Chapter 20: Immunizations Flashcards

1
Q

FDA Approval Based On:

A

Safety and efficacy for the indication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Advisory Committee on Immunization Practices

A

(ACIP)

Provides recommendations for vaccine administration in children and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CDC

A

Approves ACIP recommendation and publishes them in Morbidity and Mortality Weekly Report (MMWR) and the Pink Book

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Antibodies

A

Are naturally produced to provide immunity against antigens.
When an antigen is detected the body produces antibodies and destroys the antigen
Immunoglobulin is the medical term for antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Active Immunity

A

When the person’s own immune system produces antibodies to fight an infection or in response to vaccine administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Passive Immunity

A

Is acquired from someone else

  • Mother to baby
  • IVIG therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of Vaccines: Live Attenuated

A

“Weakened” Vaccines
Produced by modifying a disease producing “wild” virus. They have the ability to replicate and produce immunity but do not cause illness
CI: immunocompromised and pregnant patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of Vaccines: Inactivated

A

Made up of either a whole virus or bacterium or fractions of both. Immunity from this type of vaccine can diminish over time and a supplement dose may be required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Polysaccharide Vaccines

A

Inactivated
Polysaccharide molecules taken from the outside layer of encapsulated bacteria. These vaccines do not get a good response in children <2
E.g pneumococcal polysaccharide vaccine (pneumovax 23)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Conjugate Vaccines

A

Use polysaccharide molecules from outside layer of encapsulated bacteria and join the molecules to carrier proteins. Conjugation increases response in infants
E.g pneumococcal conjugate (Prevnar 13)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Recombinant Vaccines

A

A gene segment of a protein from the organism is inserted into the gene of another cell, such as a yeast cell, where it replicates
E.g Gardasil, Flublock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Toxoid Vaccines

A

Targets a toxin produced by the disease

E.g Tetanus toxoid vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

mRNA vaccines

A

Gives instructions to the body’s cells (in the form of mRNA) to produce a protein specific to the pathogen which triggers and immune response
E.g select Covid-19 vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common Live Vaccines

A
MICRO-VY
M- MMR
I- Intranasal flu
C- Cholera
R- Rotavirus
O- Oral Typhoid
V- Varicella
Y- Yellow fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Interval between MMR or Varicella and antibodies

A

A minimum of 3 months up to 11 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Live vaccines and TB skin test

A

To reduce the risk of false negative

  1. give the live vaccine on the same day as the skin test
  2. Wait 4 weeks after a live vaccine to perform skin test
  3. Administer skin test wait 48-72 hours to get the result then give live vaccine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Invalid CI to Vaccines

A
  • Mild acute illness (slight fever, mild diarrhea)
  • Current antimicrobial therapy (exceptions: varicella, live flu, oral typhoid vaccine)
  • Previous local skin reaction
  • Allergies: bird feathers, PCN, allergies to products not in the vaccine
  • Pregnancy (except live vaccines) breastfeeding and preterm birth
  • Recent TB skin test
  • Immunosuppressed person in the household, recent exposure to the disease
  • family hx of adverse events to the vaccine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vaccines for Special Groups: Infants and Children

A
  • 3 doses Hep B started at birth
  • Others start at 2 months: Prevnar 13, Dtap, Hib, Polio, Rotavirus
  • Live vaccines start at >=12 months: MMR and Varicella
  • no polysaccharide before 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vaccines for Special Groups: Adolescents and Young Adults

A
  • Meningococcal Vaccine (2 doses; 1 at 11-12 and 1 at 16 or 1st yr college students in residential housing if not previously vaccinated)
  • HPV 11-12 years (2 or 3 doses depending on start date)
  • Tdap 1st dose at >11 yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Vaccines for Special Groups: Pregnancy

A
  • Flu (not live)

- Tdap weeks 27-36 (with each pregnancy)

21
Q

Vaccines for Special Groups: Older Adults

A
  • Herpes Zoster >= 50 years

- Pneumococcal**

22
Q

Vaccines for Special Groups: Diabetes

A
  • Pneumococcal

- Hepatitis B age 19-59yrs (or >60 per healthcare provider discretion)

23
Q

Vaccines for Special Groups: Healthcare Professionals

A
  • Annual flu
  • Hep B (if no evidence of series completion)
  • Varicella (if no hx of vaccination or chickenpox infection)
  • MMR (if no hx of vaccination or chickenpox infection)
24
Q

Vaccines for Special Groups: Sickle Cell Diseases and other causes of Aslplenia

A
  • H. influenzae type B (Hib)
  • Pneumococcal
  • Meningococcal
25
Vaccines for Special Groups: Immunodeficiency
- Pneumococcal - HIV (CD4 count <200) - meningococcal - Hep A - Hep B
26
Pediarix
Dtap, HepB, and IPV | Dtap for children <7 years
27
Tdap
Adacel or Boostrix Wound prophylaxis: for deep dirty wounds revaccinate with Td or Tdap if it has been more than 5 years since last dose Each pregnancy Close contacts of infants
28
Hib
Vaxelis (Dtap-IPV/Hib) | Given to adult with asplenia
29
Hepatitis A
Havrix, VAQT | Given to patients with chronic liver disease
30
Hepatitis B
Engerix-B, Heplisav-B, Recombivax HB Routine children: start within 24 hours after birth Adults: healthcare workers, patients with ESRD, chronic liver disease, HIV, diabetes Heplisav-B age >= 18 years
31
HPV9
Gardasil Recommended 11-12 years If started before age 15; 2 doses If started >= 15 years 3 doses
32
Influenza A surface antigens
- hemagglutinin | - neuramidase
33
Trivalent Flu Vaccine
Fluad (adjuvanted) | for >=65 years
34
Quadrivalent Flue Vaccines
- Afluria - Fluarix - FluLaval - Fluzone - Flucelvax (egg free) - Flublok (egg free) - Fluzone HD (ages >=65)
35
Quadrivalent Live Flu Vaccine
FluMist (healthy people ages 2-49 years)
36
MMR vaccines
``` MMR II (store in fridge or freezer) MMR+Varicella: Proquad (store in freezer) ``` Given SubQ
37
Meningococcal Vaccines
MCV4 Menactra (ages 9 mo to 55 years) MenQuadfi (>=2yr) Menveo (2mo-55yr) MenB (Bexsero, Trumenba for 10-25yrs)
38
Prevnar 13
Routinely for children <5 yrs
39
Adult Pneumonia Vaccination
Adults aged 19-64 years with certain underlying medical conditions OR age >=65 years if never given before: PCV20 x1 or PCV15 x1 followed by PPSV23 >=12 months later (>=8weeks if immunocompromised
40
Polio Containing Vaccines
Dtap-HepB-IPV (pediarix)
41
Rotavirus vaccines
RV1: Rotarix RV5: RotaTeq Given orally
42
Varicella Vaccines
Varivax (for chickenpox): anyone without evidence of immunity to varicella should receive 2 doses of varivax. Some antivirals interfere with varivax, stop 24 hours before -Store in freezer, reconstitute immediately before administration, give subq MMRV (proquad) Shingrix (herpes zoster)
43
Non-routine Vaccines: Rabies
RabAvert | post-exposure (without previous vaccination):4 doses; 1 dose of rabies immune globulin with the 1st vaccine dose
44
Non-routine Vaccines: Typhoid Vaccine
Vivotif (oral) (live) To prevent fever caused by Salmonella typhil Complete at least 1 week prior to exposure ``` Typhin Vi (injection) ! dose at least 2 weeks prior to exposure ```
45
Non-routine Vaccines: TB
TB Calmette-Guerin (BCG) | not use often in US but can cause positive TB skin test
46
Non-routine Vaccines: Yellow Fever
YF-Vax (live) CI: with severe, life-threatening, allergy to eggs or gelatin International Certification of Vaccination (yellow card) is provided and good for 10 years Reconstitute with provided diluent Given Subq
47
Non-routine Vaccines: Cholera
Vaxchora (live) Given to people age 18-64 years who are traveling to an area of active Vibrio Cholerae transmission Store packet for reconstitution in freezer
48
How long to keep temp logs
3 years