Immunizations

Question 1

Live Vaccines

Answer 1

[COZY IV RM]

Cholera
Oral Typhoid (Vivotif)
Zoster (Zostavax)
Yellow Fever

Intranasal Influenza (FluMist)
Varicella (Varivax)

Rotavirus
MMR

[Contraindications]

1) Immunocompromised - will cause the disease
2) Pregnancy

Question 2

Polysaccharide Vaccines consideration

Answer 2

cannot be given to < 2 years bc no immune response

PPSV 23

Question 3

Spacing of Vaccines

Answer 3

Live Vaccines:

1) Same day
2) separate by 4 weeks (also for TB skin test)

MMR & Varicella:

1) Vaccine -> 2 weeks -> IVIG / Blood Transfusions
* Takes 2 weeks to obtain immune response from vaccine

2) IVIG / Blood Transfusions -> 3 months -> Vaccine
* Takes 3 months for Antibodies to be removed from body

Question 4

Sickle Cell / Asplenia & Immunodeficiency Pneumococcal Immunizations:

Answer 4

1) Pneumococcal
Age < 65 years = 4 lifetime doses

PCV13, wait 8 weeks
1st PPSV23 before 65 years, wait 5 years
2nd PPSV23, then
3rd PPSV23 after 65 years

2) Meningococcal
* @ Sickle Cell / Asplenia = Bexsero or Trumenba (≥ 10 years)

3) Hib
* @ Sickle Cell / Asplenia

Question 5

Older Adults Immunizations:

Answer 5

Herpes Zoster:
1) Shingrix (Recombinant) given IM
≥ 50 years / 2 doses, 2 months apart
*Give 8 weeks after ZOSTAVAX

2) Zostavax (Live) given SQ
≥ 60 years

Pneumococcal:
1) PPSV23: ≥ 65 years / 1 dose

Question 6

Diabetes

Answer 6

1) PPSV23: < 65 years / 1 dose

2) Hep B: 19-59 years

Question 7

Pneumococcal Vaccines

Answer 7

PPSV23:

1) [1 dose] All ≥ 65 years
2) [1 dose] 2-64 years with Heart, Liver, Lung, Smoker, DM, Alcoholism
3) [2 doses] 2-64 years with Immunocompromised / Asplenia

PCV13:
1) [1 dose] Age ≥ 6 years with Immunocompromised if never received before

Considerations:

1) PCV13 separated PPSV23 by 1 year (8 weeks if Immunocompromised / Asplenia)
2) PPSV23 doses separated by 5 years

Question 8

DTaP

Answer 8

< 7 years (5 dose series)

Question 9

Tdap

Answer 9

Adacel, Boostrix

Question 10

Gelatin or Neomycin Contraindications:

Answer 10

1) Varivax

2) Zostavax brand

Question 11

SQ Vaccines

Answer 11

1) Varicella
2) MMR
3) Zostavax
4) Yellow Fever
5) PPSV23 (IM or SQ)

Question 12

Freezer Vaccines

Answer 12

1) Varicella
2) MMR (or Refrigerator)
3) Zostavax
4) Oral Cholera