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PHM SCI 650 > Quiz 1 > Flashcards

Quiz 1 Flashcards

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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
Hep B vaccines
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
25
Post Vax testing for Hep B
-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
26
Polio pathology
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%
27
Polio Vaccine
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)
28
Varicella (or chicken pox) pathology
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
Varicella epidemiology
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
Varicella vaccine
Varivax licensed in 1995 Live attenuated viral vaccine Contraindicated: -immunosuppression -pregnancy -receipt of blood products -active untreated TB
31
Evidence of varicella immunity
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
Rotavirus epidemiology
Half million childhood deaths worldwide One third hospitalizations for diarhhea Incidence similar in developing and developed countries
33
Rotavirus vaccines
Live oral vaccine stored refridgerated Two preps Rotateq (2 doses) Rotarix (3 doses) Recommended at 2,4 and 6 months
34
Rotavirus vaccine schedule
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
Complications of RV vaccine
intussusception- bowel obstruction associated with vaccine
36
Tetanus Diptheria Pertussis Abbrev.
T always capitalized Bigger P and D mean Ped for LARGER dose Smaller p and d mean Adult for SMALLER dose
37
Pertusis pathology
-Bacterial respiratory infection -Direct transmission from close contact Major manifestation is severe paroxysms of cough (whooping cough) Severe complications include pneumonia, encephalopathy, malnutrition
38
Pertussis Vaccine
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
Cocooning
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
Diphtheria pathology
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
Diphtheria vaccine
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
Tetanus pathology
Acquired through environmental exposure Mediated via bacterial toxin Not contagious
43
Tetanus vaccine
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
Pneumococcal Pathology
Infection caused by bacteria Invasive when there is detection of the bacteria in normally sterile body
45
Pneumococcal Epidemiology
Invasive Relatively low rates 65 and above Pneumococcal pneumonia high rates above 65 years old
46
Pneumococcal vaccine
Conjugate 15,20,21 valent Polysaccharide 23 valent
47
Pneumococcal vaccine schedule for children
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
Indicated conditions for immunosuppressed Pneumococcal Vaccines
All adults 65 years and older Cancer,immunosuppressing drugs, chronic organ failure, HIV, organ transplant
49
HPV pathology
Virus which causes cancer and precancers in the cervix, anus, penis, vagina, vulva, back of throat
50
HPV vaccine
Recombinant vaccine containg Virus Particles (VLP) 6,11,16,18 (cause genital warts) and 31, 33, 45, 52, 58 (cancer)
51
HPV vaccine schedule
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
Meningococcal pathology
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
Meningococcal vaccine 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
Meningococcal A revaccination schedule
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
Meningococcal vaccine B
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
people with high risk for meningococcal disease
microbiologist asplenia (no spleen) Complement deficiency or inhibitor
57
Meningococcal Vaccine buffet
-Covers all subgroups -Currently recommended for child/adolescent if both Men A and Men B administered in same visit
58
Influenza Pathology
High fever illness caused by virus Transmitted via respiratory route Characterized by headache, fever, myalgia, cough, pharyngitis
59
Influenza vaccine regular
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
Enhanced influenza vaccine
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
Adjuvanted Influenza Vaccine
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
Recombinant influenza vaccine
Recombinant so no viruses or eggs used in prod Has 3x more antigen compared to standard dose vaccines Higher efficacy for >50 years
63
ACIP influenza vaccine recommendation
Enhanced Recombinant Adjuvant all recommended over other STANDARD influenza vaccines >65 years
64
Live Attenuated Influenza Vaccine
Administered intranasally For use in 2-49 years old Very low risk of spread of LAIV *More effective against mismatched strains
65
Influenza epidemiology
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
Rabies epidemiology
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
Rabies vaccine
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
Rabies vaccine administration
Pre exposure for high risk individuals Intramuscular *not in the butt day 0,7 21 days - 3 years
69
Post exposure therapy for vaccinated individuals
Pre exposure prophylaxis does not eliminate the need for post-exposure prophylaxis

PHM SCI 650 (3 decks)

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