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NAPLEX 2023 > 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

what is a VIS?

where can they be found?

A

Vaccine Information Statements prepared by CDC that must be handed to the patient before a vaccination is administered

can be found on CDC and Immunization Action Coalition websites

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4
Q

active immunity is when ____

A

the person’s OWN immune system produces antibodies to fight

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5
Q

passive immunity is when ____

A

antibodies are provided from someone else

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6
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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7
Q

Live attenuated vaccines are CI in which populations

A

immunocompromised and pregnant patients

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8
Q

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

A

Inactivated

response can diminish and may require a booster

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9
Q

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

A

2

example: pneumococcal polysaccharide vaccine (Pneumovax23)

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10
Q

Key live vaccines

A

Remember: MICRO Vaccines are Yellow (MICRO VY)
- MMR
- Intranasal influenza
- Cholera
- Rotavirus
- Oral Typhoid
- Varicella
- Yellow Fever

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11
Q

When can most live or inactivated vaccines be administered

A

Simultaneously

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12
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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13
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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14
Q

what is the interval required between an antibody containing product and MMR or varicella-containg vaccines?

A

minimum of 3 months, may be up to 11 months

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15
Q

Which type of vaccine can be given at any time (within first 12 months of life)

A

Inactivated
live vaccines are not recommended until after 12 months old

rotavirus (live vaccine but shown to produce response)

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16
Q

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

A

Hepatitis B

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17
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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18
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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19
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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20
Q

What is the recommended spacing between live vaccines and antibody administration

  • If giving a vaccine before antibody containing product
  • If giving an antibody containing product before a vaccine
A

Vaccine → 2 weeks → antibody-containing product

antibody-containing product → 3 months or longer → vaccine

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21
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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22
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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23
Q

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

A

3-21 days

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24
Q

Is the flu shot inactivated or live?

A

inactivated - it cannot cause the flu

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25
Q

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

A

Hx of a severe or anaphylactic reaction

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26
Q

What is the requirements for vaccine administration emergency protocols regarding epinephrine?

A

must have 3 prefilled autoinjectors on hand (doesn’t have to be prefilled as long as 3 doses are available)

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27
Q

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

A

True

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28
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

mild illnesses are not a reason to avoid vaccines, though

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29
Q

How often is Tdap or Td given in adults

A

every 10 years

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30
Q

At what age can Shingrix be given

A

≥ 50 years old

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31
Q

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

A

True

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32
Q

When is the second dose of Shingrix given

A

2-6 months after the first dose

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33
Q

Patients aged ____ years should get 1 dose of PCV20 or 2 doses (PCV15 then PPSV23) if they have what conditions

A

19-64
Heart, lung, liver disease, diabetes, alcohol abuse, smokers, etc (immunosuppressed)

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34
Q

What is the difference betweeen the pediatric and adult formulation of diphtheria, tetanus, and pertussis containing vaccines? (tdap)

A

Tdap/Td in adults (lowercase d)
TDaP in pediatrics has 3-5 times more diphtheria component

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35
Q

DTaP-HepB-IPV brand name

A

Pediarix

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36
Q

Tdap brand name

A

Adacel, Boostrix

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37
Q

Who is DTaP indicated for?

A

children < 7

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38
Q

Who is Td or Tdap indicated for?

A
  • wound ppx: deep dirty wounds (if > 5 years since last vaccine)
  • Pregnancy
  • close contact with infants
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39
Q

Who should be given haemophilus influenzae type B vaccines?

A

adults with asplenia

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40
Q

Hepatitis A vaccine brand names

A

Havrix, VAQTA

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41
Q

Hepatitis B vaccine brand names

A

Engerix-B, Heplisav-B, Recombivax HB

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42
Q

Hep A vaccine indications

A

chronic liver disease

homesless, MSM, HepA, etc

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43
Q

Hep B vaccine indications

A
  • children within 24 hours of birth
  • chronic liver disease
  • HIV infection
  • blood exposure (healthcare workers, dialysis, diabetes)
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44
Q

Age at which Heplisav-B is indicated

A

≥18

45
Q

HPV9 (9-valent) vaccine brand name

A

Gardasil 9

46
Q

recommended age for Gardasil 9
how many doses?

A

11-12 years
< 15 = 2 doses
≥ 15 = 3 doses

as early as 9, as late as 26

47
Q

What are the surface antigens on influenza A virus

A

hemagglutinin, neuraminidase

48
Q

how does the flu spread?

A

through respiratory droplet transmission

49
Q

type of symptoms with flu: abrupt or slow onset?

A

abrupt onset - fever, mylagias, ha, cough, sore throat)

50
Q
  1. Quadrivalent inactivacted (IIV4) brand name
  2. which ones are egg-free?
  3. Which are high dose?
A
  • contains egg: Afluria, Fluarix, FluLaval, Fluzone
  • no egg: Flucelvax, Flublok
  • High-dose: Fluzone High-Dose, Fluad (ages ≥ 65)
51
Q
  1. Quadrivalent Live Attentuated Influenza Vaccine (LAIV4) brand name
  2. Indication?
A
  1. FluMist
  2. health people 2-49 years old
52
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
  • if egg-containg product, must be under healthcare supervision
  • Flublok and Flucelax are egg-free options
53
Q

Which influenza vaccines are indicated only for patients ≥ 65 years

A

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

54
Q

How is FluMist administered (including the dose)

A

0.2 mL divided between the two nostrils

55
Q

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

A

ProQuad

56
Q

Brand name of the MMR vaccine

A

M-M-R II

57
Q

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

A

false - it is a live vaccine

58
Q

Where should the MMR vaccine be stored

A

In the fridge or freezer

59
Q

Where should the MMRV vaccine be stored

A

freezer ONLY d/t the varicella component

60
Q

What route is the MMR & MMRV vaccine given

A

SC

61
Q

Where should MMR vaccine diluents be stored

A

at room temp or in the refrigerator

62
Q

Healthcare workers should receive __ doses of MMR

A

2 doses

63
Q

Age ≥ ___ with high risk should receive MenB vaccine

A

10 years
high risk like asplenia/sickle cell, lab workers, during outbreak

ages 10-25 years

64
Q

Meningococcal vaccine names

A

MCV4
Menactra
MenQuadfi
Menveo

65
Q

Who needes routine Meningococcal vaccines?

A

adolescents (2 dose series)

66
Q

Who are special populations at high risk that need meningococcal vaccination

A
  1. travelers to meningitis belt in sub-saharan Africa
  2. > 2 months with HIV, asplenia/sickle cell disease
  3. lab workers
  4. 1st year college students
67
Q

important note for Menveo vials

A

BOTH vials contain vaccine (powder and liquid)

68
Q

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

A

5 years
13

69
Q

How is PPSV23 given

A

IM or SC

70
Q

Brand name of PCV13

A

Prenvar 13

71
Q

Brand name of PCV 15

A

Vaxneuvance

72
Q

Brand name of PCV20

A

Prevnar 20

73
Q

Brand name of PPSV23

A

Polysaccharide Vaccine Pneumovax 23

74
Q

Adults 19-64 with specific medical conditions should receive what pneumococcal vaccine

A
  1. PCV20 x 1
  2. PCV15 then PPSV23x1 (≥12mo later or ≥8 weeks later if immunocompromised)
75
Q

What is the name of the polio vaccine

A

IPV

76
Q

What are the brand names for the Rotavirus vaccines (RV1 and RV5)

A

Rotarix, RotaTeq

77
Q

How is the Rotavirus vaccine administered

A

orally

78
Q

Varicella Virus Vaccine (for chickenpox) brand name

A

Varivax

79
Q

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

A

2

80
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

81
Q

Where must Varivax be stored

A

in the freezer

82
Q

When should Varivax be reconstituted

A

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

83
Q

Varivax should not be given if there is a hypersensitivity to ____ or ____

A

gelatin or neomycin

remember: i am Vari allergic to gelatin and neomycin

84
Q

Varivax is administered via which route

A

SC

85
Q

How is Shingrix administered

A

IM

86
Q

Rabies vaccine brand name

A

RabAvert

87
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

88
Q

What is typhoid fever caused by?

A

Salmonella typhi

89
Q

Typhoid vaccine comes in which formulations

A

Oral, Injection

remember: typhOId, oral, Injection

90
Q

When should the oral Typhoid capsules be taken

A

at least 1 week prior to possible exposure

91
Q

When should the injectable Typhoid vaccine be taken

A

at least 2 weeks prior to possible exposure

92
Q

Oral Typhoid capsules should be stored

A

in the fridge

93
Q

How should Typhoid capsules be taken

A

On empty stomach with cold or lukewarm water

94
Q

What type of vaccines are the typhoid vaccines for both oral and injection (live or inactivated?)

A

oral - live
injection - inactivated

MICRO-VY (O = oral typhoid)

95
Q

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

A

Tuberculosis Bacille Calmette-Guerin (BCG) vaccine

96
Q

yellow fever is a live or inactivated vaccine?

A

live

remember MICRO-VY

97
Q

Yellow Fever vaccine is CI with

A

severe (life-threatening) allergy to eggs or gelatin

98
Q

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

A

International Certificate of Vaccination (yellow card)

99
Q

Yellow Fever Vaccine should be reconstituted with

A

Provided diluent

100
Q

How should Yellow Fever Vaccine be administered

A

SC

101
Q

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

A

in the freezer

102
Q

Cholera is given to people traveling to an area of active toxigenic ____

A

Vibrio cholerae transmission

103
Q

Never store vaccines where in refrigerators or freezers?

A

in the doors
always keep in original packagin
rotate stock to use vaccines with earliest expiration date

104
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

105
Q

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

A

2x

106
Q

most vaccines are stored in refrigerator
what vaccines are stores in the freezer?

what temperature?

A

Varicella
MMRV (has varicella in it)
oral cholera
**MMR can be stored in refrigerator or freezer

-58 to +5 F or -50 to -15 C

107
Q

Temperature logs should be kept for how long

A

3 years or longer

108
Q

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

A

5/8”

45 degrees

109
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 2023 (88 decks)

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