Immunizations Flashcards
types of vaccines, timing and spacing, vaccine ADR, vaccine CI and precautions, special conditions, routine vaccinations, storage, admin
gelatin is derived from
porcine (pig)
active immunity
when persons own immune system creates Abs in response to a vaccine or infection
passive immunity
immunity gained form IVIG or passed from mother to baby in utero
live vaccines are CI in
pregnant and immunocompromised
what are the live vaccines
MICRO-VY
MMR
Intranasal influenza
Cholera
Rotavirus
Oral typhoid
Varicella
Yellow fever
________________________
TB
smallpox
ebola
dengue
polysaccharide vaccine example
pneumococcal polysacharide vaccine (Pneumovax 23)
conjugate vaccine example
pneumococcal conjugate vaccine (Prevnar 20)
meningococcal conjugate vaccine (Menactra)
examples of recombinant vaccines
HPV (Garsadil 9)
recombinant influenza (FluBlok Quadrivalent)
toxoid vaccines examples
tetanus, diptheria
mRNA vaccines example
COVID-19
how long will it take for the body to produce Abs from the MMR and/or varicella vaccines
3-11 months
most live vaccines are not given to pediatric patients aged ____________
<12 months old
If a patient received IVIG or a blood transfusion today, how long would they have to wait to receive a MMR or varicella vaccine
3 months +
If a patient received MMR and varicella vaccines today, how long do they have to wait to receive IVIG or blood transfusions?
2 weeks
after a live vaccine, mild systemic reactions can occur for ______ days
3-21
a minor reaction is not a CI to future vaccines T or F
true!
when is admin of a vaccine and antibody at the same time recommended
post-exposure ppx in rabbies, , Hep A, Hep B, tetanus
what should be administered to a patient undergoing anaphylaxis from a vaccine
epi pen
benadryl
lay flat on back
call 911
CPR possible
record all vital signs
DTaP and any combination of the three are CI in
encephalopathy (coma, dec level of consciousness, prolonged seizure) within last 7 days
GBS hx
Hep B vaccine is CI in
yeast hypersensitivity
HPV is CI in
yeast hypersensitivity
LIAV is CI in
pregnancy
imm supp
anaphylaxis to egg
influenza antivirals in last 5 d
kids with asthma
close contact with imm supp person
all influenza vaccines are CI in
GBS
varicella vaccines are CI in
severe allergic rxn to gelatin or neomycin
yellow fever vaccine is CI in
anaphylaxis to egg
infants and children (30 days to 12 yo) should receive
3 doses of Hep B at birth
starting at 2 months: PCV13m DTaP, Hib, polio, rotavirus
starting at 1 yr: MMR and varicella
polysaccharide vaccines are CI in which age group? what vaccines are in this category?
CI in <2 yo
pneumococcal polysaccharide (Pneumovax 23)
what 5 vaccines should all healthcare workers have
influenza
TDaP
Hep B
varcella
MMR
what three vaccinations are started at 11-12 yo
MMR
HPV
TdaP
what is the schedule for meningococcal vaccine? What are the brand names?
MCV4: Menactra, Menveo, MenQuadfi
2 doses @ 11-12yo and 16 yo
think about how the patient usually goes to college at 18 so meningococcal has to be all set by then
if a patient is entering college and did not receive the two doses of meningococcal vaccine at 11-12 yo and 16 yo, what should they be given?
1 dose of meningococcal vaccine if they are going into college
HPV is ___ doses and recommended start is age ___
3 doses starting at age 11-12
what vaccines should a pregnant patient receive
inactivated influenza
TdaP x1 with each pregnancy
ideally, when should TdaP be given to a pregnant patient
weeks 27-36
what vaccines should a patient receive if they have SCD or another cause of asplenia
Hib
meningococcal (conjugate & serogroup B)
pneumococcal (either PCV 20 x1 or PCV15 x1 then PCV23 8+ weeks later)
what vaccines should older adults receive
shingles for 50+ (2 doses 2-6 months apart)
pneumococcal for 65+ (PCV20 x1 or PCV15 x1 then PCV23 12+ months later)
what is the difference between the pneumococcal vaccine schedule in asplenia/SCD/imm comp compared to older adults/DM?
all of them can receive PCV20 x1
asplenia/SCD/imm comp alternative is PCV15 x1 then PCV23 8+ WEEKS LATER
whereas
older adults/DM alternative is PCV15 x1 then PCV23 12+ MONTHS LATER
what vaccines should imm comp patients receive
no live vaccines
________________
pneumococcal (PCV20 x1 or PCV15 x1 then PCV23 x1 8+ weeks later)
Shingrix (19+ yo) 2 doses, 2-6 months apart
________________
additional vaccines if HIV + : Hep A and B, meningococcal conjugate
what two populations should receive the shingrix vaccine? How does the dosing differ?
50+ yo
19+ yo if immuno comp
dosing is the same! Two doses, 2-6 mo apart
what are considered imm comp conditions
chronic renal failure
nephrotic syndrome
malignancy
HIV infection
SOT
imm sup drugs
influenza vaccination can start at what age
6 months old
if a patient previously had shingles, can they receive shingrix
yes
if a patient had chickenpox (like mom did as a kid) can they receive shingrix
yes
if a patient received Zostavax can/should they get shingrix
yes
past what age is HPV vaccine likely ineffective
26 yo
if a patient received TdaP x1, when should they receive the next dose? Does it have to be TdaP?
10 years
can be TdaP or Td
what patient populations should receive the meningococcal serogroup B vaccine
10+ yo with
asplenia/SCD
during an outbreak
lab workers with N. Men exposure
what patient populations should receive the menincococcal conjugate vaccine?
routine: 2 doses at 11-12yo and 16 yo
special populations at high risk:
travelers to meningitis belt in subsaharan Africa
2 months+ with asplenia/SCD
lab workers w N. Men exposure
first year college students <21yo
military recruits
what are the different meningococcal conjugate vaccines and what age ranges are they safe in
Menactra 9mo-55yrs
MenQuadfi 2+ yo
Menveo 2mo-55yrs
what are the names of the MenB vaccines
Bexsero
Trumenba
Hep B vaccine should be given in
routine vaccination: 3 doses started at birth
if not given at birth: give to all 19-59 yo or 60+ with HIV, imm comp, incarcerated etc.
can Hep A and B be given together?
Yes
given like Hep B (3 dose series at months 0, 1, and 6
what is the vaccine that has Hep A and B
Twinrix
what is the routine Hep A vaccine schedule?
what patient should receive Hep A vaccine if not received in childhood
adults …
traveling to third world countries or housing someone coming from underdeveloped country
liver disease
hemophilia
MSM
IVDU
homeless
HIV
Pediarix =
DTaP-HepB-IPV
TDaP brands
Boostrix
Adacel
Hep A vaccine brands
Havrix
Vaqta
Hep B vaccine brands
Engerix-B
Heplisav-B
Recombivax-HB
HPV9 vaccine brand
Gardasil 9
what are the inactivated influenza vaccines (IIV4)
Fluzone quad
Afluria
Fluarix
FluLaval
Fluzone
what are the LAIV
Flumist (intranasal)
MMR vaccine brand
Prorix
MMR + varicella (MMRV)=
ProQuad
what are the generics and brands of the different pneumococcal vaccines? What classifications are there?
Conjugate
Prevnar 13 (PCV13) - not really used
Vaxneuvance (PCV15)
Prevnar 20 (PCV20)
______________________________________
Polysaccharide
Pneumovax 23 (PCV23)
PCV23 can be given
IM or SQ
Pediarix =
DTaP-HepB-IPV
rotavirus brands and dosing for each
Rotarix: 2 does at 2 and 4 mo
RotaTeq: 3 doses at 2, 4, 6 mo
varicella vaccine brand
Varivax
refrigerated vaccine storage requirements
refrigerator between 36-46F
what vaccines are stored in the freezer and at what temp
varicella
MMRV
cholera
-58 to +5 F
what vaccines are administered SQ only
yellow fever
monkey pox
dengue
small pox
what vaccines can be given IM or SQ
MMR
MMRV
PPSV23
IPV
PPSV23 =
pneumococcal polysaccharide vaccine 23 aka Pneumovax
what vaccines come in oral forms
cholera
rotavirus
typhoid
what vaccines are intranasal
FluMist Quad
SC vaccines
what gauge, needle length, angle and location?
23-25 gauge
5/8th needle
45 degree angle in fatty tissue of tricep
IM
what gauge, needle length, angle and location?
22-25 gauge
1” length
90 degree angle in deltoid
when giving IM vaccines, when should a needle length other than 1” be used?
<130lb - 5/8 to 1”
> 200lb female or >260lb male use 1 1/2”
