Vaccines

Question 1

inactivated vaccine

Answer 1

killed

Question 2

attenuated vaccine

Answer 2

modified live

Question 3

List of attenuated vaccines

Answer 3

MMR
oral polio
varicella virus (Varivax, Proquad)
yellow fever (YF-Vax)

Question 4

list of live, attenuated vaccines

Answer 4

influenza (flumist)
rotavirus (rotarix, rotateq
varcilla virus (varivax, proquad)
yellow fever
oral polio
varicella zoster (zostavax)
cholera (vaxchora)
bacilli Calmette-Guerin

Question 5

list of inactivated vaccines

Answer 5

diphtheria, tetanus, pertussis (DTP, DTaP, DT, Td, Tdap)
H. influenzae type B (HIB)
hepatitis A and B
influenza (Fluzone)
meningococcal (menactra, menomune, trumenba, bexsero)
inactivated polio vaccine (IPV)
human papillomavirus vaccine (Gardasil, Cervarix)
pneumococcal polysaccharide (PPSV23)
pneumococcal conjugate vaccine (PCV130
Japanese encephalitis, plague

Question 6

typhoid vaccine

Answer 6

available in an inactivated form and an oral live, attenuated form.

Question 7

Influenza live, attenuated influenza vaccine (LAIV3,Flumist)

Answer 7

Live attenuated influenza vaccine (LAIV) Flumist (contains two strains of flu A and one of flu B, administered intranasally, live vaccine replicates in the nasal mucosa, contraindicated in people with egg allergy asthma, immune-compromised state, and pregnancy. Administered annually to healthy patients 2 years to 49 years. Children ages 2-8 need two doses in the first year.

Question 8

Contraindications for LAIV4 (FluMist, Quadrivalent)

Answer 8

egg or egg product hypersensitivity.
asthma, reactive airway disease
chronic disorders of the pulmonary, or cardiovascular system
metabolic diseases (diabetes, renal dysfunction, hemoglobinopathies
known or suspected immunodeficiency diseases
patient receiving immunosuppressive therapies
HIV
Guillain-Barre syndrome
pregnant women
contraindicated in children younger than 2
children or adolescents on asa for reye syndrome

Question 9

what can LAIV be given with, what is the schedule, and what is the dose

Answer 9

MMR
varicella
any inactivated vaccine
inactivated or live vaccine concurrently but they must be given the same day or given 4 weeks later
ages 9-49 should receive .2ml as soon as it is available for fall
ages 5-8 who have not been previously vaccinated get 2 doses .2ml
children ages 8 or younger get 1 dose annually if they previously received 2 doses the prior year.
anyone that receives the vaccination should be advised to avoid contact with immunocompromised for 7 days
report difficulty breathing, wheezing, hives, temp 102 or higher

Question 10

spacing between vaccinations and ppds

Answer 10

mmr 4-6 weeks after administration
mmrv 4-6 weeks
bacillus Calmette-Guerin vaccine- will cause a positive ppd test for up to ten years after administration.

Question 11

REMS (risk evaluation and mitigation strategy

Answer 11

a protocol is composed of various actions (elements to assure safe use), including letters to prescriber, and/or pharmcay registration and training.
buprenorphine
naloxone
isotretinoin
extended release and long acting opioid analgesics
liraglutide
metoclopramide
mifepristone
naltrexone
olazapine
testosterone

Question 12

MMR

Answer 12

Measles, mumps, and rubella vaccine (MMR) two doses 99 % effective in providing immunity for measles (88% for mumps), contraindications: neomycin allergy, pregnancy, immunosuppression, febrile illness. Ok to give to those with egg allergies, may be given to breastfeeding women.
Adverse reactions: fever 7-12 days after vaccination.
Drug interactions: IG, high dose corticosteroids, chemotherapy
The first dose is given at the age of 12-15 months
The second dose is given at age 4-6 years or at least 4 weeks after the first dose.
One dose is given to any infant 6-12 months who will be traveling internationally (this doesn’t count as the first dose given at 12-15
months.
live vaccine
Can be given to hiv if asymptomatic

Question 13

schedule of vaccines for infant, children, teens

Answer 13

hep B 1. birth 2. 1-2months 3. 6-18 months
rotovirus- rotarex 2 dose 2&4 months/ rotateqx 3 dose 2/4/6 months.
DTap-minimum age 6 weeks-2/4/6/15-18 months, 4-6 years
hep a-minimum age 12 months for routine vaccinations 6-12 months apart for two doses.

Question 14

Proquad MMRV

Answer 14

Similar to mmr, contraindications the same as MMR (use caution in patients with a history of cerebral injury, seizures, or where physiological stress caused by fever should be avoided.
ADRS- fever greater than 102 (21.5 % vs 14.9 % with mmr) increased risk of febrile seizures.
Can be administered on the same schedule as MMR.
Uses MMR + Varicella for the first dose and MMRV for the second dose if there is a fever.
Informed consent includes risk of fever and febrile seizures.
pregnant women can not be vaccinated, pregnancy must be avoided for at least 3 months.
live vaccine

Question 15

MMR & MMRV when should vaccine be rescheduled

Answer 15

febrile illness with temp over 101.3 or untreated TB.
minor illness with or without fever should not defer vaccination such as diarrhea, upper respiratory infection, otitis media.
both are live vaccines

Question 16

Varicella Virus Vaccine (Varivax)

Answer 16

two doses 98.3 % effective against any disease, may be administered after exposure (within 3 days).
Contraindications: neomycin allergy, febrile illness, immunocompromised state, high dose steroids, pregnancy.
ADRS-fever, rash, injection site reaction.
First doses at age 12-15 months, the second dose at age 4-6 years.
Adolescents and adults with no history of varicella are given two doses 4-8 weeks apart.
Herpes zoster vaccine- shingles caused by reactivation of varicella
live

Question 17

shingrix

Answer 17

An inactivated recombination vaccine. two doses The virus is killed. Prevents shingles in adults 50 years and older, is not used for chicken pox. You should not receive the vaccine if you are allergic to any ingredients in the vaccine. There is an increased risk of Guillain-Barre syndrome, not studied in pregnant or nursing mothers, may not protects all individuals, fainting can happen after getting the vaccine, most common side effects are pain, redness, and swelling at the injection site, muscle pain, tiredness, headache, shivering, fever, and upset stomach. You should get the vaccine even if you had shingles, received zostavax, received varicella vaccine. No max age.

Question 18

Zostavax, ZVL

Answer 18

live, attenuated varicella zoster vaccine from the same strain used to develop the varicella vaccine. Two dose series 4-8 weeks apart if previously did not receive varicella-containing vaccine (VAR, MMRV).
contraindications: Anaphylactic reaction to neomycin, gelatin, or other component in vaccine. Patients with primary immunodeficiency states should not be administered vaccine, patient receiving high dose corticosteroids for more than two weeks. Is not approved for women of childbearing age and not for pregnant women. Do not administer to patients with active TB, acute illness, or fever.
Adrs- pain/tenderness/erythema, and pruritius/ headache

Question 19

Pneomovax 23, Polyvalent pneumococcal polysaccharide vaccine (PPSV23)

Answer 19

Contains 23 highly purified capsular polysaccharides from Streptococcus pneumoniae. These are the 23 most prevalent or invasive pneumococcal types. The vaccine stimulates the immune system to produce pneumococcus capsule-specific antibodies. These antibodies presumably destroy the capsule, making the pneumococcus vulnerable to antibody-and-cell mediated immunity. efficacy 60-90 percent.

Question 20

PPSV23 contraindications

Answer 20

give 3-14 days before elective splenectomy, organ transplant, immunosuppressive therapy or chemo. Patients with Hodkins disease, and immunosuppressed patients have suboptimal antibody response to vaccination.
PPSV23 cautiously used in patients with idiopathic thrombocytopenic purpura, use of vaccine during first trimester should be avoided, and it isn’t known if the vaccine is excreted in breast milk. not recommended in children.
PCV13 is pregnancy category B. No adequate studies. not for use in adults.

Question 21

what is the scheduling for pneumovax 23, and who gets it

Answer 21

recommended for all adults age 65 and older. Dose is .5 ml im or sc. Revaccination (a second dose) if the original vaccination was 5 years or more ago and the patient was younger age 65 when given.
People aged 2-65 years who have chronic illness (cardiac, pulmonary, liver, alcoholism, diabetes mellitus, cerebrospinal leaks. 1 dose.
individuals that are immunocompetent and who are at risk of death from pneumococcal disease should received PPSV23 one dose, sickle cell, asplenia should receive 1st dose and revaccination is recommended 5 years or more later.
smokers/asthma 1 dose 19-64
1 dose for 12 months-24 months after bone marrow transplant.
A dose of PPSV23 is administered 2 or more months after to children age 2 or older after last dose of PCV13 to kids 2 or older.

Question 22

Prevnar 13

Question 23

Prevnar 13

Answer 23

Approved by FDA in 2010. Targets 13 most common strains of pneumococcus that are responsible for 64 percent of invasive pneumococcal diseases in children, It is also approved for use in adults age 50 and older, age 19 and older with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants. It is not meant as a replacement for the 23-valent vaccine.

Question 24

Schedule of Prevnar 13

Answer 24

infants and toddler: four dose given at 2, 4, 6, and 12-15 months.
Children up to age 59 months who are not vaccinated with PCV 13 at the routine infant vaccine times should be dosed following the catch-up schedule. Pregnancy category B