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NAPLEX > Immunizations > Flashcards

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)
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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)
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3
Q

Common Live Vaccines

A

MICRO-VY

  • MMR
  • Intranasal Influenza (FluMist)
  • Cholera
  • Rotavirus
  • Oral Typhoid
  • Varicella
  • Yellow Fever
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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
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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
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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
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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
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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)
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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)
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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)
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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
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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
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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
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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
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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
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16
Q

Meningococcal

A
  • Serogroup B (Bexsero, Trumenba) - give with asplenia, exposure to N. meningitidis, taking certain biologics (given for 10-25 yo)
  • Conjugate vaccines (Menactra, Menveo) - same groups as above, HIV, travelers/residents to countries where disease is common (Sub-Saharan meningitis belt in Africa), military recruits, first year college students living in dorms
  • For menveo, both vial and liquid contain vaccine, must use those supplied
  • Vaccination required in Saudi Arabia during Hajj and Umrah pilgrimage time periods
  • Store in fridge, give IM
17
Q

Hep B Vaccines

A
  • Sexually active adult if not in long-term monogamous relationship, diabetics 19-59 yo (possibly 60 yo+ with doctor recommendation), household contact with infected person, IV drug abusers, patients with HIV or chronic liver disease
  • Can give alone (Engerix-B, Recombivax HB, Heplisav-B) or with Hep A (Twinrix)
  • Store in fridge, given IM, shake before administration
  • *Heplisav-B only approve for 18 yo+**
18
Q

Hep A Vaccine

A
  • Adults traveling to underdeveloped countries outside the US, household with newly adopted children from moderate to high-risk countries, liver disease, hemophilia, MSM, IVDA, homeless, HIV
  • Given alone (VAQTA, Havrix) or with Hep B (Twinrix)
  • Store in fridge, given IM, shake before administration
19
Q

DTaP

A
  • With HepB/IPV: Pediarix
  • For children <7 yo
  • Store in fridge, given IM, shake before administration
20
Q

Tdap

A
  • Adacel or Boostrix
  • Wound prophylaxis: for deep/dirty wounds, revaccinate if >5 years since last dose
  • Give if never given previously as an adult, then Q10y as routine booster
  • Recommended for each pregnancy and those in close contact with infants <12 mo if not given in past 5 years
  • Store in fridge, given IM, shake before administration
21
Q

Hib Vaccines

A
  • ActHIB, Hiberix
  • Given to those with asplenia
  • Store in fridge, given IM, shake before administration
22
Q

MMR-Containing Vaccines

A
  • ProQuad contains varicella
  • Give 2 doses to healthcare workers, HIV patients with CDC =<200 at least 6 months, international travelers
  • Live vaccine therefore DON’T use in preggo/immunocompromised
  • Store in freezer if contains varicella, diluents go in fridge or room temp, give SQ
23
Q

RotaVirus

A
  • Rotarix or RotaTeq
  • Number of doses depends on vaccine used
  • Store in fridge
  • Given orally
24
Q

Varicella-Containing Vaccines

A
  • Varicella alone = Varivax; MMRV = ProQuad
  • Live, so don’t give in preggos/immunocompromised
  • CI in allergies to gelatin or neomycin
  • For chickenpox
  • Give 2 doses to anyone without immunity
  • Stop antivirals (valacyclovir, acyclovir, famiciclovir) 24 hours before vaccine administration and stay off for 2 weeeks
  • Store in freezer, reconstitute immediately upon removing and inject ASAP (within 30 minutes), give SQ
25
Q

Rabies Vaccines

A
  • RabAvert
  • Given preventatively for high risk of exposure (3 doses) or post exposure with rabies immunoglobulin (4 doses total)
  • Store in fridge, reconstistute with diluent, give IM

NAPLEX (59 decks)

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