Immunizations Flashcards
Who provides recommendations for vaccine administration in children and adults?
advisory committee on immunization practices (ACIP)
Who approves the ACIP recommendations and publishes them in the Morbitiy and mortality weekly report?
the CDC
What the is the name of the epidemiology and prevention of vaccine preventable diseases published by the CDC? Or the Vaccine Book
The Pink Book
What is the name of the mercury containing preservative used in some vaccines that was alleged to contribute to autism
Thimerosal
contained in some multi dose flu vaccines but parents may requires a single dose flu vaccine that doesn’t have it
From the persons own immune system (from vaccines or fighting an infection) lasts a long time, often a lifetime.
active immunity
Received from someone else such as Ig that are pooled from other people through transfer from a mother to her baby
passive immunity
mother gives baby her immunoglobulins ,but they decrease with time/childs Ab production increases
Is IVIG active or passive immunity?
passive!
provides already made Ab and can be used for quick immunity after exposure to an antigen. (rabies shot is also an example)
What are the common live vaccines?
COZY IV RM
Cholera
Oral Typhoid
Zoster
Yellow fever
Intranasal flu
Varicella
Rotavirus
MMR
Are inactivated viruses less affected by circulating antibodies than live vaccines?
yes!
A pregnant women is requested Oral typhoid vaccine. can she receive it?
NO! pregant
This vaccine targets a section of the organism such as a protein, sugar, or capsid
Polysaccharide, Conjugate and Recombinant vaccines
Polysaccaride vaccines do not produce a good immune response in children
<2
children <2 should not receive pneumovax 23 until >2
This type of vaccine uses the sugar molecules from the outside layer of encapsulated bacteria and join the molecules to carrier proteins.
conjugated vaccines
what type of vaccines increase the immune response in infants?
conjugated
Prevnar 13 Meningococcal conjugate (Menactra, Menveo)
Can live and inactivated immunizations be given together?
yes
How long is the interval between an antibody containing product (IVIG) and a MMR or a varicella containing vaccine?
minimum of 3 months and can be up to 11 months
What vaccine is given at birth?
hep b
What are options to reduce the risk of a false negative PPD test?
give live vaccine on same day
wait 4 weeks after live vaccine to perform skin test
Can you give multiple live vaccines in the same day?
yes
if not space 4 weeks apart
How much spaced out time?
Vaccine–> __ weeks –> antibody containing product
2 weeks
How much spaced out time?
antibody containing product–> __ weeks –>Vaccine
3 months or longer
A patient is exposed to hep B. They need a vaccine and antibody in the form of immunoglobulin. Can they receive it?
yes - recommended for post-exposure prophylaxis of certain diseases
When patients receive a live vaccine, how should they be counseled in terms for systemic reactions?
mild reactions can occur 3-21 days after vaccine (incubation period)
A patient had a mild reaction to a vaccine.- how do you treat?
Benadryl or hydroxyzine (rx)
Whats the amount in an adult auto injector for epinephrine?
0.3mg (1mg/mL). most adults will require 1-3 doses every 5-15 minutes
What is a precaution for Dtap
Gullian Barre syndrome
Which vaccine has a contraindication to egg allergy?
Yellow fever
Live attenuated flu vaccine
What vaccine series is started at birth?
3 dose hep B started at birth
What vaccine series start at age 2 months?
Prevnar 13 DtaP Hib polio rotavirus
When do live vaccines start? (age)
> 12 months
MMR
varicella
When is the meningococcal vaccine (MCV4, Menactra or Menveo) given?
2 doses: 1 dose at 11-12 and 1 dose at age 16
if not previously vaccinated, first year college students
When is HPV given?
recommended at 11-12y
2-3 doses based on what age started
When is Tdap first given?
> 11y
What is given in pregnancy at weeks 27-36?
Tdap
When is shingrix given?
> 50y
2 doses
2-6 months apart
when is the pneumococcal 23 given?
> 65y
wait 1 year after Prevnar 13
When is Prevnar 13 given?
if immunocompromised
optional for all other adults
What vaccines are required for healthcare professionals?
flu hep b tdap varicella MMR
A patient has sickle cell disease / another cause of asplenia
what vaccines are needed?
H influenza type b (hib)
Prevnar 13, Pneumococcal 23
(before age 65, Prevnar 13x1 dose and 2 doses of 23)
pneumovax 2nd dose 5 years later
Meningococcal vaccines (conjugated - Menactra or Menveo
& serogroup B meningococcal vaccine Bexsero or Trumenba)
If the patient has sickle cell, asplenia, or immunocompromised, how do they take their prevnar and pneumococcal?
chronic renal failure
Chemotherapy
immunosuppressant drugs
systemic steroids >14 days >20mg prednisone daily
> 8 weeks (not one year spaced)
What vaccines are required for diabetes?
Pneumococcal before age 65 (1 dose)
Hep B
What vaccines are required in immunodeficient patients?
LIVE VACCINES C/I!!
```
Pneumococcal vaccines
before age 65, Prevnar 13x1 dose and 2 doses of 23
pneumovax 2nd dose 5 years later
~~~
What vaccines are required in HIV when CD4 count <200
Menactra or Menveo (Meningococcal conjugate)
Hep A
Hep B
When is the flu shot indicated?
> 6 months
When is pneumovax 23 indicated when the patient is 2-64?
heart, lung, liver, diabetes, alcoholic abuse, smokers
all the rest is >65
Brand: Pediarix
generic: DTaP-HepB-IPV
Brand: Adacel, Boostrix
generic: Tdap
Brand: Harvix, VAQTA
generic: Hep A
Brand: Engerix-B, Heplisac
Hep B
A patient comes in and is between the age of 6 months - 8 years and they have not been previously vaccinated. How do they receive the flu shot?
give 2 doses 4 weeks apart
What is the name of the flu vaccine that is egg free?
FluBlok
>18y
What flu vaccine is indicated for >65y?
Trivalent Inactivated (IIV3)
Fluzone High Dose
Fluad
How do you administer FluMist Quadrivalent?
given as 0.2mL divided between two nostrils
Who is FluMist indicated for?
2-49y HEALTHY
this is the live one
Brand: ProQuad
Generic: MMRV
Which vaccine do you store in the fridge or freezer?
MMR
Which vaccine do you store in the FREEZER
due to varicella component - MMRV, Zostavax, oral cholera
give SC
store diluents in room temp or fridge
Brand: Menveo, Menactra
Generic: MCV4 (conjugated meningococcal)
What special population need meningococcal Vaccines?
travelers to Sub-saharan africa (meningitis)
Age 2 months and older that have HIV, aslpenia, sickle cell
lab workers with exposure to N. menigititis
first year college students
military recruits
Who receives MenB (Bexsero, Trumenba)?
Age 10> with high risk
asplenia/sickle cell
lab workers
during an outbreak
Which vaccines do you store in the fridge?
Meningococcal conjugated vaccines (MCV4, MenB) Pneumococcal vaccines Shingrix Rotavirus DTap/ polio
Children <5 years are given a 4 dose series given at age 2,4,6, and 12-15 months of what vaccine?
PCV13
?????????questionable, doesn’t make sense because the book says its given once in their lifetime?
PCV13 and PPSV23 are given hpw
SC or IM
Immunocompromised patients receive PPSV23 how many times?
3
8 weeks after PCV13 at 6-64y, then 5 years apart, then after 65 (at least 5 years apart)
Which vaccine do you not give if there is an allergy to gelatin or neomycin?
varicella containing vaccines
varivax - SC
shingrix - IM
VIRCELLA IS STORED WHERE
FREEZER
A patient is receiving acyclovir for herpes. She needs varivax, what should she do?
stop 24 hours before administration and do not take for 14 days after administraiton
What vaccine can cause a positive reaction to the TB skin test?
BCG
What vaccine has a international certificate of vaccination provided with it? (its yellow)
yellow fever
What vaccines are given SC only
MMR
MMRV
Varicella
Yellow fever
IM OR SC
PPSV23
Intranasal
Flumist
PO
Typhoid (Vivotif)
SC administration
needle size:
degree:
5/8”
45 angle
(IM = 1”, >260, 200 = 1.5”)
