Pediatric Immunizations

Question 1

What is a live attenuated vaccine? Characteristics/restrictions? Examples?

Answer 1

=version of microbe weakened in lab

–stronger mucosal immunity develops
–cannot be given to immunocompromised pts
–cannot be given to pts who have received blood products in the past

Ex: MMR, varicella, rotavirus, influenza, zoster/shingles

Question 2

When are booster vaccines generally given to children?

Answer 2

Booster vaccines are typically given from 4-6YO.

Question 3

For the influenza vaccine, when is it given? Special considerations?

Answer 3

–yearly vaccine with 1 dose given to individuals over 9YO and 2 doses (28d apart) given to children between 6mo and 9YO
–quadrivalent: 2 A’s, 2 B’s
–virus changes year-to-year due to antigenic drift and shift
–especially important for very young, very old and chronically ill individuals
–inactivated and live attenuated vaccine is available but not presently used

Question 4

What are vaccines with sub-unit antigens or inactivated toxins? Characteristics/restrictions? Examples?

Answer 4

–includes “parts” that best stimulate an immune response

Ex: tetanus, diphtheria

Question 5

For the MMR vaccine, when is it given? Special considerations?

Answer 5

–live virus
–2 doses of the MMR vaccines are given: one at 12mo and one at 4-6YO
–MMR has been largely eliminated from the US

Question 6

For the varicella vaccine, when is it given? Special considerations?

Answer 6

–live virus
–2 doses of the varicella vaccines are given: one at 12mo and one at 4-6YO
–Varicella infections have greatly declined in the US

Question 7

For the zoster vaccine, when is it given? Special considerations?

Answer 7

–live virus

–given to adults

Question 8

When is the busiest time for vaccinations?

Answer 8

From birth to 24 months of age

Question 9

Which two vaccines are given to older children?

Answer 9

Meningococcal and HPV vaccines

Question 10

What are the two main benefits of vaccination?

Answer 10

Individual immunity and herd immunity

Question 11

What are some important resources for pediatricians? What is the “bible” for infectious diseases in pediatrics?

Answer 11

Resources: CDC, CDCV app, AAP, ACIP, and AAFP

“Bible”: The Red Book

Question 12

What are conjugate vaccines? Characteristics/restrictions? Examples?

Answer 12

–pathogens are surrounded by polysaccharide capsule and are immunogenic
–bacterial polysaccharides alone are poorly immunogenic in kids
–conjugation to carrier proteins strengthens immune response–>T-cell dependent immunity to polysaccharides is triggered, strengthening immune memory

Ex: meningococcal, pneumococcal, haemophilus influenza B, hepatitis B, influenza (injection), HPV, pertussis

Question 13

What is herd immunity?

Answer 13

If enough people in a community are immunized against a dz, it is difficult for the dz to infect individuals who are not immunized in the community. When community vaccination rates drop below threshold of her immunity, widespread outbreaks can occur. This threshold varies for different diseases

Question 14

For the rotavirus vaccine, when is it given? Special considerations?

Answer 14

–live virus
–2 or 3 doses give at 2, 4 and 6mo of age
–first does should not be given after 14 weeks and 6 days of age
–small risk of intussusception

Question 15

What are four common myths regarding vaccines?

Answer 15

–MMR causes autism
–people with egg allergies cannot get the influenza vaccine
–vaccines cause dz
–not getting immunizations ↓overall lifetime risk for the child

Question 16

What are inactivated/killed vaccines? Characteristics/restrictions? Examples?

Answer 16

–organism is carefully killed, either thermally or chemically
–immunogenicity is retained

Ex: hepatitis A, polio, rabies

Question 17

List the different types of vaccines

Answer 17

–vaccines with sub-unit Ags or inactivated toxins (toxoids)
–conjugated vaccines
–live attenuated vaccines
–non conjugate, inactivated or killed vaccines