Public Health & Preventive_Vaccine in Adults and Childrem Flashcards

1
Q

What are examples of live vaccines?

A
  • measkes
  • mumps
  • rubella

(MMR vaccine)

  • Sabin polio vaccine
  • varicella vaccine
  • Rotavirus
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2
Q

What is the major risk of oral polio vaccine? Some countries no longer distribute the vaccine for this reason?

A

Increased risk of vaccine-associated paralytic poliomyelitis

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3
Q

Which populations should avoid live vaccines?

A
  • pregnant women
  • the immunocompromised
  • close contacts of the immunocompromised
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4
Q

What are the standard childhood immunisations?

A
  • MMR
  • varicella
  • hepatitis B
  • hepatitis A
  • Haemophilus influenzae type b (Hib)
  • inactivated polio (IPV)
  • pneumoccocal conjugate vaccine (PCV7)
  • diphtheria and tetanus and acellular pertussis (DTaP)
  • rotavirus
  • influenza
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5
Q

What is the dosing schedule for the MMR vaccine?

A
  • 2 doses
  • 12-15 mnths and 4-6 years
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6
Q

What is the dosing schedule for the varicella vaccine?

A
  • 2 doses
  • 12-15 mnths and 4-6 years
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7
Q

Live vaccines are contraindicated in patients with HIV. True or False?

A
  • false
    • MMR and the varicella vaccine can be given to HIV patients with a CD4 T cell count > 200 cells/mL
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8
Q

What is the dosing schedule for the oral pentavalent rotavirus vaccine?

A
  • Three doses:
    • 2, 4, and 6 months old.
  • The series should not be started after the age of 12 weeks, and
  • the final dose should be given by the age of 32 weeks.
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9
Q

What is the dosing schedule for the hepatitis B vaccine?

A
  • Three doses:
    • 0-1 month old
    • 1-4 months old, and
    • 6-18 months old
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10
Q

What is the management of a child born to an HBsAg positive mom?

A
  • Give the first dose of the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) at birth
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11
Q

What is the dosing schedule for the hepatitis A vaccine?

A
  • Two doses:
    • 1 year old and then 6-18 months later
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12
Q

What is the dosing schedule for DTaP?

A
  • Five doses:
    • 2, 4, 6, 15-18 months old, and
    • 4-6 years old;
  • give Td (tetanus and diphtheria toxoids) boosters at age 11-12 years and then every 10 years
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13
Q

What is the dosing schedule for the Hib vaccine?

A
  • Four doses:
    • 2, 4, 6, and 12-15 months old
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14
Q

Since the introduction of the Hib vaccine in 1987, the number of Hib (a cause of meningitis and epiglottitis) cases in children less than 5 years old has decreased by what percentage?

A
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15
Q
  • 99%
A
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16
Q

What is the dosing schedule for the IPV?

A
  • Four doses:
    • 2, 4, and 6 months old; 4-6 years old
17
Q

What is the dosing schedule for PCV7?

A
  • Four doses:
    • 2, 4, 6, and 12-15 months old
18
Q

Who should be offered the conjugated quadrivalent meningococcal polysaccharide vaccine (MCV4)?

A
  • 11-12 year olds, at age 13-18 if not previously vaccinated
  • previously unvaccinated college freshmen living in dorms
  • to children aged 2-10 with persistent complement component deficiency or anatomic or functional asplenia
19
Q

Who should be offered revaccination with MCV4?

A
  • If the first dose was administered at age 2-6, then revaccinate children who remain at risk after 3 years.
  • If the first dose was administered at age 7 years or older, then revaccinate after 5 years.
  • Patients who remain at increased risk for meningococcal disease should be revaccinated at 5-year intervals.
20
Q

Asplenic patients are particularly vulnerable to what kind of infections?

A

Encapsulated bacterial infections

21
Q

What is the dosing schedule for the influenza vaccine?

A
  • Everyone 6 months of age and older should get an influenza vaccine every year (influenza has a high rate of mutation).
22
Q

What time of year should the influenza vaccine be administered?

A
  • Once it is available for a particular year, the vaccine may be administered at anytime (the earlier the better) before or during the influenza season, which usually peaks in the fall/winter months.
23
Q

Which patients should not be offered the influenza vaccine?

A
  • Patients with anaphylaxis to eggs (since the vaccine is prepared from viruses grown in eggs)
24
Q

Who should be offered the H1N1 influenza vaccine?

A

All patients 6 months of age and older

25
Q

What is the current recommendation for HPV vaccination?

A
  • HPV2 (protects against types 16 and 18) or HPV4 (protects against types 6, 11, 16, and 18) is recommended for females at age 11 or 12 years old
  • however, catch up vaccination can be done up until age 26.
26
Q

When should the second and third doses of HPV vaccine be administered?

A
  • Second dose 2 months after the first and
  • the third dose 6 months after the first
27
Q

Can the HPV vaccine be administered to males?

A

HPV4 may be administered to males (9-26 years old) to help prevent genital warts

28
Q

Can females over the age of 26 receive the “quadrivalent” vaccine (HPV4 for HPV type 6, 11, 16 and 18)?

A
  • Yes; however, studies are still ongoing proving safety of efficacy in this age group
29
Q

Should the vaccine be administered to those who have a history of genital warts, abnormal Pap, and/or positive HPV DNA test?

A

Yes. Vaccination is less effective for those who have already been infected with one or more of the HPV types; however, the vaccine should still be administered since there is still some protection conferred against the other HPV types.

30
Q

Why should females who have received the quadrivalent vaccine still be screened for cervical cancer?

A
  • The vaccine does not protect against all HPV types that cause cancer.
  • Patients may not have received all the doses of the vaccine.
  • Patients who already have acquired HPV may not get the vaccine’s full benefit.
31
Q

Which patients should be offered pneumococcal polysaccharide vaccine (PPV23)?

A
  • Adults ≥65 years old
  • patients with chronic respiratory disease (including asthma)
  • alcoholism
  • cardiovascular disease
  • diabetes
  • chronic liver disease
  • chronic renal failure
  • cochlear implants
  • nephrotic syndrome
  • nursing home residents
  • immunocompromised patients
  • asplenic patients
  • patients who smoke cigarettes
32
Q

What are the indications for revaccination with PPV(penumococcal polysaccharide vaccine) 23?

A
  • Patient received the vaccine ≥5 years previously
  • < 65 years old at the time of vaccination
  • immunocompromised
  • asplenia
  • postorgan or bone marrow transplantation
33
Q

Why can you not use PPV23 in children?

A
  • PPV23 contains polysaccharide antigens that are not immunogenic in children <2 years old (PCV7 contains 7 capsular polysaccharides conjugated to a protein)
34
Q

Which patients should be offered a single dose of the zoster vaccine to prevent shingles and postherpetic neuralgia?

A
  • Adults aged 60 years and older
35
Q

Which patients should not receive the shingles vaccine?

A
  • Pregnant women
  • those with a history of anaphylaxis to gelatin or neomycin
  • immunodeficient patient (including those with AIDS and on immunosuppressive therapies)
36
Q

The shingles vaccine can be given to those with history of shingles. True or False?

A
  • True. The Advisory Committee on Immunization Practices recommends offering the vaccine regardless of prior shingles history though use of the vaccine has not specifically been studied in this population.
37
Q
A