Public Health & Preventive_Vaccine in Adults and Childrem Flashcards
What are examples of live vaccines?
- measkes
- mumps
- rubella
(MMR vaccine)
- Sabin polio vaccine
- varicella vaccine
- Rotavirus
What is the major risk of oral polio vaccine? Some countries no longer distribute the vaccine for this reason?
Increased risk of vaccine-associated paralytic poliomyelitis
Which populations should avoid live vaccines?
- pregnant women
- the immunocompromised
- close contacts of the immunocompromised
What are the standard childhood immunisations?
- 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
What is the dosing schedule for the MMR vaccine?
- 2 doses
- 12-15 mnths and 4-6 years
What is the dosing schedule for the varicella vaccine?
- 2 doses
- 12-15 mnths and 4-6 years
Live vaccines are contraindicated in patients with HIV. True or False?
- false
- MMR and the varicella vaccine can be given to HIV patients with a CD4 T cell count > 200 cells/mL
What is the dosing schedule for the oral pentavalent rotavirus vaccine?
- 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.
What is the dosing schedule for the hepatitis B vaccine?
- Three doses:
- 0-1 month old
- 1-4 months old, and
- 6-18 months old
What is the management of a child born to an HBsAg positive mom?
- Give the first dose of the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) at birth
What is the dosing schedule for the hepatitis A vaccine?
- Two doses:
- 1 year old and then 6-18 months later
What is the dosing schedule for DTaP?
- 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
What is the dosing schedule for the Hib vaccine?
- Four doses:
- 2, 4, 6, and 12-15 months old
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?
- 99%
What is the dosing schedule for the IPV?
- Four doses:
- 2, 4, and 6 months old; 4-6 years old
What is the dosing schedule for PCV7?
- Four doses:
- 2, 4, 6, and 12-15 months old
Who should be offered the conjugated quadrivalent meningococcal polysaccharide vaccine (MCV4)?
- 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
Who should be offered revaccination with MCV4?
- 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.
Asplenic patients are particularly vulnerable to what kind of infections?
Encapsulated bacterial infections
What is the dosing schedule for the influenza vaccine?
- Everyone 6 months of age and older should get an influenza vaccine every year (influenza has a high rate of mutation).
What time of year should the influenza vaccine be administered?
- 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.
Which patients should not be offered the influenza vaccine?
- Patients with anaphylaxis to eggs (since the vaccine is prepared from viruses grown in eggs)
Who should be offered the H1N1 influenza vaccine?
All patients 6 months of age and older
What is the current recommendation for HPV vaccination?
- 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.
When should the second and third doses of HPV vaccine be administered?
- Second dose 2 months after the first and
- the third dose 6 months after the first
Can the HPV vaccine be administered to males?
HPV4 may be administered to males (9-26 years old) to help prevent genital warts
Can females over the age of 26 receive the “quadrivalent” vaccine (HPV4 for HPV type 6, 11, 16 and 18)?
- Yes; however, studies are still ongoing proving safety of efficacy in this age group
Should the vaccine be administered to those who have a history of genital warts, abnormal Pap, and/or positive HPV DNA test?
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.
Why should females who have received the quadrivalent vaccine still be screened for cervical cancer?
- 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.
Which patients should be offered pneumococcal polysaccharide vaccine (PPV23)?
- 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
What are the indications for revaccination with PPV(penumococcal polysaccharide vaccine) 23?
- Patient received the vaccine ≥5 years previously
- < 65 years old at the time of vaccination
- immunocompromised
- asplenia
- postorgan or bone marrow transplantation
Why can you not use PPV23 in children?
- PPV23 contains polysaccharide antigens that are not immunogenic in children <2 years old (PCV7 contains 7 capsular polysaccharides conjugated to a protein)
Which patients should be offered a single dose of the zoster vaccine to prevent shingles and postherpetic neuralgia?
- Adults aged 60 years and older
Which patients should not receive the shingles vaccine?
- Pregnant women
- those with a history of anaphylaxis to gelatin or neomycin
- immunodeficient patient (including those with AIDS and on immunosuppressive therapies)
The shingles vaccine can be given to those with history of shingles. True or False?
- 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.
