Special Consideration Pops

Question 1

What are some populations that require extra consideration?

Answer 1

-travellers
-New Canadians
-Outbreak populations
-Occupational risk groups (HC workers)
-Hard to reach individuals: no PCP, unhoused, resident of remote area
- preg or breastfeeding
- those who are off immunization schedule
- those with certain conditions (chronic)
- those with serious SEs last injection
- those who behaviour puts them at high risk of vaccine preventable diseases

Question 2

T or F: Immunocompromised is a spectra that varies over time

Answer 2

T

Question 3

Examples of people who are immunocomp

Answer 3

• chronic liver or kidney disease
• asplenia or functional asplenia
• congenital or AIDs
• use of immune suppressive therapy

Question 4

Requirements for corticosteroids to be considered immuno-suppressive

Answer 4

• systemic admin (not inhaled, topical etc)
• high dose: prednisone equivalent dose of >/=2 mg/kg/day
• long term >/= 2 weeks

Question 5

T or F: Immunocomp people are at higher risk of diseases and therefore have additional vaccinations that are recommended (but they aren’t publicly funded for them normally)

Answer 5

F- normally publicly funded additional vaccinations for this pop

Question 6

T or F: vaccination should occur when max immune response will be obtained

Answer 6

T - this may mean stopping immunosuppressive therapy during or waiting till no longer deficient

Question 7

T or F: we can’t give inactive vaccines to immunocomp people

Answer 7

F- we can give them to this pop but may not get strong response
— may need to use serological tests to see if revaccination is needed

Question 8

T or F: live vaccines are CI generally for immunocomp people

Answer 8

T: generally don’t give as they can cause serious SEs (uncontrolled pathogen growth)

• CI unless IC is mild OR B> R

Question 9

What impacts the degree of immunodeficiency in those with HIV

Answer 9

CD4 count

Question 10

HIV: ideally when should inactive vaccines be given

Answer 10

early on in course to maximize vaccine response (but can be given at any time )

Question 11

What is the criteria to give MMR + varicella vaccines to those who have HIV

Answer 11

CD4 >/+ 200 x 10^6 cells/L or >/= 16%

Question 12

T or F: those with asplenia have a high risk of bacteremia

Answer 12

T

Question 13

What vaccines are important for those with functional asplenia to get ?

Answer 13

Hib, meningococcal and pneumococcal vaccines

Question 14

When can vaccines be given to those getting a surgical splenectomy

Answer 14

• at least 2 week before elective surgery OR 2 weeks after

Question 15

If getting a blood transfusion + immunocomp, what vaccines are recommended

Answer 15

Hep A and B

Question 16

T or F: maternal Ab can transferred to fetus via BS or breast milk

Answer 16

T - can transfer + give fetus protection

Question 17

T or F: live vaccines are okay for pregnant people

Answer 17

no avoid giving ; try to give at least 28 days before pregnant

• if do get a live vaccine + don’t know they were pregnant: not indication to termination (not teratogenic)

Question 18

T or F: pregnancy is a RF for severe flu complications

Answer 18

T

Question 19

What vaccines are key to stay up-to date on during pregnancy?

Answer 19

Inactivated flu vaccine

Tdap

Question 20

T or F: Infants are at a high risk of whooping cough

Answer 20

T

Question 21

T or F: Tdap vaccine should be given to only pregnant people who are out of date on it

Answer 21

F - give to everyone no matter vaccination history

Question 22

What is the ideal timing for Tdap vaccine

Answer 22

at 27-32 weeks : want to give about 4 wks before delivery (if given then: high levels of Ab transferred to baby + gives protection for 1st 2mths of life)

• may give bw 14-26 wks if high risk of preterm delivery

Question 23

When should the HPV vaccine be given to pregnant people

Answer 23

After delivery

Question 24

Can live + inactive vaccines be given during breastfeeding?

Answer 24

Yes