Immunizations Flashcards
1
Q
Polysaccharide Vaccine
A
- Inactivated vaccine made from outside layer of encapsulated bacteria
- Inadequate immune response in children <2 yo
- Ex: PPSV 23 (Pneumovax)
2
Q
Conjugate Vaccine
A
- Use polysaccharide molecules from outside layer of bacteria and join them to carrier proteins
- Increased immune response in infants
- Ex: PCV 13 (Prevnar)
3
Q
Common Live Vaccines
A
MICRO-VY
- MMR
- Intranasal Influenza (FluMist)
- Cholera
- Rotavirus
- Oral Typhoid
- Varicella
- Yellow Fever
4
Q
TST
A
- Tuberculin skin test, aka purified protein derivative (PPD)
- If live vaccine given, must wait 4 weeks to administer skin test
- Recommend to give TST first, wait 48-72 hours to get result, then give vaccine
5
Q
Vaccines for Infants/Chilren
A
- 3 dose Hep B at birth (within 24 hours)
- Prevnar 13, DTaP, Hib, polio, rotavirus at 2 months
- Live vaccines start at 12 mo old or older: MMR, varicella
- No polysaccharide =< 2 yo
6
Q
Vaccines for HCP
A
- Annual influenza
- Hep B if no evidence of series completion or blood test showing insufficient immunity
- Tdap: 1 dose every 10 years
- Varicella if no vaccination or previous chickenpox infection
- MMR if no history of vaccine or insufficient immunity
7
Q
Vaccines for Adolescents/Young Adults
A
- Meningococcal (MCV4: Menactra, Menveo): 1 dose at 11-12, 1 dose at 16, 1 dose if first-year college students in group housing
- HPV: recommended for 11-12 years old (with age, number of doses increases from 2 to 3)
- Tdap: first dose at >11 yo
8
Q
Vaccines for Sickle Cell Disease/Asplenia
A
- H.influenzae type b (Hib)
- Pneumococcal (13 and 23): <65 yo - give 13 first, wait 8 weeks, then 2 doses of 23 (5 years apart)
- Meningococcal vaccines: 4 serogroups and serogroup B (Bexsero or Trumenba)
9
Q
Vaccines for Preggos
A
- NO LIVE VACCINES (CI)
- Inactivated flu vaccine at any trimester
- 1 Tdap with each pregnancy (weeks 27-36 optimally)
10
Q
Vaccines for Older Adults
A
- Shingrix for 50 yo+, 2 doses given 2-6 mo apart
- Pneumococcal for 65 yo+: 23 given once or 13 given once beforehand if immunocompromised (timing between depends on immunocompromised)
11
Q
Vaccines for Immunodeficiency
A
- NO LIVE VACCINES (CI)
- Pneumococcal: Before 65 - give 13 once, wait 8 weeks, then give 23 twice (5 years between)
- If HIV CD4 < 200: Meningococcal conjugate (Menactra or Menveo), Hep A and B vaccines
12
Q
Influenza
A
- Recommended annually for all patients >= 6 mo
- Trivalent (Fluad): recommended for 65 yo+-
- Quadrivalent: Afluria/Fluarix/FluLoval/Fluzone (approved for various ages), Flucelvax (approved 4yo+, egg-free), Flublok (approved 18 yo+, egg-free), Fluzone High-dose (approved 65 yo+)
- FluMist: Quadrivalent, live nasal mist, approved for health patients 2-49 yo, divided between two nostrils
- Give vaccine as soon as available
- Store in fridge
13
Q
Shingles
A
- Vaccinate all adults over 50 yo even if they had shingles/chickenpox or Zostavax previously
- 2 dose series, 2nd dose given 2-6 mo after the first
- Shingrix, do not freeze, given IM
14
Q
HPV
A
- Give to adults =< 26 yo if they didn’t complete series (indicated up to 45 yo)
- Recommended for 11-12 yo (may start as young as 9 if history of sexual abuse)
- <15: 2 doses, >15: 3 doses
- Store in fridge, given IM, shake before administration
- Caution for fainting, give to seated patients
15
Q
Pneumococcal
A
- Give PPSV 23 to all adults 65 yo+, 1 dose 2-64 yo (need heart, lung, or liver disease, diabetes, alcohol abuse, or smoke), 2 doses 2-64 yo if immunocompromised
- Give PCV13 in 6 yo+ immunocompromised patients (if not received before, optional for adults 65 yo+
- Store in fridge, shake prior to use, PPSV can be given IM or SQ