Vaccine questions LEIK Flashcards
HPV - Gardasil
girls and boys
total of 3 doses
Age 13-14 years or older
Give Tdap if did not receive it at age 11 to 12 years
If no history of varicella immunization (or the disease),
then give the varicella vaccine.
MenACWY-D (Menactra):
Youngest age is 9 months or older
MenACWY-CRM (Menveo):
Youngest age is 2 months or older
Administer Menactra or Menveo vaccine
first dose age 11 to 12 years. If missing, catch-up
age is 13 to 15 years. Booster (second dose) at age 16 years.
Administer Menactra or Menveo vaccine
for first-year college students (living in dorms) and people with asplenia, functional asplenia (sickle cell), splenectomy, HIV infection, complement deficiencies,
and others at higher risk.
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
Tetanus, Diphtheria, Pertusis
Td (three doses primary, then every 10 years); substitute Tdap for one dose of Td (once
in a lifetime)
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
Polio Vaccine
IPV (three doses)
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
Hepatitis B
Hepatitis B (three doses)
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
MMR
MMR (two doses)
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
Varicella
Varicella (two doses) if no history of chickenpox
Primary Series of Vaccination: Missing or Not Done
After Seventh Birthday (Never Been Vaccinated)
HPV
HPV (three doses; give if younger than age 26 years)
Immunizations: Age 10 and Older
Hepatitis B
Total of three doses over 6 months. If missing a booster, give until total of three
doses. Do not repeat series.
Immunizations: Age 10 and Older
Measles, Mumps, Rubella (MMR)
Give second dose (if needs to catch up). Live virus precautions.
Immunizations: Age 10 and Older
Varicella
Give second dose (if needs to catch up) if no proof of varicella. Live virus
precautions.
Immunizations: Age 10 and Older
Tetanus
Give Tdap at age 11 to 12 years (or older if missed this dose). Replace one Td booster with Tdap.
Immunizations: Age 10 and Older
Hepatitis A
Needed for high-risk groups (homosexuals) and endemic areas (certain areas of
southwestern United States).
Immunizations: Age 10 and Older
Influenza
Needed annually after age of 6 months.
Immunizations: Age 10 and Older
Human Papillomavirus
Indicated for boys and girls. Give first dose at age 11 to 12 years. Catch-up dose at age 13 years if missed. Gardasil: Need three doses. Give second dose 1 to 2
months after first dose. Give third dose 6 months after the first dose.
Immunizations: Age 10 and Older
Meningococcal
First does at age 11 to 12 years. Give booster at age 16 years. Meningococcal conjugate vaccine (MCV4) needed for all college freshmen living in
dormitories.
Immunization Schedule age 7-18 years
Tdap
All 11- or 12-year-olds: Give Tdap as booster, then Td every 10 years for lifetime.
Immunization Schedule age 7-18 years
HPV (Gardasil)
All 11- or 12-year-olds: Give to girls and boys. Minimum age (HPV vaccines): 9 years old All 11- or 12-year-olds: Give first shot. Needs two doses, from 6 to 12 months apart. From age 15 to 26 years needs three doses.
Immunization Schedule age 7-18 years
Menactra, Menveo, Trumenba
All at age 11–12 years, give single dose of Menactra or Menveo vaccine at age 11–12 years with booster at age 16 years.
Catch-up: age 13–18 years, give Menactra or Menveo. If first dose at age 13–15 years, needs booster at age 16–18 years. But if first dose at age 16 years, no booster dose is needed.
Clinical discretion:
Young adults 16–23 years may be vaccinated with either Bexsero or Trumenba.*
Immunization Schedule age 7-18 years
Influenza inactivated
everyone annually from age 6 months and older
Immunization Schedule age 7-18 years Hepatitis B (Recombivax HB)
Catch-up: Give the third dose if not completed.
Immunization Schedule age 7-18 years
Hepatitis A
Recommended for children with certain health or lifestyle
conditions placing them at risk.
Immunization Schedule age 7-18 years
MMR
Catch-up: Give the second dose if not completed.
Immunization Schedule age 7-18 years
If no reliable history of chickenpox (verbal OK). Live virus is contraindicated
Meningococcal vaccine is now required for all
starting at age 11 to 12 years (not only
for college freshmen living in dormitories).
Centers for Disease Control and Prevention recommends HPV
vaccine for females until age 26 years;
for males until age 21 years (except males who have sex with males);
and for gay, bisexual, or males who have sex with males until age 26 years
- In small children with acquired immunodeficiency syndrome (AIDS), which of
the following vaccines is contraindicated?
A) Diphtheria and tetanus (Td)
B) Hepatitis B and mumps
C) Varicella
D) Td and oral polio
C) Varicella The data regarding efficacy of the varicella vaccine are insufficient; therefore, varicella vaccine is contraindicated in HIV-infected individuals.
- A 14-year-old girl who is sexually active is brought to the health clinic by her mother for an immunization update. According to the mother, her daughter has had one dose of hepatitis B vaccine. Which of the following vaccines would you
administer at this visit?
A) Tdap, hepatitis B, and HPV vaccine
B) DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B
C) Hepatitis B only
D) MMR (measles, mumps, rubella), Td, and HPV vaccine
A) Tdap, hepatitis B, and HPV vaccine
There are two types of HPV vaccine.
Gardasil can be used for both girls and boys, but Cervarix can only be used for females.
HPV vaccine is recommended for preteen boys and girls at age 11 or 12 years. Young women can get HPV vaccine until age 27 years and men can get the
HPV vaccine until age 22 years.
- All of the following statements are correct regarding the Td vaccine except:
A) Fever occurs in up to 80% of the patients
B) A possible side effect is induration on the injection site
C) The Td is given every 10 years
D) The DPT and DT should not be given beyond the seventh birthday
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A) Fever occurs in up to 80% of the patients Side effects of the Td vaccine include induration at the injection site. Td is given in adults every 10 years.
The DPT and DT should not be given beyond 7 years of age. Fever may occur, but studies do not support 80% of patients having fever.
- A 20-year-old college student reports to the student health clinic with a laceration of her left hand. She tells the nurse practitioner that she cut her hand while working in her garden. Her last Td booster was 5½ years ago. Which of the following is
correct?
A) Administer a booster dose of the Tdap vaccine
B) Administer the Td vaccine and the Td immunoglobulin (HyperTET)
C) Administer Td immunoglobulin (HyperTET) only
D) She does not need any Td immunoglobulin (HyperTET) or a Td booster
A) Administer a booster dose of the Tdap vaccine The Centers for Disease Control and Prevention (CDC) recommends the Tdap for teens or adults who need
a Td booster (once in a lifetime). A tetanus vaccine booster is recommended for recent injuries if it has been more than 5 years since the last dose.
- A 15-year-old boy has just moved into the community and is staying in a foster
home temporarily. There is no record of his immunizations. His foster mother wants
him to be checked before he enters the local high school. Which of the following
immunizations does this patient need?
A) Meningococcal vaccine
B) Measles–mumps–rubella (MMR) vaccine
C) Tdap vaccine
D) All of the above
D) All of the above This 15-year-old teenage patient will follow the Centers for Disease Control and Prevention (CDC) “catch-up” schedule (CDC, 2017) and
needs the meningococcal vaccine, MMR vaccine, and Tdap vaccine.
In addition to these three vaccines, this patient needs the hepatitis B vaccine, human papillomavirus
(HPV) vaccine, and varicella vaccine (if no history of chickenpox).
365. You would recommend the pneumococcal vaccine (Pneumovax) to patients with all of the following conditions except: A) Sickle cell anemia B) Splenectomy C) HIV infection D) G6PD-deficiency anemia
D) G6PD-deficiency anemia Pneumococcal vaccine is not indicated for glucose-6-phosphate dehydrogenase (G6PD)-deficiency anemia. There two
types of pneumonia vaccine for adults: PPSV23 (Pneumovax 23) and PCV13
(Prevnar 13). Pneumococcal vaccine is recommended for individuals beginning at
age 65 years, but the two types should not be given together. The Centers for Disease
Control and Prevention (CDC) recommends administering Prevnar 13 first, then
waiting at least 1 year (12 months) and giving the Pneumovax. The immunogenic
response is better using this method. Prevnar 13 is recommended for all infants and
children younger than 2 years of age, all adults aged 65 years or older, and people (2
to 64 years old) with certain medical conditions that increase risk of pneumococcal
disease, such as functional or anatomic asplenia (sickle cell), HIV infection, chronic
renal failure, leukemia, heart failure, cyanotic congenital heart disease, chronic lung
disease (asthma, chronic obstructive pulmonary disease [COPD]), diabetes, and
others.
461. All of the following vaccines are contraindicated in pregnant women except: A) Influenza B) Mumps C) Varicella D) Rubella
A) Influenza Not all vaccinations are safe to get during pregnancy. However, the
flu vaccine can be given before, during, and after pregnancy. The other vaccines are
live viruses and are contraindicated during pregnancy.
- A 13-year-old adolescent girl is brought to the health clinic by her mother for a sports physical. The mother reports that the teen’s last vaccines were given at the age of 6 years.
Which of the following vaccines is recommended by the Centers for Disease Control and Prevention (CDC) for this patient? A) Td and HPV vaccines B) Tdap, MCV4, and the HPV vaccines C) DTap and the flu vaccine D) DT and MCV4 vaccines
B) Tdap, MCV4, and the HPV vaccines
Vaccine questions usually are not this
complicated, but there are several lessons that can be learned with this question.
The 2017 Centers for Disease Control and Prevention (CDC) recommendations for individuals 13 to 18 years of age are the Tdap catch-up (if not received at age 11–12 years), human papillomavirus (HPV) catch-up (if not received at age 11–12 years), and the MCV4 or meningococcal conjugate vaccine (Menactra).
Thereafter, the Td form of the vaccine is indicated every 10 years. The DTaP (diphtheria–tetanus–
acellular pertussis) and DT (diphtheria–tetanus) forms of the tetanus vaccine are not given after the age of 7 years.
- All of the following are true statements about the human papillomavirus vaccine
(Gardasil) except:
A) The Centers for Disease Control and Prevention (CDC) recommends the first
dose at age 11 to 12 years
B) The CDC does not recommend the HPV vaccine for males
C) For children younger than age 14 years, only two doses of the vaccine are
needed
D) The minimum age at which the vaccine can be given is 9 years
B) The CDC does not recommend the HPV vaccine for males The HPV vaccine is now recommended for both males and females.
If it is given before age 14 years, only two doses are required, But if the child is older than 14 years, three doses are required to be given over 6 months. The vaccine can be given until the age of 26
years, especially if the individual is at high risk.
Do not use the vaccine in children younger than 9 years. There are two types of HPV vaccine (Gardasil and Cervarix).
Gardasil can be used for both genders, but Cervarix can only be used for females.
