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Primary Care I > Exam 1 - Immunizations > Flashcards

Exam 1 - Immunizations Flashcards

1
Q

Rotavirus route

A

Oral

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2
Q

Flu route

A

IM (intranasal no longer recommended)

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3
Q

Varicella route

A

Subcutaneous

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4
Q

MMR route

A

Subcutaneous

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5
Q

Which vaccines is ALUMINUM present in?

A

Hep A, Hep B, DTap/Tdap, Hib, HPV, PCV

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6
Q

DTaP, Tdap, Td schedule

A
  • Min. age = 6 weeks
  • Primary series @ 2, 4, 6, and 15-18 months
  • Secondary series (“boosters”) @ 4-6 y/o, Tdap 11-12 y/o, and Td booster every 10 years thereafter.
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7
Q

DtaP vaccines

A
  • Pentacel (DTap, IPV, HIB)
  • Pediarix (DTap, IPV, Hep B)
  • Kinrix (Dtap/IPV combo), only approved for secondary booster
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8
Q

DtaP contraindications

A
  • Severe allergic reaction to vaccine component or following a prior dose
  • Encephalopathy not due to another identifiable cause occurring within 7 days after vaccination
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9
Q

DtaP precautions

A
  • Moderate or severe acute illness
  • Temp >105 F or higher within 48 hours
  • Collapse or shock-like state within 48 hours
  • Persistent, inconsolable crying lasting >3 hours, occurring within 48 hours
  • Convulsions with or without fever occurring within 3 days
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10
Q

DTaP/Tdap for previously unvaccinated individuals

A
  • 3 shot series, first 2 doses should be separated by 4 weeks, 2nd and 3rd dose separated by 6-12 months.
  • One of these should be Tdap.
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11
Q

Tdap contraindications

A
  • Previous severe allergic reaction to Tetanus or a component of the vaccine
  • Severe or moderate illness
  • If unable to receive the vaccine, high-risk individuals will need Tetanus immunoglobulin (TIG)
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12
Q

Tdap side effects

A
  • Local redness and swelling at injection site
  • More severe reactions include peripheral neuropathy, Guillain-Barre and urticaria
  • Fever and systemic symptoms are uncommon
  • Rare risk of seizures: SNCA 1 Dravet’s syndrome
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13
Q

HiB schedule

A

3 (PedVaxHiB) to 4 (ActHiB) doses depending on which HiB vaccine and age at first dose. Generally 2, 4, 6 (except for PedVaxHiB), and 12-15 month booster.

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14
Q

“ActHiB” schedule

A
  • 2, 4, 6 and 12-15 month booster
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15
Q

“HiBerix” schedule

A
  • Attached to tetanus toxoid

- 2, 4, 6 and 12-15 month booster

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16
Q

“PedVaxHiB” schedule

A
  • 2, 4, and 12-15 months

- Can be alone, when given in combo with Hep B it’s called “ComVax”

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17
Q

“Pentacel” schedule

A

2, 4, 6, 15-18 months

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18
Q

“Comvax”

A
  • HiB + Hep B

- Approved for infants 6-15 months of age born to HBsAg negative mothers

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19
Q

HiB vaccine contraindications

A
  • Severe allergic reaction after a previous vaccine or vaccine component
  • Age younger than 6 weeks
  • Severe illness with fever
  • HiB vaccine has NEOSPORIN in it; so if they’re allergic to neosporin then it’s contraindicated
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20
Q

HiB side effects

A
  • Few symptoms occur
  • 5-30% have local irritation at injection site
  • 1/20 have fever >101 F
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21
Q

IPV vaccine schedule

A

Ages 2, 4, 6-18 months and 4-6 years (4 doses)

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22
Q

IPV contraindications

A
  • Severe allergic reaction to neomycin, polymyxin B, Streptomycin (the vaccine contains trace amounts of these antibiotics)
  • Severe allergic reaction to a previous polio vaccine
  • Moderate illness
23
Q

IPV side effects

A

Soreness at site of injection.

24
Q

PCV 13 schedule

A
  • All children 2 to 59 months

- [4 doses] starting at age 2 months, continuing 4, 6, 12-15 months

25
Q

PCV contraindications

A
  • Severe allergic reaction to a previous PCV vaccine
  • Mild or moderate illness
  • Safety in pregnancy not determined
26
Q

PCV adverse reactions

A
  • Local reactions
  • Fever, myalgia
  • Severe adverse reactions are rare
27
Q

“Energix B” (Hep B) schedule

A
  • 1st dose given at birth, 2nd dose 1-2 months later, 3rd dose at age >24 weeks
  • [3 doses] for children, and [2-3 doses] for adolescents and high risk adults
28
Q

Hep B vaccine contraindications

A
  • Severe allergic reaction to previous HBV or one of its components in the past
  • Moderate or severe illness
  • Infant weighing <2,000 g
29
Q

Hep B side effects

A
  • Soreness at the injection site

- Low grade fever

30
Q

Rotavirus vaccines

A

“Rotateq” and “Rotarix”

31
Q

“Rotarix” schedule

A
  • Administer first dose to infants beginning at 6 weeks of age
  • Administer second dose after an interval of at least 4 weeks and prior to 24 weeks of age
  • Minimum interval dose is 4 weeks
  • NO ADMINISTRATION AFTER 8 MONTHS
32
Q

Rotavirus vaccine contraindications

A
  • Hypersensitivity
  • GI tract congenital malformation
  • History of intussusception
  • Severe combined immunodeficiency disease
  • Severe allergic reaction to a vaccine component or following a prior dose of vaccine
  • Latex allergy
33
Q

Rotavirus vaccine precautions

A
  • Other diseases that affect immune competence, spina bifida, bladder extrophy, gastro of moderate to severe
34
Q

Rotavirus vaccine & Preterm infant guidelines

A

ACIP recommends to administer vaccine if:

  • chronological age is at least 6 weeks
  • clinically stable
  • administered at the time of discharge or after discharge from the NICU/nursery
35
Q

Rotavirus vaccine adverse reactions

A
  • Vomiting
  • Diarrhea
  • Irritability
  • Fever
  • NO serious adverse reactions
36
Q

Influenza vaccine schedule

A

For children aged 6 months to 8 years,

  • First dose as soon as possible after vaccine becomes available
  • Second dose >4 weeks later
37
Q

Influenza vaccine contraindications

A

Severe allergic reaction to any vaccine component, including egg protein, or after previous dose of any flu vaccine

38
Q

Influenza vaccine precautions

A
  • Moderate to severe acute illness with or without fever; history of Guillain-Barre syndrome within 6 weeks of receipt of influenza vaccine
39
Q

Hepatitis A vaccine schedule

A

Adults/children

  • 1 dose (Min. age = 12 months)
  • Booster dose 6-18 months after first dose
40
Q

Hep A vaccine contraindications

A
  • Severe allergic reaction to vaccine or components in the past
  • Moderate illness
  • Safety in pregnancy not studied (weight risk/benefit)
41
Q

Hep A vaccine side effects

A
  • Soreness at injection site
  • Fever, fatigue, malaise, headache less common
  • Rare anaphylaxis
42
Q

MMR vaccine schedule

A
  • [2 doses] First dose at 12-15 mo., second at 4-6 y/o
  • Seroconversion is optimal at 15 months
  • If there’s an outbreak, you can give it before 12 mo. but repeat at 12 mo.
  • If un-immunized, give on dose at first visit, second dose 4 weeks later
  • Administer MMR vaccine to infants age 6-12 months who are traveling internationally
43
Q

MMR contraindications

A
  • Pregnancy, or plans to become pregnant
  • Severe allergic reaction to previous vaccine
  • Immunocompromised
  • NOT contraindicated if allergic to eggs
  • NOT contraindicated if breastfeeding
44
Q

MMRV vaccine

A
  • Approved for children 12 months through 12 years
  • Do not use for persons >13 y/o
  • May be used for both first and second doses of MMR and Varicella vaccines
  • Minimum interval between doses is 3 months
45
Q

Varicella schedule

A

[2 doses] - minimum interval 3 months

  • Routine first dose at 12-15 months of age
  • Routine second dose at 4-6 years of age
46
Q

Varicella-containing vaccines contraindications and precautions

A
  • Severe allergic reaction to vaccine component or following a prior dose
  • Immunosuppression
  • Pregnancy
  • Moderate or severe acute illness
  • Recent blood product (except herpes zoster virus)
47
Q

Indications for Meningococcal vaccine

A
  • Complement component deficiencies
  • Functional or anatomic asplenia (includes kids with SCD)
  • Infants who are in defined risk group for a community or institutional outbreak
  • Infants traveling to an area where meningococcal disease is hyperendemic or epidemic
48
Q

Meningococcal immunization schedule (at-risk children)

A
  • 4 dose infant series: 2, 4, 6, and 12 mo.

- 2 dose older infant series: 7-9 and 12 mo.

49
Q

MCV4: Menactra schedule

A
  • All 11-12 year olds

- Booster at 16 y/o

50
Q

HPV schedule

A
  • 3 dose series for females: 4 weeks between dose 1/2, 12 weeks between doses 2/3, 24 weeks between doses 1/3
  • HPV 4 approved for 3 dose series in males age 9-18 to reduce likelihood of genital warts
51
Q

HPV adverse reactions

A
  • local reactions
  • fever
  • no serious adverse reactions reported
52
Q

HPV and syncope

A

Providers should strongly consider observing patients for 15 minutes after they are vaccinated

53
Q

HPV contraindications

A

Severe allergic reaction

54
Q

HPV precaution

A

Moderate severe or acute illnesses (defer until symptoms improve)

Primary Care I (3 decks)

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