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immunizations Flashcards

1
Q

live vaccines are CI in

A

pregnant and immunocompromised patients

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2
Q

live vaccines

A 
C cholera
O oral typhoid
Z zostavax
Y yellow fever
I Intranasal flu
V varicella 
R Rotavirus
M MMR
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3
Q

increasing the interval between a vaccine series does what

A

it doesnt diminish the effectiveness of the vaccine but may delay protection

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4
Q

decreasing the interval between a vaccine series does what

A

interferes with antibody response and protection

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5
Q

antibodies/ IVIG can interfered with ___ vaccines

A

live, like MMR usually a waiting period

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6
Q

waiting period for MMR and varicella vaccines such as varivax and MMRV is 3-11 months for ___ vaccines

A

live

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7
Q

vaccine given at birth

A

hep b

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8
Q

most live vaccines witheld until ___ years of age accept

A

1 year, rotavirus

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9
Q

inactivated vaccines are started when a baby is __ onths

A

2, except hep b which is given at birth

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10
Q

tubercullin skin test also called PPD test interaction with ___ vaccines can cause a ___ negative

A

false

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11
Q

how to reduce risk of false negative with TB test and live vaccine

A

give live vaccine on same day as tb test
wait 1 month after live vaccine for tb test
administer skin test first, wait 48- 72 hours to get result then give live vaccine

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12
Q

if live vaccines arent given on the same day, how long apart

A

4 weeks ( 1 month )

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13
Q

if vaccine requires more than one dose series can be ___ but not ___

A

extended but not shortened

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14
Q

if patient has an adverse reaction to a vaccine report it to

A

vaers

fda’s vaccine adverse event reporting system

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15
Q

live vaccines can cause mild systemic reactions that can occur __ - __ days after the vaccine is given

A

3-21 days

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16
Q

minor allergic reaction tx

A

benadryl or hydroxyzine

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17
Q

severe allergic reaction tx

A

anaphylaxis, epinephrine

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18
Q

epi pen is IM or SQ

A

IM

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19
Q

how many 0.3mg auto injectors should be available in the pharmacy

A

3

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20
Q

most adults will require how many doses of epi for severe allergic reaction

A

1-3 doses of 0. 3mg every 5-15 min

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21
Q

can you give a vaccine if the patient has a slight fever

A

yes

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22
Q

can you give a vaccine if the patient is taking antibiotics

A

yes

exceptions :varicella, zoster, oral typhoid

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23
Q

can you give a vaccine if the patient has had a previous local skin reaction

A

yes

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24
Q

can you give a vaccine if the patient has immunosupressed person in the household, recent exposure to the disease or convalesence

A

yes

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25
can you give a vaccine if the patient has a family history of adv events to the vaccine
yes
26
CI for Hep B vaccine (recombivax HB) and HPV (gardisil)
yeast!
27
avoid the live flu vaccine in what patient
asthma patients
28
varicella CI in
gelatin or neomycin allergy
29
what age is flu shot recommended
6 months
30
infants and children vaccines
3 dose hep b started at birth other series started at 2 months: prevnar 13, DTaP, Hib, polio, rotavirus live vaccine series started at 1 year: MMR and Varicella no polysaccharide vaccines before age 2
31
health care professional vaccines
``` annual flu Hep B Tdap Varicella MMR ```
32
Adolescents and YA
Meningococcal (MCV4, Menactra or Menveo) - 2 doses: 1 dose at 11-12 yo and 1 dose at 16 - first year college students (if not previously vaxed): 1 dose) -HPV vaccine (gardisil) age 11-12 2-3 doses depending on starting age Tdap first dose at age >11
33
sickle cell disease and other causes of asplenia (damaged or missing spleen) vaccinations
H. influenzae type b (Hib) vaccine Pneumoccocal vaccines (prevnar 13 and 23) - before age 65: 1 dose of prevnar 13 (if not received previously) and 2 doses of pneumovax 23 - give prevnar 13 first then 23 8 weeks later, then 23 again 5 years later Meningococcal vaccines - meningococcal conjugate vaccine (menactra or menveo) - serogroup b meningococcal vaccine (bexsero or trumenba)
34
pregnancy vaccines
live vaccines are contraindicated flu vaccine can be given in any trimester tdap needs to be given once in every pregnancy (3rd trimester is optimal)
35
diabetes vaccines
pneumococcal vaccine before age 65: 1 dose of pneumovax 23 hep b: age 19-59 (blood/needle protection vaccine)
36
causes of immunodeficenicy
chemotherapy/bone marrow transplant drugs strong immunosupressant (etanercept, infliximab) transplant drugs (tacrolimus, cyclosporine) hiv w/ cd4 count <200 (aids) systemic steroids for at least 2 weeks at 20 mg or more or 2 mg/kg prednisone daily/ equivalent chronic renal failure
37
steroid dose to be immunosuppressed
1) 2 weeks or more | 2) 20 mg or 2mg/kg prednisone/ equivalent daily
38
Tdap starts at what year
>11 years old
39
shingrix for all adults age
50 and older 2 doses 2-6 months apart wait 8 weeks (2 months) after zostavax
40
HPV indicated for adults less than ___and up tp ___
26 and less | and up to 45
41
age for pneumovax23
65
42
pneumovax 23 before age 65 (1 dose) if:
heart, lung, liver disease, diabetes, alcohol abuse, smoker
43
prevnar 13 is for any patient ___ or older who are immunocompromised/asplenic
6 or older
44
meningococcal serogroup b vaccines (bexsero, trumenba) give if
``` complement component deficiency raking eculizumab (soliris) asplenia microbiologist with exposure to N. Meningitidis serogroup b outbreak exposure ```
45
conjugate vaccines for meningococcal (menactra, menveo) give if
``` HIV travelers/residents to countries in which the disease is common military recruits first year college students in dorms if not up to date ```
46
Hep B (engerix B, recombivax HB, heplisav b) who gets blood virus twinrix is hep b with hep a
- sexually active adults not in monogomas relationship - diabetes age 19-59 - household contact with infected patient - iv drug users - HIV or chronic liver disease
47
hep a vaccine who gets it (havrix, vaqta) twinrix is hep a and b virus is fecal oral
``` adults traveling to undeveloped countries outside of the US household members and other close contacts of adopted children newly arriving from countries with moderate-high infection risk liver disease hemophilia men who have sex with men iv drug users homeless HIV ```
48
HIV hep a b or both
both
49
liver disease hep a b or both
both
50
diabetes hep a b or both
hep b
51
iv drug users hep a b or both
both
52
homeless hep a b or both
hep a
53
men who have sex with men hep a b or both
hep a
54
sexually active not in monogamous relationship hep a b or both
hep b
55
Dtap for peds have 3-5 times more __
diptheria
56
Dtap is for children younger than ___
7
57
dtap-Hepb-IPV:
pediarix
58
Dtap is how many doses of childhood vaccine
5 doses
59
Dtap series ends at how old
6
60
Tdap booster typically given at age
11 or greater if not previously received
61
wound prophylaxis with td or tdap
for deep dirty wounds | revaccinate with td or tdap if its been more than 5 years since last dose
62
must be how hold to receive a tdap shot
7
63
tdap / td boosters given every __ years
10
64
haemophilus influenzae type b or Hib vaccine is given to patients with
asplenia
65
Hib is also a routine ___ vaccine
childhood
66
you can give hep a to anyone who __
wants it
67
hep a and b are routine childhood __-
vaccines
68
hep b is started
within 24 hours after birth
69
patients with ESRD and incarcerated people get ___
hep B vaccine
70
heplisav-b is hep b vaccine for what age
age 18 or older (2 dose series)
71
recommended age for gardasil 9 (HPV 9)
age for gardisil 9-26 recommended 11-12 CI with severe yeast allergy
72
gardisil is fda approved up to age
45
73
2 doses of hpv is age
9-14
74
3 doses of hpv is age is
15 or greater
75
dosing schedule for gardisil
2 doses: come back 6-12 months later | 3 doses: 2nd dose=1-2months, 3rd dose: 6months
76
patients age 6months to 8 years getting their first flu vaccine are to receive what
2 doses 1 month apart
77
flublok is a ___ free product approved for what age
egg | 18 and older
78
do not administer the live influenzia vaccine (flumist) to a patient with what allergy
egg | or pregnant patient
79
flu vaccines indicated for patients 65 or older
fluzone HD fluzone HD QUAD and fluad
80
live=
SQ
81
not live =
IM
82
flumist age
2-49 | half dose in each nose
83
pcv13
prevnar 13 CONJUGATED must know
84
PPSV23
pneumovax 23 (polysaccharide) must know
85
heplisav b how many doses
2
86
engerix b and recombivax hb how many doses
3
87
if patient already has hep b its too late to give them the
hep vaccine
88
only vaccine that can be in the freezer or fridge
MMR (measles mumps rubella)
89
no mmr for what allergy
neomycin or gelatin allergy
90
do not give MMR (live vaccine) in
pregnancy or immunocompromised esp HIV patients
91
MMR+varicella is called
proquad MMRV
92
Proquad is in the ____
freezer
93
when is varicella vaccine given
1 year or older , 2 doses
94
shingles occurs on __ side of the body
one side, (back moving to front)
95
rotarix is rotavirus vacccine whats special about it
live and oral | given in infants
96
typhoid which is live which isnt | only for travelers
live is oral (vitotif berna) | not live is IM typhim vi
97
yellow fever is a ___ vaccine
live and travelers vaccine given through mosquitos use DEET
98
twinrix age
greater than 18
99
varicella is in the
freezer
100
fridge temps
2-8 c. | 36-48 f.
101
freezer temp
- 50 to -15 c. | - 58 to 5 f.
102
varivax needs to be given right ___
away after reconstituion
103
healthy 66 year old, doctor wants patient to get prevnar 13 and pneumovax 23 whats the squence
prevnar 13 first then 23 one year later
104
age for menB vaccine
10-25 | sickle cells gets menB

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