Immunization Flashcards
Examples of live attenuated viral vaccine
MMR, varicella, yellow fever, nasal influenza,
smallpox, oral rotavirus
Examples of live attenuated bacterial vaccine
BCG, oral typhoid
Examples of inactivated whole virus vaccine
Polio, rabies, hepatitis A
Examples of inactivated fractional protein based vaccine
Subunit: hepatitis B, parenteral influenza, acellular
pertussis
Examples of inactivated fractional polysaccharide based vaccine
Toxoid: ________
Pure:_________
Conjugate: _______
diphtheria, tetanus
pneumococcal, Hib, meningococcal
Hib, pneumococcal, meningococcal
For stimulation of an adequate and persisting antibody response,______ doses are usually required
2 or more
Rule for lapsed immunization
Lapsed immunizations—a lapse in schedule does not require reinstitution of the entire series
Dose—No reduced dose or divided dose should be administered, including to babies born prematurely or at low birth weight (exception:_______
first dose hepatitis B).
Active immunization of people who recently received gamma globulin
Live virus vaccine may have diminished immunogenicity when given shortly before or during the several months after receipt of immunoglobulin (Ig) so
live vaccine is delayed (3–11 months).
T or F
Minor illness, with or without a fever, does not contraindicate immunization.
T
Why is egg allergy not a contraindication to the MMR
MMR is derived from chick embryo fibroblast tissue cultures but does not contain significant amounts of egg cross-reacting proteins
Why is egg allergy not a contraindication to the Influenxa
Influenza vaccine (and yellow fever) does contain egg protein and on rare occasions may induce a significant immediate hypersensitivity reaction.
Post exposure immunization for measles
0–6 months
Immune serum globulin if mother is not immune
Post exposure immunization for measles
Pregnant or immunocompromised
Immune serum globulin
How to give Varicella passive immunization in pregnant mother
VZIG also for susceptible pregnant women, newborn whose mother had the onset of chicken pox within 5 days before delivery to 48 hours after delivery, and certain
hospitalized premature infants
Active Immunization for Hepatitis B: after exposure in nonimmune patient, give _________
hepatitis B Ig plus vaccine;
repeat vaccine at 1 and 6 months
Active Immunization Hepatitis A: if patient is not vaccinated,__________
give 1 dose of vaccine as soon as possible
but within 2 weeks of exposure
Mumps and Rubella active immunization
Not protected by postexposure administration of live vaccine
The infant born to a hepititis B surface antigen (HBsAg)-positive mother should receive
the first dose of hepatitis B virus (HBV) plus hepatitis B Ig at 2 different sites within 12 hours of birth; all 3 doses should be given by age 6 months (treat
same as exposure
DTaP
The rates of local reactions, fever, and other common systemic reactions are substantially lower with ______vaccines than with whole-cell vaccine
(but may still occur).
acellular pertussis
DTaP
Total of 5 doses is recommended before school entry, with the final given at
preschool age, 4–6 years.
________ vaccine is now recommended during adolescence, regardless of immunization status; is also recommended even if one has already had pertussis
disease.
Pertussis booster (Tdap)
Tetanus Prophylaxis in Wound Management
Clean wound
<3 or unknown
Td: Y
TIG: N
Tetanus Prophylaxis in Wound Management
dirty wound
<3 or unknown
Td: Y
TIG: Y
Tetanus Prophylaxis in Wound Management
Clean wound
> 3
Td: No, unless >10 years from last dose
TIG: N
Tetanus Prophylaxis in Wound Management
dirty wound
> 3
Td: No, unless >5 years from last dose
TIG: N
the only poliovirus vaccine available in the United States
IPV
How to give IPV
Four doses of IPV, with the last at preschool age, 4–6 years
HiB Conjugated Vaccine
• Does not cover________
nontypeable Haemophilus
HiB Conjugated Vaccine
If immunization is not initiated (i.e., child is behind) until age 15–59 months, then there is catch-up (1 dose), but not given after ________
age 5 years in normal children
WHat type of Pneumococcal vaccine is available?
Purified polysaccharides of 13 serotypes conjugated to diphtheria protein
Pneumococcal conjugate vaccine (PCV13
Routine administration as a 4-dose series for all children age________
15 months and younger
PCV catch up dose
If no dose given yet between age 15–59 months, then there are catch-up doses
__________—given as additional protection
to the PCV13 in some high-risk children (e.g., functional/anatomic asplenia)cage >2 years
23-valent pneumococcal polysaccharide vaccine (PS23)
What vaccine?
Recommended at age 12 months or older for healthy people who have not had varicella illness, with second dose at age 4–6 year
Varicella
advantage of Varicella vaccination
May still have breakthrough varicella; milder than unimmunized, rarely spreads
DOsing of MMR
- First dose given at age 12–15 months
- Second dose given at preschool age, 4–6 years
- Catch-up with 2 doses
How to give Hep A vaccine
- Recommended for all children age >1 year (12–23 months)
* Two doses, 6 months apart
Hep A vaccine is recommended for:
Also recommended routinely for chronic liver disease patients, homosexual and bisexual men, users of illegal drugs, patients with clotting-factor disorders, and
those at risk of occupational exposure
Meningococcal Conjugate Vaccine (MCV4)
Administer MCV4 to
– All children at the age 11–12 visit and booster at age
Meningococcal Conjugate Vaccine (MCV4)
There is now a vaccine for _____to be used for high risk patients and during outbreaks (status post concurrent type B outbreaks at Princeton and UC Santa Barbara)
serotype B
WOF Egg allergy in what type of vaccine
Influenza Vaccine
When should influenza vaccine be given?
Given annually during flu season for children greater than 6 months of age (A strains, B strains, and H1N1)
Live influenza vaccine
– Administered ________
– Contraindicated in the immunocompromised
– Given only to healthy people_______of age who are not pregnant and do not have certain health conditions
intranasally
2–49 years
How is rotavirus given?
- Oral live attenuated vaccine
- Given at ages 2, 4, 6 months
- Essentially no catch-up if behind (no dose after age 8 months
Types of HPV vaccine
Quadrivalent vaccine (6, 11, 16, 18) or bivalent vaccine (16, 18) to girls at the age 11-12 visit (through age 26) for cervical cancer prevention
_____ to boys age 11–12; for genital warts caused by
HPV 6,11.
Quadrivalent vaccine (6, 11, 16, 18)
See Vacc chart
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