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Neonatal Pharmacology > Immunizations > Flashcards

Immunizations Flashcards

(75 cards)

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1
Q

Preemies should receive their immunizations when?

A

At same Chronological age as term infants

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2
Q

True/False: Preemies have lower absolute primary antibody responses vs term babies?

So, they need what?

A

True–despite this, many achieve adequate protection

Repeated doses (like terms)

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3
Q

When should HBV and HBIG be given to a baby of an HBsAg positive mom?

A

from birth-12 hours of life

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4
Q

When should HBV be given to a baby of an HBsAg neg mom?

A

Birth-Discharge (2 months)

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5
Q

What should be given to a baby of a mother with unknown HBsAg status?

A

HBV for sure + HBIG (if <2000 gms w/in 12 hrs) unless mom’s status can be determined.
(if >2000 gms have up to 7 days to verify status before HBIG needs to be given)

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6
Q

True/False: Infants respond to Hep B Virus w/high immunogenic effects when infected during delivery or household contact w/those infected.

A

True

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7
Q

___% of kids who contract Hep B–>chronic Hep B w/significant Liver dz.

A

90%

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8
Q

___% of mothers w/Hep B aren’t receiving tx that would prevent infection of their NB

A

20%

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9
Q

Of infants born to mom’s who are Heb B +, ___-___% would NOT become infected if given HBV + HBIG w/in 24 hrs.

A

85-95%

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10
Q

Do single dose HBV contain Thimerasol?

A

No

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11
Q

In preterm or LBW babies, does the birth dose of Hep B count towards their full course?

A

No, does not count as 1st dose.

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12
Q

What are the most frequently reported s/e’s of HepeB vaccine?

A

Fever

Pain at injection site

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13
Q

Is Anaphylaxis common w/HBV?

A

No

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14
Q

HBIG provides what type of immunity?

A

Passive immunity to HepB.

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15
Q

Which infant’s are given HBIG, why?

A

Those w/HBsAg + moms

They have high risk of being infected and becoming chronic carriers.

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16
Q

How is HBIG prepared?

A
  • From Hyper-immunized Donors whose plasma is known to contain a high concentration of Anti-HBs (high aby titers)
  • It is pooled
  • All donors are HBsAg neg and HIV aby neg
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17
Q

What % of infants given HBV & HBIG w/in 1st few months do NOT become carriers?

A

94%

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18
Q

What are the s/e’s of HBIG?

A

Pain -injection site

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19
Q

Synagis (Palivizumab) is a __________ antibody that inhibits ____ replication by binding to the ___ glycloprotein on the surface of the virus to keep it from invading the lower respiratory tract.

A

Monoclonal antibody
RNA replication
F-glycoprotein

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20
Q

Synagis reduces RSV-related hospitalizations by ____%?

A

55%

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21
Q

The mean T2 of Synagis is?

A

~20 days

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22
Q

Adequate titers of Synagis last about?

A

1 month

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23
Q

Does synagis interfere w/vaccines?

A

No

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24
Q

RSV is transmitted through _____ to _____ migration beginning in the ______ respiratory tract and migrating to the _____ respiratory tract

A

cell to cell
Upper
Lower

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25
Synagis blocks:
Cell to cell transfer of RSV
26
Who qualifies?
- Preterm born <29 weeks GA & younger than 12 months at season's start - Those w/hemodynamically sig Cong. Heart Dz & <12 months - CLD 1st yr: (<32 wks + >21% FiO2 at least 28 days post-birth) - CLD 2nd yr: only those who cotinue to require medical support (chronic steroid tx, diuretic tx, O2) w/in 6 months of season start
27
When should qualifying babies in the NICU receive their 1st dose of Synagis?
Before discharge from the hospital
28
We are most concerned about which babies getting RSV?
Preterm, CLD, Hemodynamically sig. heart dz, CHF, PPHN, Cong airway abnormalities, Neuromuscular Dz
29
What are the 2 most discussed risk factors for developing RSV?
1. Exposure to other children >4 hrs/wk (2> unrelated children) 2. Sibs <5 y/o
30
What are the other risk factors for development of RSV?
Tobacco smoke exposure, LBW, Lack of Br feeding, Family Hx Asthma
31
When would you NOT want to give Synagis?
Plt count <40k
32
What is the most commonly reported s/e of Synagis?
Mild transient Erythema, Pain and Induration of injection site
33
If a baby getting RSV prophyaxis w/Synagis gets RSV, should Synagis injections continue?
Yes.
34
True/False: Inactivated Polio Vaccine is the only one available in the U.S.
True
35
How does IPV work?
Produces specific antibodies to Poliomyelitis
36
What is the most common s/e of IPV?
Erythema and tenderness at injection site
37
Have there been serious adverse events of IPV?
No
38
Prevnar/PCV 13 contains how many serotypes of Pneumococcus Pneumoniae?
13
39
Bedsides Pneumonia, the Peumococcal vaccine also provides protection against what?
``` Otitis Media (7 types) ```
40
What are the most commonly reported s/e's of Pneumococcal vaccine?
Injection site swelling/redness | Fever (w/in 1-2 days; particularly w/conjugate vaccination)
41
DTap in the US is now exclusively what type?
Purified, acellular-component Pertussis
42
What are the most commonly reported s/e's of DTaP vaccine?
``` Local & Febrile reactions Allergic Reactions Seizures Hypotonic-Hyporeponsive episodes Fever Prolonged crying (the most common) ```
43
There is an a/w increased _______ after DTaP vaccination. What should be monitored and for how long?
Apnea CV monitoring min 48 hrs-per unit policy
44
How many single types of HIB vaccines are available? | Conjugate?
3-single | 2-conjugate
45
What does the HIB vaccine prevent?
Serious systemic bacterial dz: Meningitis, Sepsis, Septic Arthritis, Epiglottitis, Osteomyelitis, Pericarditis, Pneumonia (capsular strains of type B--H.Influenza)
46
Does HIB provide protection in the first 2 weeks after administration?
No
47
How many Rotavirus Vaccines are available in the U.S.? | How many in the series?
2 1-3 dose 1-2 dose
48
All Rotavirus vaccines are what form?
Oral
49
What is the most common cause of gastroenteritis in infants and children?
Rotavirus
50
When is the 1st vaccine given?
6 wks--14 wks 6 days
51
World-wide, Rotavirus causes _____ deaths/year in children <5 y/o. How many in the U.S.?
500,000 (1/2 Million) Only a few in the U.S.
52
Rotavirus doses should be given by ___ months each dose separated by ____ weeks
8 months | 4 weeks
53
Rotavirus vaccine has done what?
Reduced ER visits and Hospitalizations
54
Rotavirus vaccine is proven safe & effective except in kids with what conditions?
Pre-existing, chronic GI dz
55
There are ___ Influenza vaccines. Both are _____ containing 3 virus strains.
2 | Multivalent
56
Can the Influenza vaccine cause the flu?
No, it contains non-infectious viruses and can not produce active Influenza infection.
57
What are some s/e's of the Flu vaccine?
Headache, Fever, Nausea, Lethargy, Muscle aches, Chills
58
Starting at what chronological age should all infants receive the flu vaccine? How is it dosed in infants?
6 months | 2 doses 1 month apart
59
Who is at especially high risk? | How can they be helped?
Preterm infants | Family home herd immunity
60
Hep A Vaccine is given by ___ inactivated vaccines available in the U.S.
2
61
Is there preservative in Hep A vaccine
No
62
When is Hep A vaccine given?
2 doses one at 12 months, second 6-12 months later
63
What are the adverse events of Hep A
Mild pain and induration at injection site
64
MMR provides protection against?
Measles, Mumps, Rubella
65
What does MMR also protect against if it is an MMRV vaccine?
Varicella
66
When is MMR 1st dose?
12-15 months
67
When is MMR second dose?
4-6 yrs
68
Is MMR a live virus vaccine?
yes, it is live
69
In general combination vaccines need to be given ___ weeks apart.
4 weeks
70
What are the adverse effects of MMR vaccine
``` Fever >103 (5-15%) Transient Rashes (5%) Febrile Seizures (1:3000--1:4000) Transient Thrombocytopenia (1:22k--1:40k) ```
71
True/False: Varicella is a live-attenuated vaccine?
True
72
When is Varicella given?
12-15 months
73
What are the adverse effects of Varicella Vaccine?
Injection site reactions: pain, redness, swelling | Localized rash
74
All vaccines: | Do not give if platelet count
40K 3/4-1" & 25-27 gauge 3/8-5/8" & 23-25 gauge 2 y/o & walking
75
Antipyretics given at the time of vaccination may do what?
Decrease immune response to the vaccine. | May be given for significantly elevated temps & local discomfort

Neonatal Pharmacology (17 decks)

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