Vaccines Flashcards
The burden of herpes zoster vaccine ____ the burden of herpes zoster infection (shingles).
a. Greater than
b. Less than
c. Equal to
b. Less than
Vaccines are widely accepted as efficient and effective and less burdensome than disease conditions.
A patient with a history of shingles is not eligible to receive the herpes zoster vaccine.
a. True
b. False
b. False
In May 2008, the Advisory committee on immunization practices, which consits of 15 experts assembled by US Dept of HHS and CDC recommended that all persons 60 + who have no contraindications should receive herpes zoster. A contrainidcation is the administration of more than 20 mg of prednisone within 2 weeks of the vaccine (or its equivalent) as this drug causes too much immunosuppression for the pt to mount an immune response.
The HPV vaccine protects against all strains of herpes virus associated with cervical and vaginal cancer.
a. True
b. False
b. False
Most vaccines, including HPV, protect against either the most common or pathogenic strains.
The parents of a healthy 7-month-old female comes to the clinic seeking advice regarding influenza vaccination for their child. They tell you that their friends mentioned at a dinner party that influenza vaccines should not be given to any children within their first year of life, as the vaccine can cause serious side effects, such as severe developmental delay, in infants. In response, you mention that the influenza vaccine can be administered to certain age groups. How do you proceed with the discussion?
a. Tell the parents that their daughter is old enough to receive the inactivated injectable vaccine only
b. Tell the parents that their daughter can get either the live attenuated vaccine or the inactivated injectable vaccine, based on their preference
c. Inform them that their friends were correc, and their daughter should not get the influenza vaccine because she is too young.
d. State that their daughter cannot get any kind of influenza vaccine unless she has been already vaccinated against hepatitis B
a. Tell the parents that their daughter is old enough to receive the inactivated injectable vaccine only
An 18 yo male w/o a significant PMH comes to your office to get an influenza vaccine for the first. He would like to get the inactivated injectable vaccine, but is concerned about the common side effects associated with this type of vaccine. Your response sould include which of the following?
a. Some studies have found that vaccination can result in lifelong seizures in approximately 1 out of every 150 individuals vaccinated against influenza
b. There are no side effects associated with this type of influenza vaccine.
c. The most common side effects include fever, fatigue, and joint pain, which usually resolve within 1 week after vaccination
d. The most common side effects include itchy eyes, diarrhea, and jaundice, which usually resolve within 1 week after vaccination
c. The most common side effects include fever, fatigue, and joint pain, which usually resolve within 1 week after vaccination
A mother brings her healthy 5 yo child for a well-child visit. Per the provider’s recommendations, she wants to get her child vaccinated against influenza, but she wants to know which vaccine her child should receive. You tell her that both the inactivated influenza vaccine (IIV) and live attenuated intranasal vaccine (LAIV) are effective and can be used. How do you explain what is understood about the preference of children for one route of vaccination over the other?
a. When given the choice, younger children prefer LAIV over IIV, because IIV is more painful than LAIV. Furthermore, recent studies suggest that LAIV may be more effective than IIV for healthy children aged 2 to 8 years
b. When given the choice, younger children often prefer IIV because the shot does not cause side effects as compared to LAIV, which does.
c. When given the choice, younger children prefer LAIV over IIV because the spray also helps them to breathe better
d. When given the choice, younger children prefer IIV over LAIV because if they get the IIV they will not have to get another influenza vaccine for the next 2 years because IIV may be more effective than LAIV in healthy children aged 2 to 8 years old.
a. When given the choice, younger children prefer LAIV over IIV, because IIV is more painful than LAIV. Furthermore, recent studies suggest that LAIV may be more effective than IIV for healthy children aged 2 to 8 years
A 39 yo man with a hx of asthma, well-controlled with albuterol, comes in for his annual well visit. You mention that influenza season is about to begin and ask if he has thought about getting the vaccine. He replies that he has thought about getting the vaccine. He replies that he has been hesitant about getting vaccinated as he has heard from friends and the media that the vaccine can cause influenza virus infection, along with other unwanted side effects such as permanent paralysis. However, he is willing to obtain information from you regarding the benegits of getting vaccinated. How do you respond?
a. Chastise him for his opinions regarding the vaccine and tell him that if he does not get vaccinated he will likely contract the influenza virus and have severe complications as a result
b. Respectfully ask him to share more inforamtion regarding why he has been hesitant to get vaccinated; afterwar, mention that there are no current recommendations for getting vaccinated against influenza, particularly because the vaccine does not cover all of the different types of influenza infection.
c. Respectfully ask him to share more information regarding why he has been hesitant to get vaccinated; afterward, provide a concise yet thorough explanation for why the influenza vaccine is beneficial, and provide supplementatl information about the vaccine
d. Tell him that you respect his beliefs and forego further discussion about influenza vaccination.
c. Respectfully ask him to share more information regarding why he has been hesitant to get vaccinated; afterward, provide a concise yet thorough explanation for why the influenza vaccine is beneficial, and provide supplementatl information about the vaccine
Which of the following approaches to patient/parent concerns around vaccination have evidence of engaging patients/parents to consider or adopt vaccination.
Select all that apply.
a. Use listening, caring and empathy to build trust
b. Start with science: “Here is a fact and here is a study to support that fact.”
c. Build an environment of inquiry, asking about concerns
d. Sharing a mother’s written perspective about her child contracting measles, showing a picture of a child with mumps and a baby with rubella
e. Question the value and veracity of sources of information the patient or parent uses to make healthcare decisions
f. Provide supplemental (including written) education materials
g. Discuss vaccine safety concerns with respect for differing views
a. Use listening, caring and empathy to build trust
c. Build an environment of inquiry, asking about concerns
d. Sharing a mother’s written perspective about her child contracting measles, showing a picture of a child with mumps and a baby with rubella
f. Provide supplemental (including written) education materials
g. Discuss vaccine safety concerns with respect for differing views
Administering inactivated quadrivalent influenza vaccine and 23-valent pneumococcal polysaccharide vaccine in which way is associated with a better antibody response to vaccines?
a. At the same time
b. At separate times
c. Response is similar if given together or apart
c. Response is similar if given together or apart
Most vaccines can be given at the same time. Many can even be given mixed int he same syringe, although clinicians generally do not do this - manufacturers do (MMR, DTap)
HPV vaccines are recommended for only women.
a. True
b. False
b. False
Which of the following is NOT an effective strategy to overcoming barriers to HPV vaccination?
a. Fainting is a potential adverse effect associated with HPV vaccination
b. Providing a strong, presumptive recommendation for the vaccine
c. Focusing on the anti-cancer message
d. Acknowledging that there is an association with increased sexual activity following vaccination
d. Acknowledging that there is an association with increased sexual activity following vaccination
A patient with no prior hx of HepB immunization accidently sticks herself iwth an insulin syringe that belongs to her uncle, who has diabetes, but is also known to be an HBsAg-positive person. Appropriate management of the patient would include which of the following?
a. Initiate Hep B vaccine series and HBIG
b. Initiate Hep B vaccine series
c. Administer HBIG
d. Administer IGIV 400 mg/kg and initiate Hep B vaccine series
a. Initiate Hep B vaccine series and HBIG
In thic clincial situation, prophylaxis is driven primarily by the exposed adolescent not being immunized with the Hep B vaccine and the source is HBsAg-positive. The patient should receive HBIG and start the vaccine series. This should be started within 24 hours of the needlesick. However, the 2 drugs can elicit good effets if given within 7 days after contact with an infected person’s blood and within 14 days after sexual contact.
If the pt is unimmunized and the source is unknown or not testd, the recommendation is to initiate the Hep B vaccine series alone
There is between a 6% and 30% risk of transmission of HepB from a needlestick, depending on the viral load of the varrier
HBIG is made from human-derived plasma and cotnains antibodies to hepatitis B. It is an IgG. It gives fast protiction, but the protection is not long-lasting.
* The exact mechanism of passive immunization is unknown; HBIG may block HBV entry and binding to hepatocytes, neutralize circulating HBV and target HBV-infected cells thorugh an antibody-mediated immune response. The drug is well tolerated, and common side effects include fever, chills, and arthralgias that are usually mild and transient
Hepatitis B is an infection of the liver that’s caused by a virus. Symptoms inlcude poor appetite, stomach pain, nausea (feeling sick to your stomach), vomiting (throwing up), and jaundice (yellow skin and eyes). Some people don’t have any symptoms
* One out of 10 adults infected with Hep B has an infection that doesn’t go away (called a chronic infection)
* The younger you are, the higher chance of havinga chronic infection - more than 9/10 babies infected with hepatitis B will have a chronic ifnection
* If you have a chronic hepatitis B infection, you have it forever; you can spread it to others, even if you don’t look of feel sick
* A chornic hepatitis B infection can lead to liver damage (cirrhosis), liver cancer, and death
Around the world each year 500,000 to 1.2 million people die from HepB related diseases
