Vaccination & travel meds Flashcards

1
Q

Common live vaccines

A
  • BCG
  • MMR
  • Varicella
  • Rotavirus
  • Oral poliovirus
  • Yellow fever
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2
Q

Schedules for HBV vaccination

A

D1: Birth
D2: 2 month
D3: 6 month

Adult boosters for those with nil evidence of immunity/past infection

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3
Q

Schedules for DTaP/Tdap vaccination

A

D1: 2 month
D2: 4 month
D3: 6 month
B1: 18 month
B2: 10-11 y.o. (Tdap)

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4
Q

Schedules for poliomyelitis vaccination

A

Same as HBV

D1: 2 month
D2: 4 month
D3: 6 month
B1: 18 month
B2: 10-11 y.o.

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5
Q

Schedules for Hib vaccination

A

D1: 2 month
D2: 4 month
D3: 6 month
B1: 18 month

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6
Q

Schedules for pneumococcal vaccination for children

A

D1: 4 month (PCV)
D2: 6 month (PCV)
B1: 12 month (PCV)

1-2 doses of PPSV only for those with specific medical conditions

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7
Q

Schedules for MMR vaccination

A

D1: 12 month
D2: 15 month

Adult MMR booster x 2 doses for those with nil evidence of immunity/past infection

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8
Q

Schedules for varicella vaccination

A

Same as MMR

D1: 12 month
D2: 15 month

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9
Q

Schedules for HPV vaccination

A

D1: 12-13 y.o.
D2: 1 year later

If no childhood vaccination done, 3 doses are needed

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10
Q

Schedules for influenza vaccination

A
  • 1 dose/season for 6 months to up to 5 y.o.
  • 1 dose/season for people above 5 y.o. with specific medical conditions
  • 1 dose/season for everyone 65 y.o. and above
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11
Q

HBV vaccination for dialysis patients

A
  • 4 dose series with Engerix-B
  • 0, 1, 2, 6 months intervals
  • 2 mL dose instead of 1 mL
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12
Q

Pneumococcal vaccination for adults

A
  • Routine vaccination for adults 65 y.o. and above
  • 1 x PCV, followed by 1 x PPSV at least 8 weeks later (immunocompromised) or 1 year later (rest)
  • 1 x PPSV booster if 2 dose series completed before 65 y.o.
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13
Q

Tetanus vaccination for adults

A

For wound management:
- 1x Td/Tdap booster if 10 years gap (clean wound) or 5 years (all other wounds)

For pregnancy:
- 1 x Tdap booster

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14
Q

Varicella vaccination for adults

A

Only indicated if nil immunity demonstrated
- 1 dose if previously immunised
- 2 doses 4-8 weeks apart if no immunisation

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15
Q

Typhoid vaccination for travellers

A

IM/SC vaccine 2 weeks before travel
Efficacy lasts up to 2 years

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16
Q

Which medications should be avoided when administering oral typhoid vaccines?

A
  • All antibiotics (within 3 days from immunisation)
  • Mefloquine (avoid 8-24 hours after po mefloquine)
  • Chloroquine (can be given tgt)
17
Q

HAV vaccination recommendations

A
  • Lowest age: 1 y.o.
  • 2 doses schedule
  • Second dose 6-12 months after 1st dose (max 18 months)
  • No booster needed
18
Q

Meningococcal vaccination recommendation

A
  • Menactra (tetravalent)
  • 9 months and up
  • Single dose at least 10 days before travel; not more than 8 years from vaccination
  • Booster after 3 years (<7 y.o.), after 5 years (7 y.o. and above)

MenB vaccine for serotype B only
- Not as travel vaccine
- Two dose series (1 month apart)

19
Q

Rabies vaccine recommendations

A
  • 3 dose series (0, 7, 21/28 days)
  • For those with occupational exposure risk
  • Higher risk exposure may require antibody titre check every 6 month-2 years
  • 2 x boosters are only needed if bitten after completion of schedule
  • 4 doses (0, 3, 7, 14 days) if not previously immunised and bitten
20
Q

When are rabies immunoglobulin needed?

A
  • Not immunised against rabies
  • With severe transdermal wounds and contamination with saliva
  • Bat bites
21
Q

Japanese encephalitis vaccination

A
  • For travels to endemic areas >1 month

IM for Ixiaro (NA, Europe, australia)
- 2 months and up
- 2 doses and 1 booster (1 year later, if needed)

SC for Imojev (Asia)
- 9 months and up
- 1 dose, booster (5 years later, if needed)

22
Q

Yellow fever vaccination

A
  • Liver attenuated
  • Single SC dose at least 10 days before travel
  • No booster (unless immunocompromised, pregnancy or HSC transplant)

Associated with increased risk of:
- Viscerotropic diseases
- Neutropenic diseases

23
Q

Transmission of diseases by mosquitoes

A
  • Japanese encephalitis (Culex; dusk to dawn)
  • Yellow fever (Aedes; dawn to dusk)
  • Malaria (Anopheles; dusk to dawn)
24
Q

Drug of choice for malaria prophylaxis for P falciparum

A
  • Atorvaquone-proguanil (Malarone)
  • Doxycycline
25
Q

Dosing for Malarone

A
  • Start 1-2 days before
  • Daily dosing
  • Continue 1 week after
  • Adults (>40 kg): 1 adult tablet
  • Avoid in ESRF, pregnancy/breastfeeding,
26
Q

Dosing for doxycycline

A
  • Start 1-2 days before
  • Daily dosing
  • Continue 4 weeks after
27
Q

Dosing for mefloquine

A
  • Start 2-3 weeks before
  • Weekly dosing
  • Continue 4 weeks after
  • Avoid in neuropsychiatric disease, QTc prolongation
28
Q

Terminal prophylaxis of malaria

A
  • Primaquine 30 mg daily for 2-3 weeks
  • Not for pregnancy & G6PD deficiency (lower dose)
  • Only indicated in those with prolonged exposure to P vivax
29
Q

Dose of acetazolamide

A
  • PO 125 mg q12 hours start 1 day before ascending
  • Continued throughout ascend
  • Continue for 1st 2 days at the same altitude
30
Q

How long to avoid blood donation after traveling to malaria endemic countries

A

4 months

Monitor symptoms for up to 12 months