Immunizations - Exam 2 Flashcards

Question

Which states allow for medical exemptions to vaccines? Does WV allow religious or non-medical exemptions?

Answer 1

ALL states allow medical exemptions WV does NOT allow religious or non-medical exemptions

Answer 2

safety and SEs do not want too many vaccines to overload the immune system belief that vaccines are not necessary lack of choice, parents know what is best for their kids Belief that it is better to be naturally infected than vaccinated lack of trust in the gov/health authorities ethical, moral or religious objections

Answer 3

vaccine refusal increases risk of outbreak outbreak harms the individuals who CANNOT get vaccinated the most (too young, chemo, medical exception) aka so do it so the people who CANNOT are more protected establish a positive dialogue! **identify parental concerns** and provide education targeted to those concerns, while maintaining a relationship with the family! TRUST is super important

Answer 4

Most outbreaks have been related to religious groups or communities opposed to immunizations

Answer 5

start at the first encounter!! and continue at every visit after!! Acknowledge shared goal (what is best for child) Acknowledge large volume of complex, conflicting information about vaccine benefits and safety provide online resources that have proper information (CDC and NIH sites)

Answer 6

Alternative vaccine schedules offer incomplete and delayed protection against life threatening illnesses Should only be considered only after other options have failed and family would otherwise refuse entirely pts are at an increased risk of undervaccination

Answer 7

When they are ill, it is important to tell the provider they are not fully immunized!!!

Answer 8

Put in as an ACTUAL appointment instead of “shot only” or on nursing only schedule give yourself time for pt education!!!

Answer 9

The recommended compressed, catch-up, or accelerated immunization schedule for such children is difficult to follow and understand but is provided annual and published for providers aka you need to look it up!

Answer 10

In this situation, the clinician must determine if any records exist (previous pediatrician if transfer patient) SIIS unvaccinated, and vaccine schedule should be catch-up schedule

Answer 11

rapidly as feasible

Answer 12

**premature babies less than 2000 grams (4# 6 oz should delay first HBV to 1 mo WCC) but otherwise premature babies need to vaccinated on schedule!! regardless of weight

Answer 13

Requires that all health care providers provide parents or patients with copies of Vaccine Information Statements prepared by the CDC (Centers for Disease Control and Prevention) BEFORE administering dose requires that clinically significant adverse events after vaccination be reported to the Vaccine Adverse Event Reporting System (VAERS)

Answer 14

1. Serious allergic reaction (anaphylaxis) after a previous vaccine dose or to a vaccine component 2. Immunocompromised states or pregnancy (for live virus vaccines) 3. Moderate or severe acute illness with or without fever

Answer 15

severe immunosuppression resulting from 1. Congenital immunodeficiency 2. HIV 3. leukemia 4. lymphoma 5. cancer therapy 6. prolonged course of high dose steroids (> 2 mg/ kg/ day for over 2 weeks) 7. pregnancy

Answer 16

> 2 mg/ kg/ day for over 2 weeks

Answer 17

**For HIV infected children who DO NOT have evidence of severe immunosuppression, MMR vaccination is recommended at 12 months of age with a second dose 1 month later rather than waiting until 4-6 years for booster

Answer 18

Vaccine is contraindicated for persons with cellular immunodeficiency

Answer 19

Varicella is 2 doses, 3 months apart for these kids

Answer 20

Mild acute illness (with or without fever) Convalescent phase of illness Recent exposure to infectious disease **Current antimicrobial therapy Breastfeeding Mild to moderate LOCAL reaction to previous vaccine History of Penicillin or other non-vaccine allergy Receiving allergy extract immunotherapy (allergy shots)

Answer 21

A no-fault system in which persons thought to have suffered an injury or death as a result of administration of a covered vaccine can seek compensation

Answer 22

vaccine-preventable: should be reported to the state or local health departments traceable disease , it reports to the local Health Department

Answer 23

16 and 18 90%

Answer 24

2 doses: 0 and 6-12 months later After 15: 3 doses: 0, 1-2 months and 6 months Immunocompromised: Gets all 3 doses

Answer 25

Age 11-12 but can be started as early as 9

Answer 26

prior to individual’s sexual debut None of the HPV vaccines treat or accelerate the clearance of preexisting vaccine type HPV infections or related disease

Answer 27

all indicate prior HPV infection but not necessarily with types in vaccine, so still recommended

Answer 28

Meningitis ACWY (Menactra, Menveo, MenQuadfi) Meningitis B (Trumenba or Bexsero)

Answer 29

Required before the 7th and 12th grade Given 1 dose @ 11-13 year, then 16-18 years

Answer 30

Give 1 dose @ age 16-18, with a second dose either 1 month apart or 6 months apart (depends on vaccine)

Answer 31

Recommended annually for children 6 months of age and up Children 6 months to 8 years of age require 2 doses the first time they receive the flu vaccine, with single annual doses thereafter

Answer 32

age 2—live attenuated vaccine; sometimes not as effective

Answer 33

Children under 6 months of age History of severe allergic reaction to influenza virus or any component of the vaccine.

Answer 34

pts with egg allergies should still receive the flu shot! need to observe for 30 minutes for signs of a reaction staff just need to be prepared for a reaction. 1/million will have anaphylaxis

Answer 35

Any influenza vaccine appropriate for age and health status annually aka no change if hives is the reaction

Answer 36

Should be withheld from children with moderate to severe acute illness until symptoms resolve MINOR illness with or without fever, okay to give flu shot

Answer 37

Children under 2 Children of any age with asthma and children 2-4 with a history of recurrent wheezing Children who are close contacts of severely immunocompromised individuals (someone IC lives with them)

Answer 38

LIVE attenuated vaccine Routine immunization with MMR is recommended for children at 12-15 months, and a second (MMRV) at age 4-6 years

Answer 39

MMRV also includes varicella This is due to an increase in risk of febrile seizures when MMRV is administered in children <4 yrs of age Proceed with caution with the first dose if family has febrile Sz, need to separate MMR if hx of febrile seizures

Answer 40

Pregnancy-do not get pregnant for at least 28 days after MMR administration d/t theoretical risk of rubella Immunodeficiency

Answer 41

May have mild flu symptoms, very mild (runny nose, headache, low grade fever) Can still get flu if the vaccine does not match current subtypes but cannot get the flu because the virus is already dead

Answer 42

NO!! can still get mild form of the disease

Answer 43

only 12 kiddos were used kiddos were carefully selected at a birthday party he attended research funding was provided by lawyers acting for parents who wanted to sue the vaccine manufacturers entire report was fraud for financial compensation Wakefield and colleagues lost their licenses MMR vaccine

Answer 44

50-95% of population must be vaccinated (to also protect immunocompromised kids who can’t receive vaccinations)

Answer 45

Primary Prophylaxis: used to prevent infection before a first occurrence Secondary Prophylaxis: used to prevent recurrence after a first exposure.

Answer 46

Prophylaxis is recommended for: -all household contacts, especially young children -child care or nursery school contacts in the previous 7 days -direct exposure to index patient’s secretions through kissing or sharing toothbrushes or eating utensils -Contacts who frequently sleep or eat in the same dwelling -Passengers seated directly next to the index case during airline flights lasting longer than 8 hours

Answer 47

not recommended for casual contacts with no history of direct exposure to the patient’s oral secretions (work or school mate), indirect contact with the index patient or medical staff without direct exposure

Answer 48

Rifampin BID for 2 days, ceftriaxone once and ciprofloxacin once are recommended regimen all 3 things!

Answer 49

immediate cleansing using soap and water Tetanus prophylaxis after wound cleansing includes vaccination (Toxoid) of person with incomplete immunization and tetanus immunoglobulin for contaminated wounds (soil, feces, saliva) puncture wounds, avulsions, crushing, burns or frostbite

Answer 50

Rabies immune globulin (RIG) and rabies vaccine are extremely effective for prophylaxis after exposure to rabies but are of no known benefit after symptoms appear. needs to be given BEFORE symptoms appear, once symptoms appear it is too late

Answer 51

ANY healthy-appearing domestic animal responsible for an apparently unprovoked bite should be observed for 10 days for signs of rabies without immediate treatment of the victim. wild animal is assumed rabid unless the animal is caught and euthanized and brain examined for evidence of rabies

Answer 52

Skunks Raccoons Foxes Woodchucks (chipmunks) Bats

Answer 53

has rabies bat = has rabies

Answer 54

All rabies post-exposure management begins with immediate cleansing with soap and water and if available a virucidal agent such as iodine Rabies (Immunoglobulin) RIG: 20U/kg administered as a full dose of RIG infiltrated Subcutaneously into the area around the wound if possible--the rest in the arm Rabies vaccine: Dosed at day 0, 3, 7, 14 Day 28 for immunocompromised

Answer 55

Azithromycin Treat with antibiotics and monitor for symptoms for 21 days after exposure