Cell disease, travelers/residents to countries in which the disease is common (such as the meningitis belt in Sub-Saharan Africa), military recruits, first year college students living in dorms, if not up-to-date

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36
Q

Which adult populations should receive Hep B vaccine

A

Sexually active adults who are not in long-term, monogamous relationships, patients with diabetes age 19-59 years (or >/= 60 years per HCP discretion), household contact with an infected person, IV drug abusers (IVDAs), patients with HIV or chronic liver disease

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37
Q

What is the combination Hep A and B vaccine called

A

Twinrix

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38
Q

Which adult populations should receive Hep A vaccine

A

Adults traveling to undeveloped countries outside of the US, household members and other close contacts of adopted children newly arriving from countries with moderate-high infection risk, liver disease, hemophilia, men who have sex with men, IVDAs, homeless individuals, HIV

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39
Q

What are the Hep B vaccine names

A

Engerix-B
Recombivax HB
Heplisav-B

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40
Q

What are the Hep A vaccine names

A

Havrix

VAQTA

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41
Q

Which formulation of the Diphtheria Typhoid vaccine is for peds (younger than 7 years old)

A

DTaP

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42
Q

Which formulation of the Diphtheria Typhoid vaccine is for adults

A

Tdap or Td

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43
Q

Tdap brand name

A

Adacel, Boostrix

44
Q

DTaP-HepB-IPV brand name

A

Pediarix

45
Q

When should someone get revaccinated with Td or Tdap

A

Wound ppx for deep or dirty wounds if it has been more than 5 years since the last dose

46
Q

Who should receive a booster dose of Td or Tdap

A
  • Pregnant or postpartum women with each pregnancy
  • close contacts of infants younger than 12 months
  • Healthcare personnel
  • Children age 7-10 years who did not get fully vaccinated with the DTaP series
47
Q

Adults with ____ should receive Hib vaccine

A

asplenia

48
Q

HepB vaccine is started within what time after birth

A

24 hrs

49
Q

Which HepB vaccine is only given in patients >/= 18 years

A

Heplisav-B

50
Q

Brand name for HPV9

A

Gardisil

51
Q

Recommended age to receive HPV9 vaccine

A

11-12 years

52
Q

If HPV9 is started before the age of 15, how many doses are needed

If HPV9 is started at or after the age of 15 or if the patient is immunocompromised, how many doses are needed

A

2 doses

3 doses

53
Q

Which patients need to receive 2 doses of the influenza vaccine 4 weeks apart

A

age 6 months to 8 years who are not previously vaccinated

54
Q

Patients with an egg allergy can receive which influenza vaccine

A

any-age appropriate inactivated influenza vaccine (NOT FLUMIST) even if severe allergy symptoms

55
Q

Which influenza vaccine is an egg-free product and what age group can receive it

A

Flublok

Age >/= 18 years

56
Q

Which influenza vaccines are indicated only for patients >/= 65 years

A

Fluzone High-dose, Fluzone High-Dose Quadrivalent, and Fluad

57
Q

Fluzone HD and Fluad are (trivalent or quadrivalent) inactivated vaccines

A

Trivalent

note: fluzone HD comes as a tri and quadrivalent vaccine

58
Q

Afluria, Fluarix, FluLaval, Fluzone, Flucelvax, & Flublok are (trivalent or quarivalent) inactivated vaccines

A

Quadrivalent

note: fluzone HD comes as a tri and quadrivalent vaccine

59
Q

Which flu vaccine is a quarivalent live attenuated vaccine

A

FluMist

60
Q

What age group can receive FluMist

A

Healthy people age 2-49 years

61
Q

How is FluMist administered (including the dose)

A

0.2 mL divided between the two nostrils

62
Q

What is the combination MMRV (MMR + Varicella) vaccine brand name

A

ProQuad

63
Q

What the the name of the MMR vaccine

A

M-M-R II

64
Q

T/F: MMR vaccine can be given to pregnant and immunocompromised patients

A

false - it is a live vaccine

65
Q

Where should the MMR vaccine be stored

A

In the fridge or freezer

66
Q

Where should the MMRV vaccine be stored

A

freezer ONLY d/t the varicella component

67
Q

What route is the MMR & MMRV vaccine given

A

SC

68
Q

Where should MMR vaccine diluents be stored

A

at room temp or in the refrigerator

69
Q

Age >/= ___ with high risk should receive MenB vaccine

A

10 years

70
Q

Children age < ___ years receive PCV13 as part of routine childhood vaccinations

A

5 years

71
Q

How is PPSV23 given

A

IM or SC

72
Q

How many times should a patient receive PCV13

A

once in their lifetime

73
Q

How many times should a patient receive PPSV23

A

1, 2 or 3 doses

  • 1 dose before age 65 if they have diabetes, heart, lung or liver disease, alcohol abuse, smokers
  • 2 doses before age 65 if they have SCD, asplenia, HIV, chronic renal failure, malignancy, transplant, immunosuppressive drugs, including steroids
  • 1 dose age 65+ for all patients
74
Q

If PCV13 is given to an immunocompetent person, how long must you wait to give PPSV23

A

1 year

75
Q

If PPSV23 is given to a patient at age 63, how many years must you wait to give another dose if the patient is now 65

A

5 years after the last dose of PPSV23

76
Q

If PCV13 is given to an immunocompromised person, how long must you wait to give PPSV23

A

at least 8 weeks

77
Q

What is the name of the polio vaccine

A

IPV

78
Q

What are the brand names for the Rotavirus vaccine

A

Rotarix, RotaTeq

79
Q

How is the Rotavirus vaccine administered

A

orally

80
Q

Varicella Virus Vaccine (for chickenpox) brand name

A

Varivax

81
Q

Anyone without immunity to varicella should receive how many doses of Varivax

A

2

82
Q

Some antivirals (e.g, acyclovir, valacyclovir, famiciclovir) can interfere with the live vaccines (including varivax) & should be stopped how long before vaccine administration and should not be taken for 14 days after vaccination

A

24 hrs

83
Q

Where must Varivax be stored

A

in the freezer

84
Q

When should Varivax be reconstituted

A

Right away upon removal from the freezer and inject due to short stablility

85
Q

Varivax should not be given if there is a hypersensitivity to _____

A

gelatin or neomycin

remember: i am Vari allergic to gelatin and neomycin

86
Q

Varivax is administered via which route

A

SC

87
Q

How is Shingrix administered

A

IM

88
Q

Rabies vaccine brand name

A

RabAvert

89
Q

A person who has been exposed to rabies without previous vaccination should get how many doses of Rabies Vaccine

A

4 doses: 1 dose of Rabies immune globulin should be given with the first vaccine dose

90
Q

Typhoid vaccine comes in which formulations

A

Oral, Injection

remember: typhOid, oral

91
Q

When should the oral Typhoid capsules be taken

A

at least 1 week prior to possible exposure

92
Q

When should the injectable Typhoid vaccine be taken

A

at least 2 weeks prior to possible exposure

93
Q

Oral Typhoid capsules should be stored

A

in the fridge

94
Q

How should Typhoid capsules be taken

A

On empty stomach with cold or lukewarm water

95
Q

Which vaccine can cause a positive reaction to the TB skin test

A

Tuberculosis BCG vaccine

96
Q

Yellow Fever vaccine is CI with

A

severe (life-threatening) allergy to eggs or gelatin

97
Q

What is provided and valid for 10 years after receiving Yellow Fever Vaccine

A

International Certificate of Vaccination (yellow card)

98
Q

Yellow Fever Vaccine should be reconstituted with

A

Provided diluent

99
Q

How should Yellow Fever Vaccine be administered

A

SC

100
Q

Where should the packet for reconstitution for the cholera vaccine be stored

A

in the freezer

101
Q

The CDC recommends a calibrated thermometer or a digital data logger be connected to a _____ in the fridge and freezer

A

buffered temperature probe

102
Q

Temperatures in fridge and freezer should be read and documented at least how many times per workday

A

2x

103
Q

Temperature logs should be kept for how long

A

3 years or longer

104
Q

What size needle should be used with a SC injection & how should it be inserted into the skin

A

5/8”

45 degrees

105
Q

What size needle should be used with a IM injection & how should it be inserted into the skin

A

1” (exceptions: weight < 130 lbs, use 5/8”-1” needle & males >260 lbs or females >200 lbs. use a 1.5” needle)
90 degrees

NAPLEX (74 decks)

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