Vaccinations Flashcards
Meningitis vaccination recommendations for adults less than 55
2 doses of meningococal conjugate vaccine quadravalent (MCV4) Menectra
Meningitis vaccination recommendations for adults over 55
meningococcal polysaccaride vaccine (MPSV4) Menomune in 5 year intervals
which is more immunogenic, PPSV23 or PCV 13?
PCV 13 (conjugated) is more immunogenic than PPSV23 (polysaccharide)
If a 19 y/o pt has not received PCV13 or PPSV23, what is the next step?
give a PCV13 first then PPSV23 8 weeks later
What if the 19 y/o had one dose of PPSV23, what is the next step?
give a single PCV13 at least one year from his previously received PPSV23
A patients blood work returns, they have anti-HBs and anti-HBc. What does this tell you?
They had a natural infection
A patients blood work returns, they have Anti-HBs. What does this tell you?
They are immune due to a vaccine
A patients blood work returns, they have HBsAg and Anti-HBc. What does this tell you?
They have a chronic infection
What is the Hep B vaccine series?
zero, one month and 6 months
How well are people protected after each Hep B vaccine?
healthy adults less than 40 are protected 75% after 2nd and 90% after 3rd. by age 60 only 60%
Oops that 19 y/o kid missed a dose of Hep B, do we have to restart the series?
Nope, just give him the next dose asap and the third 8 weeks later
How soon could you check for protect from the HepB vaccination and what is the minimum concentration?
1-2 months after the 3rd dose and a minimum concentration of 10 mIU/mL is considered protective
After doing a Hep Bpost vaccination serological test, the pt is found to be 6 mIU/mL, what is your next step?
revaccinate with three dose series
What is the zoster vaccine good for?
it decreases the incidence of zoster and post herpetic neuralgia
At what age can we give the zoster vaccine?
current ACIP says wait until 60, FDA approved for 50-59.
Can you give the zoster vaccine with an antiviral?
no you should wait at least 24 hours off anti-viral to maximize the effectiveness of the vaccine
Which is for kids and which is for adults, TD vs Td?
TD (diphtheria-tetanus toxoid) is for kids and Td (tetanus-diphtheria) is for adults
How do you give unvaccinated people over 7 y/o a tetanus vaccination?
This age group uses Td formulation (adults). 1st and 2nd are separated by at least 4 weeks and the third is given 6-12 months after. One them should be Tdap. Td booster every 10 years after
According to the ACIP, should we give Td or Tdap to all people over 65?
Tdap
Do we give pregnant women tetanus vaccines?
Yes, a Tdap with each pregnancy, more so for the pertussis
What are some examples of encapsulated organisms?
pneumococcal, meningococcal, HiB
Which vaccinations are contraindicated in pregnancy?
MMR, zoster, varicella
What CD4 count do you see multiple painful livid reddish brown plaques papules and nodules of both lower limbs and purplish nodules on the hard palate
Anything 400 or less
What CD4 count do you see bacterial skin infections, herpes simplex, zoster, oral skin fungal infections?
500
