Vaccinations Flashcards
Define vaccine
Any suspension containing antigenic molecules (weakened or killed pathogen), given to stimulate an immune response to an infectious disease
Define immunization
process by which an individual’simmune systembecomes fortified against an agent.
Define prophylaxis
A measure taken to maintain health and prevent the spread of disease
Define titer
measurement of the amount or concentration of a substance in a solution
What is an example of a titer?
medicine or antibodies found in a patient’s blood.
What is an antibody titer?
laboratory test that measures the presence and amount of antibodies in blood. The antibody level in the blood is a reflection of your past exposure to an antigen.
What is herd immunity?
occurs when thevaccinationof a significant portion of apopulation(or herd) provides a measure of protection for individuals who have not developed immunity.
What is the herd immunity threshold?
The percentage of the population vaccinated at which herd immunity is induced.
What is an active immunization?
ANTIGEN ADMINISTRATION (either live, killed, or derivative such as a protein or polysaccharide) or a toxoid (deactivated toxin).
What are the benefits of active immunizations?
Live versions more efficacious and provide longer lasting immunity than nonliving vaccines
What is a passive immunization?
administration of pre-formed ANTIBODY (such as immunoglobulin)
What are the effects of passive immunization?
Results in immediate protective immunity
Immunity is short term (typically lasts only 3-6 months
What are some examples of immunotherapy (passive immunization)?
Hepatitis B immune globulin (HBIG) given within 12 hours of birth. Palivizumab (Synagis) is a respiratory syncytial virus (RSV) immune globulin. Rabies exposure
So which type of immunization is congruent with vaccination?
Active immunization. (Passive immunization is NOT vaccination, therefore the two terms are NOT interchangeable. A vaccine can be termed an immunization but immunization cannot necessarily be termed vaccination)
What are the classifications of vaccines?
live attenuated, inactivated (whole or fractional)
What are some disadvantages of live attenuated vaccines?
possibility exists that a live attenuated vaccine could revert to a virulent form and cause disease. Not everyone can safely receive live, attenuated vaccines (ppl with immune system abnormalities).
Describe characteristics of live attenuated vaccines
Attenuated (weakened) form of the “wild” virus or bacterium. Must replicate to be effective. Immune response similar to natural infection. produces immunity with one dose
What are protein based fractional inactivated vaccines?
toxoid (inactivated bacterial toxin) . subunit products
Describe polysaccharide-based fractional inactivated vaccines?
cell wall polysaccharide from bacteria conjugate. polysaccharide is linked to a protein to make it a more potent vaccine.
Describe characteristics of inactivated vaccines?
Cannot replicate. not as effective as live vaccines, require 3-5 doses. Immune response is humoral. Antibody titer may diminish with time. Require booster shots
What can be used for fractional inactivated vaccines?
toxoid or polysaccharide- based
What steps should be taken in a vaccinating a patient with a previous anaphylactic rxn to a specific vaccine?
Avoid revaccination with the specific vaccine because of risk of recurrence.
What local adverse rxn to vaccines?
pain, swelling, redness at site of injection
usually mild and self-limited
What are systemic adverse rxn to vaccines?
fever, malaise, headache, allergic reaction
nonspecific, may be unrelated to vaccine
What used to be a mild SE of vaccines?
Serum sickness-like reaction (perhaps caused by residual animal proteins horse serum). Doesn’t happen anymore cause we don’t use horse serum
What vaccines should you avoid if you have a H/O of allergies to eggs or egg protien?
vaccines prepared in embryonated chicken eggs or cultures because these vaccines may contain residual egg protein (measles, mumps, flu, yellow fever)
What vaccines shouldn’t be given to ppl with previous anaphylactic rxn to neomycin or streptomycin?
Avoid measles, mumps, rubella (MMR) vaccine because the MMR vaccine contains trace amounts of neomycin
What precautions should ppl who are immunocompromised take in regard to vaccines?
Avoid live virus vaccines because there is an increased risk of viral replication in immunocompromised individual
What vaccines should household members of immunocompromised patients avoid?
Avoid oral polio because vaccine induced disease (if it occurs) could be transmitted to the immunocompromised individual.
What kind of vaccines should pregnant women avoid?
Avoid all live virus vaccines because of the potential risk to the fetus
What kind of vaccine is the diptheria vaccine?
Formalin-inactivated diphtheria toxin
What is diphtheria?
An acute bacterial respiratory or cutaneous illness caused by Corynebacterium diphtheriae (C. diphtheriae)
How many doses of diptheria vaccine (DTap) should be given and when does it need a booster?
fFive doses + booster, Booster every 10 years
What do letters in diptheria/tetanus/pertussis combinations mean?
Upper-case letters denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccine. Lower-case “d” and “p” denote reduced doses of diphtheria and pertussis used in the adolescent/adult-formulations. The “a” in DTaP and Tdap stands for “acellular,” meaning that the pertussis component contains only a part of the pertussis organism
What is included in DTaP and who is it given to?
Diphtheria and tetanus toxoids and acellular pertussis vaccine; given to infants and children ages 6 weeks through 6 years.
What is included in DT vaccine and who is it given to?
Diphtheria and tetanus toxoids, without the pertussis component; given to infants and children ages 6 weeks through 6 years who have a contraindication to the pertussis component.
What is included in Tdap and who is it given to?
Tetanus and diphtheria toxoids with acellular pertussis vaccine; given as a one-time dose to adolescents and adults. Women should receive Tdap during each of their pregnancies (preferably in the third trimester between the 27th and 36th week).
What is inclued in a Td vaccine and who is it given to?
Tetanus and diphtheria toxoids; given to children and adults ages 7 years and older as a booster shot or after exposure to tetanus.
What is tetanus?
Tetanus is a nervous system disorder characterized by muscle spasms that is caused by the toxin-producing anaerobe, Clostridium tetani.
What is the pathogenesis of tetanus?
Anaerobic conditions allow germination of spores and production of toxins. Toxin binds in central nervous system. Interferes with neurotransmitter release to block inhibitor impulses. Leads to unopposed muscle contraction and spasm
What are the clinical features of tetanus?
Incubation period; 8 days ,Spasms continue for 3-4 weeks, Complete recovery may take months
What is seen with generalized tetanus?
descending symptoms of trismus (lockjaw), difficulty swallowing, muscle rigidity, spasms
WHat are the three clinical forms of tetanus?
local (not common), cephalic (rare), generalized (most common)
What kind of vaccine is the tetanus toxoid?
inactivated tetanus toxin
What are complications of tetanus?
Laryngospasm, Fractures, Pulmonary embolism
Aspiration pneumonia, Death
What are symptoms of pertussis?
severe coughing spells which can lead to difficulty breathing, vomiting, disturbed sleep, wt. loss, incontinence, rib fractures and passing out f
Who should receive a tetanus vaccine?
All adults who have not had a tetanus shot in the past 10 years should receive a Td booster dose.(Tdap) .Adults who received a Td only within the past 10 years should receive a dose of Tdap.
Pregnant women who have not received the primary tetanus vaccination series should begin this series during pregnancy, after 20 weeks, using Tdap.
What are symptoms of pertussis?
severe coughing spells which can lead to difficulty breathing, vomiting, disturbed sleep, wt. loss, incontinence, rib fractures and passing out
What is haemophilus influenzae B (HIB)?
Severe bacterial infection, particularly among infants. Organism colonizes nasopharynx. Hib was a leading cause of childhood meningitis, pneumonia, and epiglottitis,
What kind of vaccine is the HIB vaccine (HbOC)?
Polysaccharide-based conjugate vaccine
WHo should received HbOC over 5yrs of age?
ppl with sickle cell disease, HIV/AIDS, removal of the spleen (asplenia), bone marrow transplant, or cancer patients on chemotherapy.
What are some rxns to watch for after giving the diptheria/tetanus/pertussis vaccines?
Moderate or severe acute illness, Temperature >105°F (40.5°C), Collapse or shock-like state, Persistent, inconsolable crying lasting >3 hours, Convulsions with or w/o fever
When should booster doses of diptheria/tetanus/pertussis be given?
11 or 12 years of age if 5 years since last dose (Tdap). Every 10 years thereafter (Td or Tdap
What is the schedule for HbOC?
Recommended interval 8 weeks for primary series doses, Minimum interval 4 weeks for primary series doses, Minimum age 6 weeks
What are measles?
Highly contagious viral illness.Respiratory transmission of virus. Replication in nasopharynx and regional lymph nodes
What are clinical features of measles?
Incubation period 10-12 days
Stepwise increase in fever to 103°F or higher, Cough, coryza, conjunctivitis, Koplik spots
What are Koplik spots?
whitish, grayish, or bluish elevations, seen on the buccal mucosa typically opposite the molar teeth.
pathognomonic for measles infection
Describe the rash that occurs with measles?
2-4 days after prodrome, 14 days after exposure
Maculopapular,Begins on face and head, Persists 5-6 days. Fades in order of appearance
What are complications of measles?
Otitis media, Pneumonia, Encephalitis, Laryngotracheobronchitis (croup)
What is mumps?
a virus that causes fever, headache, muscle pain, loss of appetite, and swollen glands (parotitis).
WHat are complications of mumps?
deafness, meningitis, painful swelling of the testicles or ovaries (orchitis), and rarely sterility.
What is rubella (german measles)?
virus that causes rash, arthritis (mostly in women), and mild fever.
What happens if a pregnant women gets rubella?
she could have a miscarriage or her baby could be born with serious birth defects(congenital rubella syndrome)
What kind of vaccine is the MMR vaccine?
Live virus attenuated vaccine
What is the schedule for the MMR vaccine?
First dose of MMR at 12-18 months
Second dose of MMR at 4-6 years
Second dose may be given any time at least 4 weeks after the first dose