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Clin Med/Spec > Ped Exam 1 Lecture 5: Immunizations > Flashcards

Ped Exam 1 Lecture 5: Immunizations Flashcards

1
Q

Who should get the catch up schedule for vaccines?

A
  • kids born outside the US

- kids w/illnesses that prevented them from getting vaccinated at normal time

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2
Q

What is the aim of childhood vaccinations from a public health perspective?

A

Prevention of acute and chronic diseases (liver and cervical cancer)

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3
Q

What disease is caused by toxin-mediated release and transmitted person to person usually by respiratory droplets

A

Diphtheria

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4
Q

What are the Sxs that diphtheria causes in the respiratory tract

A
  1. Membranous nasopharyngitis
  2. Obstructive laryngotracheitis

(thick grey pseudomembrane –> diffic swallow/breathing)

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5
Q

3 Complications of Diphtheria

A

“MAVis has diphtheria”

Myocarditis
Ascending paralysis
Vocal cord paralysis

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6
Q

Formulation of the Diphtheria vaccine if <7 y/o? older than 7?

A

< 7 –> DTaP or DT (“Dominic is 6”)
> 7 –> Tdap or Td (“Tommy is 8”)

note: capital D = higher diphtheria dose

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7
Q

What are 2 ways to prevent tetanus with the tetanus toxoid?

A
  1. Vaccine (given in combo w/diphtheria)

2. Tetanus Immune globulin (TIG)

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8
Q

Components of the DTap vaccine?

A
  1. Diphtheria toxoid
  2. Tetanus toxoid
  3. Bordella Pertussis
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9
Q

What is the minimum number of doses for the DTap vaccine? Why do you need more than 1 dose for this vaccine?

A

3 doses

Boosters are needed because the vaccine has shorter immunity

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10
Q

Why do you need more than 1 dose for both Tdap and DTap vaccine?

A

Boosters are needed because the vaccine has shorter immunity

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11
Q

What is the only CI to the Tdap vaccine?

A

Anaphylaxis after receiving any Tdap component

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12
Q

What age group should be given the Tdap vaccine as catch up?

A

adolescents (13-18 y/o)

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13
Q

What is the purpose of giving pregnant mothers the Tdap vaccine? How often/when should it be given?

A

Tdap ↓ risk of infant pertussis exposure and severe disease

GIVE DURING EACH PREGNANCY (ideal = 27-32 wks gestation)

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14
Q

What are the CIs (relative) to the pertussis vaccine?

A
  1. Anaphylatic rxn

2. Encephalopathy w/in 7 days

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15
Q

When is acceptable to defer immunization of the pertussis vaccine? What is given if the deferral occurs at the age of 1?

A

Evolving neuro d/o

Give DT if defer at age 1 (no pertussis)

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16
Q

What type of virus is the Polio virus?

When must the last dose be given?

A

Killed/inactivated virus

Last dose must be given at age 4+ & at least 6 mo after last dose

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17
Q

Why is the oral/live attenuated polio virus no longer used?

A

Some conversion/mutation of the live attenuated version that leads to paralysis

(killed version doesn’t have this risk)

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18
Q

What vaccine has eradicated the dz associated with it?

A

Haemophilus Influenza B (HiB) Vaccine

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19
Q

What are the 2 types of the HiB Vaccine?

A
  1. PRP-T

2. PRP-OMP

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20
Q

What combination is no longer available for the HiB vaccine?

A

HiB-MenCY

- HiB w/Meningococcal groups C & Y

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21
Q

Makeup of the HiB vaccine?

Problem associated w/this type of vaccine?

A

Polysaccharide Vaccine

- young kids have harder time responding to the vaccine

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22
Q

What is the benefit of a conjugate vaccine, such as the Pneumococcal Conjugate Vaccine (PCV13/Prevnar 13)?

A

Can be admin to younger kids who are able to mount a response (more immunogenic)

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23
Q

What populations are at increased risk of invasive pneumococcal dz and should therefore be given an additional dose of PCV13?

A
  1. Anatomic of Functional Asplenia (SCD)
  2. HIV or immunocompromised
  3. Cochlear implant or CSF leak
  4. Chronic Renal Falure or nephrotic syndrome
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24
Q

How is the Pneumococcal Polysaccharide Vaccine (Pneumovax) different from the Conjugate version?

A

Pneumovax

  • less immunogenic than Prevnar13
  • includes 11 more serotypes than Prevnar13
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25
Q

When are you more risk for getting S/Es with Pneumovax? Solution?

A

When given w/in 8 weeks of the Prevnar vaccine

wait more than 8 wks… be patient you fool

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26
Q

What are the indications for Pneumovax? When should you revaccinate?

A

High risk children, over age 2

revaccinate high risk kids ONCE after 5 yrs

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27
Q

What is not included in the Meningococcal Conjugate Vaccine (Menactra, Menveo)?

Note: usually first dose not given til older but special populations dosed in infancy

A

Serogroup B not included

28
Q

Who can the Meningococcal B vaccine be given to?

A

adolescents who arent high risk

29
Q

When can the Meningococcal B vaccine be given at age 10?

A

special high risk populations and during outbreaks

30
Q

Major RF for Hep B?

A

UNKNOWN –> why vaccine needed

31
Q

Content of Hep B vaccine? Duration of immunity?

A

HBsAg

Vaccine has long immunity ( > 30 yrs)

32
Q

What is the content of the combination Hep B vaccine in children vs adults?

A

Children: DTaP + HepB + IPV

Adults: Hep A + Hep B

33
Q

If a mother is HBsAg (-) how many doses of the Hep Vaccine should be given to the child?

How does the time of admin for the 1st dose differ when the baby is preterm (< 2 kg)

A

3 doses

1st dose in full term baby = at birth (w/in 24 hrs)

1st dose in preterm baby = 1 month of age or hospital D/C (whichever is first)

34
Q

If a mother is HBsAg (+) what should be given to the child for protection vs Hep B & how soon?

A

Baby should get Hep B immunoglobulin w/in first 12 hours of birth

35
Q

Other indications for Hep A vaccine, other than routine childhood immunization at age 1?

A
  1. Tavelers to endemic areas
  2. close contact w/internat’l adoptees
  3. Hep A outbreak
  4. Chronic Liver Dz
36
Q

What type of cancer is most a/w HPV?

A

Cervical Cancer

37
Q

What do low risk HPV types cause?

high risk?

A

low risk HPV –> warts

high risk HPV –> cancer

38
Q

Why is it ideal to give the HPV vaccine prior to exposure?

A

Prevents infection, warts, and cancer

39
Q

What the makeup of the Gardasil vaccine (9vHPV)?

A

Virus-like particles

NOT LIVE VACCINE

40
Q

What is the maximum age the catch-up vaccination w/Gardasil can be given for females vs males?

A

Females –> 26

Males –> 21

41
Q

What is the earliest age the HPV vaccine can be given?

A

9 years old

42
Q

What vaccines are included in MMRV?

A

Measles, Mumps, Rubella, Varicella

43
Q

Which one of the MMRV components is not a true live virus?

A

Varicella Vaccine - live attenuated virus

44
Q

What are 3 CIs to the Measles Vaccine (applies to all live vaccines)

What is NOT a CI?

A
  1. Pregnancy
  2. Immunocompromised
  3. Recent Immunoglobulin

Egg allergy is NOT a CI

45
Q

When should you still administer the Measles (or other live vaccines) to immunocompromised patients?

A

Admin if HIV+ and CD4 > 15%

46
Q

When can the TST (TB Skin Test/PPD) be performed for the Measles Vaccine?

A

Day of vaccination or 1 month later

BUT NOT B/TWEEN THIS TIME PERIOD

47
Q

During an outbreak of Measles what is the youngest age a child can be to receive the vaccine?

Why does this not count as the first dose for the vaccine at this age?

A

6 months old

Doesnt count at 1st dose of Measles b/c 1st dose must be given after 12 months

48
Q

When is Mumps MC?

A

Winter and Spring

49
Q

Mumps clinical presentation?

4 main complications of Mumps?

A

Mumps presents w/Parotitis

Complications

  1. Meningoencephalitis
  2. Sensorineural hearing loss
  3. Ochitis
  4. Pancreatitis

“PeoPle Often get Mumps in Spring”

50
Q

How to Dx and Tx Mumps?

A

Dx: viral isolation by PCR
(by Saliva, buccal swab, CSF, or serology)

Tx = supportive

51
Q

Although the Mumps is a live vaccine what is unique about it?

A

It doesnt often cause reactivity

52
Q

Since Rubella is a fairly benign dz why is a vaccine given?

A

Rubella vaccine given to prevent intrauterine infection (during pregnancy)

53
Q

Unique AEs a/w Rubella vaccine?

A

LAD, transient arthralgias

54
Q

What is unique about when the Varicella vaccine can be given?

A

Varicella vaccine can be given post-exposure and is still very effective if given w/in 3 days

55
Q

Unique AEs a/w Varicella vaccine?

A 
Papulovesicular rash ("chicken pox like")
- localized at injection site, NOT SYSTEMIC
56
Q

What med must you avoid for 6 weeks after giving Varicella vaccine? why?

A

ASA –> a/w Rye Syndrome

57
Q

What are the two types of orally administered live Rotavirus vaccines and their associated # of doses?

A

Pentavalent RV5 - 3 doses

Monovalent RV1 - 2 doses

58
Q

AE for Rotavirus vaccine

A

Risk of intussusception

59
Q

CIs for Rotavirus vaccine

A
  1. SCID (Severe Combined Immunodeficiency)

2. Hx of intussusception

60
Q

What is the maximum age that the Rotavirus can be given?

A

8 months

risk > benefit

61
Q

What 4 vaccines is vaccination rate at or above target levels based on the Healthy People 2020 goals?

A
  1. MMR
  2. Hep B
  3. IPV
  4. Varicella
62
Q

How do UNvaccinated children differ from UNDERvaccination?

A

UNvaccinated –> conscious refusal

UNDERvaccination –> related to SES and access

63
Q

Obvious but possibly important points about vaccines (flip over for info)

A
  1. MMR/vaccines DONT CAUSE AUTISM (duh)
  2. No evidence to support that you may overwhelm the immune system w/multiple vaccines at once
  3. Natural immunity (getting the dz) has greater risk than passive immunity
64
Q

1st dose of this vaccine can be given at birth?

A

Hep B

65
Q

1st dose of what 5 vaccines can be given 2 months old at the earliest?

A
  1. RV
  2. DTaP
  3. HiB
  4. PCV13
  5. IPV
66
Q

1st dose of what vaccine is given earliest at 6 months and yearly thereafter?

A

Influenza

67
Q

1st dose of what 3 vaccines is given earliest at 1 year?

A
  1. MMR
  2. Varicella
  3. Hep A

Clin Med/Spec (11 decks)

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