Vaccinations and Disease Control Flashcards
What do antigens in a vaccine stimulate?
Macrophages, T cells, B cells
What role do macrophages play after vaccination?
Ingest proteins into small antigen remnants
What do MHC molecules do after macrophages ingest antigens?
Display the antigen
What happens after T cells recognize the antigen?
Stimulation of B cells to secrete antibodies
Why does the immune system respond to vaccines as if they were real viruses?
It does not differentiate between the vaccine and the real virus
Why do we need more than one dose of some vaccines?
Immunity wanes with age
What is the purpose of booster doses?
To re-expose the immune system to the antigen to improve protection
What are the common side effects of the MMR vaccine within 6-14 days of injection?
Fever, rash, joint pain
What are the uncommon side effects of the MMR vaccine?
Febrile seizures, low platelets
How can the need for re-vaccination be measured?
By measuring anamnestic response (titers)
How many doses of the MMR vaccine are given to children?
2 doses
What could a high level of immune response from a booster trigger?
Arthus reaction
At what ages are children typically given the MMR vaccine?
Around 1 and 5 years
What is an Arthus reaction?
Type III hypersensitivity reaction causing local vasculitis
What factors affect vaccine response?
Smoking, diet, stress, genetics, recent illness, aging, timing
How many doses of the MMR vaccine do adults over 18 need if born after 1956?
One dose
At what ages is the DTAP vaccine administered?
2, 4, 6, 15 months and age 5
When should titers be drawn after vaccination?
No less than 4 weeks after vaccination
What are the most common side effects of the DTAP vaccine?
Fever, redness, and pain at the injection site
What are the types of vaccinations mentioned?
Live vaccines
What are some less common side effects of the DTAP vaccine?
Fussiness, fatigue
Why was the live oral polio vaccine (OPV) discontinued in the US?
Associated with paralytic disease in 1 out of 2.4 million patients
Since when has the OPV not been used in the US?
Since 2000
Who adapted the slides for the presentation?
Kayla Martinez, PA-C
What is the current recommendation for polio vaccination in the US?
Use IPV only
What are rare but serious side effects of the DTAP vaccine?
Seizure, crying, high fever over 105 F
Who is the original author of the slides?
Janet Furman, PhD, PA-C, DFAAPA
What is the adult booster dose for DTAP called?
Tdap
What is the composition of the IPV vaccine?
Mixture of live and attenuated viral strains
What type of vaccine is the Hepatitis B vaccine?
Inactivated, conjugate vaccine
What is the seroconversion rate of the varicella vaccine in children?
95%
Who should routinely receive the Hepatitis B vaccine?
Children and unvaccinated health care workers
What is the adult schedule for the Hepatitis B vaccine?
3 doses, with second and third doses 1 and 6 months after the first dose
Who developed the first smallpox vaccine and in what year?
Edward Jenner in 1796
What is the seroconversion rate of the varicella vaccine in adults?
70%
What virus did Edward Jenner use to develop the smallpox vaccine?
Cowpox
What is the modern name for the virus used in the smallpox vaccine?
Vaccinia
How long after exposure can the smallpox vaccine prevent or lessen symptoms?
Within 3 days
When was the smallpox vaccine made compulsory for infants in England?
1853
What option was available for those who opposed the compulsory smallpox vaccination in England?
Conscientious objection
When did the smallpox vaccination become non-compulsory by law in England?
1907
Around what year did most US states mandate the smallpox vaccine?
Circa 1972
What was the landmark case that upheld mandatory vaccination in the US?
Jacobson v Massachusetts
What should be done if the Hepatitis B vaccine series is interrupted?
It does not need to be restarted
What are the side effects of the varicella vaccine?
Rash, low grade fever, soreness at injection site
What provides immediate protection for unvaccinated individuals exposed to Hepatitis B?
HBIG and HBV
How many doses of the varicella vaccine are given to children?
2 doses
When did the WHO begin eradication efforts for smallpox?
1967
What is the dosing schedule for the varicella vaccine in adolescents or adults with no varicella history?
4-8 weeks apart
What vaccination strategy was used in the eradication of smallpox?
Ring vaccinations
What are common side effects of the Hepatitis B vaccine?
Headache, dizziness, irritability, injection site soreness
Can the varicella vaccine be administered after exposure to the virus?
Yes, within 3-5 days
Who should not receive the varicella vaccine?
Pregnant or immunocompromised individuals
Why can’t we eradicate measles?
Due to recent outbreaks caused by vaccine hesitancy
What does the HPV vaccine consist of?
Virus-like particles (VPLs) of the major capsid protein of HPV
What are the two options for mpox vaccination?
Jynneos and ACAM2000
When were measles declared eliminated in a specific area?
2000
Which HPV strains does Gardasil 9 target?
6, 11, 16, 18, 31, 33, 45, 52, and 58
At what age is the HPV vaccine recommended?
Ages 11-12, but can be given starting at 9
What type of virus is used in the Jynneos vaccine?
Live attenuated orthopoxvirus MVA
What does it mean for a disease to be declared eliminated?
Absence of continuous disease transmission for 12 months or more in a specific area
How many doses of the HPV vaccine are needed if started between ages 15-26 or if immunocompromised?
Three doses
What is the period between exposure and rash for measles?
14-21 days
Who is eligible for pre-exposure prophylaxis with the Jynneos vaccine?
18+ at risk for mpox
Can the HPV vaccine be given during pregnancy?
No
What are the side effects of the Jynneos vaccine?
Pain, redness, swelling at injection site; fatigue, headache, chills, myalgias
What is the period between exposure and rash for smallpox?
7-10 days
What can the HPV vaccine prevent?
Persistent infection, genital warts, and cervical/anal cancers due to HPV
What is an early symptom of smallpox?
Rash
What are the contraindications for the Jynneos vaccine?
Anaphylaxis with previous dose
What are common side effects of the HPV vaccine?
Pain/redness at injection site, fever, dizziness, headache, nausea
What type of virus is used in the ACAM2000 vaccine?
Live vaccinia virus
Where can you find more information about vaccines and preventable diseases?
https://www.cdc.gov/vaccines/vpd/index
What type of vaccine is the Haemophilus influenzae b (HIB) vaccine?
Conjugate vaccine
What do conjugate vaccines consist of?
Polysaccharides from surface coat of bacteria linked to protein carriers
At what ages is the HIB vaccine administered?
2, 4, 6 months and a booster at 12-15 months
Where can you find a detailed article on the history of smallpox vaccination?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905528/
What is the purpose of conjugate vaccines?
Prevention of bacterial infections
Who should receive the HIB vaccine if older than 5 years?
Individuals with asplenia or sickle cell disease
Where can you find the adult immunization schedule?
https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
What is the dosing schedule for the PCV 13 vaccine?
2, 4, 6 months, and 1 year
What are common side effects of the HIB vaccine?
Low grade fever, erythema, and pain at injection site
What are the two types of influenza vaccines?
Nasal (live) and injectable (conjugate)
Who is recommended to receive the PCV 13 vaccine?
Some adults age 65+ and those 19-64 with immunocompromise, CSF leaks, or cochlear implants
What diseases does the PCV 13 vaccine protect against?
Pneumonia and meningitis
Who is at most risk for influenza?
Young, elderly, and healthcare workers
What are the side effects of the PCV 13 vaccine?
Fussiness, sleepiness, injection site inflammation, low grade fever
Why is the influenza vaccine changed every year?
Based on strain prediction (antigenic cartography)
What is a challenge in developing influenza vaccines?
Influenza mutates rapidly, has antigenic diversity, and can be pandemic
Who is recommended to receive the PPSV 23 vaccine?
All adults over age 65, age 2-64 with chronic health issues, weakened immune system, age 19-64 with asthma or smokers
Why is yearly vaccination needed for influenza?
Due to decline in antibody production over time and antigenic drift
What are the three types of influenza vaccines?
Egg-based, cell-based, recombinant
What are the side effects of the PPSV 23 vaccine?
Erythema, soreness at injection site, fever, myalgias in 1 out of 100
What is a suggested first step in improving influenza vaccination?
A vaccine against all strains of Influenza A
How does the COVID-19 mRNA vaccine work?
Gives instructions to make the spike protein and cell then destroys the mRNA
Why is the PCV 13 vaccine used in children under 2 years of age instead of PPSV 23?
PPSV 23 is not as effective in children less than 2 years of age
What does the COVID-19 mRNA vaccine cause the body to produce?
Antibodies to the spike portion of the virus
What is the recommended sequence of pneumococcal vaccines for adults over 65 years old?
PCV 13 first, then PPSV 23 about a year later
Is the COVID-19 mRNA vaccine a live or killed virus?
Neither
What is the combination vaccine for diphtheria, tetanus, and acellular pertussis called?
DTaP
What is the schedule for the Zoster vaccine (Shingrix)?
2 doses at least 2 and up to 6 months apart
What is the dosing schedule for the DTaP vaccine?
2, 4, 6, 15 months and age 5
Who should receive the Zoster vaccine?
All adults over 50, even if they have had zoster or varicella in the past
When should the Zoster vaccine not be administered?
During active shingles
What are the common side effects of the DTaP vaccine?
Fever, redness and pain at injection site, fussiness, fatigue
What are the severe side effects of the DTaP vaccine?
Seizure, crying, high fever over 105 F
What is the booster dose for adults called for diphtheria, tetanus, and acellular pertussis?
Tdap
What are common side effects of the Zoster vaccine?
Site soreness, fever, chills, headache, nausea, rash
What type of vaccine is the RSV vaccine?
Recombinant RSV F protein antigen
Who may benefit from the RSV vaccine?
Adults over 60 with risk factors for severe disease
What is the efficacy of the RSV vaccine in the first season?
83-89%
What are common side effects of the RSV vaccine?
Pain, redness, swelling at injection site; fatigue, nausea, diarrhea, myalgias/arthralgias
What type of vaccine is the Hepatitis A vaccine?
Inactivated
At what age is the Hepatitis A vaccine routinely given to children?
Between 12 and 23 months old
What is the adult schedule for the Hepatitis A vaccine?
2 doses, 6 months apart
What provides protection for exposure to Hepatitis A?
Hepatitis A Virus (HAV) IG
What are common side effects of the Hepatitis A vaccine?
Local pain and swelling
What are indications for the Hepatitis A vaccine?
Travel to endemic countries, IV drug use, chronic liver disease
What are contraindications for the Hepatitis A vaccine?
Mild illness, severe life-threatening allergy
At what ages is the inactivated polio vaccine (IPV) administered?
2, 4, and 6 months and 4-6 years
Who should receive the IPV vaccine as adults?
Unvaccinated individuals traveling to endemic areas, lab workers handling the virus, healthcare workers treating polio patients
What are common side effects of the IPV vaccine?
Mild illness, injection site soreness
What is an example of a disease eradicated by vaccination?
Smallpox
Should Pregnant women receive the Covid-19 vaccine?
Yes