Chapter 20: Immunizations Flashcards
Who provides the recommendations for vaccine administration in children and adults
The Advisory committee on Immunization Practices (ACIP)
Who approves the ACIP recommendations and where do these recommendations get published?
CDC
CDC’s Morbidity & Mortality Weekly Report (MMWR) & The Pink Book
____ 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
Live attenuated
Live attenuated vaccines are CI in which populations
immunocompromised
pregnant patients
____ vaccines can be composed of either a whole virus or bacterium, or fractions of either. They cannot replicate
Inactivated
Polysaccharide vaccines do not produce a good immune response in children < __ years of age
2
Key live vaccines
Remember: COZY IV RM
- Cholera
- Oral Typhoid
- Zoster
- Yellow Fever
- Intranasal influenza
- Varicella
- Rotavirus
- MMR
When can most live or inactivated vaccines be administered
Simultaneously
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
True
Decreasing the interval between doses of vaccine can interfere with antibody response & protection
Antibodies in some blood products and IVIG can interfere with ______ and a separation period may be required
live vaccine replication
Which type of vaccine can be given at any time
Inactivated
Inactivated vaccines are started when a baby is 2 months old, except for which vaccine which is given at birth
Hepatitis B
Live vaccines can cause a false-negative TB skin test. Options to reduce the risk of a false-negative include:
- give the live vaccine on the same day as the skin test
- Wait 4 weeks after a live vaccine to perform the skin test
- Administer the skin test first, wait 48-72 hrs to get the result, then give the live vaccine
Multiple live vaccines can be given on the same day or (if not given on the same day) spaced _____ weeks apart
4
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
True
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:
Vaccine → 2 weeks → antibody-containing product
antibody-containing product → 3 months or longer → vaccine
Simultaneous administration of vaccine and antibody (in the form of immunoglobulin) is recommended for post-exposure ppx of certain diseases, such as
Hep A & B
rabies
tetanus
Adverse reactions that require some type of assistance should be reported to
FDA’s Vaccine Adverse Events Reporting System (VAERS)
With live vaccines, mild systemic reactions can occur __ - ___ days after the vaccine is given
3-21 days
When does a vaccine become contraindicated in a person (besides being immunocompromised or pregnant with live vaccines)
A severe or anaphylactic reaction
T/F: Treatment with antibiotics is NOT a valid reason to delay vaccines
True
T/F: If a person has a moderate-severe acute illness, it is not necessary to delay vaccines until the condition has improved
False - it is reasonable to delay the vaccine
How often is Tdap or Td given in adults
every 10 years
At what age can Shingrix be given
> /= 50 years old
T/F: Shingrex should still be given even if a patient has previously had chicken pox
True
When is the second dose of Shingrex given
2-6 months after the first dose
Pneumovax 23 is given to all adults >/= ___years
65
Patients age 2-64 years should get 1 dose of Pneumovax 23 if they have which condition(s)
Heart
lung
liver disease
diabetes
alcohol abuse
smokers
Patients age 2-64 years should get 2 doses of Pneumovax 23 if they have which condition(s)
Immunocompromised
(e.g, SCD
asplenia
HIV
chronic renal failure
malignancy
transplant
immunosuppressive drugs including steroids)
T/F: Prevnar 13 is optional for adults age >/= 65 years
True
Any patients >/= 6 years old who are ____ should receive Prevnar13
immunocompromised
Which meningococcal vaccines are serogroup B
Bexsero
Trumenba
Which adult populations should receive Meningococcal serogroup B vaccines
complement component deficiency
taking aculizumab (Soliris)
asplenia
microbiologist with exposure to Neisseia Meningitidis
serogroup B meningococcal vaccine exposure
Which meningococcal vaccines are conjugate vaccines
Menactra
Menveo
Which adult populations should receive Meningococcal conjugate vaccines
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
Which adult populations should receive Hep B vaccine
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
What is the combination Hep A and B vaccine called
Twinrix
Which adult populations should receive Hep A vaccine
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
What are the Hep B vaccine names
Engerix-B
Recombivax HB
Heplisav-B
What are the Hep A vaccine names
Havrix
VAQTA
Which formulation of the Diphtheria Typhoid vaccine is for peds (younger than 7 years old)
DTaP
Which formulation of the Diphtheria Typhoid vaccine is for adults
Tdap or Td