Immunizations Flashcards
What is active immunity?
protection produced by the person’s own immune system (usually permanent)
What is passive immunity
protection transferred from another person or animal (temporary)
What is a antigen?
a live or inactivated substance capable of producing an immune response
What is a antibody?
protein molecules produced by B lymp to help eliminate an antigen
What is most important in infancy?
transplacental passive immunity
How do you get passive immunity
blood products
human antibody (immune globulin)
human hyperimmune globulin
heterologous hyperimmune serum (anti-toxin)
What is a monoclonal antibody
antibody specific to a single antigen derived from single cell
What are monoclonal antibodies used for?
diagnosis and therapy of certain cancers and autoimmune dx
What antibody is used for prevention of RSV?
Palivizumab (Synagis)
What type of antibody is Palivizumab?
monoclonal
contains RSV antibody
no interference w/ live virus vaccine
Vaccine produce what type of immunity
active
How does a vaccine relate and contrast with natural immunity
it gives a memory response similar to infection, WITHOUT risk of disease
What are two types of live attenuated vaccines?
viral
bacteria
What are the two classifications of vaccines
live attenuated
inactivated
What are three forms of inactivated vaccines
whole
fractional (protein based)
polysaccharide-based
What is a general rule of vaccines?
the more similar to the disease the better the immune response to the vaccine
A live attenuated vaccine is what?
“weakened” form of the wild virus or bacterium
A live attenuated vaccine usually requires
one dose
What are some live viral attenuated vaccines?
measles mumps rubella varicella zoster yellow fever rotavirus intranasal influenza rotavirus vaccinia
What are some live bacteria attenuated vaccine
BCG* (not available in US)
oral typhoid
Which is more effective live or inactivated?
live
How many doses are required for inactivated vaccines
3-5 doses
With inactivated vaccines, antibody titers….
diminish with time
What are whole cell viral inactivated vaccines
polio, hepatitis A, rabies, influenza (not in US)
What are whole cell bacteria inactivated vaccines
pertussis, typhoid, cholera, plague
What are fractional vaccines subunit
hep B, influenza, acellular pertussis, human papillomavirus, anthrax
What are toxoid fractional vaccines
diphtheria, tetanus
What are pure polysaccharide vaccines
pneumococcal
meningococcal
Salmonella Typhi (Vi)
What are conjugate polysaccharide
haemophilus influenzae type b
pneumococcal
meningococcal
pure polysaccharide vaccines are not consistent in whom
children younger than 2 yrs of age
What is the general rule of inactivated and live vaccines
inactivated vaccines are NOT affected by circulating antibody
Live are affected
When it comes to antibodies and vaccines… when should vaccines be given
wait 2 weeks before giving antibody
When it comes to antibodies and vaccines… when should antibody be given
wait 3 months or longer before giving vaccine
What does RBC w/wo washed have
antibody content
What is the general rule of admin vaccines
all vaccines can be admin at the same visit
Two live injected vaccines should be given how far apart?
4 weeks
Intranasal influenza vaccine should be given how far apart
4 weeks
For asplenic children what two vaccines must be give 4 weeks apart
pneumococcal conjugate
and
Menactra brand meningococcal conjugate vaccines
T/F interference can occur between two live vaccines given less than 28 days (4wks) apart?
TRUE
If two live vaccines or live intranasal influenze is given less than 28dy apart what should be done
the second vaccine given should be repeated
The only vaccines that can be given less than 28d apart is ?
yellow fever after measles vaccine
T/F increasing the interval between multidose vaccines will interfere with its effectiveness?
FALSE
Decreasing the interval between doses of multidose vaccine will interfere w/ protection
TRUE
TWO RULES regarding admin of vaccines
1- shouldn’t be given less than minimum intervals
2- or earlier than minimum age
The ACIP can valid a vaccine if it is
given up to 4 days before minimum requirements
If given more the minimum requirements who might not accept it?
immunization programs or school entry requirements
Is it necessary to add or restart series bc of extended intervals between doses
NO
What causes adverse reactions?
effect caused by vaccine
side effect
What causes adverse event
any event following vaccination
may be true adv rxn
or coincidental
S/S of local adverse rxn to vaccine
pain, swelling, redness at site of injection
mild and self limited
Adverse rxn are common with what vaccines
inactivated vaccines
S/S of systemic adverse rxn to vaccine
fever, malaise, headache
nonspecific
unrelated to vaccine
What must live attenuated vaccines do to produce immunity
replicate
(mild)
occurs 7-21dys after incubation period
S/S of allergic adr to vaccine
vaccine or vaccine component
rare
risk minimized by screening
Precaution to vaccines means?
a condition the person has that might increase adr or compromise ability of vaccine to produce immunity
What are the 4 permanent contraindications to vaccination?
- severe allergic rxn
- encephalopathy not due to another cause occurring 7 DAYS pertussis vaccination
- Severe combined immunodeficiency
- hx of intussusception
allergy to component
contraindicated in both
encephalopathy
contraindicated in both
pregnancy
live contraindicated in women
inactivated if need except HPV
immunosupression
live contraindicated
inactivated if need
severe illness
precaution in both
recent blood product
live precaution only MMR or varicella not zoster
inactivated if need
Should live vaccines be given to pregnant women
NO
Should HPV given to preggo?
no
When should Tdap be admin to the preggos?
during late 2nd or third after 20wks
IF NOT
immediately after postpartum
Should live vaccines be admin to immunosuppressed
NO
Should inactivated vaccines be admin to immunosuppressed?
YES- but response might be decreased
What is considered a immunosuppression disease
congenital immunodeficiency
leukemia or lymphoma
generalized malignancy
What is considered a immunosuppression due to chemotherapy
alkylating agents
antimetabolites
radiation
What Vaccines should be given to asymptomatic HIV/AIDS patients
Varicella
MMR
yellow fever consider
What vaccines should NOT be given to asymptomatic HIV/AIDS patients
Zoster
MMRV
LAIV
Rotavirus
What vaccines should NOT be given to symptomatic HIV/AIDS patients
ALLL OF THEM!!!!!
For HCT recipients when should vaccines be re-admin
6-12mo post transplant
What are HCT recipients at an increased risk for?
pneumococcal disease
When should Stem cell transplant ppl be re-admin
inactivated influenza = 6mo
inactivated DTap/Td, IPV, hep b Hib, PCV, PPV = 12m
MMR and varicella = 24m
Healthy household contacts of immunosuppressed persons should
receive MMR and Varicella and annual flu
What are not good reasons to get a vaccine?
Mild illness
Antimicrobial therapy
Disease exposure or convalescence
Pregnant or immunosuppressed person in the household
Breastfeeding
Preterm birth
Allergy to products not present in vaccine or allergy that is not anaphylactic
Family history of adverse events- only your vaccination accounts
Tuberculin skin testing
Should vaccines be admin during a acute illness?
Yes, but best to delay until after improvement
