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M&S 2 > Immunization > Flashcards

Immunization Flashcards

1
Q

How many death per year are prevented by vaccines?

A

3 million deaths/year in children

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2
Q

What is Herd Immunity/Community Immunity?

A

When a significant portion of the population is immune and provides protection for individuals who are not immune

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3
Q

What is the Advisory Committee on Immunization Practices?

A

ACIP provides advice and guidance on effective control of vaccine-preventable disease in the U.S. Develop written recommendation for routine admin of vaccines to the pediatric and adult population., along with vaccination schedules regarding appropriate periodicity, dosage, and contraindications

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4
Q

What are the routine child hold immunization since 2009?

A

Measles, Rubella, Mumps (MMR)

Diphtheria Tetanus Pertussis

Polio

Hib (Infant)

HepB

Varicella

Pneumococcal Disease

Influenza

Meningococcal

Hep A

Rotavirus

HPV

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5
Q

When does a physician use the catch-up schedule?

A

For children who start late or are more than 1 month behind or 1 dose behind.

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6
Q

T/F MenHibrix vaccine is still given to children

A

False, removed from schedule and discontinued in the US

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7
Q

What are the recommendations for routinely recommended vaccines for adults based on?

A

Age group Immunization received as a child or adolescent Medical Conditions Pregnancy Occupation Other factors including lifestyle

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8
Q

Primary precautions and contraindications are included in what?

A

Adult schedule table

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9
Q

There were some changes made to the adult schedule in 2018. What are they?

A
  1. It is referred that the Recombinant zoster vaccine (RZV) be sed for adults 50 and older 2. Use of additional dose of MMR vaccine in a cups outbreak setting 3. HPV dose for male and females changed to 2-3 doses depending on age at skies initiation 4. MPSV4 no longer available
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10
Q

What are the two most important issues for appropriately administering vaccines?

A

Timing and spacing

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11
Q

All vaccines can be administered at the same time except?

A

PCV13 and PPSV23 -> must give PCV13 first MCV4 (Menactra) and PCV13 -> must give PCV13 first

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12
Q

What is the ACIP four day grace period?

A
  • Any vaccine doses given up to 4 CALENDAR days before the minimum interval or age can be counted as valid. - A dose given more than 4 days before the minimum interval or age is invalid and must be repeated
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13
Q

When do children need most of their shots by?

A

By age 2

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14
Q

When are vaccinations generally given?

A
  • At birth - Age 2, 4, 6, and 12-18 months - 4-6 years old - 11-12 years old - 16 years old
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15
Q

What vaccines are needed in Infants and children age 0 through 6 years of age?

A
  • Hepatitis B (at birth) - Rotavirus - Diphtheria, Tetanus and Pertussis - Haemophilus influenzae type b - Pneumococcus - Polio - Influenza - Measles, Mumps and - Rubella - Varicella - Hepatitis A
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16
Q

What vaccine is for sure given at birth?

A

Hepatitis B

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17
Q

Which vaccines are needed in children and teens age 7 through 18?

A

Tetanus, diphtheria and pertussis Human papillomavirus (HPV) Meningococcus Influenza

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18
Q

Which vaccines do certain adolescents and teens typically need to catch up?

A

Hepatitis A Hepatitis B Poliovirus Measles, Mumps and Rubella Varicella

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19
Q

When do adults typically need vaccines?

A
  • At certain ages - During pregnancy - Before travel - For occupation risk - before travel - when they have certain medical conditions
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20
Q

What vaccines do adults typically need?

A

Td/Tdap Human Papillomavirus (HPV) Varicella Herpes Zoster Measles, Mumps and Rubella Influenza Pneumococcal Hepatitis A Hepatitis B Meningococcus

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21
Q

If a women is pregnant what vaccines can you can or not give her?

A

Live vaccines are not permitted You can give them inactivated vaccines m

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22
Q

What are examples of inactivated vaccines that you can give pregnant women?

A
  • Influenza (during any trimester) - Tdap (27-36 wks) - Vaccines if indicated (Hep A, B) - Vaccines if increased risk (except HPV) - At the provider discretion they can also be given PVC13, His, MenB
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23
Q

Influenza infections is highest amongst which population?

A
  • highest among children, with complications - Hospitalizations greatest among persons aged >65 years, children aged <2 years, and persons of any age who have medical conditions that confer increased risk for complications from influenza
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24
Q

When was the flu pandemic?

A

1918 (50 million deaths worldwide)

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25
Q

When does influenza activity often begin? Peak? End?

A

Begin in October Peaks in December and February Can last to May

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26
Q

What do flue vaccines protect against?

A

The 3 or 4 viruses

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27
Q

In 2017/2018 the three-components vaccine contained?

A
  • A/Michigan/45/2015 (H1N1)pdm09-like virus (updated) - A/Hong Kong/4801/2014 (H3N2)-like virus - B/Brisbane/60/2008-like (B/Victoria lineage) virus
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28
Q

Which vaccines protect against the second lineage of B viruses?

A

Quadrivalent (four components) vaccines - B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

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29
Q

How does the weekly influenza activity estimate reports?

A

By state and territorial epidemiologist

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30
Q

Which influenza strains cause seasonal epidemics every winter in the US

A

Human Influenza A and B

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31
Q

Which virus dominates the flu season?

A

Influenza A (H3N2)

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32
Q

The annual influenza vaccination continues to be recommended to which age group?

A

Persons 6 mo of age and older without contraindications or precautions (people with egg allergy can still take the vaccine)

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33
Q

Why do you continue to recommend the flu vaccine despite its low effectiveness (36%) against H3N2?

A

the individual is less likely to suffer from a severe illness, and less likely to be hospitalized. i.e DECREASES THE EFFECTS

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34
Q

This vaccine should not be used during the 2017-2018 season due to its concerns about its effectiveness against influenza (H1N1), what is it?

A

FluMist Quadrivalent (LAVIV4)

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35
Q

There has been an increase number of MUMPS outbreak since 2006 in which population group?

A

Amongst College Students Also outbreaks have also occurred in communities with high immunization rates and people who have receive both recommended doses.

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36
Q

What is the major factor contributing to the Mumps outbreak?

A

Crowded environment

37
Q

What is the recommended vaccination dose , by the CDC, for MMR?

A

Two doses - 1st does at age 12-15 mon - 2nd dose at age 4-6 - children and adults should also be up to date on vaccination

38
Q

If there is a mumps out break , what is recommended?

A

A third dose of mumps vaccine is recommended

39
Q

What is HPV?

A

Human Papillomavirus is a viral infection that is passed between people through skin-to-skin contact

40
Q

What is a crazy fact about HPV that would have you blown away? ;)

A

100% of sexually active men and women acquire genital HPV at some point in their life. HE SAID 100% BRAH!!!!!!!

41
Q

Most people with HPV never develop symptoms. When does it typically go away?

A

Can resolve on its own within 2 years

42
Q

What can HPV infection cause?

A
  • cancers of the cervix, vagina, and vulva in women
  • cancers of the penis in men
  • cancers of the anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men
43
Q

64% of cancers are attributed to?

A

HPV 16/18

44
Q

10% of cancers are attributed to what infection?

A

HPV 31/33/45/52/58

45
Q

50% of _______ is attributed to HPV 16/18 and 25% attributed to the 5 additional types?

A

CIN2

Cervical intraepithelial neoplasia grade 2 or worse

46
Q

HPV vaccines prevents?

A

Cervical, vulvar, vaginal, and anal cancer and precancer, genital warts

47
Q

When should the HPV vaccine typically be given?

A

age 11-12 but can be started as early as 9

48
Q

If a patient does not get vaccinated for HPV at the recommended time, when else should it be given?

A

Females: age 12-26

Males: Age 13-21

49
Q

Why do you provide the HPV vaccine at age 11-12?

A

Higher antibody level attained when given to pre-teens rather than to older adolescents or women

  • precedes typical sexually active age
50
Q

This vaccine is an anti-cancer vaccine?

A

HPV

51
Q

If you initiate the HPV vaccine between the age of 9-14 and the person is not immunocompromised, how may doses do they receive and when?

A

2 doses

(second dose is give 6-12 months after the initial dose)

52
Q

If you initiate the HPV vaccine between the age of 15-26 or 9-26 in a immunocompromised patient how many doses do they receive and when?

A

3 doses

(second dose is given 1-2 months after the first dose and the 3rd dose is given 6 months after the first dose)

53
Q

If the HPV series is interrupted do you start over?

A

No there is no maximal interval between HPV vaccine doses

54
Q

How many serogroups does the meningococcal disease have?

A

13

Abrupt onset of disease, rapid course of disease

55
Q

Which serogroups of meningococcal disease are the most invasive?

A

A, B, C, Y, W-135

56
Q

What are the long term affects of Meningococcal disease?

A

deafness, neurologic deficit, limb loss

57
Q

What are the risk factors for menigococcal disease?

A
  • Host: asplenia, smoking, upper respiratory infection, age younger than 1 year
  • Crowding
  • College freshmen living in dorm
58
Q

What are the two vaccines used to treat meningococcal disease?

A
  • Meningococcal Conjugate Vaccines (MenACWY)
  • Meningococcal Serogroup B Vaccines (MenB)
59
Q

Meningococcal Serogroup B Vaccines (MenB) is given to individuals in which age group?

A

Recommended for people at increased risk age 10 years and older (since 2014)

60
Q

Meningococcal Conjugate Vaccines (MenACWY) is given to individuals in which age group?

A

Recommended at age 11-12 since 2005

(booster given at age 16)

if given later:

13-15 -> then booster is given at age 16-18

16-18 -> then booster is not given

61
Q

What are the two types of MenACWY vaccines?

A

Menactra (Sanofi Pasteur)

Menveo (GlaxoSmithKline)

62
Q

Menectra is approved for which age groups?

A

Person 9months-55years

(revaccination in persons 15-55 years)

63
Q

Menveo is approved for which age group?

A

Person 2 months-55 years

64
Q

After a single dose of MenACWY, when do the antibodies decline?

A

After 3-5 years, this is why a booster is given

65
Q

Which groups are at increased risk for the Meningococcal B Disease?

A
  • complement component deficiencies including treatment with eculizumab (Soliris)
  • anatomic or functional asplenia
  • risk in a serogroup B meningococcal disease outbreak
  • certain microbiologists

INDIVUALS should receive MenB vaccine

66
Q

Which population is not at risk for Meningococcal B disease?

A

International travelers

HIV patients

First year college students

67
Q

What are the two types of the Meningococcal Serogroup B vaccines?

A

MenB-FHbp

MenB-4C

(the two vaccines are not interchangeable)

Preferred age group is 16-18

68
Q

What is the recommended age and dose for MenB-FHbp?

A

Ages 10-25 years

2-3 doses

69
Q

What is the recommended age and dose for MenB-4C?

A

Age 10-25 years

2 doses (0, >1mo)

70
Q

MenB is currently a low risk disease. What is ACIP recommendation?

A

Insufficient evidence to make a public recommendation but they do believe there is enough evidence to encourage individual clinical decision making

71
Q

If a person age 40 and up is seropositive for VZV, what are they at risk for?

A

Herpes Zoster

72
Q

10-18% of people who acquire Herpes Zoster are at risk for?

A

Post Herpatic Neuralgia (PHN)

73
Q

What are the risk factors for Herpes Zoster?

A

Increasing age

Immunosuppression

Persons loses VZV specific mediated antibodies which cause them to be at risk

74
Q

Live attenuated Zoster Vaccine

A
  • Efficacy 51% (decreases in older age)
  • Immunity over 1-2 years
  • Efficacy 67% for PHN
  • Contraindicated in people with immunosuppression
75
Q

It is recommended that the Herpes Zoster vaccine be given when?

A

Routine Vaccination for adults more than 60 years old

76
Q

Why is Zostavax not recommended?

A

Uncertain long term protection

77
Q

What is Shingrix?

A

Adjuvanted Recombinant Zoster Vaccine

  • Recombinant glycoprotein E subunit
  • 2 dose series (0, 2-6mo)
  • in 2017 approved for adult 50 and older
78
Q

Why is the Shingrix (herpes Zoster subunit vaccine) recommended?

A

For Prevention of herpes zoster and related complications for immunocompetent adults aged 50 years and older

Prevention of HZ and related complications for immunocompetent adults who previously received zoster vaccine live (Zostavax®)

79
Q

Why is Adjuvanted recombinant vaccine (Shingrix®) more preferred over live zoster vaccine (Zostavax®) ?

A

For the prevention of herpes zoster and related complication

  • Shingrix has a longer effect (4 years)
  • High efficacy
  • Cost effective
80
Q

What are the bacterium that cause pneumococcal disease?

A

Streptococcus pneumoniae, or pneumococcus

81
Q

What are the symptoms of pneumococcal infections?

A

ear and sinus infection or pneumonia and bloodstream infection

82
Q

Which age group are at most risk for pneumococcal disease?

A

Children younger than 2 years old and adults 65 years or older, also people at increased risk

83
Q

23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) is given to which age group? How is it administered?

A

Also known as Pneumovax

  • 2 years and older
  • No more than 2 doses recommended (separated by 5 years)
  • Subcutaneous or IM injection

Number in front is the number of serogroups

84
Q

13-Valent Pneumococcal Conjugate Vaccine (PCV-13) is given to which age group?

A

Also known as Prevnar

  • 6 weeks and older
  • 1 dose recommended
  • Given by IM injection

Number in front is the number of serogroups

85
Q

T/F PCV13 and PPSV23 cannot be administered during the same clinic visit

A

TRue

86
Q

Why are parents typically hesitant about vaccines?

A

They are afraid of the adverse effects

Believe that the disease is not harmful

Philosophical and religious beliefs

Too many shots too soon

Link to health problems

87
Q

Who is the most important source for immunization information?

A

Pediatrician parent trust

88
Q

Resources about vaccines and immunizations can be found where?

A

CDC website

89
Q
A

M&S 2 (15 decks)

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