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Immunizations Flashcards

1
Q

While there is no evidence of vaccines causing autism, what is the component that may pose a risk for acquiring autism?

A

Thimerosal

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2
Q

What is the difference between antigen and antibodies?

A

Antigen: non-self substances
Antibodies: Ig that provide immunity and destroy the antigen

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3
Q

What is the difference between active and passive immunity?

A

Active: person producing antibodies through infection or vaccinations
Passive: acquired from someone else (mother to child or IVIG)

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4
Q

Patient populations contraindicated for live vaccines

A

Immunocompromised or pregnancy

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5
Q

Common live vaccines

A

MICRO-VY

MMR
Intranasal Influenza
Chlolera
Rotavirus
Oral Typhoid
Varicella
Yellow Fever

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6
Q

In the case of blood or IVIG infusions, the antibodies may interfere with live vaccine replication. What vaccines should be delayed? How is it different in children?

A

MMR or Varicella should be given minimum 3 months sometimes up to 11 months.

Vaccine → 2 weeks → Ab-containing product

Most live vaccines are given until 12 months of age due to mother antibodies with the exception of rotavirus

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7
Q

How should live vaccines and TB skin test be given?

A

Live vaccines may cause false negative

  1. Give the live and TST on the same day
  2. Wait 4 weeks after a live vaccine to preform the TST
  3. Administer the TST first, wait ≥24 hrs then give live
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8
Q

How should you space out live vaccines?

A

Can be given on the same day or 4 weeks apart (except PO rotavirus or typhoid)

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9
Q

Resources for vaccines

A
  1. FDA
  2. ACIP
  3. CDC/ MMWR and Pink Book
  4. VIS (for patients)
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10
Q

Medications used to resolve mild vaccine allergies

A

Diphenhydramine or hydralazine

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11
Q

Medications used to resolve severe vaccine allergies

A

Prefilled epi auto injectors
Diphenhydramine

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12
Q

Vaccinations recommended for infants and children

A
  1. 3 doses of hep B started at birth
  2. RSV if mother is not vaccinated
  3. At 2 months, PCV 15 or 20, DTaP, Hip, polio, rotavirus
  4. At ≥12 months, Varicella and MMR

Avoid PPSV23 (polysaccharide vaccine) before 2 years

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13
Q

Vaccine recommendations for HCP?

A
  1. Annual flu
  2. Hep B, Varicella, MMR if no immunity from blood test
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14
Q

Vaccine recommendations for adolescent and young adults?

A
  1. MenACWY (Menveo,, MenQuadfi): 2 doses (11-12 yrs and 16 yrs) or 1 dose (college)
  2. HPV at 11-12 years
  3. Tdap at 11-12
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15
Q

Vaccine recommendations for sickle cell and asplenia

A
  1. Hib
  2. PCV20 once or PCV 15 then PPSV23 ≥8 weeks later
  3. MenACWY
  4. MenB
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16
Q

Vaccines for pregnancy

A
  1. Live are CI
  2. Inactivated flu
  3. RSV at 32-36 weeks
  4. Tdap at 27-36 weeks
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17
Q

Vaccines for immunodeficiency

A
  1. Live are CI
  2. PCV20 once or PCV 15 then PPSV23 ≥8 weeks later (19-64)
  3. Herpes zoster (Shingrix): ≥19 yrs, 2 doses 2-6 months apart

HIV infections: MenACWY, Hep A, and Hep B

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18
Q

Vaccines for older adults

A
  1. HZV ≥50 yrs (2 doses 2-6 months apart)
  2. PCV20 once or PCV 15 then PPSV23 12 months later (≥8 weeks if immunocompromised)
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19
Q

Vaccines for diabetes?

A
  1. PCV20 once or PCV 15 then PPSV23 12 months later (≥8 weeks if immunocompromised)
  2. Hep B ≥60 if not previously vaccinated
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20
Q

How often should Tdap be administered

A

10 years

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21
Q

How is Shingrix administered

A

≥50 years or ≥19 if immunocompromised

2 doses, 2-6 months apart (1-2 months if immunocompromised)

Vaccinate even if patient has had Zostavax or chickenpox

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22
Q

What age can COVID-19 vaccines be given?

A

≥12yrs

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23
Q

DTaP

A

Daptacel, Infanrix

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24
Q

DTaP-HepB-IPV

A

Pediarix

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25
Q

Tdap

A

Adacel, Boostrix

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26
Q

When is DTaP recommended?

A

5 doses (2,4,6,15-18 months and 4-6 yrs)

Children under 7

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27
Q

When is Td or Tdap recommended

A
  1. Pregnancy
  2. Close contact of infants
  3. HCP
  4. Wound prophylaxis if more than 5 yrs since last shot
28
Q

Hib

A

ActHIB, Hiberix, PedvaxHIB

29
Q

Hep A vaccines

A

Harris, Vaqta

30
Q

Hep B vaccines

A

Engerix-B, Heplisav-B, Recombivax HB

31
Q

Hep A and B

32
Q

Who is Hep A recommended?

A

Liver disease, MSM, HIV, travelers

33
Q

When is Hep B recommended?

A

Within 24 hrs (3 doses)

Adults all ages if not received: Liver disease, HIV, HCP, dialysis, diabetes (blood exposures)

34
Q

Describe the dosing of HPV vaccine?

A

Before 15: 2 doses (months 0 and 6-12)
15 or older: 3 doses (months 0, 1-2, and 6)

35
Q

Live flu vaccines

36
Q

Egg free flu vaccines

A

Flucelvax, Flublk

37
Q

Indications for Fluzone high dose

38
Q

Flu vaccines approved for ≥6 months

A

Afluria, Fluarix, FluLaval, Fluzone

39
Q

How should MMR vaccine be stored?

A

MMRII: refrigerator or freezer
MMRV: freezer

Store diluents at room temperature or in the refrigerator

40
Q

MenACWY

A

MenQuadfi
Menveo

41
Q

MenB

A

Bexsero, Trumenma

42
Q

MenABCWY

43
Q

PCV20

A

Prevnar 20

44
Q

PCV 15

A

Vaxneuvance

45
Q

PPSV23

A

Pneumovax 23

46
Q

How is PPSV23 given?

47
Q

RV1

48
Q

RV5

49
Q

When should rotavirus be administered?

A

Rotarix: 2 doses (2 and 4 months)
Rotateq: 3 doses (2,4, and 6 months)

Do not initiate after 15 weeks of age

50
Q

RSV vaccines

51
Q

RSV monoclonal antibitodies

A

Nirsevimab (Beyfortus)
Palivizumab (Synagis)

52
Q

Indications for RSV vaccine vs antibodies

A

Vaccine: pregnancy or infants <6 months, ≥60 yrs at increased risk

Antibodies: neonates and infants <8 months born during or entering first RSV season (Beyfortus)

Palivizumab: premature infant or infants high risk for hospitalization

53
Q

MMRV

54
Q

Varicella

55
Q

Zoster

56
Q

Counseling for Varivax

A

Stop antivirals 24 hrs prior and don’t restart til 14 days after

57
Q

How is Varivax given

A
  1. Freezer
  2. Reconstitute immediately and administer within 30 minutes
  3. Don’t give if sensitive to gelatin or neomycin
  4. SC or IM
58
Q

What vaccines can cause positive TB test?

59
Q

Oral vaccines

A

Rotavirus, Typhoid, cholera

60
Q

How is RaAvert dosed in patient having not received vaccine?

A

4 doses plus 1 dose of rabies IG with first dose

61
Q

Vaccines that must be stored in the freezer?

A

Varicella, MMRV, MMRII (or fridge)

62
Q

SC only vaccines

A

Yellow fever
Dengue
Small and monkeypox

63
Q

IM or SC vaccines

A

MMRII, MMRV, Varicella, PPSV23, IPV

64
Q

What combo product contains polio vaccine

A

DTaP-HBV-IPV (Pediarix)

65
Q

IN vaccines

66
Q

Needle length for IM

A

Adults: 1 inch
Males >200 or Females >250 lbs: 1.5 inch

67
Q

Needle for SC

A

23-25 gauge, 5/8”

NAPLEX Prep (2 decks)

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