Immunizations Flashcards
how many vaccine-preventable diseases do we currently target?
17
what vaccines are included in the new 2018 schedule?
Hep B
DTaP
Hib
PCV13
MMR
IPV
Varicella
Hep A
what is the causative organism of diptheria?
cornybacterium diptheriae
toxin-mediated disease
what is the hallmark sign of diptheria?
pseumembranous pharyngitis
when do you switch from DTaP to Tdap?
Age greater than 7 years
how is tetanus transmitted?
through open wounds on the skin in dirt
What does DTaP contain and what is the frequency?
Diptheria, tetanus, selected Bordatella pertussis components
5 dose series
Efficacy 80-95% (minimum 3 doses for protection)
how much does immunity wane per year with Tdap?
10-15% per year
approx. 90% efficacy at peak
when should pregnant women receive Tdap?
every pregnancy, optimally at 27-36 weeks gestation
what is the polio vaccine?
killed virus with >99% seroconversion
what kind of vaccine is less immunogenic?
polysaccharide vaccine
What is Prevnar13?
pneumococcal conjugate vaccine
greater than >90% of pneumococcal invasive serotypes
overall efficacy approx. 75%
what are the meningococcal conjugate vaccines?
MenACWY-D (Menactra)
or
MenACWY-CRM (Menveo)
Why do we immunize against HepB?
Becasue the majority of cases are contracted from unknown causes
HepB vaccine has what efficacy and lasts how long?
>90%
>30 years of efficacy
How do you immunize preterm infants <2kg birthweight for HepB?
Give a reduced dose at birth
1st dose at discharge or 1 month of age, whichever is first
don’t count dose at birth as a “dose” for series
When do you give Hepatitis A vaccine?
- chronic liver dz
- travelers to endemic areas
- close contact with international adoptees
- Hep A outbreak
- Routine childhood - 2 doses 6 months apart, starting at 1 year of age
What is the measles vaccine?
live virus
7-12 days after immunization, 5-10% get mild fever, rash
efficacy 97%
if you receive MMR, what is the dosing?
at 1 year of age
booster at 5 years of age (measles coverage)
what is the mumps vaccine?
live virus
Effectiveness is 88%
What is the rubella vaccine?
live virus
97% effective
we do it because congenital rubella is devastating
what is the varicella vaccine?
live attenuated
98% effective for any disease
100% prevention of severe disease
about 90% effective post-exposure if given within 3 days
why are immunizations dropping in the face of immunization laws in 50 states?
exemption provisions you can drive a truck through
religious
personal belief
what major study helped to refute that scumbag Wakefield?
A Population Based Study of MMR Vaccination and Autism, 2002
Denmark 500k+ cohort study
82% had vaccine
no statistically significant correlation at 95 CI
what is the likelihood that you can change the mind of parents who are refusing vaccines?
You can’t - studies show little success
better to target under vaccinated population
Title 14 Medicaid program -
what are some ways we can try to improve immunization rates?
- make exemption process more difficult
- improved enforcement of existing vaccination requirements for school entry
- incentives for vaccinating children on time (reduced insurance rates, tax rebates, or direct payments)
