Immunizations Flashcards
what must you give before any vaccine?
the most up-to-date Vaccine Information Statement
what is active immunity
when a person builds their own immune response because they survived an infection or received a vaccination
what is passive immunity
when a person is immune because they transferred someone else’s immune system as in giving antibodies from a mother to child
how long after you give a live vaccine should you wait to give any antibodies?
at least 2 weeks
how long do you wait between giving a antibody product and MMR or varicella vaccines? (except zoster)
at least 3 months or up to 11 months (see the PINK book)
why are live vaccines started 12 months after birth?
cuz baby has circulated vaccines
which vaccine can be started at birth?
hep b
when to start inactivated vaccines?
2 months
can you give more than one vaccine at a time ?
YES as many as possible at one time. no contraindications in the US
in the case where you have multiple doses that need to be given for a vaccine at certain intervals, what happens if you delay the interval a little
you are just delaying more protection, but you can vaccinate them after the recommended interval.
can you decrease the time interval of multi dose vaccines?
no usually not. For high risk exposure, you may do so but usually decreasing interval doesn’t allow enough time for immune system to respond
can you give live vaccines on the same day sat the PPD test?
yes inf efact its recommended on the same day because you avoid false negatives
what if a person already got a live vaccine and you want to give them the PPD test?
you have to wait 4 weeks in order to avoid false negatives of the PPD test
what if a person already got the PPD but not the live vaccine yet?
wait 48-72 hours after until the person gets the results and then given them the live vaccine
what are the most common local SE of vaccines?
pain
swelling
redness at site injection
what are systemic adverse reactions to vaccines?
fever malaise myalgias headache loss of appetite
what is the incidence of an anaphylactic reaction to a vaccine?
1 in 500,000
what are anaphylactic reactions usually mediated by?
IgE
what to administer in case of a anaphylactic reaction
epinphrine 1:1000 IM 0.01mg/kg/dose max 0.5mg/dose
who should your report an adverse reaction for vaccines?
FDA
Vaccine Adverse Event Reporting System (VAERS)
which are contraindications to vaccination with live vaccines?
pregnancy and immunosupression
define immunosuppression
20mg daily prednisone daily for at least 14 days
or 2mg/kg x 14 days or longer
when are live vaccines contraindicated for HIV patients?
only if CD4 < 200
when can a pregnant women receive a live vaccine?
never, even 1 month before pregnancy
when can a pregnant women receive an inactivated vaccine?
whenever
what about HPV vaccine and pregnancy?
defer
what about the flu vaccine and pregnacy
yes as long as its not the live vaccine
when should a pregnant woman get her TdAP?
> 2 weeks of gestation and has not had her Tdap booster (Q 10 years)
what if you are allergic to eggs, which vaccines can you not get?
influenza
yellow fervor
if anaphylactic allergy to eggs
what if a person can eat lightly cooked eggs or only gets hives from eating egg containing foods?
can give them the Inactivated form and watch the patient for 30 minutes
is allergy to eggs contraindication to MMR vaccine
no, no logner
Which vaccines can you not get if you are allergic to gelatin or neomycin?
varicella (zostavax & varivax)
MMR
what vaccines can you not give if streptomycin , polymyxin B or neomycin allergies?
inactivated polio vaccine
who should receive the DTaP vaccine?
< 7 yo
Havrix
HepA vaccine
Vaqta
HepA vaccine
two brands of HepA vaccine
Havrix/ Vaqta
engerix-B
hepatitis b vaccine
Recombivax HB
hep B vaccine
Twinrix
Hep A/B vaccien
who gets the Hep A vaccien
> 1 yo
- MSM
- IVDU
- Chronic disease
- travelers
who get the hep B vaccine?
HC workers
- MSM
- multiple partners
- IVDU
- ESRD/ chronic liver disease
dosing schedule for hep b?
0, 1 , 6 months
accelerated twinrix dosing schedule?
days 0, 7, 21, 30 and booster at month 12
for HepA dose given?
1ml if >18yo , if less, see package
for hepB dose given
1ml if > 20yo , if <20, see package
who is indicated for HPV vaccine?
females 9-26 years old, recommend 11-12yo before sexual activity
-males 9-26
dosing schedule for HPV vaccine
0, 1-2 months, 6 months
which is the only HPV vaccine for males?
HPV 4: gardasil
which HPV vaccine for females?
HPV2: Cervarix
afluria
TIV
Flumist
LAIV
agriflu
TIV
fluarix
TIV
flulaval
tiv
fluvirin
TIV
fluzone
TIV
whats the diff between normal flu vaccine and flu zone (high dose)
in 2010 licencse for >= 65 yo but ctaonains 60mcg of each strain instead of 15mcg like the others
what is the diff between normal flu and flu zone intradermal vaccine?
uses a small needle to reduce pain but causes more redness, swelling, itching.
Preg B
who should receive a flu vaccine?
everyone > 6months old
who can get the nasal spray?
2-49 yearls old , healthy, not pregnant, w/o high risk medical conditions
what are the age limits of AFLURIA?
> 9 yo patent only due to report of febrile illness in young children
if < 3 yo , which is the only vaccine you can give?
Fluzone
when is flu season?
60% of peaks occur in february or later
for MMR who is considered generally already immune to it?
people born < 1957
storage of MMRV
freezer
proquad
MMRV
M-M-RII
MMR
menomune
MPS4 meningiococcal
menactra
MCV 4 meningiococcal
menveo
MCV4 meningiococcal
indications for meningiococal vaccine
1 dose age 11-12 and booster at 16-18 1 dose if 13-18 yo 2-55 yo if: -college freshman in dormitories -asplenia -military -traveler -immunodeficiency -lab workders w/ n. meningidits exposure
age restriction menomune?
> 56 yo pts
menactra age?
9months to 55yo
menveo age?
2-55 years old
menomune IM or Sc
SC
mcv 4 IM OR Sc
IM
pneumococcal conjugate
PREVNAR 13
pneumococcal polysaccharide
Pneumovax 23
age limit prevnar
> 6 weeks
age limit pneumovax
> 2 years old
prevnar 13 indications
children younger than 2
50 + adults
19 + if immunocompromised
pneumovax inidcations
65+
19-64 if smoke or asthma
2-64 w/ chronic disease
vivotif special storage
MUST REFRIGERATE CAPSULES
vivotif berna
Typhoid
for what age group DTaP?
6 weeks to 6 years old
for what age group the Tdap?
patients 7-10 who didn’t ge tteh full dose of the Dtap series (give a single dose)
11-64: one dose of Tdap
then Q 10 years a dose of Td
>65: vaccinate if in proximity w/ <12month olds, otherwise optional
pregnancy and TDAP
> 20 weeks gestation get the shot if booster is need
in patients who have never gotten the vaccine, what should you do?
start w/ the TDAP as first dose then the boosters as necessary
when children get varicella vaccine?
12 months and 4 years
varivax
varicella vaccine
zostavax
zoster vaccine
adults that get varivax?
2 doses 4 weeks apart
IM or SC varivax/zostavax?
SC
storage of varivax/zostavx
frozen at -15 degrees: the vaccine
store diluent in the fridge
where do you inject the varivax/zostavax?
SC tissue behind triceps
how much time after reconstituting varivax/zostavax should you inject it?
30 min otherwise discard
