Vaccination Schedule

Question 1

How can a patient’s post-vaccination immune response be measured?

Answer 1

Antibody titers

Question 2

Vaccination erradicated _________ in 1980.

Animal vaccination erradicated _________ in 2011.

Answer 2

Vaccination erradicated smallpox in 1980.

Animal vaccination erradicated Rinderpest in 2011.

Question 3

Give an example of each of the following:

Passive natural immunization -

Passive artificial immunization -

Active natural immunization -

Active artificial immunization -

Answer 3

Give an example of each of the following:

Passive natural immunization - breastfeeding

Passive artificial immunization - administration of pre-made antibodies

Active natural immunization - infection

Active artificial immunization - vaccination

Question 4

Passive artificial immunization is used in response to which infectious agents?

Answer 4

Tetanus, botulinum, HBV, diptheria, rabies.

(‘To be healed damn rapidly’)

Question 5

Live vaccines are contraindicated in which patient populations?

Answer 5

Children < 9 mo. (the rotavirus is an exception), pregnant women, and immunodeficient patients

Question 6

True/False.

Many live vaccine second doses are administered to catch any non-responders (not as boosters).

Answer 6

True.

Question 7

Multiple live vaccines can be given simultaneously, but, if given at different times, they should be administered at least ____ weeks apart to avoid possible interference. (Note: They may be administered simultaneously with inactivated vaccines.)

Answer 7

Multiple live vaccines can be given simultaneously, but, if given at different times, they should be administered at least 4 weeks apart to avoid possible interference. (Note: They may be administered simultaneously with inactivated vaccines.)

Question 8

HIV-positive individuals can be vaccinated with live attenuated vaccines (e.g., MMR and varicella) if their CD4 cell count is ≥ _____ cells/mm³.

Answer 8

HIV-positive individuals can be vaccinated with live attenuated vaccines (e.g., MMR and varicella) if their CD4 cell count is ≥ 200 cells/mm³.

Question 9

_________ vaccine is given in its nonattenuated form to military recruits.

Answer 9

_Adenovirus_ vaccine is given in its nonattenuated form to military recruits.

Question 10

Which are the live-attenuated vaccines?

“TYler And Paul Burnt their INFamous ROasted YELLOW-RUBy CHICKEN MEAt Very MUch”

Answer 10

TYphoid, Adenovirus, Polio, BCG, INFluenza, ROtavirus, YELLOW fever, RUBella, CHICKENpox, MEAsles, Varicella, and MUmps

Question 11

Describe proper intramuscular vaccination administration.

Answer 11

Lightly pinch deltoid of relaxed patient arm;

insert needle at 90º to skin

(Quick and painless –> give the injection as if you were throwing a dart at a wall)

Question 12

Name some of the inactivated vaccines.

Answer 12

COVID-19

Hepatitis A

Influenza (most)

Typhoid

Pertussis

Rabies

Polio (Salk)

Plague

Cholera

Question 13

The immune response to inactivated vaccines is mostly _________.

Answer 13

The immune response to inactivated vaccines is mostly humoral.

Question 14

Approximately ______ of patients will develop a mild reaction to a live vaccination.

Answer 14

Approximately 1/3 of patients will develop a mild reaction to a live vaccination.

(Could be swelling at the injection site, fever, headaches, fatigue, flu-like symptoms; typically begins 2-3 days following vaccination and lasts 1-2 days)

Question 15

True/False.

Live-attenuated vaccines sometimes cause a mild form of the disease.

Answer 15

True.

Live-attenuated vaccines sometimes cause a mild form of the disease, usually appearing with 1 - 3 weeks of administration.

Question 16

The risk of serious adverse reaction (with permanent effects) following vaccine administration is ~______________.

Answer 16

The risk of serious adverse reaction (with permanent effects) following vaccine administration is ~ 1 / 1,000,000 .

Question 17

What are some general contraindications to live vaccines for healthy patients?

Answer 17

• Previous life-threatening adverse reaction to vaccination
• Severe allergy to some vaccine component
• Acute illness with fever > 101.3ºF

Question 18

Name some common false contraindications to live vaccine administration.

(I.e., people think these things are contraindications, but they aren’t.)

Answer 18

Low-grade fever

Current or recent illness

Current or recent antibiotic use (oral typhoid is the exception)

Current or recent steroid use

Adjustment according to weight

Question 19

Should preterm infants be vaccinated according to gestational age or post-partum chronological age?

Answer 19

Chronological age

Question 20

Should vaccine dosages be adjusted for child weights or heights or both or neither?

Answer 20

Neither

Question 21

What vaccinations are relevant to a newborn?

Answer 21

Hepatitis B

(if the neonate is >2 Kg)

Question 22

What vaccinations are relevant to an infant four weeks following birth?

Answer 22

Hepatitis B (2nd dose)

(if the neonate is >2 Kg)

Question 23

What vaccinations are relevant to an infant six weeks following birth?

Answer 23

Rotavirus

Poliovirus (inactivated)

DTaP

Question 24

What vaccinations are relevant to an infant eight weeks following birth?

Answer 24

Hemophilus influenza type B

Pneumococcal conjugate 13

Question 25

What vaccinations are relevant to an infant four months following birth?

Answer 25

**DTaP** (2nd dose) **Rotavirus** (2nd dose) **Poliovirus** (2nd dose; inactivated) **Hemophilus influenza type B** (2nd dose) **Pneumococcal conjugate 13** (2nd dose)

Question 26

When do infants/children first become eligible for the influenza vaccine?

Answer 26

Six months

Question 27

What vaccinations are relevant to an infant six months following birth?

Answer 27

**Hepatitis B** (3rd dose) **DTaP** (3rd dose) **Rotavirus** (3rd dose) **Poliovirus** (3rd dose; inactivated) **Hemophilus influenza type B** (3rd dose) **Pneumococcal conjugate 13** (3rd dose) **Influenza virus** (yearly after this)

Question 28

What vaccinations are relevant to an infant one year following birth?

Answer 28

**Hemophilus influenza type B** (4th shot; booster shot) **Pneumococcal conjugate 13** (4th shot) **Hepatitis A** (1st dose --- 2nd dose after 6-18 months) **MMR** (1st dose) **Varicella** (1st dose)

Question 29

What vaccinations are relevant to a four-year-old child?

Answer 29

**DTaP** (5th dose) **Poliovirus** (4th dose; inactivated) **MMR** (2nd dose) **Varicella** (2nd dose)

Question 30

What vaccinations are relevant to an eleven-year-old child?

Answer 30

**TDaP** (booster shot) **HPV** (2-dose series) **Meningococcal conjugate** (1st dose)

Question 31

What vaccinations are relevant to a sixteen-year-old child?

Answer 31

**Meningococcal conjugate** (booster shot)

Question 32

When are pneumococcal polysaccharide 23 and/or meningococcal vaccines recommended for pediatric patients?

Answer 32

In high-risk individuals

Question 33

Describe the vaccination recommendations for low-risk, healthy adults between the ages of 18 and 49.

Answer 33

**TDaP** boosters every 10 years Annual **influenza** **vaccine** Catch-up **HPV** vaccination in adults \< 26 years old

Question 34

Describe the vaccination recommendations for low-risk, healthy adults 50 years and over.

Answer 34

**Zoster virus** in adults ≥50 years **Pneumococcal polysaccharide 23** in adults ≥65 years

Question 35

What mnemonic can be used to remember the major vaccines in the childhood schedule?

Answer 35

I'm **HH**ating **P**e**D**s **I**mmunization/**V**accination **Mm**e**HM**orizing. The childhood immunization schedule includes: **H**epB 0, 2, 6 **H**ib 2, 4, 6, 12–15 **P**neumo 2, 4, 6, 12–15 **D**TaP 2, 4, 6, 15–18, 4–6 years; Td 10 years **I**PV 2, 4, 6, 4–6 years; **V**aricella 12–15, 4–6 years **MM**R 12–15, 4–6 years **H**epA 2 years **M**eningococcus 11–12 years.

Question 36

How long does immunity typically last following hepatitis B vaccination? How long does immunity typically last following TDaP vaccination? How long does immunity typically last following rotavirus vaccination?

Answer 36

≥ 20 years ~ 10 years ≤ 3 years

Question 37

How long does immunity typically last following meningococcal conjugate vaccination? How long does immunity typically last following varicella vaccination? How long does immunity typically last following hepatitis A vaccination?

Answer 37

5 years 10-20 years 25 years (slightly less in children)

Question 38

Name some of the major vaccinations to be considered (depending on location) in patients who are travelling internationally?

Answer 38

Japanese encephalitis Yellow fever Rabies Typhoid and paratyphoid Meningococcal conjugate

Question 39

What vaccinations are indicated in pregnant women?

Answer 39

**TDaP** **Influenza**