Class 8 - vaccines preventable diseases

Question 1

define herd immunity

Answer 1

refers to the immunity of a population against a specific infectious disease. The resistance of the population to the spread of an infectious disease is based on the percentage of people who are immune and the probability that those who are still susceptible will come into contact with an infected person

Question 2

How many people are required to be immune to reach herd immunity

Answer 2

• Depends on several factors
• important one being the transmissibility of the infectious agent either from a symptomatically infected person or from an asymptomatically colonized person

Question 3

In which situations do we initiate immunizations?

Answer 3

• once passive immunity from mother is lost
• communicable disease are a real risk to the infant
• immune system capable of an adequate response
• prematurity (> 28 wks is regular schedule, <28wks dependable)

Question 4

Are immunization schedules the same across Canada?

Answer 4

Technically no; NACI provide suggestions to provinces, and provinces will take suggestion and create their guidelines accordingly

Question 5

What are examples of vaccines not covered under Manitoba Health

Answer 5

• RSV
• Shingles

Question 6

What does informed consent look like for immunizations

Answer 6

• public education (S&S, use, etc)
• legalities of consent (mature minor, language/culture)
• documentation (consent form, vaccine name, manufacture, lot #, site/route, date + time)
• health care provider/client communication

Question 7

What is considered a special population for immunizations

Answer 7

• children (infants + school setting)
• people with disabilities/chronic illness
• uniformed & unwilling

Question 8

What are ways to prevent adverse reactions from vaccines

Answer 8

know the potential contraindications:
- anaphylaxis to a component of the vaccine
- significant immunosuppression (live vaccine only)
- pregnancy (live only)
- review vaccine ingredient-specific contraindications in advance

Question 9

Examples of contraindications for vaccines

Answer 9

• anaphylaxis to a component in the vaccine
• egg allergy (varies)
• febrile seizures
• pregnancy

Question 10

What are common symptoms of an anaphylactic shock

Answer 10

• sneezing, coughing
• itchiness
• “pins & needles” sensations
• flushing
• facial edema
• hives
• respiratory difficulties
• shock/collapse
• anxiety

Question 11

What are common symptoms of a syncopal episode

Answer 11

• pallor
• slow pulse
• saliva
• nausea
• vomiting
• sweating

Question 12

What are the treatment steps in case of an anaphylactic shock

Answer 12

• activate EMS (dial 911)
• place person in supine position (feet elevated)
• admin adrenaline IM into large muscle (avoid site of injection), up to 3x
• monitor vitals
• admin diphenhydramine IM
• transport to hospital
• documentation (AEFI)

Question 13

What are the treatment steps in case of a syncopal episode

Answer 13

• lowering head
• raising feet
• deep breaths
• responds quickly…

Question 14

Define natural immunity

Answer 14

acquired from exposure to the disease organism through infection with the actual disease

Question 15

Define acquired immunity

Answer 15

immunity you develop over your lifetime. It can come from:
- vaccine
- exposure to an infection or disease
- another person’s antibodies (infection-fighting immune cells)

Question 16

Define active immunity

Answer 16

• results when exposure to a disease organism triggers the immune system to produce antibodies to that disease
• can be acquired through natural immunity or vaccine-induced immunity

Question 17

Define passive immunity

Answer 17

provided when a person is given antibodies to a disease rather than producing them through his or her own immune system

Question 18

Who is eligible for influenza vaccine

Answer 18

• 6 month of age or older
• (high-dose) 65 years of age and older
• international student and out-of-province visitors

Question 19

Which vaccine preventable disease has been eliminated in Canada? (2019)

Answer 19

• polio

Question 20

Which diseases do we continue to see excess of 1,000 cases per year?

Answer 20

• mumps
• Hep B
• Pertussis

Question 21

Which vaccines are the most cost effective

Answer 21

• influenza for >65yr = $45
• MMR for kids = $16
• pneumococcal >65yr = $8
• DTaP for kids = $6

Question 22

National guidelines for immunization, guidelines (1-8)

Answer 22

1) Immunization services should be readily available.
2) facilitate timely receipt of vaccine and eliminate unnecessary prerequisites
3) screen for needed vaccines and administer all vaccine doses for which a vaccine recipient is eligible at the time
4) communicate current knowledge about immunization using an evidence-based approach.
5) should inform, in specific terms, about the risks and benefits of vaccines
6) recommend deferral or withholding of vaccines for true contraindications only
7) vaccinations are accurately and completely recorded
8) maintain easily retrievable summaries of immunization records

Question 23

National guidelines for immunization, guidelines (9-16)

Answer 23

9) report clinically significant adverse events following immunization (AEFI) promptly
10) report all cases of vaccine-preventable diseases
11) adhere to appropriate procedures for the storage and handling
12) maintain up-to-date, easily retrievable immunization protocols
13) properly trained and maintain ongoing education
14) errors and immunization-related incidents should be reported to local jurisdiction
15) operate an immunization tracking system
16) Audits should be conducted to assess the quality of records and the degree of coverage.

Question 24

To be considered interchangeable, the vaccines should:

Answer 24

• be authorized with the same indications and with equally acceptable schedules,
• be authorized for the same population,
• contain comparable type and quantity of antigen,
• be similar in terms of safety, reactogenicity, immunogenicity and efficacy.

Question 25

Should one aspirate when immunizing?

Answer 25

Aspiration prior to injection of vaccine is not recommended

Question 26

What is the cold chain and why is it important?

Answer 26

• process used to maintain optimal conditions, particularly temperature, during the transport, storage and handling of vaccines, (from manufacturer to administration)
• Monitoring of vaccines’ cold chain is required to ensure that these products have been stored and transported at recommended temperatures and in correct conditions.

Question 27

What are negative consequences of breaks in the cold chain

Answer 27

• exposed to temperatures above the recommended temperature range may experience some loss of potency with each episode of exposure
• vaccines containing an aluminum adjuvant experience a permanent loss of potency due to adjuvant clustering when subjected to freezing and thawing.
• Freezing of a vaccine or diluent may cause cracks in the container which may lead to contamination of the contents.

Question 28

Why/How does blood products, or human IG impact timing of immunization

Answer 28

can interfere with the immune response to parenteral live virus vaccines if given concomitantly with or shortly before or after the vaccine

Question 29

DTap-IPV-Hib (5 in 1) =

Answer 29

diphtheria, tetanus, pertussis, polio, HID

Question 30

Tdap =

Answer 30

tetanus, diphtheria, pertussis

Question 31

Td =

Answer 31

tetanus, diphtheria