immunization quiz 3 Flashcards
1
Q
explain serious health effects and costs of becoming sick with measles, mumps, and rubella
A
- measles: highly contagious disease causing fever, cough, runny nose conjunctivitis, and koplik spots/rash descending on the body; risk of ear infections, diarrhea, pregnancy complications; also pneumonia, encephalitis, subacute sclerosing panencephalitis for young kids (SSPE)
- mumps: contagious for a long time; prodrome including malaise, fever, myalgias, anorexia, headache; classic is parotid gland swelling, men may get testes inflammation, women may get mastitis or ovaries inflammation; rare but possible hearing loss, encephalitis, meningitis, pancreatitis, myocarditis, death
- rubella: kids may get fever or rash progressing downward, adults prodrome of fever, headache, runny nose, conjunctivitis, lymphodemopathy followed by rash; complications like arthralgias, arthritis, thrombocytopenic purpura, encephalitis, neuritis, panencephalitis, congenital rubella syndrome for pregnant people
2
Q
identify and explain why patients require vaccination against measles, mumps, and rubella
A
- saved 23 million lives since 2000
- 3 in 1 deal
- dose 1 efficacy: 93-95% against measles, 78% mumps, 97% rubella
- dose 2 efficacy: 97-99% measles, 88% mumps
- used for pre and post exposure prophylaxis as well (IGIM/IVIG also used post)
3
Q
apply knowledge to identify vaccine specific effects
A
- common: high fever, rash, post pubertal females arthralgia and arthritis
- rare: thrombocytemia, lymphadenopathy, parotitis, testes inflammation, allergic reaction, CNS dysfunction
- no link to autism
- do not give to pregnant women
4
Q
explain storage, dosage, route, administration and handling of measles, mumps, and rubella containing vaccines
A
- MMR stored in fridge or freezer
- MMRV stored in freezer
- 2 doses at 12-15 mo and 4-6 yrs (minimum interval 1 mo)
- 0.5mL SQ
5
Q
answer patient questions regarding measles, mumps, and rubella immunization
A
- low rates of vax show outbreaks of all diseases
- live vaccine
- catch up recommended at 11-12 yo, women of childbearing age, healthcare workers
- if born before 1957 and not HCP, considered immune if vaxed or not because it was so prevalent
6
Q
identify valid contraindications to vaccination
A
- severe allergic reaction to vaccine or its counterparts (gelatin, neomycin)
- egg not considered an allergy risk but possible
- wait if moderate-severe illness or active Tb
- wait if pregnant
- do not get if immunosuppressed
- asymptomatic HIV and not severely immunocompromised considered ok
- wait if recently received antibodies
- don’t get if can’t handle fever
- don’t get if have thrombocytopenia, thrombocytopenia purpura, or if became thrombocytopenic within 6 weeks of prior dose
7
Q
identify patients at risk for varicella virus related disease
A
- infants
- adults (especially older adults)
- pregnant (congenital varicella syndrome)
- immunocompromised
8
Q
identify and explain why patients are recommended to receive varicella or zoster vaccines based on CDC’s recommendations
A
- varicella vaccine will prevent chicken pox, and no zoster vaccine will be needed if disease is prevented entirely
- zoster vaccine recommended age 50+ (younger if immunocompromised) if had chicken pox to prevent flare up
- herpes zoster can lead to post herpatic neuralgia which is largest concern bc long term pain
9
Q
apply knowledge to identify vaccine specific adverse effects and answer patient questions regarding varicella or zoster vaccines
A
- 33% injection site rxn
- systematic: fever 10-15%, rash including a few lesions 6%
- zoster association very rare
- MMRV: increased rates of fever, febrile seizures, rash
- ## severe: rare in immunocompetent, but likely in patients with T cell dysfunction
- higher grade of inflammatory responses due to strong aluminum adjuvant
- serious risk 12.6% (injection site rxn 9.4%, systemic rxn 10.8%)
- common 7 days after: pain 70-88%, myalgia 35-57%, fatigue 37-57%, headache 29-51% (more common dose 2), swelling 23-31%, shivering 23-31% (more common dose 2), shivering 20-36%, fever 14-28%, GI symptoms 14-24%, redness 2.6-3.1%, possibly optic ischemic neuropaty
10
Q
explain dosing, storage, administration technique, and/or schedule for varicella containing vaccines
A
- varicella: 0.5mL SQ, 2 dose schedule at 12-15mo and 4-6yrs, minimum interval 3mo (28 days countable), catch up at any age if no contraindications
- MMRV only approved in ages 1-12 without HIV and not recommended with dose 1 under 48mo or with history of fever
- zoster: 0.5mL IM, 2 doses separated by 2-6mo, age 50+ if immunocompetent, 19+ if immunocompromised
- varicella (Varivax) and MMRV (Proquad) must be stored in freezer
- zoster (Shingrix) stored in fridge
11
Q
identify if circumstances are valid contraindications to varicella vaccines
A
- varicella: moderate to severe disease including active Tb, allergy to vaccine or component (gelatin, neomycin), pregnancy, immunosuppressed, spacing with meds that could cause interference (steroids, antivirals) or cause reactions (salicylates)
- zoster: known allergy to vax or component, delay if pregnant or lactating
- if people have not had chickenpox and, give varicella first
12
Q
identify patients at risk for rotavirus related disease
A
basically only kids under 5
13
Q
explain why patients are recommended to receive rotavirus vaccine
A
- 3 mil cases annually before vaccine
- first infection, especially if child is around 3mo is worst
- intussusception possible disease symptom, telescoping of intestines
- many kids get hospitalized with disease
14
Q
explain dose, schedule, storage, and administration for rotavirus vaccine
A
- RotaTeq: 2mL oral dose, 3 dose series at 2, 4, 6mo and cannot be given <6wks or >32wks
- Rotarix: 1mL oral dose (needs recon), 2 dose series at 2 and 4mo, do not give if <6wks or >24 wks
- refridgerated
- do not repeat if infant spits up or vomits after dose
- if need to mix brand give 3 doses
- do not start series if pt is 15 weeks per ACIP
- do not give last dose if infant is 8mo per ACIP
- separate doses by at least 4wks
15
Q
answer caregiver questions regarding rotavirus vaccination
A
- live vaccine
- RotaTeq has 5 viruses, Rotarix has 1
- intussusception very rare but possible with current vaccines
- max age helps prevent side effects
- 80-90% effective against any rotavirus gastroenteritis
- 85% protection against severe gastroenteritis
