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Pedia > Immunization > Flashcards

Immunization Flashcards

1
Q

Achieved by administration of preformed antibodies

A

Passive immunity

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2
Q

Passive immunity can be induced naturally through

A

transplacental transfer of maternal IgG

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3
Q

Live attenuated vaccines

A 
Measles
Mumps
Rubella
Varicella
Rotavirus
Live attenuated influenza vaccine
BCG
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4
Q

Influenza 2 types

A

Live attenuated

Inactivated vaccine

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5
Q

Wild virus or bacterium
Prolonged immunity
Multiplies in human host with stronger immune response
But can revert back to virulent form hence do not give to immunocompromised

A

Live attenuated

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6
Q

Intramuscular
Do not multiply in human host
Immune response depends on antigen content
Little cell mediated immunity but no possibility of vaccine assoc infection

A

Inactivated vaccine

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7
Q

Birth to 2 mos

A

BCG

Monovalent Hepa B

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8
Q

4-8 mos

A

Hep B

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9
Q

T/F: all vaccines can be administered at the same visit as all other vaccines

A

True

Except in persons with functional or anatomic asplenia PCV13 and Menactra meninggococcal conjugate should not be administered at same visit

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10
Q

Vaccine spacing by at least

A

4 weeks

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11
Q

BCG is given

Dose

A

Intradermally

  1. 05ml for <12 mos
  2. 1 ml for >12

First two months of life

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12
Q

If more than 2 mos and patient wasn’t given BCG, do

A

PPD prior to BCG if

Congenital TB
Hx of close contact with known TB patient
Clinical finding suggestive of TB

Otherwise no PPD diff mx

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13
Q

4 month old no BCG
Father sputum +

What is plan of action?

A

Do PPD prior giving BCG

Investigate

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14
Q

More than 2 months of age do not give BCG without prior BCG if

A

Congenital

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15
Q

PPD is positive if

A

induration of 5mm

No longer recommended to give BCG

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16
Q

IM
Administer first dose as monovalent to all newborns within:

2nd dose given:

Final dose:

A

Hepa B
12 hrs of life

1-2 mos after birth

Final: not earlier than 24 weeks or after 6 mos of age

0-1-6

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17
Q

If mother is HBsAg +

A

Administer Hep B and
HBIG 0.5ml
within 12 h of life not later than 7 days of age if not available

Give active and passive

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18
Q

If mother’s HBsAg is unknown

>/= 2 kg newborn

A

Administer Hep B within 12 hrs of life

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19
Q

If infant is preterm and mother is HBsAg negative

A

1st dose of HepB given at 30d chronological age
Hold at birth
Count as part of 3 dose primary series

If you give agad, not counted so give 3 more

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20
Q

IM
3 dose primary series within minimum age of 6 weeks and interval of 4 weeks

Booster given between 12-15mos

A

HiB

6-10-14

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21
Q

IM
Min age of 6 w with minimum interval of 4 weeks
Penta dose series
Do not give 5th if administered at 4 years or older

A

DPT

2-4-6-15 to 18 and 4-6 years

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22
Q

Component of DPT vaccine is highly responsible for adverse effect after vaccination

A

Pertussis: seizure

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23
Q

IM
Given in combination with DTaP and Hib with or without Hep B
Min age of 6 weeks with min interval of 4 weeks
Primary series consists of 3 doses 2-4-6 to 18 and 4 to 6

Booster given on or after 4th birthday at least 6 mos from previous dose

A

Inactivated poliovirus vaccine

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24
Q

Given per orem

Min age of 6 weeks within min interval of 4 weeks between doses

Last dose should be administered not later than 32 weeks of age

A

Rotavirus

25
Q

Rotarix give

Rotateq give

A

2 dose at 2 and 4 mos

3 dose series 2, 4, 6

Max age for first dose at 14 weeks and 6 days
Max age for final dose is 32 weeks (8 mos)

26
Q

Rotavirus vaccine complication

A

Intusussception

27
Q

IM

Routine: 4 dose series at 2-4-6 m and booster at 12-15 mos

Catch up: 1 dose of PCV13 to all healthy children aged 24 to 59 mos 2-5yrs not completely vaccinated

A

PCV

28
Q

Trivalent given IM/SQ
Quadri given IM
Min age of 6 months
Dose: 0.25 ml for children 6 mos to 35 mos and 0.5ml for children 36 mos to 18 years

A

Influenza

29
Q

Children 6 m to 8 years for firs time, give

A

2 doses

30
Q

Give LAIV or IIV if

A

Healthy
Non pregnant
2-49 years

31
Q

Do not give LAIV if

A

With severe allergic reactions
Children 2-17 years receiving aspirin or aspirin containing products
Egg allergy
Pregnant
Immunosupressed
2-4cyrs with asthma or wheezing
If taken antiviral influenza within 2 days

32
Q

SC

Age of 9 mos but given as early as 6 mos of age in case of outbreak

A

Measles

33
Q

SC
Min age of 12 mos
2 dose series (12-15 m and 4-6 y)

2nd dose may be given earlier but with min 4 week interval

Catch up: all school aged children and adol 2 doses

A

MMR

34
Q

SC
Min 12 months
2 dose series at 12-15 at first and 4-6 yr
Give 2nd dose earlier at interval of 3 mos from first dose

Children 7-12yrs interval 3 mos

A

Varicella

35
Q

IM
Min age of 12 mos

Initiate 2 dose HepA at 12 to 23 mos separate 2 doses by 6-18 mos

A

Hepa A

36
Q

IM

For 9-14 years a 2 dose series 0-6
Bi, quad or nona give at 0 (first) and 6 mos

For 15 above, 3 dose series 0-2-6

For males 9-18 quad and nona given for prevention of anogenital warts or anal cancer

A

HPV

37
Q

IM

For children fully immunized (aka 5 dose series) 2,4,6,12-14 and 4-6 yr Td booster should be given every 10 years

7 and older single dose of TdaP given and replace due to Td
Administered regardless of interval

A

Tetanus and
Diptheria toxoid (Td)
And Acellular Pertussis
Baccine (TdaP)

38
Q

Min 9 mos
Admin Menactra kr Menveo at 13-18

If Menactra given to child with asplenia or sickle cell do not give 2 years of age and at least 4 weeks after completion of all PCV13

A

Meninggococcal vaccine

39
Q

MMR may be given to HIV + child if

A

Asymp or symp without evidence of severe immuno

40
Q

Varicella give to HIV + if

A

CD4 is at least 15%

41
Q

If receiving >2 mg or >20 mg/ day prednisone for 14 days or more do not give

On same dose level but <2 weeks, wait for

A

Live attenuated until discontinued at least 1 month

2 weeks after therapy discontinuation

42
Q

Contraindication to vaccines

A

Anaphylactic reaction
Anaphylactic hypersensitivity to vaccine constituent if essential, desensitize
Defer in children with moderate to severe acute illness regardless of presence of fever until recovered

43
Q

Arthritis after MMR is caused by

A

Rubella

44
Q

Acellular type of Pertussis can be given with Hib conjugate

A

at the same time

45
Q

No min interval bet 2 inactivated vaccine
Min interval of 4 weeks for same inactivated vaccine
Live and inactivated can be given at the same time ar different sites
2 live vaccines can be given at same time or 4 weeks interval

A

Vaccination p

46
Q

Texas star vaccine

Given to

A

Vibrio cholera

Military

47
Q

If px is allergic to eggs what vaccination should be cautioned

A

Influenza
Yellow fever
MMR
Rabies

48
Q

CI to vaccines

A

Moderate to severe acute illness with fever

49
Q

Vaccines contraindicated to HIV and pregnancy

A

Live attenuated

50
Q

Father of immunization
Introduced vaccination
Mild form of small pox

A

Edward Jenner

51
Q

Max age for first dose of rota virus

Last dose should be given at if first dose given

A

14 weeks and 5 days or less than 15 weeks

32 w

52
Q

Congenital rubella:

A 
IUGR
Congenital cataract
Microcephaly
Heart defect(PDA)
Salt and pepper retinopathy
Blueberry muffin skin lesions
Sensorineural deafness
53
Q

Also presents with blueberry muffin skin lesions

A

Leukemia

54
Q

Principle #5

Vaccine doses should not be adminstered at intervals less than the minimum intervals or earlier than the minimum age.

Doses administered too close together or at too young an age can lead to a

A

suboptimal immune response

55
Q

Accelerated schedules can be used

A

Catch-up immunization in children behind schedule
Impending international travel
Should not be used routinely

56
Q

Exception to minimum intervals and minimum age

A

Measles during measles outbreak
Original: 9 months
May be administered as early as 6 months of age

Dose should be repeated at 12 months of age or older

Vaccine doses given up to 4 days before the minimum interval or age are counted as valid -> “The Grace Period”

Does not apply to rabies vaccine

57
Q

If minimum age or interval of vaccination has been violated -> dose is

A

invalid

Action:
A repeat dose should be administered for at least a minimum interval from the invalid dose

58
Q

Principle #6

Increasing the interval between doses of a multidose vaccine does not diminish the effectiveness of vaccine

Decreasing the interval between doses of a multidose vaccine may interfere with antibody response and protection

A

Lapsed immunization will not reduce final response to vaccine.

There is no need to re-start a series of give additional doses, do catch-up immunization.

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