Immunizations Flashcards

1
Q

What is the difference between active and passive immunity?

A

Active: Protection produced by persons own immune system. Permanent. Surviving an infection or vaccination
Passive: Protection by antibody containing products of from passage from mom to baby, immunity usually weans over time

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2
Q

Which vaccines are live?

A

MMR, MMRV (MMR w/ varicella), varicella, zostavax, yellow fever, flumist, rotavirus, cholera, Vivotif

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3
Q

Polysaccharide vaccines should not be given to? Why?

A

Infants and young children because their immune system isnt fully developed yet and these vaccines do not provide effective immune response in children < 2 YO

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4
Q

Live vaccines and antibody products can diminish immune response but is most concerning for MMR and varicella. How far apart should you separate these?

A

If you give the vaccine, wait 2 weeks before giving AB products.
If you give AB, wait 3-11 months before giving live vaccine
Consult the pink book.

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5
Q

Multiple live vaccines must be given on the same day or they must be spaced out by how many weeks?

A

4

All live vaccines except oral rotavirus

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6
Q

If a vaccine requires multiple dose series, can the intervals between doses be shortened or lengthened?

A

They can be lengthened but never shortened.

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7
Q

In patients with asplenia, Prevnar and Menactra should be separated by how many weeks?

A

4

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8
Q

Live vaccines can interfere with the tuberculin skin test (false negative). What can be done to prevent this interference?

A

Administer the live vaccine on the same day as the PPD skin test

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9
Q

What are the 3 types of adverse reactions to vaccines?

Explain them

A

Local: Pain, swelling, redness at site (80%) -mild, self limited
Systemic: Fever, malaise, muscle pain
Allergic: Anaphylaxis, this is why we screen

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10
Q

What are the 2 biggest contraindications to live vaccines?

A

Pregnancy and immunosuppression

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11
Q

What dose of prednisone is considered immunosuppressed and thus shouldn’t receive vaccination?

A

Systemic steroids equivalent to prednisone 20mg/day for 14 days or longer

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12
Q

Which vaccines are contraindicated in HIV patients with CD4 count < 200?

A

MMR and varicella

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13
Q

Which vaccines are recommended during pregnancy?

A

Seasonal influenza, TDAP (3rd trimester), live vaccines are contraindicated

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14
Q

Which vaccines are recommended in asplenia?

A

HiB, prevnar then pneumovax, menactra/menveo + bexsero/trumemba

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15
Q

Which form of Tdap is given to children under the age of 7? When should it be given?

A

DTaP x 5 doses: 2, 4, 6, 12-18 months and 4-6 years, then Tdap x 1 at 11-12 years

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16
Q

When should HiB be given?

A

As part of routine childhood vaccination and to adults after splenectomy

17
Q

Hep A and B vaccine schedule?

A

3 dose series given at 0, 1, and 6 months

18
Q

Who should Gardasil-9 be given to?

A

Females 9-26 (ideally before sexual activity) ages 11-12 recommended
Males 9-26 (ages 11-21 and up to 26 recommended in HIV and men-men sex)
Regimens: If started before age 15 - 2 doses (0 and 6-12 mos)
If started after age 15 - 3 doses (0, 1-2, 6 mos)

19
Q

How is influenza virus spread?

A

Person to person through respiratory droplets

20
Q

Who is recommended to receive flu vaccine?

A

> 6 months unless there is contraindication

21
Q

Flu vaccine recommendations for patients age 6 months-8 YO who have never been vaccinated?

A

2 doses, 4 weeks apart

22
Q

What flu vaccine can patients with egg allergy recive?

A

FluBlok, only if they are over 18 YO

23
Q

Which 2 flu vaccines are recommended for age >65?

A

Fluad (adjuvanted influenza) Fluzone HD

24
Q

What is the difference between tri and quad valent flu vaccines?

A

Trivalent: 2 a strains, 1 b strain
Quad: 2 A, 2 B strains

25
Q

How should MMR and MMRV be stored?

A

MMR: Fridge or frozen
MMRV: Contains varicella so must be frozen

26
Q

What are the brand names of the MCV4 meningitis vaccines? What serotypes do they cover?

A

Menactra, Menveo cover serotypes ACWY

27
Q

What are the brand names of the meningitis vaccines that cover serotype B?

A

Bexsero, Trumenba

28
Q

Routine vaccination for MCV4 in adolescents?

A

one dose of MCV4 (Menactra or Menveo) at 11-12 years and give booster at 16 YO.

29
Q

What are the age cutoffs for use of each of the MCV4 vaccines? What about for the Men B vaccines?

A

Menactra: 9mos-55YO
Menveo: 2 mos-55years
Bexsero/Trumenba: 10-55 YO

30
Q

When should the first dose of prevnar be given as part of routine childhood vaccinations?

A

If first dose of PCV13 (Prevnar) is given > 6 YO, only 1 dose needed

31
Q

Adults over 65 who have not received any pneumococcal vaccines should receive what?

A

PCV13 then PPSV23 1 year later.

32
Q

Children < 2 YO should receive which type of pnemonia vaccine and at what age?

A

Prevnar by earliest age 6 weeks

33
Q

Which pneumonia vaccine can be given both IM or SQ?

A

Pneumovax (PPSV23)

34
Q

Immunocompromised pt ages 6-64 should receive how many pneumonia vaccines?

A

1 Prevnar + 2 Pneumovax (8 weeks after Prevnar, then 5 years after first dose of pneumovax)

35
Q

Anyone without evidence of immunity to varicella should receive how many doses of varicella vaccine?

A

2

36
Q

Which vaccines should be avoided if patient has allergy (hypersensitivity) to neomycin or gelatin?

A

Zostavax or varicella

37
Q

Some antivirals can interfere with varicella and zostavax. How long before and after vaccination should a patient hold antiviral medications?

A

Stop 24 hours before vaccination, do not take until 14 days have passed

38
Q

How is Vivotif given?

A

It is a live oral vaccine against typhoid fever and should be completed AT LEAST 1 week prior to travel and given Q 5 years if continued risk. It is 4 capsules taken on days 0, 2, 4, 6 on an empty stomach with cold or lukewarm water

39
Q

Japanese encephalitis vaccination schedule?

A

2 doses IM separated by 28 days, complete series at least 1 week prior to travel