Hep A+B, HPV, Mpox, Pneumococcal, RSV Flashcards
Hepatitis B is caused by…
Viral infection (HBV)
Duration of hepatitis B is usually…
Short-term; most clear infection after 4-8 weeks
Some people are chronic HB carriers
HBV is transmitted via…
Blood or bodily fluids containing HB virus
(sharing injection equipment, sexual contact, vertical transmission)
Signs + symptoms of hepatitis B may include…
Fatigue, fever, N/V, decreased appetite
Jaundice
Asymptomatic in 50% of adult cases and majority of children cases
Hep B vaccination is given…
Part of primary series (2 doses, grade 6)
Is a booster required for HBV?
Not for healthy population - potentially for some special populations based on serology
HBV serology presents as:
HBsAg: Negative
Anti-HBc: Negative
Anti-HBs: Negative
This patent would be considered ____ to HBV.
Susceptible
HBsAg = surface antigen
Anti-HBs = surfac antibody
Anti-HBc = virus core
HBV serology presents as:
HBsAg: Negative
Anti-HBc: Negative
Anti-HBs: Positive with >10 IU/L
This patent would be considered ____ to HBV.
Immune, from vaccination
HBV serology presents as:
HBsAg: Negative
Anti-HBc: Positive
Anti-HBs: Positive
This patent would be considered ____ to HBV.
Immune, from infection
If healthy patients have received appropriate immunization series for HBV, they are considered immune/protected for life even if anti-HBs drops below ____, because…
<10: immune memory to HB persists. Therefore another HB vaccine dose NOT required.
Another dose may be given if anti-HBs is below 10 for…
Some special populations (immunocompromised, CKD)
Hepatitis A is caused by…
Viral infection (HAV)
Hepatitis A is transmitted via…
Fecal-oral
Contaminated food, water, drinks
Signs + symptoms of hepatitis A include…
Adolescent/adults - anorexia, nausea, fatigue, fever, jaundice
Younger patients are usually asymptomatic
Hepatitis A schedule is different from hepatitis B, in that…
It is not routinely given in childhood vaccinations - only recommended for people at increased risk of infection
Ex: Travel, certain living conditions, liver disease, unsafe injection equipment
Twinrix contains ____ and is primarily used in SK today for…
Both HA and HB immunization - convenience for travel (someone requires HA for travel and unsure/no documentation for HB series)
If someone does have HB series done, then HA only (cheaper)
HPV is caused by…
Viral infection
HPV is transmitted…
Sexually - skin-skin contact
Vertically
Most common STI
Signs + symptoms of HPV infection may include…
Mostly asymptomatic
Some develop genital warts
Some develop cancer
HPV vaccine is available as…
HPV-9 (Gardasil)
HPV-2 (Cervarix) - this one is not commonly used
NACI’s new recommendations regarding the HPV vaccine include…
Number of doses? Which vaccine to use?
HPV-9 preferred over HPV-2
9-20: 1 dose
21-26: 2 doses
27+: 2 doses
Immunocompromised: 3 doses
May be offered in pregnancy
As of 2024, SK follows old schedule with 2/3 doses
HPV vaccine is approved for women up to age…
45 - consider discussing with unvaccinated adults with new sexual partners
The HPV vaccine is ____, so it should be administered….
Adjuvanted - administered last (more painful)
The HPV vaccine does not protect against…
Other STI’s
HPV vaccine is most effective…
When given at a younger age, before exposure to HPV
Vaccine after onset of sexual activity is still recommended - unlikely that vaccine recipient has been infected with all HPV types in vaccine
Still indicated with in women with abnormal pap test, cervical cancer, genital warts
Mpox is caused by…
Viral infection
Mpox is transmitted by…
Skin-skin contact
Respiratory droplets
Animal to human
Most cases of mpox have been diagnosed in…
Men who have sex with men
Signs + symptoms of Mpox include…
Systemic illness - fever, chills, headache, myalgias, rash (similar to shingles)
Atypical = lesions without systemic illness
Cases of mortality in immunocompromised, or those who developed encephalitis
Mpox is contagious until…
All lesion scabs have fallen off
____ vaccine protects against Mpox.
Smallpox
The smallpox vaccine is…
Type?
Live-attenuated, but non-replicating
Safe in immunocompromised
Smallpox/Mpox immunization scheduling is…
Not routine - based on risk factors (multiple sexual partners, environment)
Prophylaxis: 2 doses given 1 month apart
Post-exposure - 1 dose, up to 14 days since last exposure
Pneumococcal vaccine is related to…
Bacterial infection due to streptococcus pneumonia
Many serotypes
Streptococcus pneumonia is transmitted via…
Respiratory droplets; direct/indirect contact with oral secretions
Streptococcus pneumonia can cause…
Sinusitis, AOM, pneumonia
Bacteremia, meningitis
Interchangability of pneumococcal vaccines…
Is important to consider - most are not interchangeable due to conjugate and polysaccharide
There are many types of pneumococcal vaccines because…
The most common serotypes that cause disease vary across different populations, and tend to change over time
Compared to the polysaccharide vaccine, the conjugate vaccine…
Produces longer lasting immunity and has a more robust immune response that involves both B + T cells
Polysaccharide is T-cell independent
NACI recommends this for pneumococcal routine childhood scheduling…
PCV15 or PCV20
SK = PCV15 x 3 doses
NACI recommends this for pneumococcal routine adult scheduling…
NO IPD risk factors
65+ regardless of pneumococcal vaccination history with PCV13, 15 or 23: Give 1 dose of PCV 20 or 21.
SK = only public funding if patient has not received ANY prior pneumococcal vaccines
Wait 1 year from last pneumococcal dose
If someone is at increased risk of IPD, NACI recommends this for pneumococcal vaccine scheduling…
18+ with medical/environmental IPD risk factors, regardless of previous vaccination with PCV 13, 15, or 23: 1 dose of PCV 20 or 21.
SK - if IPD risk factors present, potentially eligible for public funding
RSV is caused by…
Viral infection
RSV is transmitted by…
Respiratory droplets - annual outbreaks + reinfection is common
Individuals at high risk of severe RSV include…
Chronic respiratory, cardiac, renal conditions
Diabetes
Immunosuppressed
Signs + symptoms of RSV include…
URTI - mild, cold-like symptoms
Lower lung infections
Severe cases = oxygen + hospitalization required
The three approved RSV vaccines in Canada include…
Arexvy - monovalent, adjuvanted
Abrysvo - bivalent
Mresvia - monovalent
RSV vaccination is recommened for the following individuals who are RSV-vaccine naive (NACI)
Everyone 75+
60-74 LTC residents, or are at increased risk of severe RSV (chronic diseases)
However, NOT publicly funded in SK yet
NACI recommends this dosing schedule for RSV…
Abrexvy or Abrysvo x 1 single dose
RSV efficacy studies showed…
A decrease in RSV-lower respiratory tract disease compared to placebo. Better results in those with higher risk factors
RSV vaccine AE’s include…
Arexvy contains an adjuvant, Abrysvo does not.
Injection site rxns - pain, redness, swelling
Systemic rxns - fatigue, myalgia, headache
Serious AE’s relatively similar to placebo; possibility for GBS, AFib
