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NURS 875: Pediatrics > Immunizations > Flashcards

Immunizations Flashcards

1
Q

vaccines given at BIRTH

A

hepatitis B

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2
Q

vaccines given at the 2-month visit

A
  • 2nd dose of hepatitis B (if not yet given @ 1 month visit)
  • rotavirus (oral)
  • DTaP (diphtheria, tetanus, and acellular pertussis)
  • Hib (haemophilus influenzae type b)
  • PCV13 (pneumococcal)
  • IPV (inactivated poliovirus)
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3
Q

vaccines given at the 4-month visit

A

dose 2 of the following:

  • rotavirus (oral)
  • DTaP (diphtheria, tetanus, and acellular pertussis)
  • Hib (haemophilus influenzae type b)
  • PCV13 (pneumococcal)
  • IPV (inactivated poliovirus)
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4
Q

vaccines given at the 6-month visit

A

dose 3 of

  • hepatitis B
  • rotavirus (oral) if 3-dose series is given (as opposed to Rotarix, which is a 2-dose series)
  • DTaP
  • Hib
  • PCV13 (pneumococcal)
  • IPV (inactivated poliovirus)

**now eligible for influenza (if flu season)

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5
Q

how early in a child’s life can the annual influenza vaccine be given?

A

6 months

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6
Q

how early in a child’s life can the 1st dose of the MMR vaccine be given?

A

12 months

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7
Q

how early in a child’s life can the 1st dose of the Varicella vaccine be given?

A

12 months

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8
Q

hepatitis A vaccination series…

  1. how many doses?
  2. how far apart?
  3. when is the 1st dose?
A
  1. 2-dose series
  2. 6 months apart
  3. 1st dose at 12 months
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9
Q

At what age is HPV vaccination begun?

A
  • routinely recommended at ages 11-12
  • can begin as early as age 9
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10
Q

HPV vaccinations…

  1. how many doses?
A

2-3 dose series depending on age of vaccination initiation

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11
Q

Who gets Tdap? DTaP?

A
  • DTaP for children < age 7
  • Tdap for ages 7+
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12
Q

DTaP…

  1. How many doses in series?
  2. When are they given?
A

5-dose series at the following times:

  • 2 months
  • 4 months
  • 6 months
  • 15-18 months
  • 4-6 years
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13
Q

Live Virus vaccines

A
  • MMR: measles, mumps, rubella
  • MMRV: measles, mumps, rubella, varicella
  • Varicella
  • Rotavirus (Rotariq & Rotateq)
  • BCG
  • Smallpox
  • Influenza (one formulation)
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14
Q

Rotavirus vaccine carries an increased risk of _____ within 7 days of the ____ dose

A
  • Intussusception
  • 1st or 2nd
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15
Q

If the MMRV is given as the first immunization dose for measles, there is an increased risk of ______ (as opposed to the first measles immunization being given as MMR)

A

Febrile seizures

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16
Q

How do we induce passive immunity?

A

Administration of immunoglobulins

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17
Q

Adverse reactions of immunoglobulin administration

A
  • Localized injection site pain
  • Flushing
  • Headache
  • Chills
  • Sweating
  • Shock
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18
Q

What immunoglobulin is used to treat infants at high risk for adverse outcomes from RSV?

A

Palivisumab (Synagis)

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19
Q

What is the name of the book (and who is it from) that contains recommendations for vaccinations for children?

A

AAP Red Book

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20
Q

What happens if a live vaccine is given during IVIG therapy?

A

Patient will not post an immune response; vaccine won’t work; don’t give during IVIG therapy

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21
Q

Major symptom for mumps

A

Enlarged parotid gland (cheek)

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22
Q

Only oral vaccine that infants get

A

Rotavirus

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23
Q

Who gets the meningococcal B vaccine?

A

College age, dorm living

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24
Q
  • How many doses are in the MMR series?
  • When are the doses given?
A
  • 2 doses
  • 1st dose 12-15 months
  • 2nd dose 4-6 years
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25
Q
  • How many doses are in the polio vaccine series?
  • When are they given?
A
  • 4 doses
  • 2 months old
  • 4 months old
  • 6-18 months
  • 4-6 years
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26
Q
  • How many doses are in the Hib vaccine series?
  • When are they given?
A

3-4 doses, depending on manufacturer

  • 2-dose series = PedvaxHIB
  • 3-dose series = ActHIB, Hiberix, Pentacel, or Vaxelis
  • 2 months
  • 4 months
  • 6 months for some formulations
  • booster at 12-15 months
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27
Q
  • How many doses in hepatitis B?
  • dosing schedule
A
  • 2-3-dose series
  • w/in 12-24h of birth
  • 1 month after dose 1
  • 6 months after dose 1
28
Q

How soon after birth is the hepatitis B vaccine given?

A
  • negative hepatitis B status: w/in 24hr
  • unknown or positive hepatitis B: w/in 12 hours
29
Q
  • How many doses in the varicella vaccine?
  • When are they given?
A
  • 2 doses
  • 12-15 months
  • 4-6 years
30
Q
  • How many doses in the pneumococcal vaccine series?
  • When are they given?
A
  • 4 doses
  • 2 months
  • 4 months
  • 6 months
  • 12-15 months
31
Q
  • How many doses in the rotavirus vaccine series?
  • When are they given?
A
  • 2-3 doses
  • 2 months
  • 4 months
  • 6 months (if needed based on formulation; RotaTeq)
32
Q

Rotarix vs. Rotateq

A
  • both are rotavirus vaccines
  • not interchangeable
  • Rotarix = LIVE, given in 2 doses (2 and 4 months)
  • Rotateq = LIVE, given in 3 doses (2, 4, and 6 months)
  • last doses need to be given before 8 months of age
33
Q

What does rotavirus cause?

A

severe gastroenteritis

34
Q

Describe the connection between a rotavirus vaccine and intussusception.

A
  • Rotashield (live virus) withdrawn from market (1999) for causing intussusception
  • Rotavirus vaccine schedule is the way it is due to the risk of naturally-occurring intussusception being low
  • Over 80% of intussusception cases associated w/ rotavirus vaccine were in children who received 1st dose after 3 months of age
  • Peak of naturally-occurring intussusception is around 6 months
  • Final doses should be given before 8 months minimize overlap w/ naturally-occurring intussception
  • Australia: https://www.nps.org.au/radar/articles/rotavirus-vaccines-rotarix-and-rota-teq-for-prevention-of-rotavirus-gastroenteritis
35
Q

Name the CDC’s book on vaccines

A

Pinkbook

36
Q

All vaccines except which one are 0.5mL?

A
37
Q

What is the EXCEPTION with DTaP?

A

only given until age 7; after that Tdap is given

38
Q

What is the difference between DTaP and Tdap?

A
  • DTaP contains more diptheria and pertussis than Tdap
  • DTaP given until age 7; Tdap given after age 7
39
Q

What to do for an infant traveling to an area endemic for measles?

A
  • only demonstrated to be effective when 1st vaccine at 1 year
  • no MMR in breastmilk
  • give 1st vaccine before travel
  • vaccinate again at 1 year
40
Q

EXCEPTION for rotavirus vaccine

A

not given after 8 months of age

(intussusception affected kiddos after 8 months of age)

41
Q

What happens if the mom is hepatitis B positive or her hepatitis B titer status is unknown?

A

give hepatits B vaccine w/in 12 hours of birth

AND

give immuneglobulin to baby

42
Q

What is the minimum # of weeks between vaccines and why? (particularly important when trying to catch up vaccines)

A
  • > 4 weeks between subsequent doses of the same vaccine
  • need time for body to mount an immune response (T Lymphocytes)
43
Q

Who gets Tdap?

A
  • patients who need a booster
  • pregnant patients
  • healthcare workers
44
Q

EXCEPTION for HIB

A

Not given after age 5

45
Q

Who gets PCV-23 (Pneumovax)?

A

patients who have issues with their spleen (splenectomy or a spleen that isn’t 100% effective)

46
Q

When is PPSV-23 given? How many doses are given?

A
  • around age 2
  • only need 1 dose
47
Q

Can we given the polio vaccine on a sugar cube?

A

no longer available in the U.S.

48
Q

EXCEPTIONS for FLU VACCINE

A
  • not given until 6 months of age
  • if under age 9: 1st time child is vaccinated, needs 1 dose and 2nd dose 1 month later
  • vaccinated yearly
  • under age 3: 0.25mL given
  • > 3: 0.5mL given
49
Q

Varicella dosing

A
  • 1st @ 1 year
  • need to be 3 months apart
50
Q

How is hepatitis A transmitted?

A

oral-fecal

51
Q

When is the 1st hepatits A vaccine given?

A

age 1 year

52
Q

Meningococcal vaccine: dosing and spacing

A
  • age 12
  • age 16
53
Q

What happens if pt does not present for meningococcal vaccine until age 16?

A
  • give 1 dose
  • no booster needed
54
Q

If a child needs catch-up vaccines, how should you think about it?

A
  • focus on the age of the child currently, and what vaccines can be given at that age
  • What is their age now?
  • How many vaccine doses they need
55
Q

What allergy contraindicates administration of IPV?

A

anaphylaxis to streptomycin

(HOWEVER, there is an IPV not grown on streptomycin)

56
Q

What kind of egg issue keeps a patient from getting the flu vaccine?

A

anaphylactic reaction to eggs

57
Q
  • Who should receive 2 HPV doses?
  • Who should receive 3?
A
58
Q

Minimum interval between HPV doses

A

5 months

59
Q

Which Meningitis serotypes cause 90% of meningococcal disease in the U.S.?

A

B, C, Y, and W135

60
Q

Which meningitis serotype has a recommended vaccination for college-age patients?

A

Meningitis B

61
Q

What is the limit of PPSV23 doses prior to age 65?

A

2 doses

62
Q

What to tell parents when a child is given the MMR vaccine?

A
  • transient rashes adn fever of 103 can occur 5-12 days after vaccination
  • fever typically resolves in 1-2 days, sometimes takes 5 days
63
Q

Contraindications to measles vaccine

A
  • pregnancy or planning pregnancy w/in 28 days
  • anaphylactic reaction to gelatin, egg, neomycin or prior MMR vaccine
  • febrile illness
64
Q

How soon after measles exposure should the vaccine be given to provide protection?

A

w/in 72 hours

65
Q

Who in the U.S. is eligible for the BCG vaccine?

A

infants and children with:

  • negative TB skin test who:
  1. life w/ persons w/ infectious pulmonary TB (not effectively treated) & child cannot be removed
  2. live w/ persons w/ drug resistant TB (to isoniazid and rifampin) & cannot be separated from those persons
66
Q

True or False?

(And why?)

A child can experience recurrent RSV infection–even if they received palivizumab

A

True

Because more than one strain of RSV can be circulating in a community

67
Q

Which children are eligible for palivizumab (Synagis)?

A
  • infants born prior to 29W (until they are 12 months old)
  • children born prior to 32W w/ chronic lung disease (until they are 2 years old)
  • infants w/ cyanotic or complicated CHD (up to 12 months of age)
  • infants w/ neuromuscular disorders or congenital anomalies that compromize clearing of respiratory secretions (up to 12 months of age)

NURS 875: Pediatrics (12 decks)

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