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PHM SCI 650 > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Role of Advisory Committee on Immunization Practices (ACIP)

A

Provide external advice to CDC and Secretary of Dept of Health and Human Services on the use of vaccines in the US

*Develops recommendations on how to use vaccines to control diseases in the US

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2
Q

Benefits of Vaccines

A

Routine childhood immunization
Infant immunization prevents disease from spreading

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3
Q

Process to monitor vaccine safety

A

-Retrospective or prospective screening
-Use ACIP guidelines
-Use screening form to identify precautions and contraindications
-Obtain vaccination history
-Consider patients age, lifestyle and medical conditions

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4
Q

Vaccine administration

A

Document vaccine administration in accordance with law and standard of practice

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5
Q

Using questionnaire

A

use a questionnaire to screen for vaccine indication and precautions

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6
Q

No vaccination records

A

Attempt to locate missing records
Consider susceptible and immunize

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7
Q

Immunization records

A

Maintain record in pharmacy
Report to primary care provider
Personal immunization record
Report any adverse events to primary care provider and VAERs
Document patient education provided
Wisconsin Immunization Registry

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8
Q

National Vaccine Injury Compensation program

A

Compensation for loss or damage to injured
Protector of vaccinator from personal liability
Primarily pediatric patients but will cover adults too

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9
Q

Listed vaccines

A

Diphtheria, Influenza type B, hep a and b, HPV, influenza, measles, mumps, meningococcal, pertussis, pneumococcal conjugate, polio, rotavirus, rubella, tetanus, varicella, RSV or Nirsevimab (antibodies for RSV)

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10
Q

Passive immunity

A

Transfer of immunity produced by one human or animal to another
Can have drug interaction with live vaccine

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10
Q

VICP claims

A

Requires documentation in immunization log or in permanent medical record
-Patient name
-Vaccine, manufacturer, and lot number
-Date of administration
-Name, address, and title of individual administering vaccine
-VIS edition date and date provided to patient

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11
Q

Active Immunity

A

Stimulate the host to produce a protective response to an antigen

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12
Q

Live vaccine timing

A

Live vaccines must be separated by 4 weeks if not administered simultaneously
Live vaccines administered on or after 1st bday so mothers protective antibody is gone

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13
Q

Vaccine dosing intervals

A

Increasing the interval between doses does not diminish the effectiveness
Decreasing the interval between doses may interfere with vaccine response

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14
Q

Vaccine contraindications

A

Severe allergy to vaccine
Pertussis containing vaccines can cause Encephalopathy

Temporary:
Pregnancy
Immunosuppression
Severe illness
Recent receipt of blood or immune globulin products

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15
Q

Herd immunity

A

Protection conferred to susceptible individuals when sufficient proportion of the population is immune
Depends on reproduction number
*No infection has ever achieved this
Must be combined with immunizations

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16
Q

Measles

A

Highly infective
Transferred by respiratory droplets
Symptoms include: Fever. cough, runny nose or coryza, conjunctivitis
-Can consider those born prior to 1957 immune

Vaccine:
-Live attenuated
-Vaccine administered at 12-15 months of age with a second does prior to entering school

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17
Q

Mumps

A

Acute self limited parotitis
Transmitted by large respiratory droplets
Complications include gastritis, meningoencephalitis, orchitis, mastitis, and oophoritis

Vaccine:
-Live attenuated
-Administered with measles and rubella

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18
Q

Rubella

A

Mild exanthematous viral infection
Transmitted via respiratory route

Vaccine:
-Live attenuated
-Administered with measles and mumps or Varicella

*Do not immunize pregnant people

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19
Q

Hep A

A

Viral disease
Transmitted oral-fecal
More serious in adults

Vaccine indications:
-Men who are gay
-People who use drugs
-People with occupational risk
-Unimmunized
-Homeless people

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20
Q

HiB

A

Small gram neg organism causing infections ranging from colonization to meningitis

Vaccine:
Conjugate vaccines
Recommended at 2, 4, 6, and 12-15 months

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21
Q

ACIP tasks

A
  1. Consideration of disease epidemiology and burden
  2. Vaccine efficacy and effectiveness
  3. Vaccine safety
  4. Economic analysis
  5. Implementation issues
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22
Q

Hep B virus pathology

A

Viral disease caused by hep B virus
Transmitted by parenteral routes
-blood transfusion
-sharing of needles
-sexual contact
-mother to neonate

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23
Q

Hep B immunization of adults

A

All adults < 60 years old
Routine immunization of infants since 1991
Routine immunization of adolescents since 1997

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24
Q

Hep B vaccines

A

Recombinant hep B surface antigen witgh aluminum adjuvant
-Engerix (ped or adult)
-Recombivax (ped or adult)
-Three doses at 0,1,6 months
Recombinant hep B surface antigen with CpG 1018 adjuvant
-Heplisav-B (18 or older)
-Two doses separated by 1 month
Recombinant hep B vaccine with MULTIPLE surface antigens with aluminum adjuvant
-Prehevbrio (18 or older with trouble getting vaccinated)
-Three doses at 0,1,6 months

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25
Q

Post Vax testing for Hep B

A

-Antibody testing in healthcare workers at risk for sharp injury
-100% effective in those who develop an antibody response
-For older individuals (> 40 years), chronic conditions, immunosuppression at risk for non response

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26
Q

Polio pathology

A

Acute viral illness which in its serious form affects the central nervous system
Fecal-oral transmission
Complications include flaccid paralysis
Death rate as high as 10%

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27
Q

Polio Vaccine

A

Live attenuated oral vaccine - OPV no longer used —> Can lead to Vaccine derived Polio outbreak in areas with low vaccination
Enhanced potency inactivated vaccine - IPV
Recommended at 2, 4, 6-18 months and again at 4-6 years (4-6years is very important)

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28
Q

Varicella (or chicken pox) pathology

A

Highly contagious disease due to varicella zoster virus
spread by contact or the respiratory route
Chracterisitic pruritic vesicular rash with fever
Complication include bacterial infection of lesion, pneumonia, encephalitis, and cellulitis

29
Q

Varicella epidemiology

A

Children
3.5-4 million cases each year
generally mild disease with rare complications
Adults
5% of all cases occur in those > 15 years
complications much more common

30
Q

Varicella vaccine

A

Varivax licensed in 1995
Live attenuated viral vaccine
Contraindicated:
-immunosuppression
-pregnancy
-receipt of blood products
-active untreated TB

31
Q

Evidence of varicella immunity

A

Born in the US before 1980
Physician documented clinical history of chicken pox or zoster
Laboratory evidence of immunity
Two doses of varicella vaccine after first birthday separated by at least 4 weeks
(for healthcare workers no birth before 1980)

32
Q

Rotavirus epidemiology

A

Half million childhood deaths worldwide
One third hospitalizations for diarhhea
Incidence similar in developing and developed countries

33
Q

Rotavirus vaccines

A

Live oral vaccine stored refridgerated
Two preps
Rotateq (2 doses)
Rotarix (3 doses)
Recommended at 2,4 and 6 months

34
Q

Rotavirus vaccine schedule

A

first dose between 6 and 14 weeks of age
Second and third doses spaced by 4 to 10 weeks
Series must be completed by 8 months

35
Q

Complications of RV vaccine

A

intussusception- bowel obstruction associated with vaccine

36
Q

Tetanus Diptheria Pertussis Abbrev.

A

T always capitalized
Bigger P and D mean Ped for LARGER dose
Smaller p and d mean Adult for SMALLER dose

37
Q

Pertusis pathology

A

-Bacterial respiratory infection
-Direct transmission from close contact
Major manifestation is severe paroxysms of cough (whooping cough)
Severe complications include pneumonia, encephalopathy, malnutrition

38
Q

Pertussis Vaccine

A

Administered in combination with diphtheria and tetanus
Recommended at 2, 4, 6 and 15-18 months with boosters at 4-6 years
Routine Tdap for 11-12 year olds

39
Q

Cocooning

A

Strategy for protecting young infants from pertusis
Tdap recommended for pregnant females in late 2nd or 3rd trimester
Immunization of parents grandparents siblings out of home care providers

40
Q

Diphtheria pathology

A

Bacterial infection
Person to person transmission through direct contact
Major manifestation is membranous inflammation of respiratory tract
May damage myocardium, nervous system, and kidneysD

41
Q

Diphtheria vaccine

A

Toxoid absorbed inducing immunity to the bacterial exotoxin
Administered in combination with tetanus and pertussis
Recommended at 2,4, 6 and 15-18 months and at 4-6 years
Routine boosters every 10 years

42
Q

Tetanus pathology

A

Acquired through environmental exposure
Mediated via bacterial toxin
Not contagious

43
Q

Tetanus vaccine

A

Toxoid
Administered in combination with diphtheria and pertussis
Recommended at 2, 4, 6 and 15-18 months and at 4-6 years
Routine boosters

44
Q

Pneumococcal Pathology

A

Infection caused by bacteria
Invasive when there is detection of the bacteria in normally sterile body

45
Q

Pneumococcal Epidemiology

A

Invasive
Relatively low rates 65 and above

Pneumococcal pneumonia
high rates above 65 years old

46
Q

Pneumococcal vaccine

A

Conjugate 15,20,21 valent

Polysaccharide 23 valent

47
Q

Pneumococcal vaccine schedule for children

A

2,4,6, and 12-15 month schedule for infants

Immunocompromised children 6-18 years
-One dose PCV20
-one dose PCV15 either PCV20 or PCV23 1 year later

48
Q

Indicated conditions for immunosuppressed Pneumococcal Vaccines

A

All adults 65 years and older
Cancer,immunosuppressing drugs, chronic organ failure, HIV, organ transplant

49
Q

HPV pathology

A

Virus which causes cancer and precancers in the cervix, anus, penis, vagina, vulva, back of throat

50
Q

HPV vaccine

A

Recombinant vaccine containg Virus Particles (VLP) 6,11,16,18 (cause genital warts)
and 31, 33, 45, 52, 58 (cancer)

51
Q

HPV vaccine schedule

A

9-14 years two doses 0, 6-12 months
15-26 years three doses 0,1-2, 6 months
27-45 years old by shared clinical decision making

52
Q

Meningococcal pathology

A

Five major subtypes A,B,C,Y, and W
Transmission via direct contract with respiratory secretions of a nasopharyngeal carrier
Most common cause of bacterial meningitis in 2-18 years old
Mortality rates 10-13%
10% have severe side effects post infection

53
Q

Meningococcal vaccine A

A

Conjugate vaccine
Covers subgroups A,C,Y, W
Repeat dose(s) for high risk
Recommended for routine use in 11-12 year old
and repeat dose at 16

Revaccinate individuals with prolonged risk of invasive disease

54
Q

Meningococcal A revaccination schedule

A

Revaccinate adolescents at 16 years of age
Revaccinate after 5 years if >7 years
Revaccinate after 3 years of age 2-6 years
Continue to revaccinate every 5 years if high risk

55
Q

Meningococcal vaccine B

A

Recombinant serogroup B
Induces complement dependent antibody responses

Trumenba
2 dose series for 16-23 years old
(0, 6 months)
3 dose series for high risk and outbreaks
(0,2,6 months)

Bexsero
Larger antibody concentrations
Recombinant multicomponent
2 dose series 1 month apart for 10-25 year old

56
Q

people with high risk for meningococcal disease

A

microbiologist
asplenia (no spleen)
Complement deficiency or inhibitor

57
Q

Meningococcal Vaccine buffet

A

-Covers all subgroups
-Currently recommended for child/adolescent if both Men A and Men B administered in same visit

58
Q

Influenza Pathology

A

High fever illness caused by virus
Transmitted via respiratory route
Characterized by headache, fever, myalgia, cough, pharyngitis

59
Q

Influenza vaccine regular

A

All vaccines are trivalent (2A strains + 1B strain)
Vaccine formulation strategies:
-Grown in eggs
-Grown in MDCK cells
-Recombinant DNA grown in transfected insect cells

Vaccines
Enhanced influenza vaccine
Adjuvanted influenza vaccine
Recombinant influenza vaccine
*All individuals >6 months
*Vaccinate before and during flu season
*Persons with history of egg allergy of any severity should receive flu vaccine

60
Q

Enhanced influenza vaccine

A

High dose
adjuvanted (chemical in it that makes it more potent)
Has more antigen in it than reg vaccine
Recommended for those ages >65 years old
Higher rate of injection site reactions

61
Q

Adjuvanted Influenza Vaccine

A

Trivalent for >65 years old

Solid organ transplant patients may receive high dose or adjuvanted influenza vaccine age 18-64 years
*Acceptable but not a preference

62
Q

Recombinant influenza vaccine

A

Recombinant so no viruses or eggs used in prod
Has 3x more antigen compared to standard dose vaccines
Higher efficacy for >50 years

63
Q

ACIP influenza vaccine recommendation

A

Enhanced
Recombinant
Adjuvant
all recommended over other STANDARD influenza vaccines >65 years

64
Q

Live Attenuated Influenza Vaccine

A

Administered intranasally
For use in 2-49 years old
Very low risk of spread of LAIV
*More effective against mismatched strains

65
Q

Influenza epidemiology

A

Infants at high risk for hospitalization
School aged children targeted the most but have lowest complication rate

High risk groups
-All adults 50 or older
-Nursing home residents
-Chronic medical conditions
-Immunosuppressed patients
-High BMI
-Pregnant women
-Healthcare workers

66
Q

Rabies epidemiology

A

Thousands require rabies post exposure prophylaxis annually
About 1 to 2 cases annually

Sources of exposure
-High canine exposures internationally
-Bats in the US

Types of exposure
Transmitted by introduction of virus via bite wound or open cuts
Aerosolized in caves

67
Q

Rabies vaccine

A

Human diploid cell vaccine
Purified chick embryo cell vaccine

Antibody response in 7-10 days
Lasts for 2 years
Rabies Immune Globulin
Around wound site
Conc: 150 IU/mL
Dose: 20 IU/kg

*both products used simultaneously for post exposure prophylaxis unless previously immunized

68
Q

Rabies vaccine administration

A

Pre exposure for high risk individuals
Intramuscular
*not in the butt
day 0,7 21 days - 3 years

69
Q

Post exposure therapy for vaccinated individuals

A

Pre exposure prophylaxis does not eliminate the need for post-exposure prophylaxis

PHM SCI 650 (3 decks)

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