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DipHIV > Vaccines > Flashcards

Vaccines Flashcards

1
Q

At what CD4 count is there an increased risk of vaccine-associated disease with replicating vaccines?

A

<200

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2
Q

What is the recommended time for spacing between administration of replicating vaccines?

A

4 weeks

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3
Q

If blood products are or have been administered when can replicating vaccines be given?

A

FOURTEEN days before transfusion
or
THREE months after

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4
Q

What impact does CD4 have on the response to non-replicating vaccines?

A

REDUCED response

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5
Q

What impact does vaccination have on viral load?

A

transient INCREASE

no clinical significance

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6
Q

Which type of vaccines can be given in pregnancy?

A

NON-REPLICATING

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7
Q

What organism causes ANTHRAX?

A

Bacillus anthracis

Gram positive bacterium

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8
Q

How is ANTHRAX acquired?

A

Handling of infected herbivorous animals live or dead

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9
Q

When is ANTHRAX vaccine recommended for PLWHIV?

A

if significant risk of anthrax exposure

  • occupational
  • member of ministry of defence
  • as part of post exposure prophylaxis
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10
Q

What is the recommended ANTHRAX vaccine regimen?

A

FOUR doses + BOOSTER
0, 3, 6 WEEKS
SIX months
ANNUAL booster

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11
Q

What organism causes CHOLERA?

A

Vibrio cholerae
Non-invasive toxin secreting
Gram negative bacterium

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12
Q

How is the CHOLERA vaccine administered?

A

ORAL

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13
Q

What is the recommended CHOLERA vaccine regimen?

A

TWO doses oral
1 week apart
+
single BOOSTER

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14
Q

When is CHOLERA vaccine recommended for PLWHIV?

A

if significant risk of cholera exposure and unable to take adequate precautions

  • assisting in disaster relief
  • visiting remote areas
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15
Q

What organism causes DIPHTHERIA?

A

Corynebacterium diphtheriae or ulcerans

Gram positive bacterium

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16
Q

What two other vaccines is diphtheria given in combination with?

A

TETANUS toxoid

Inactivated POLIO vaccine

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17
Q

What is the recommended DIPHTHERIA vaccine regimen?

A 
Combination diphtheria/tetanus/polio
THREE doses
1 month apart
then
TWO BOOSTERS 5 & 10 years
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18
Q

Vaccinated individuals who are then exposed to diphtheria what is the recommended post exposure prophylaxis?

A

Antibiotics
+
BOOSTER dose vaccine

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19
Q

What organism is HAEMOPHILUS INFLUENZAE SEROTYPE b?

A

Gram negative coccobacillus

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20
Q

When is Hib vaccine recommended for PLWHIV?

A

Asplenia
Splenic dysfunction
Complement deficiency

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21
Q

What is the recommended Hib vaccine regimen?

A

ONE dose

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22
Q

What is the recommended hepatitis A vaccine regimen for PLW HIV?

A

CD4 >350
TWO doses 0 & 6 months
CD4<350
THREE doses 0, 1 & 6 months

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23
Q

What difference does CD4 count make to hepatitis A vaccination schedule?

A

THREE doses if CD4<350, 2 doses if >350

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24
Q

If a PLWHIV has CD4<200 and requires urgent PRE-EXPOSURE prophylaxis to hepatitis A what should be given?

A

Human immunoglobulin
and
Vaccination

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25
Q

What is the POST-EXPOSURE prophylaxis regimen for hepatitis A?

A

Vaccination within FOURTEEN days

if CD4 <200 add IMMUNOGLOBULIN

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26
Q

What is the recommended regimen for HEPATITIS B vaccination?

A 
FOUR doses
0, 1, 2 and 6 months
Double dose ENGERIX 40mcg
or
Fendrix 20mcg
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27
Q

When can ultra-rapid hepatitis B vaccination be considered in PLW HIV?

A

CD4 >500

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28
Q

When should HBsAb be checked after hepatitis B vaccination?

A

4-8 weeks after last dose

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29
Q

If HBsAb is <10 after full course of vaccination what is the next step for PLW HIV?

A

THREE further doses
DOUBLE dose 40mcg
or
Fendrix 20mcg

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30
Q

When should hepatitis B revaccination of non-responders be delayed?

A

If CD4<350, wait until increased

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31
Q

If HBsAb is 10-100 after full course of vaccination what is the next step for PLW HIV?

A

ONE further DOUBLE dose

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32
Q

Which PLW HIV are recommended to have HPV vaccine?

A

Unvaccinated

  • men + women aged up to 26
  • MSM to 40 yrs
  • Women to 40 yrs
33
Q

What is the recommended HPV vaccine course for PLW HIV?

A

THREE doses

0, 1 and 6 months

34
Q

What are the 3 types of INFLUENZA?

A

A, B, C

35
Q

Which INFLUENZA types cause the most disease?

A

A and B

36
Q

When is the INFLUENZA season in Northern hemisphere?

A

October to May

37
Q

When is the INFLUENZA season in Southern hemisphere?

A

April to September

38
Q

When is the INFLUENZA season in the tropics?

A

ALL year round

39
Q

What are the two types of flu vaccine formulation used in the UK?

A

Inactivated
and
Live attenuated

40
Q

How is the live attenuated flu vaccine administered and to whom?

A

INTRANASAL

to children

41
Q

What allergy needs to be screened for before administering inactivated flu vaccine?

A

EGG allergy

vaccine cultured inside hen egg

42
Q

When in the year is the optimum timing for flu vaccination?

A

September to November

benefit until March

43
Q

Which flu vaccine type is recommended for PLWHIV?

A

QUADRIvalent

44
Q

In which regions of the world can Japanese encephalitis virus occur?

A

South east Asia

Western pacific

45
Q

What is the vaccination schedule for Japanese encephalitis?

A

TWO doses
1 month apart
then
BOOSTER 12 months

46
Q

How might MEASLES present differently in people with advanced HIV?

A

No RASH

complications DELAYED up to several months from initial infection

47
Q

What type of vaccine is the MMR?

A

replicating LIVE attenuated

48
Q

What is the MMR vaccine schedule for ADULTS?

A

TWO doses

1 month apart

49
Q

What is contraindicated following the MMR vaccine?

A

PREGNANCY for 1 month

50
Q

Who is the MMR contraindicated in?

A

Severe immunocompromised
- CD4 <200
Pregnant

51
Q

What is the post exposure prophylaxis for contact with MEASLES?

A 
within THREE days
CD4 >200
-check Measles IgG 
-if negative, give human normal IG
CD4 <200
- give IG regardless of measles IgG
52
Q

Which PLW HIV should be given the MMR?

A

IgG negative

  • CD4 >200
  • established on ART
53
Q

What is the recommendation for meningococcal vaccination in PLW HIV?

A

Follow national guidance

  • <25 years + never vaccinated
  • asplenia
  • travel risk
54
Q

What is the MENINGOCOCCAL vaccine schedule?

A

TWO doses

2 months apart

55
Q

What THREE other vaccines is PERTUSSIS combined with?

A

DIPHTHERIA
TETANUS
POLIO

56
Q

What is the recommendation for pertussis vaccination for PLW HIV?

A

National guidance
- pregnant
ONE dose

57
Q

What TWO pneumococcal vaccines are used in the UK?

A

Pneumococcal polysaccharide vaccine (PPV) 23
and
Pneumococcal protein-conjugated vaccine (PCV) 13

58
Q

How many serotypes are covered with pneumococcal vaccine PCV 13?

A

THIRTEEN

59
Q

What is the recommended pneumococcal vaccination schedule for PLW HIV?

A

SINGLE dose
PCV-13
then
PPV-23 as per national guidance (>65 years old)

60
Q

Should pneumococcal vaccination be repeated?

A

NO

however should receive PPV23 when older

61
Q

What is the recommended POLIO vaccination schedule for PLW HIV?

A 
if never/uncertain vaccinated
- THREE doses
1 month apart
then
TWO doses
5 & 10 years
62
Q

Is rabies vaccine inactivated or live?

A

INACTIVATED

63
Q

What is the RABIES vaccination schedule?

A

THREE doses

0, 7 and 28 days

64
Q

What is the RABIES post-exposure prophylaxis recommendation for PLW HIV?

A

No previous vaccine
FIVE doses
0, 3, 7, 14, and 30 days (ie roughly double interval between each)
and
Immunoglobulin around bite site in select cases

65
Q

At what CD4 count level might response to RABIES vaccine be reduced?

A

CD4 <500

66
Q

What is the recommendation for people with CD4 <500 and receiving rabies vaccine?

A

Check serology 2-4 weeks after third dose

Ab<0.5 IU/mL offer BOOSTER (DOUBLE dose)

67
Q

What is the TETANUS vaccination schedule?

A 
FIVE doses total
THREE
1 month apart
then
5 & 10 years
68
Q

What is post exposure prophylaxis for TETANUS?

A

Vaccination if >10 years since last dose

If high risk wound add immunoglobulin

69
Q

What is the TICK-BORNE ENCEPHALITIS vaccination schedule?

A

THREE doses
0, 1 and 2 months
then
BOOSTER 9-12 months

70
Q

What is the recommended vaccination schedule for SALMONELLA TYPHI (typhoid)?

A

NON REPLICATING
ONE dose
2 weeks before risk

71
Q

What is the recommendation for BCG vaccination in PLW HIV?

A

DO NOT give
increased risk of local and systemic complications
no clear benefit of vaccine

72
Q

How is chickenpox spread?

A

RESPIRATORY
or
direct contact with skin LESIONS

73
Q

What type of vaccine are the VARICELLA vaccines?

A

LIVE replicating vaccines

74
Q

How many VARICELLA vaccines are there?

A

TWO

chicken pox and shingles

75
Q

What are the UK national guidelines for SHINGLES vaccination?

A

Vaccinate >70 yrs old
+
immunocompetent

76
Q

What is the recommendation for VARICELLA vaccination in PLW HIV?

A 
If seropositive
- NATIONAL age based shingles vaccine
If seronegative + CD4>200
- TWO dose CHICKENPOX vaccine
3 months apart
77
Q

Which group of PLW HIV are recommended to have YELLOW FEVER vaccination?

A

Travel to high risk country
Age <60
CD4 >200

78
Q

Why is YELLOW FEVER vaccine contraindicated in PLW HIV with CD4 <200 or age >60?

A

Higher risk of

VACCINE INDUCED NEUROLOGICAL DISEASE

DipHIV (14 decks)

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