Immunizations

Question 1

Vaccine

Answer 1

whole or fractionated microorganisms

administration causes recipients immune system to manufacture antibodies directed against microbe from which the vaccine was made

Question 2

Toxoid

Answer 2

bacterial toxin that has been changed to a nontoxic form

causes immune system to manufacture antitoxins

Question 3

Vaccination

Answer 3

any vaccine or toxoid

Question 4

killed vaccines:

Answer 4

composed of while killed microbes or isolated microbial components

Question 5

live attenuated vaccines

Answer 5

composed of live microbes that have been weakened or rendered avirulent

dangerous in immunocompromised patients - unable to mount immune response against virulent organism

Question 6

immunization

Answer 6

more inclusive term than vaccination

refers to both active immunity and passive immunity

Question 7

active immunization

Answer 7

response to infection or to administration of vaccine or toxoid

results in endogenous production of antibodies

takes weeks or months to develop but is long lasting

Question 8

passive immunization

Answer 8

conferred by giving patient preformed antibodies (immune globulins)

protects immediately but lasts only as long as antibodies remain in body

Question 9

MMR Vaccine: overview and efficacy

Answer 9

combination product composed of three live virus vaccines

administration incudes synthesis of anybody production against MMR

efficacy: 95%

Question 10

MMR vaccine: adverse effects

Answer 10

Mild: local soreness, erythema, swelling, transient rash; fever; pain, stiffness, and swelling in joints;

Severe: transient thrombocytopenia; anaphylactic reactions

Question 11

MMR: precautions and contraindications

Answer 11

Contraindications:
- pregnancy,
- severe immunodeficiency,
- moderate-severe febrile illness

Precautions:
- children with hx of thrombocytopenia, anaphylactic reactions to gelatine or neomycin;
- can be given to kids with mild febrile illness;
- postpone vaccination in kids who receive products containing immune globulins

Question 12

TDaP: overview and efficacy

Answer 12

produces antibodies against diphtheria, tetanus, and B.pertussis

immunization reduces risk of disease by 80-90%
- protection begins after 3rd dose and persists for 4-6 years against pertussis, and 10 years against diphtheria and tetanus

Question 13

TDaP: adverse effects:

Answer 13

mild: Low fever, fretfulness, drowsiness, anorexia, local reactions (pain, swelling, redness)

mild: persistent and uncontrollable crying; fever; convulsions with or without fever; shocklike state

severe: encephalopathy within 3 days
- develop chronic neurological malfunction later in life

Question 14

TDaP: Precautions and Contraindication

Answer 14

contraindicated if prior vaccination resulted in:
- immediate anaphylactic reaction
- encephalopathy within 7 days of vaccination

administer with caution if prior vaccination resulted in:
- shocklike state
- fever occurring within 48h
- persistent and uncontrollable crying for 3+ h occurring within 48h of vaccination
- seizures with or without fever occurring within 3 days of vaccination

Question 15

Poliovirus vaccine: overview and effiacy

Answer 15

inactivated vaccine

between 97.5 and 100% of children develop antibodies against poliovirus type 1,2 and 3
- develops after 2+ doses and lasts many years

Question 16

Poliovirus vaccine: Adverse effects

Answer 16

• local soreness
• allergic reactions in children allergic to streptomycin, neomycin and bacitracin

Question 17

Varicella virus vaccine: overview and efficacy

Answer 17

composed of live attenuated varicella viruses

two dose series ensures full protection in 99% of patients
- among those who do get chickenpox, fewer lesions, lower fever, and quicker recovery

Question 18

Varicella virus vaccine: adverse effects

Answer 18

• erythema, soreness, swelling at inj. site
• fever
• mild local varicella-like rash with few lesions
• theoretical transmission of virus to others after vaccination (LAV)

Question 19

Varicella virus vaccine: Precautions and contraindications

Answer 19

contraindicated for:
- pregnant patients
- patients with certain cancers: leukemias, lymphomas
- individuals with hypersensitivity reactions to neomycin or gelatine
- immunocompromised patients - HIV infection, congenital immunodeficiency, ppl taking immunosuppressive drugs

precautions:
- avoid salicylates for 6 weeks d/t risk of Reye’s syndrome

Question 20

Haemophilus influenzae type B: overview and efficacy

Answer 20

conjugated with a polysaccharide from H.influenzae to either a tetanus toxoid or outer membrane protein from meningitidis to enhance antigenicity

decreases risk of disease by 88-98%

Question 21

Haemophilus influenzae type B: adverse reactions

Answer 21

local reactions: swelling, erythema, warmth and tenderness at inj. site

fever, crying, diarrhea, vomiting

Question 22

HepB Vaccine: Overview and Efficacy

Answer 22

Contains hepatitis B surface antigen - primary protein in viral envelope (killed vaccine)

Greater than 85% of vaccinated pts are protected after second dose and more than 90% protected after third dose

Duration has not been precisely determined - estimated 5-7 years

Question 23

HepB Vaccine: Adverse Effects

Answer 23

soreness at injection site, mild to moderate fever

Question 24

HepB Vaccine: Contraindications

Answer 24

prior anaphylactic reaction to hepB vaccine or to baker’s yeast

Question 25

Pneumococcal Conjugate Vaccine: overview

Answer 25

contains pneumococcal capsular polysaccharide antigens that have been conjugated to a protein carrier (nontoxic variant of diphtheria) - increases antigenicity esp. in infants

antigens are form serotypes of streptococcus pneumoniae that cause majority of pneumococcal infections in children under 6

Question 26

Pneumococcal Conjugate Vaccine: Adverse Effects

Answer 26

drowsiness, loss of appetite, erythema, tenderness at inj. site

swelling, mild fever

high fever

majority become irritable or fussy

Question 27

Meningococcal Conjugate Vaccine: Overview and Efficacy

Answer 27

1. mentactra - tetravalent and active against 4 serotypes;
2. Menveo - conjugated to different diphtheria protein

do not know efficacy at preventing disease, but vaccine is highly immunogenic

Question 28

Meningococcal Conjugate Vaccine: Adverse Effects

Answer 28

local pain, headache and fatigue, local redness, swelling and induration

Question 29

Rotavirus Vaccine: Overview

Answer 29

two live attenuated vaccines available; administered PO

Question 30

Rotavirus Vaccine: Adverse effects

Answer 30

small risk of intussusception

Question 31

HPV Vaccine: Overview

Answer 31

• 9-valent vaccine designed to stimulate production of neutralizing antibodies directed at 9 types of HPV
• consists of virus-like particles which are empty spheres composed of viral capsid proteins (killed vaccine)

Question 32

HPV Vaccine: Adverse Effects

Answer 32

• inj. site reactions - pain, erythema, swelling, itching
• fainting in teenage girls
• few cases of deaths and GBS, but causal link not established

Question 33

HPV vaccine: contraindications

Answer 33

pregnancy

• note: breastfeeding women can receive the vaccine