Immunizations

Question 1

how many vaccine-preventable diseases do we currently target?

Answer 1

17

Question 2

what vaccines are included in the new 2018 schedule?

Answer 2

Hep B

DTaP

Hib

PCV13

MMR

IPV

Varicella

Hep A

Question 3

what is the causative organism of diptheria?

Answer 3

cornybacterium diptheriae

toxin-mediated disease

Question 4

what is the hallmark sign of diptheria?

Answer 4

pseumembranous pharyngitis

Question 5

when do you switch from DTaP to Tdap?

Answer 5

Age greater than 7 years

Question 6

how is tetanus transmitted?

Answer 6

through open wounds on the skin in dirt

Question 7

What does DTaP contain and what is the frequency?

Answer 7

Diptheria, tetanus, selected Bordatella pertussis components

5 dose series

Efficacy 80-95% (minimum 3 doses for protection)

Question 8

how much does immunity wane per year with Tdap?

Answer 8

10-15% per year

approx. 90% efficacy at peak

Question 9

when should pregnant women receive Tdap?

Answer 9

every pregnancy, optimally at 27-36 weeks gestation

Question 10

what is the polio vaccine?

Answer 10

killed virus with >99% seroconversion

Question 11

what kind of vaccine is less immunogenic?

Answer 11

polysaccharide vaccine

Question 12

What is Prevnar13?

Answer 12

pneumococcal conjugate vaccine

greater than >90% of pneumococcal invasive serotypes

overall efficacy approx. 75%

Question 13

what are the meningococcal conjugate vaccines?

Answer 13

MenACWY-D (Menactra)

or

MenACWY-CRM (Menveo)

Question 14

Why do we immunize against HepB?

Answer 14

Becasue the majority of cases are contracted from unknown causes

Question 15

HepB vaccine has what efficacy and lasts how long?

Answer 15

>90%

>30 years of efficacy

Question 16

How do you immunize preterm infants <2kg birthweight for HepB?

Answer 16

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

Question 17

When do you give Hepatitis A vaccine?

Answer 17

• 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

Question 18

What is the measles vaccine?

Answer 18

live virus

7-12 days after immunization, 5-10% get mild fever, rash

efficacy 97%

Question 19

if you receive MMR, what is the dosing?

Answer 19

at 1 year of age

booster at 5 years of age (measles coverage)

Question 20

what is the mumps vaccine?

Answer 20

live virus

Effectiveness is 88%

Question 21

What is the rubella vaccine?

Answer 21

live virus

97% effective

we do it because congenital rubella is devastating

Question 22

what is the varicella vaccine?

Answer 22

live attenuated

98% effective for any disease

100% prevention of severe disease

about 90% effective post-exposure if given within 3 days

Question 23

why are immunizations dropping in the face of immunization laws in 50 states?

Answer 23

exemption provisions you can drive a truck through

religious

personal belief

Question 24

what major study helped to refute that scumbag Wakefield?

Answer 24

A Population Based Study of MMR Vaccination and Autism, 2002

Denmark 500k+ cohort study

82% had vaccine

no statistically significant correlation at 95 CI

Question 25

what is the likelihood that you can change the mind of parents who are refusing vaccines?

Answer 25

You can’t - studies show little success

better to target under vaccinated population

Title 14 Medicaid program -

Question 26

what are some ways we can try to improve immunization rates?

Answer 26

• 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)