Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EBAC - Infectious Disease > Immunizations in HIV > Flashcards

Immunizations in HIV Flashcards

1
Q

What does ACIP recommend for immunizing people with HIV?

A

Immunizing similarly to the general population, with key exceptions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which live virus vaccines are contraindicated in people with HIV with CD4 <200 cells/mm3?

A
  • Measles
  • Mumps
  • Rubella
  • Varicella (VAR)
  • Live attenuated typhoid Ty21a
  • Yellow fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which live virus vaccine is contraindicated for any CD4 counts?

A

Live attenuated influenza vaccine (LAIV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What vaccines have specific recommendations related to HIV status?

A
  • COVID-19
  • Hepatitis A (HAV)
  • Hepatitis B (HBV)
  • Meningococcus serogroup A, C, W, Y (MenACWY)
  • Pneumococcal vaccines
  • Human papillomavirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What defines advanced HIV?

A

CD4 count <200 cells/mm3, history of AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should adults and children >5 years with HIV receive regarding COVID-19 vaccinations?

A

A dose of the updated COVID-19 vaccine regardless of their CD4 count or HIV viral load.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

True or False: Individuals with advanced or untreated HIV may receive one additional COVID-19 vaccine dose.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the association between lower CD4 counts and COVID-19 outcomes in people with HIV?

A

Lower CD4 counts are associated with higher risk for ICU admission, invasive mechanical ventilation, or death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the recommended dosing schedule for the hepatitis A vaccine (HepA) for people with HIV?

A

A two-dose series (0 and 6–12 months for Havrix or 0 and 6–18 months for Vaqta).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should be administered for people with HIV traveling to countries with endemic HAV?

A

Immunoglobulin G (IgG) 0.1 mL/kg for travel <1 month; 0.2 mL/kg for travel ≥2 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the preferred hepatitis B vaccine for people without chronic HBV infection?

A

Heplisav-B intramuscularly at 0 and 4 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the vaccination schedule for prior non-responders to Hepatitis B vaccine?

A

Administer HepBCpG (Heplisav-B) IM at 0 and 4 weeks, with consideration for a third dose at 24 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should be done for people with HIV who have been exposed to HBV and were vaccinated previously?

A

No additional vaccine is needed if they have documented antibody response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the recommended HPV vaccine for people with HIV?

A

9-valent inactivated recombinant vaccine (Gardasil 9).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

At what age should the HPV vaccination series ideally be initiated for people with HIV?

A

At age 11 or 12 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the recommendation regarding the influenza vaccine for people with HIV?

A

Administer age-appropriate inactivated influenza vaccine or recombinant influenza vaccine annually.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What vaccine is contraindicated for people with HIV?

A

Live attenuated influenza vaccine (LAIV).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should be administered to pregnant people with HIV regarding influenza?

A

Inactivated influenza or recombinant vaccine at any time during pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the significance of the influenza vaccine formulations?

A

Vaccine formulations are updated yearly to reflect circulating strains.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is contraindicated for people with HIV?

A

LAIV administered via nasal spray

LAIV stands for Live Attenuated Influenza Vaccine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What type of influenza vaccines are recommended for people with HIV aged 65 years or older?

A

High-dose, recombinant, and adjuvanted influenza vaccines

These are recommended over standard-dose unadjuvanted inactivated vaccines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

During which months do annual epidemics of seasonal influenza typically occur in the United States?

A

October to April

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the two surface antigens used to categorize Influenza A viruses?

A
  • HA
  • Neuraminidase (NA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is antigenic drift?

A

Point mutations and recombination events within a subtype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

True or False: People with HIV are at high risk of serious influenza-related complications.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the recommended vaccination strategy for people with HIV who have minimal AIDS-related symptoms and normal CD4 counts?

A

Receive inactivated influenza vaccine (IIV) to develop adequate antibody responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the effectiveness of trivalent IIV for prevention of confirmed influenza illness in people with HIV?

A

75%

Based on a randomized placebo-controlled trial in South Africa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the recommended timing for influenza vaccination?

A

Before onset of influenza activity in the community

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What should health care providers aim for when offering influenza vaccination?

A

By the end of October if possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the MMR vaccine contraindicated for?

A

People with HIV with CD4 count <200 cells/mm3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the recommended vaccination schedule for the MMR vaccine for those with CD4 count ≥200 cells/mm3?

A

Two doses at least 1 month apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What should be done for measles exposure of nonimmune individuals with CD4 count <200 cells/mm3?

A

Administer immunoglobulin (IG) within 6 days of exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the mortality rate of measles in people with advanced HIV?

A

As high as 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the incidence of measles cases in the European region in 2022?

A

Greater than 30,000 cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What should be done if there is no serologic evidence of immunity after two doses of MMR vaccine?

A

Consider repeating the two-dose MMR vaccine series

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the recommended vaccination for adolescents and adults with HIV who have not been previously vaccinated against meningococcal disease?

A

Two doses of quadrivalent meningococcal conjugate vaccine (MenACWY) at least 8 weeks apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the recommendation for repeat vaccination against meningococcal disease for people with HIV who have been vaccinated previously?

A

Repeat vaccination every 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the most common cause of bacterial meningitis among children and young adults in the United States?

A

Meningococcal meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the increased risk of meningococcal disease in people with HIV?

A

Five- to 24-fold increased risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What should be administered within 72 hours of measles exposure for nonimmune individuals with CD4 count ≥200 cells/mm3?

A

MMR vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the available vaccines for meningococcal disease?

A
  • MenACWY
  • MenB
  • MenABCWY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the recommended MenB vaccination strategy for adolescents and young adults with HIV?

A

Offer MenB vaccination with shared decision-making

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the primary vaccine recommended for people with HIV to prevent meningococcal disease?

A

MenACWY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What vaccination should individuals with component deficiency or using a complement inhibitor receive?

A

MenB vaccination

Eculizumab and ravulizumab are examples of complement inhibitors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the two available MenB vaccines?

A
  • MenB-4C (Bexsero; two-dose series at 0 and 1 month)
  • MenB-FHbp (Trumenba; three-dose series at 0, 1–2, and 6 months for people with HIV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What components does MenB-4C consist of?

A
  • Three recombinant proteins
  • Outer membrane vesicles containing outer membrane protein porin A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Are MenB vaccines interchangeable?

A

No, the same product must be used for all doses in the series.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What should be done if a person previously vaccinated with MenB is identified as being at increased risk during an outbreak?

A

A single booster dose of the same vaccine is recommended ≥1 year after the primary series completion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

True or False: Urban outbreaks of meningococcal meningitis have been reported among men who have sex with men in the U.S.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is recommended for pregnant and lactating people with HIV regarding MenACWY vaccine?

A

They should receive MenACWY vaccine if indicated (AIII).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the recommendation regarding MenB vaccination during pregnancy?

A

It should be deferred unless the pregnant person is at increased risk and benefits outweigh potential risks (CIII).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the live nonreplicating smallpox and mpox vaccine available?

A

JYNNEOS (Bavarian Nordic)

53
Q

Who should receive mpox vaccination with JYNNEOS?

A
  • All people with HIV
  • Pregnant or breastfeeding individuals with potential mpox exposure
  • Any other people with HIV who request vaccination
54
Q

What is the vaccination schedule for JYNNEOS?

A

Two doses (0.5 mL subcutaneous or 0.1 mL intradermal) 4 weeks apart (AII).

55
Q

What is the recommendation for unvaccinated people with HIV who experience known exposure to mpox?

A

Administer a complete series of JYNNEOS as soon as possible, ideally within 4 to 14 days after exposure (BII).

56
Q

What are the available pneumococcal vaccines?

A
  • PCV15 (Vaxneuvance, Merck)
  • PCV20 (Prevnar 20, Pfizer)
  • PPSV23 (Pneumovax, Merck)
57
Q

What is the recommendation for people with HIV without a history of pneumococcal vaccination?

A

Administer either PCV20 or PCV15 (AII).

58
Q

What should be done if PCV15 is used?

A

Administer a dose of PPSV23 at least 8 weeks later (AII).

59
Q

What is recommended for people with HIV who received PCV13 and were 65 years or older when they received PPSV23?

A

They do not require further doses of PPSV23.

60
Q

What RSV vaccine is recommended for all people with HIV older than 75 years?

A

A single respiratory syncytial virus (RSV) vaccine (Abrysvo, Arexvy, or mRESVIA) is recommended (CIII).

61
Q

What is the efficacy of RSVPreF3 (Arexvy) against RSV-related lower respiratory tract disease?

A

83% efficacy compared to placebo.

62
Q

What are the contraindications for administering live replicating vaccinia vaccines?

A

Contraindicated in pregnant, breastfeeding, or immunocompromised individuals, including those with HIV (AII).

63
Q

What is the recommendation for Tdap vaccination for individuals with HIV?

A

Administer Tdap once if not vaccinated at age 11 or older, then Td or Tdap every 10 years thereafter (AII).

64
Q

When should pregnant people with HIV receive Tdap vaccination?

A

One dose of Tdap during each pregnancy, preferably between 27 weeks and 36 weeks gestation (AIII).

65
Q

What vaccine should a person with HIV receive if they have not been vaccinated at age 11 or older?

A

Acellular pertussis vaccine (Tdap) once

Followed by tetanus and diphtheria toxoids vaccine (Td) or Tdap every 10 years thereafter.

66
Q

When should pregnant people with HIV receive the Tdap vaccine?

A

During each pregnancy, preferably between 27 weeks and 36 weeks gestation

This is recommended to protect both the mother and the baby.

67
Q

What should adolescents and adults with HIV who have not received the primary vaccination series for tetanus, diphtheria, or pertussis do?

A

Administer one dose of Tdap followed by one dose of Td or Tdap at least 4 weeks later, and another dose 6 to 12 months after the last dose

Tdap can be substituted for any Td dose and is preferred as the first dose.

68
Q

How does CD4 count affect antibody response to tetanus and diphtheria vaccination?

A

Antibody response varies; it is attenuated in individuals with advanced HIV and low CD4 counts

For CD4 count >300 cells/mm3, response to tetanus is similar to the general population, but diphtheria response remains diminished.

69
Q

What are the two Tdap vaccines available for individuals aged ≥10 years in the United States?

A

Adacel and Boostrix

Both are inactivated vaccines considered safe at any CD4 count.

70
Q

What is the vaccination schedule for adults not previously vaccinated for tetanus, diphtheria, and pertussis?

A

Receive a single dose of Tdap, followed by a Td or Tdap booster every 10 years

This schedule is the same for individuals with HIV and those without.

71
Q

What is the live attenuated varicella vaccine available?

A

Varivax (Merck)

This vaccine is used to prevent primary varicella infection.

72
Q

What conditions indicate presumed immunity to varicella for people with HIV?

A

Receipt of two doses of varicella vaccine, diagnosis of varicella or herpes zoster, or laboratory evidence of immunity

This includes confirmed disease history.

73
Q

What is the recommendation for varicella vaccination for people with HIV and CD4 count ≥200 cells/mm3?

A

Administer two doses of varicella vaccine 4 to 8 weeks apart

This is applicable for those who are varicella nonimmune.

74
Q

Is VAR contraindicated for people with HIV with CD4 count <200 cells/mm3?

A

Yes

This is due to the increased risk of vaccine-related complications.

75
Q

What vaccine is recommended for people with HIV aged ≥18 years to prevent herpes zoster?

A

Recombinant adjuvanted zoster vaccine (RZV), Shingrix

Administer two doses at 0 and 2 to 6 months.

76
Q

When should RZV vaccination be considered for people with HIV?

A

Consider delaying until the patient is virologically suppressed on ART or until the CD4 count is ≥200 cells/mm3

This ensures a robust vaccine response.

77
Q

Is RZV recommended during pregnancy?

A

No

Vaccination is not recommended during pregnancy due to safety concerns.

78
Q

Should RZV be given during an acute episode of herpes zoster?

A

No

Administration during an acute episode is contraindicated.

79
Q

What is the vaccination recommendation for people with HIV regarding COVID-19?

A

People with HIV should receive a complete COVID-19 vaccine series regardless of their CD4 count or HIV viral load or their pregnancy or breastfeeding status.

Current recommendations can be found on CDC.gov.

80
Q

What is the preferred vaccination for HAV nonimmune individuals?

A

Two-dose series of either Havrix or Vaqta.

Havrix: 1.0 mL IM (0, 6–12 months); Vaqta: 1.0 mL IM (0, 6–18 months).

81
Q

What should be done if total antibody response to HAV vaccination is negative after 4 weeks?

A

Revaccinate, preferably after the CD4 count is ≥200 cells/mm3.

This is a recommendation for individuals who are susceptible.

82
Q

What is the preferred vaccination for HBV nonimmune individuals?

A

Heplisav-B IM at 0 and 4 weeks.

Alternative options include Engerix-B or Recombivax HB.

83
Q

What is the definition of vaccine nonresponder for HBV?

A

If anti-HBs <10 mIU/mL after complete series.

This indicates a lack of adequate immune response.

84
Q

What should be administered to exposed individuals who have not received a vaccine for HBV?

A

Administer or complete the HepB vaccine series and a dose of HBIG.

This should be done as soon as possible after exposure.

85
Q

What is the vaccination schedule for the recombinant 9-valent HPV vaccine?

A

0.5 mL IM three-dose series (0, 1–2, and 6 months).

Vaccination is not recommended during pregnancy.

86
Q

What is the annual recommendation for influenza vaccination?

A

One dose of age-appropriate IIV or RIV annually.

LAIV is contraindicated.

87
Q

What type of vaccine is contraindicated if CD4 count is <200 cells/mm3?

A

MMR vaccine.

This highlights the risk for immunocompromised individuals.

88
Q

What is the recommended post-exposure prophylaxis for measles?

A

Administer MMR vaccine within 72 hours of exposure or IG within 6 days.

MMR vaccine and IG should not be administered simultaneously.

89
Q

What is the vaccination recommendation for individuals with no prior polyvalent meningococcal vaccine?

A

MenACWY vaccine (Menveo or MenQuadfi) two-dose series (0.5 mL IM) at least 8 weeks apart.

Pregnant and lactating people with HIV should receive MenACWY if indicated.

90
Q

What is the vaccination recommendation for individuals with increased risk for MenB?

A

Administer either MenB vaccine: two-dose series of Bexsero or three-dose series of Trumenba.

MenB vaccines are not interchangeable.

91
Q

What is the vaccination recommendation for mpox exposure?

A

Administer two-dose series of JYNNEOS (0.5 mL SQ or 0.1 mL ID) given 28 days apart.

Live-replicating vaccinia vaccines are contraindicated for people with HIV.

92
Q

What is the pneumococcal vaccination recommendation for those with no prior pneumococcal vaccine?

A

Administer either PCV20 or PCV15 followed by PPSV23 after at least 8 weeks.

ACIP recommended PCV21 as an option for adults aged ≥19 years.

93
Q

What should be done if a patient previously received only PPSV23?

A

Administer either PCV20 or PCV15 at least 1 year after last PPSV23 dose.

No follow-up with another dose of PPSV23 is necessary.

94
Q

What is the recommendation for adults aged ≥65 years who received PPSV23?

A

No further doses of PPSV23 are required.

Shared decision-making is recommended regarding administration of PCV20.

95
Q

What is the CD4 count threshold for optimizing vaccine efficacy?

A

> 200 cells/mm3

96
Q

What is recommended for individuals who have previously received only PPSV23?

A

Administer either PCV20 or PCV15 at least 1 year after last PPSV23 dose

97
Q

What is the recommended dose of PCV20?

A

0.5 mL IM x 1

98
Q

What is the recommended dose of PCV15?

A

0.5 mL IM x 1

99
Q

Is follow-up with another dose of PPSV23 necessary after administering PCV15 or PCV20?

100
Q

What is the recommended RSV vaccine dosage for individuals aged ≥75 years?

A

One dose 0.5 mL IM of RSV vaccine (Arexvy, Abrysvo, or mRESVIA)

101
Q

What is the recommendation for individuals aged 60–74 years with a comorbid condition increasing RSV disease risk?

A

One dose 0.5 mL IM of RSV vaccine (Arexvy, Abrysvo, or mRESVIA)

102
Q

What is the recommendation for pregnant people between 32–36 weeks’ gestation regarding RSV vaccine?

A

One dose 0.5 mL IM of RSV vaccine (Abrysvo)

103
Q

When is the RSV season in the continental United States?

A

Typically September–January

104
Q

What is the recommended timing for RSV vaccination before delivery?

A

At least 14 days prior to delivery

105
Q

What is the vaccination recommendation for those not previously vaccinated for Tetanus, Diphtheria, and Pertussis?

A

One dose 0.5 mL IM Tdap, followed by Td or Tdap at least 4 weeks later

106
Q

What is the recommended Tdap booster schedule after the initial dose?

A

Td or Tdap every 10 years

107
Q

When should Tdap be administered during pregnancy?

A

Preferably in gestational weeks 27–36

108
Q

What is the varicella vaccine recommendation for individuals with CD4 count ≥200 cells/mm3?

A

Two-dose (0.5 mL SQ) series of VAR 4–8 weeks apart

109
Q

What is the contraindication for Varivax?

A

CD4 count <200 cells/mm3

110
Q

What are the criteria for evidence of immunity to varicella?

A

Documented receipt of two doses of Varivax or MMRV; diagnosis of varicella or zoster; laboratory evidence of immunity or disease

111
Q

What is the recommended vaccination for individuals aged ≥18 years regarding Zoster?

A

Two-dose (0.5 mL IM) series of RZV (Shingrix) 2–6 months apart

112
Q

When should RZV vaccination be delayed?

A

Until patient is virologically suppressed on ART or after immune reconstitution

113
Q

What is the recommendation for cholera vaccination for travelers?

A

Not routinely recommended for most travelers

114
Q

What is the cholera vaccination recommendation for individuals aged 18–64 years with CD4 count >200 cells/mm3?

A

Lyophilized CVD 103-HgR (Vaxchora) single oral dose at least 10 days prior to potential exposure

115
Q

What is the recommended vaccination for typhoid for those at risk?

A

One dose 0.5 mL (25 mcg) IM Vi capsular polysaccharide vaccine at least 1 week before exposure

116
Q

What is the recommendation for yellow fever vaccination for individuals aged ≤59 years?

A

One dose of YF vaccine if asymptomatic with CD4 count >500 cells/mm3

117
Q

What is contraindicated for yellow fever vaccination?

A

CD4 count <200 cells/mm3

118
Q

What is the recommended vaccination schedule for polio for those at higher risk?

A

Three doses IPV 0.5 ml IM at 0 and 1–2 months, with third dose given 6–12 months after second dose

119
Q

What is the vaccination recommendation for COVID-19 in relation to HIV?

A

For current COVID-19 vaccination recommendations, please visit the CDC’s COVID-19 Vaccines website

120
Q

What is the recommended vaccination schedule for Hepatitis A?

A

Two to three doses (varies by formulation)

121
Q

What is the recommended vaccination schedule for Hepatitis B?

A

Two to three doses (varies by formulation and indication)

122
Q

What is the HPV vaccination recommendation for ages 18–26 years?

A

Three doses

123
Q

What is the vaccination recommendation for Influenza?

A

One dose annually

124
Q

What is the recommendation for MMR vaccination for those born after 1956?

A

Two doses if no history of vaccination or positive antibody titer

125
Q

What is the recommended schedule for Meningococcal A,C,W,Y Conjugate (MenACWY)?

A

Two doses, then booster every 5 years

126
Q

What is the vaccination recommendation for Mpox (MVA-BN, Attenuated)?

127
Q

What is the recommendation for Mpox (ACAM2000, Live-Replicating)?

A

Contraindicated

128
Q

What is the vaccination recommendation for Pneumococcal Conjugate (PCV15, PCV20)?

129
Q

What is the recommendation for Pneumococcal Polysaccharide (PPSV23)?

A

One dose (if conjugate vaccine was PCV-15)

EBAC - Infectious Disease (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions