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446- ID and transplant > Vaccine Preventable Diseases > Flashcards

Vaccine Preventable Diseases Flashcards

1
Q

3 vaccines recommended in pregnancy

A

influenza
Tdap
COVID

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2
Q

the varicella zoster virus causes

A

chicken pox

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3
Q

reactivated varicella zoster is

A

herpes zoster = shingles

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4
Q

varicella transmission

A

airborne (resp droplets) and virus shed from skin lesions- highly contagious (primary infection)

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5
Q

list 1 complication from varicella

A

pneumonia, abcteremia, severe skin infection, death

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6
Q

T or F: varicella infection results in life long immunity

A

T

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7
Q

2 preparations for varicella

A

live attenuated univalent
live attenuated MMRV

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8
Q

how many doses of varicella is required for immunity

A

2 dose primary series

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9
Q

which of the following is false
1. varicella zoster causes shingles upon reactivation
2. complications of varicella include pneumonia
3. varicella may be vaccinated against along with measles, mumps, and rubella
4. pregnant women are a priority in being vaccinated for varicella

A

4- can’t give varicella during pregnancy, women of childbearing age are a priority

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10
Q

should those >50yrs old, born before the varicella vaccine receive the vaccine?

A

no- assume that they had chickenpox

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11
Q

should those <50yrs get the varicella vaccine

A

yes- 2 doses if susceptible

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12
Q

____ doses of varicella are given _______

A

2 doses before school entry

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13
Q

varicella zoster virus inhabits _______ in the body

A

nerve base at specific dermatomes

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14
Q

zostavax is a ______ vaccine given ____ (route). it is approved for _____ and is ____ effective than shingrix

A

life attenuated
SC
>50yrs (rec >60yrs)
less eff than shingrix

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15
Q

shingrix is a ________ vaccine with ____ doses given ____. Recommended use is in ____ and is ____ effective than zostavax

A

inactivated, adjuvant
2 doses
IM
>50yrs
more eff than zostavax

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16
Q

RZV should be offered to those ________
1. are >50yrs without CI
2. have previously had shingles
3. have previously had chickenpox or the varicella vaccine
4. all of the above

A

4

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17
Q

protection against shingles for those that are immunocompromised can be done with

A

RZV (shingrix)

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18
Q

pros of chingrix

A

Much more eff than live attenuated - Adjuvant increases immune resp = longer lasting + greater immunogenicity
High lvl of efficacy up to 7yrs of FU
Not a live vaccine (↑ data in immunocomp pts)
89-91% eff in preventing PHN (~67% w/ LZV)

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19
Q

cons of chingris

A

Req 2 doses
Expensive + not publicly funded
Injection site (pain, redness, swelling) + other rxns (myalgia, fatigue, fever)
Rxns occur more often in 50-69yrs (↓ in 70yrs)

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20
Q

pneumococcal transmission

A

close, direct contacts, respiratory droplets

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21
Q

strep pneumoniae causes

A

otitis media, sinusitis, bronchitis, pneumonia

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22
Q

IPD is

A

invasive pneumococcal diseases including: meningitis, bacteremia, endocarditis, septic arthritis, osteomyelitis, peritonitis

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23
Q

2 types of pneumococcal vaccine + their routes

A

conjugate (M) and polysaccharide (IM or SQ)

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24
Q

number of doses of pneumococcal for ≥65yrs, regardless of RFs or prev pneumococcal vacc + which preparation

A

1 dose of polysaccharide

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25
Q

number of doses of pneumococcal for 18-65yrs at high risk of IPD due to underlying condition (heart, kidney, liver, lung, DM) + which prep

A

1 dose + 1 booster at least 5 years later
polysaccharide for both

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26
Q

which vaccine + schedule of pneumococcal for 18-65yrs + residents of LTC, smokers, alcoholism, homeless

A

1 dose of polysaccharide

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27
Q

which vaccine + schedule of pneumococcal for adults with immuncomp condition

A

1 dose Pneu-C-13
1 dose Pneu-P-23 at least 8 wks after Pneu-C-13
1 booster dose of Pneu-P-23 at least 5 yrs later

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28
Q

should those that are >65yrs and immunocomp receive pneumococcal

A

consider individually

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29
Q

which pneumococcal vaccine is effective in preventing pneumonia and IPD

A

pneu-C-13

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30
Q

which pneumococcal vaccine may or may not prevent CAP, but may be as effective as conjugate in preventng IPD

A

pneu-P-23

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31
Q

does the pneu-P-23 protect against pneumonia

A

may/ may not- not as good as conjugate

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32
Q

describe hyporesponsiveness to polysaccharide vaccines

A

Too many doses of polysaccharide = dead B cells = hyporesponsiveness = 2 doses max of polysaccharid

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33
Q

influenza is a _____ virus

A

RNA

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34
Q

influenza transmission is through

A

primarily by droplets spread through coughing or sneezing, direct or indirect contact with respiratory secretions

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35
Q

describe Type A influenza

A

Classified into strains or subtypes based on proteins/ antigens on virus surface (ex- H1N1, H3N2)
Seasonal, avian, swine influenza
Can cause significant disease
Infects humans and other species (Ex birds)
Can cause epidemics and pandemics (worldwide epidemics)

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36
Q

describe type B influenza

A

Classified into 2 antigenically distinct lineages- Yamagata and Victoria
Seasonal influenza
Generally causes milder disease but may also cause severe disease
Limited to humans
Generally causes milder epidemics

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37
Q

which influenza type is classified into subtypes based on proteins/ antigens on virus surface

A

type A

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38
Q

which influenza type is limtied to humans and generally seasonal

A

type B

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39
Q

trivalent influenza vaccines included

A

2 influenza A + 1 B

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40
Q

quadrivalent influenza vaccines included

A

2 A + 2B

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41
Q

how does WHO recommend which influenza strains to be included in the vaccine

A

look at what is spreading in the southern hemisphere

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42
Q

antigenic drift is

A

slight changes in strain that occur within a host

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43
Q

antigenic shift is

A

when 2 or more strains of influenza recombine in host = produces totally new strain = causes outbreaks

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44
Q

which influenza subtype experiences antigenic shift
1. type A
2. type B
3. both
4. neither

A

1

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45
Q

common influenza vaccine SEs

A

inj site pain, tenderness, redness, swelling, HA, malaise, fatigue, myalgia, fever, arthralgia

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46
Q

rare influenza SEs

A

immediate allergic type resp like hives, angioedema, anaphylaxis, GBS, ORS

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47
Q

CIs to TIV/QIV inactivated influenza vaccine

A

<6mths
anaphylactic rxn to prev dose of influenza
known hypersens to any component (except egg)
dx w/ GBS within 6wks of prev dose
experienced severe ORS w/in 24hrs of receiving influenza vaccine (assess before immunizing)

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48
Q

CIs to LIAV influenza vaccine

A

<2yrs
anaphylactic rxn to prev dose of influenza
known hypersens to any component
immune comp conditions
children with severe asthma (or medically attended wheezing in 7d prior to vaccination
children/ adolescents receiving aspirin

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49
Q

which flu vaccine is grown on mammalian cell culture

A

flucelvax

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50
Q

the immune response to the influenza vaccine includes production of circulating ____ to the viral _____ and _____ proteins, as well as a more limited _____ response

A

circulating IgG antibodies
viral haemagglutinin and neuraminidase proetins
cytotoxic T lymphocyte response

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51
Q

Ab levels achieved within 2 weeks of influenza vaccine usually lasts

A

<1yr

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52
Q

when is high dose influenza vaccine used

A

> 65yrs old

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53
Q

Evidence from SRs showed the high dose influenza had __________ eff in preventing influenza illnesses, influenza and pneumonia hospitalization and mortality compared to normal dose

A

no difference/ more

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54
Q

NACI recs for influenza vaccine

A

supports vax in =>6mths

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55
Q

consequences of influenza in pregnancy include

A

higher rates hospitalization, CV complications, death (vs general public), risk premature labor and delivery

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56
Q

the influenza vaccine in pregnancy
1. provides protection for the mother only
2. associated with infants that are larger for gestational age
3. may have safety concerns depending on mother medical conditions
4. provides protection to the fetus by transplacental antibodies

A

4

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57
Q

the influenza vaccine in preg is assocaited with

A

lower hospitalization rates in pregnancy + infants less likely to be premature or small for gestational age

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58
Q

in children <9yrs who are receiving influenza vaccine for the first time will recieve

A

2 doses, 1 month apart
1st dose is the priming dose

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59
Q

in children <9yrs who are getting their first shot of influenza vaccine, how long is the interval between the primer dose and booster dose

A

1mth

60
Q

what happens if child getting flu shot for first time doesn’t come back for booster dose 1mth later

A

no protection for that first year, do 1 dose next year as normal

61
Q

GBS is an illnses that attacks the

A

nervous system

62
Q

GBS is characterized by

A

loss of reflexes + symmetrical paralysis usually starting in the legs

63
Q

T or F: BGS has a complete/ near complete recovery in most cases

A

T

64
Q

the risk of GBS with influenza __ influenza vaccine

A

>

65
Q

Recommended to not provide influenza immunization to those diagnosed with GBS within ___ of previous influenza immunization

A

6 wks

66
Q

GBS may be triggered by

A

infection

67
Q

ORS onsets ___ after immunization

A

24hrs

68
Q

ORS sx

A

bilateral red eyes + respiratory sx

69
Q

COVID virus type

A

RNA

70
Q

covid transmission

A

primarily by droplets spread through coughing, sneezing, or talking- lesser degree via contaminated surfaces

71
Q

Long covid/ post covid complications include

A

wide range of sx that can persist weeks or years post exposure, more common in those who had severe COVID (vaccinated may be less at risk)
fatigue that intx w/ daily activities, sx worsen with physical/ mental activity, fever, cough with SOb, chest pain, heart palpitations, HAs, sleep problems, GI issues, joint and muscle pains

72
Q

increase cases of covid increases the risk of

A

variants/ mutations

73
Q

the WHO watches for variants of concern by watching for those that impact (3)

A

transmissibility
immunity to vaccines
infection severity

74
Q

the WHO divides variants into

A

variants of concern
variants of interest

75
Q

covid vaccine development has focused predominantly on the

A

viral structural spike protein

76
Q

next generation vaccine platforms include

A

viral vector
DNA/ RNA
antigen presenting cells

77
Q

the pfizer mRNA vaccine can be given as ______ for ______

A

bivalent booster dose for =>5yrs

78
Q

the moderna vaccine primary series can be given to those _____ and the bivalent booster for those _________

A

primery series +6mths
18+ bosoter

79
Q

what type of vaccine is the AZ covid vaccine

A

viral vector

80
Q

what is the difference between mRNA vaccine in deltoid vs lymph node

A

deltoid has proteosomal degradation + presentation on MHC 1 to CD8 T cell
lymph node also has endosome intake to presentation on MHC 2 to CD4 T cell

81
Q

what is the most common correlate of immunogenicity/ protection

A

neutralizing Ab titers

82
Q

COVID recommendations for mod-severely immunocomp

A

primary series of 3 doses of mRNA, if already received a 1 or 2 dose vaccine = rec additional dose of mRNA

83
Q

COVID vaccine recommendations for pregnancy/ breast feeding

A

mRNA preferred, but protein subunit or VLP may also be offered to those not able/ unwilling to receive mRNA

84
Q

when should those infected with COVID get boosters

A

can do immediately but prefer to wait 5 months (3 months if immunocompromised)

85
Q

Pts =>6mths, COVID vaccines may be given concurrently with ____________________

A

nonCOVID vaccines (including live and nonlive)

86
Q

hep A transmission

A

fecal oral route

87
Q

hep A incubation period

A

avg 28 days

88
Q

hep A cases are infectious ________ until ____________

A

2 weeks before onset of sx until 1 wk after onset of jaundice

89
Q

severity of hepA increases with

A

age
Children <6yrs commonly asymptomatic, 25% adult cases hospitalized

90
Q

T or F: infection with hepA confers immunity

A

T

91
Q

infants and children can shed hepA virus for up to

A

6 months after infection

92
Q

HAV vaccine type

A

inactivated

93
Q

which of the following is false about hepA vaccines
1. it is a 2 dose series
2. it can be given pre and post exposure (if within 1 week of exposure)
3. the booster is given 2 months after 1st dose
4. it is adsorbed to aluminum hydroxide adjuvant

A

3- booster given at 6-36 months

94
Q

who should be considered for preimmunization serology for anti-HAV

A

born prior to 1945, from endemic country, hx of hepatitis or jaundice that may have been caused by HA, dx w/ hepB/ C

95
Q

who should get HAV preexposure

A

those 6mths and older at increased risk of infection or severe HA (Ex- travel)

96
Q

who should get HAV preexposure

A

offered to household and close contacts of proven or suspected cases of HA (ex- group childcare centres, clients of infected food handlers)
Vaccines should pref be given ASAP, and ideally within 14 days

97
Q

when shoudl the HAV vaccine be given post exposure

A

pref ASAP, ideally within 14 days
can consider if >14 days (no data here tho)

98
Q

in those <6mths of age who have been exposed to hepA, what should be recommended

A

immunoglobulin

99
Q

hep B virus type

A

DNA virus

100
Q

hep B is transmitted by

A

blood, semen, vaginal fluids

101
Q

in hepB
1. initial infection may be asymptomatic
2. those who clear the virus in the first 6 months become immune
3. the risk of a chronic infection decreases with age
4. all of the above
5. none of the above

A

4

102
Q

T or F: hepB vaccine may be given post exposure

A

T- highly eff in preventing HBV when given to exposed infants, within 1 wk of percutaneous exposure or within 2 wks of sexual exposure

103
Q

anti-HBs +, HBsAg and anti-HBc - =

A

immune (vaccinated)

104
Q

anti-HBs +, HBsAg - and anti-HBc + =

A

immune (infected before)

105
Q

anti-HBs, HBsAg, and anti-HBc - =

A

susceptible

106
Q

how long does hepB immunity last after immunzation

A

indefinitely - boosters not recommended for immunocompetent individuals

107
Q

routine bosters may be recommended if anti-HB titres fall below

A

10IU/L (but timing is important)

108
Q

when would a person quality for a second vaccine series/ a higher dose of hepB

A

if negative for anti-HBs after 1st series

109
Q

HPV is a _____ virus

A

DNA

110
Q

what is the most common STI in Canada

A

HPV

111
Q

HPV is
1. usually symptomatic and causes warts
2. can cause head and neck cancer
3. high risk HPV = 6,11
4. men can not get HPV

A

2

112
Q

which HPV vaccine is not approved for males

A

HPV2- only covers 16 and 18 - cervical cancer

113
Q

which HPV straisn are low risk

A

6, 11 = causes warts

114
Q

which HPV strains are oncogenic

A

16,18

115
Q

what are the recommendations for HPV for 9-27yrs old

A

HPV 2, 4, or 9

116
Q

boys and men 9-27yrs old should get the HPV ___ or ___ vaccinse

A

4 or 9

117
Q

which of the following groups have a disproportionately high burden of HPV
1. men who have sex with men
2. women 45 years or older
3. women in their 20s
4. women who have sex with women

A

1

118
Q

diphtheria is transmitted by

A

close, direct contact with droplets from a cough or sneeze

119
Q

T or F: infection with diphtheria confers natural immunity

A

F

120
Q

diphtheria vaccine is
1. a primary series of 3 vaccines
2. is only available in combos
3. is recommended for infants starting at 1 month of age
4. 1+2

A

4
not 3 because rec starting 2mths of age

121
Q

in those 14-16yrs olds, _____ should be the first diphtheria 10yr booster dose

A

Tdap

122
Q

what is in the Tdap vaccne

A

tetanus, diphtheria, pertussis

123
Q

what is in the Td vaccine

A

tetanus and diphtheria

124
Q

adults should protect themselves from diphtheria by getting the ____ vaccine q__yrs

A

Td vaccine q10yrs

125
Q

pregnant females should get 1 dose of ____ with each pregnancy

A

Tdap

126
Q

tetanus transmission

A

not contagious, spreads through spores in the environment (introduced into wound)

127
Q

T or F: tetanus infection does not confer immunity

A

T

128
Q

tetanus vaccine
1. is a 3 dose series
2. is only available in combo vaccines
3. can result in hypersensitivity rxns if too many doses are given
4. all of the above
5. none of the above

A

4

129
Q

postexposure prophylaxis to tetanus is

A

Td +/- tetanus immunoglobulin

130
Q

pertussis sx

A

paroxysmal cough, whooping caused by inspiration against closed glottis (lasts 6-12wks)

131
Q

immunity after pertussis infection is
1. life long
2. 2-10 years
3. 4-20yrs
4. not present- will kill you

A

3

132
Q

why is Tdap recommended every pregnancy

A

Maternal IgG Abs actively transferred through placenta to provide passive immunity in first few months (minimal transfer until 13-16wks gestation- continuously incr in 2nd/3rd trim

severe disease most commonly seen in infants <2mth old

133
Q

whole cell pertussis vaccine was changed to acellular due to

A

SEs from whole cell

134
Q

polio is transmitted through the _______ route

A

fecal oral

135
Q

polio is a _____ dose primary series

A

3

136
Q

what is the gold standard for indicating polio in a community

A

monitoring wastewater`

137
Q

which polio vaccine is no longer recommended? why?
1. trivalent inactivated polio vaccine
2. combination polio with Tdap
3. OPV
4. 1 and 2

A

3- associated with paralytic polio

138
Q

how many boosters is rec for polio- who needs the booster?

A

1 only for those at increased risk of exposure

139
Q

what was the most common cause of bacterial meningitis in Canada

A

haemophilus influenzae type B

140
Q

Hib is
1. natural infection may result in lifelong immunity
2. natural infection will result in lifelong immunity
3. was the second most common cause of bacterial meningitis
4. is transmitted by feces

A

1

141
Q

the Hib vaccine is (pick all that apply)
1. live attenuated
2. inactivated IM
3. inactivated PO
4. toxoid
5. polysaccharide
6. conjugate

A

5,6

142
Q

the primary series of Hib is ___ doses in the first ___ then a booster at ____

A

3 doses in first 2mths
booster at =>12mths

143
Q

meningococcal is transmitted through

A

respiratory droplets, mouth secretions

144
Q

describe the Characteristic rash of meningococcal disease

A

petechial rash caused by damage to small blood vessels

145
Q

which 5 serotypes of meningococcal cause nearly all invasive meningococcal diseases in Canada

A

A, B, C, Y, Q135

446- ID and transplant (18 decks)

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