Immunizations Introduction

Question 1

Vaccines are intended to induce/provide immunity ? by administering an immunobiologic agent.

Answer 1

artificially

Question 2

What kind of immunity is acquired when getting a vaccine?

Answer 2

active immunity

Question 3

Immediate goal of immunization

Answer 3

Prevention of diseases

Question 4

Ultimate goal of immunzation

Answer 4

Eradication of diseases

Question 5

Herd immunity definition/concept

Answer 5

High vaccination rates will protect the person who’s immunized but also protect other members of the community who can’t be vaccinated due to medical reasons, etc. and reduce disease outbreaks

Question 6

Spacing of ≥2 inactivated vaccines

Answer 6

No spacing required; can give all at once or at any interval

Question 7

The exception to the rule of spacing ≥2 inactivated vaccines

Answer 7

PCV13 and PPSV23 need to be spaced 8 weeks apart (up to a year)

PCV13 and Menactra should be spaced ≥4 weeks apart

Question 8

Spacing for an inactivated and a live vaccine

Answer 8

No spacing required

Question 9

Spacing for ≥2 live vaccines

Answer 9

28-day minimum interval if not given simultaneously

Question 10

What happens when you decrease the vaccine interval?

Answer 10

Decrease protection/less antibody response

Question 11

What happens when you increase the vaccine interval?

Answer 11

Delayed protection

Question 12

In general, do you restart a vaccine series?

Answer 12

No

Question 13

When do you use the catch-up series?

Answer 13

If a vaccine dose isn’t recorded in a patient’s vaccination record

Question 14

When should immunization be avoided/postponed?

Answer 14

Moderate-severe illness, history of Type I hypersensitivity, immunodeficiency diseases, live attenuated vaccines for pregnant women

Question 15

Live attenuated vaccine interaction with chemo/radiation

Answer 15

Vaccinate 2 weeks before or 3 months after treatment

Question 16

Live attenuated vaccine interaction with systemic corticosteroids

Answer 16

If the duration of steroid treatment is <14 days, can vaccinate immediately after D/C or wait ~2 weeks

If it’s ≥14 days, must wait at least 1 month to vaccinate

Question 17

Live attenuated vaccine interaction with IVIG

Answer 17

IVIG shouldn’t be administered for 14 days after immunization (need to re-administer otherwise)

Generally, vaccines shouldn’t be given <3 months post-IVIG

Kawasaki disease: hold live vaccines for 11 months

Question 18

Live attenuated vaccine and PPD interaction

Answer 18

Give simultaneously or wait 4-6 weeks

Question 19

ARVs and live attenuated vaccine interaction

Answer 19

Avoid ARV use for 14 days after vaccination if possible

Question 20

Vaccine adverse effects

Answer 20

Injection site reactions with or without fever, tiredness, fatigue, hypersensitivity reactions, vasovagal syncope, sterile abcesses

Question 21

Vaccine storage

Answer 21

Most vaccines require storage between 2-8ºC, some require a freezer, some are light-sensitive

Question 22

IM vaccines

Answer 22

COVID, Td, Tdap, flu (inactivated), PCV, PPV, herpes

Question 23

SQ vaccines

Answer 23

Herpes zoster, PPV

Question 24

What angle do you administer an IM vaccine at?

Answer 24

90º

Question 25

What angle do you administer an SQ vaccine at?

Answer 25

45º

Question 26

What vaccine can be administered intranasally?

Answer 26

Live attenuated flu vaccine

Question 27

What happens if a patient sneezes during an intranasal vaccine?

Answer 27

Just leave it alone; don’t redose