Vaccines

Question 1

When is the first hep B virus vaccine given?

Answer 1

At birth within 12 hours

Question 2

What specific consideration should be known for giving the first Hep B virus vaccination?

Answer 2

If the neonate has a low birth weight (less than 2 kg or 4.4 pounds), then the first HBV vaccine can be delayed for 1 month or until the neonate has reached 2 kg.

If the mother tests HBV positive, give IV immunoglobulin to the neonate.

Question 3

What is the established vaccine series for Hep B virus?

Answer 3

First dose: Birth

Second dose: 1 month

Third dose: 6 months

Question 4

When is RSV given to pregnant patients?

Answer 4

32 to 36 weeks

Question 5

what is the vaccination schedule for Polio virus?

Answer 5

First dose: 2 months

Second dose: 4 months

Third dose: 6 months

Fourth dose: 4 years

Question 6

What is the vaccination schedule for Hemophilus influenza (type b)?

Answer 6

First dose: 2 months (as early as 6 weeks)

Second dose: 4 months

Third dose: 6 months

Booster: 1 years

Question 7

Rotavirus vaccine is given at ____ months and _____ months

Answer 7

Rotavirus vaccine is given at 2 months and 4 months

This is the only live-attenuated vaccine that is given to children less than 1-year old.

Question 8

The contraindications for Rotavirus vaccine are ______ and ______

Answer 8

history if intussusception and SCID.

Question 9

How many doses of DTaP are given to children before 7 years old?

Answer 9

5 Doses:
First dose: 2 months

Second dose: 4 months

Third dose: 6 months

Fourth dose: 15 months

Fifth dose: 4 years

Question 10

When are tetanus boosters given for wounds?

Answer 10

• For patients who have received ≥3 tetanus toxoid doses, a booster dose of tetanus toxoid is indicated only if their last tetanus dose was ≥10 years ago (for clean or minor wounds) or ≥5 years ago (for dirty or severe wounds).
• Patients who have received <3 tetanus toxoid doses they are considered to be incompletely immunized, and those whose vaccine status is uncertain the default logic is that they are not considered completely immunized and should receive a tetanus toxoid booster. If such patients have dirty or severe wounds, they should also receive tetanus immune globulin.

Question 11

When do patients begin receiving Tdap vaccine?

Answer 11

Starting at 11, at least 7 years old.

Td is given every 5 to 10 years until 65 years old

Question 12

When do pregnant patients get Tdap?

Answer 12

27 to 36 weeks pregnant

Question 13

What is the contraindication for pertussis-containing vaccines?

Answer 13

Encephalopathy within 7 days of vaccine administration.

Use PRECAUTION if within 6 weeks or less the patient develops a progressive neurological disorder such as GBS, infantile spasms, epilepsy, progressive encephalopathy, defer vaccine until neurological condition stabilizes.

Question 14

Which Pneumococcal vaccine is given to children?

Answer 14

PCV15 or PCV20

First dose: 2 months

Second dose: 4 months

Third dose: 6 months

Fourth dose: 1 year

Question 15

What additional considerations are there for children with risk factors for invasive pneumococcal disease?

Answer 15

They may require additional doses, including a dose of PPSV23.

Question 16

Do children under 5 years who received a dose of PCV at 2 years of age or older need further doses?

Answer 16

No, further doses are not needed for these children.

Question 17

What is the PCV primary series for children?

Answer 17

The PCV primary series includes 3 doses (PCV15 or PCV20):

Dose 1: at 2 months of age
Dose 2: at 4 months of age
Dose 3: at 6 months of age

Question 18

When should a booster dose of PCV15 or PCV20 be given for children?

Answer 18

A booster dose should be given at 12–15 months of age.

Question 19

If a patient has received one dose of PPSV23 (at an age less than 65 years old) and one dose of PCV13 (at any age), then what pneumococcal vaccine is indicated?

Answer 19

Give the patient either PCV20 or PCV21 at or greater than five years after their last pneumococcal vaccination. If the patient is older than 65 years, engage in shared decision-making to determine whether to administer PCV20 or PCV21, ensuring it is given at least 5 years after their most recent pneumococcal vaccination.

Question 20

If a patient was given just PPSV23, without any other pneumococcal vaccines, then what vaccine would be indicated?

Answer 20

Give the patient PCV20 or PCV15 or PCV21 one year after administration of PPSV23.

Question 21

What is the minimum age for PCV21?

Answer 21

18 years old

Question 22

What is the minimum age for PPSV23?

Answer 22

2 years

Question 23

What are the main risk factors for invasive pneumococcal disease?

Answer 23

Risk factors for invasive pneumococcal disease:

chronic heart disease, chronic lung disease, chronic renal disease (CKD or nephrotic syndrome), chronic liver disease (including secondary to excessive alcohol use), diabetes mellitus, CSF leak, cochlear implant, functional or anatomical asplenia (including sickle cell disease), immunosuppression from disease (including HIV) or treatment, and smoking.

Administer PCV15 or PCV20 first, then PPSV23 at least 8 weeks later.

When PCV20 is given, they do not require PPSV23.

Question 24

Is the PCV13 vaccine given anymore?

Answer 24

No, as of April 2024 this is no longer available.

If a patient has only obtained one dose of PCV13, then they need one dose of PCV20 or PCV21 (the same applies to PCV7). A patient does not need to wait one year after receiving PCV13 to receive a dose of PCV20 or PCV21.

Question 25

In what instances are the pneumococcal vaccines given to patients earlier than 65 years old?

Answer 25

The pediatric series (2 months, 4 months, 6 months, Booster at 1 year). Vaccinate patients (older than 19 and less than 65 years old) who are at risk for pneumococcal infections. These are patients who have CSF leaks, cochlear implants, smoke, have liver disease or alcoholism, have COPD or other lung diseases like asthma or CF, are asplenic, have chronic heart disease or chronic kidney disease, are diabetic, or are immunocompromised due to immunotherapy, organ transplant, cancer (i.e. leukemia), or have contracted HIV. If the patient is given PCV15, then the patient must also be given PPSV23, which is given 1 year after PCV15 but can be given as early as 8 weeks for immunocompromised patients. If the patient is given PCV20, then they do not require an additional vaccination for pneumococcous.

Question 26

What Pneumococcal vaccine is given to patients over 65 years old?

Answer 26

Give either PCV15 or PCV20 for all patients over 65 years old. If the patient is given PCV15, then the patient must also be given PPSV23, which is usually given 1 year later. An exception to the 1-year rule is allowed for the adult patients with immunocompromising conditions, cochlear implants, or CSF leaks, where in these cases, the follow-up vaccine can be given ≥ 8 weeks after a previous pneumococcal conjugate vaccine. If PPSV23 is unavailable, administer another dose of PCV20 or PCV21. If the patient is first given PCV20, then they do not require a follow-up vaccination for pneumococcus.

Question 27

What is the minimum age for PCV15 and PCV20?

Answer 27

6 weeks.

Question 28

When is the MMR vaccine given?

Answer 28

First dose: 12 months Second dose: 4 years

Question 29

A 12-month old child develops a fever and mild rash a week following the MMR, what should be part of the treatment management?

Answer 29

Reassurance. The very next vaccination at 4 years old can be given without any antipyricis as a small fraction of patients develop a self-limits mild rash and fever 1-3 weeks after vaccination (primarily due to measles). Patients do not need to self isolate, however, they do need to stay away from immunocompromised individuals.

Question 30

What are the contraindications for obtaining the MMR vaccine?

Answer 30

Pregnancy, immunocompromised, if the patient has ever experienced anaphylaxis in the past after getting the MMR vaccine.

Question 31

When is varicella vaccine given?

Answer 31

First dose: 12 months Second dose: 4 years 2 Doses at least 2 months apart of recombinant (RZV) for all patients over 50 years old and immunocompromised patients over 19 years old.

Question 32

Are neonates given influenza vaccinations?

Answer 32

No, the earliest a child can obtain an influenza vaccine is 6 months, and the IIV4 is given. Instead cargivers of children less than 6 months are given an influenza vaccine.

Question 33

What are the three main vaccines given for influenza?

Answer 33

Inactivated Influenza Vaccine (IIV4) which is an IM administered quadrivalent vaccine that protects against four strains (two influenza A and two influenza B). Live Attenuated Influenza Vaccine (LAIV4): is either egg-based or culture-based administered intranasally and given to children over 2 years old. This vaccination is temperature sensitive and can replicate in the nose (but not in the lung). Recombinant Influenza Vaccine (RIV4): is produced without the use of eggs, using recombinant DNA technology and is also administered IM.

Question 34

What consideration should be known for administration of any influenza vaccination with GBS?

Answer 34

Use caution (a precaution rather than C/I) for any patients who have a history of Guillain-Barré syndrome that occurred ≤ 6 weeks after an influenza vaccine.

Question 35

During what season are patients in the both the Northern and Southern hemispheres vaccinated for Influenza?

Answer 35

Northern Hemisphere Season: Influenza typically peaks during the fall and winter months (October to April). Southern Hemisphere Season: Influenza typically peaks during the winter months (May to September).

Question 36

Which influenza vaccine is given to patients older than 65?

Answer 36

IIV4 or RIV4

Question 37

what are the major C/I for live attenuated influenza vaccine?

Answer 37

- Adults older than 50 - children less than 2 - children between 2 and 4 with asthma or wheezing - long term salicylate therapy (Reye Syndrome) - Recent anti-viral therapy - Close contact with those who are immunocompromised

Question 38

which vaccination for influenza is given to patients who are in close contact with those who are immunocompromised or elderly?

Answer 38

Recombinant Influenza Vaccine (RIV4)

Question 39

Inactivated Influenza Vaccine (IIV4) is suitable for which age groups?

Answer 39

IIV4 is suitable for all age groups (children over 6 months), including pregnant individuals and those with weakened immune systems.

Question 40

What are the conditions for giving the Hep A vaccine?

Answer 40

2 doses at 1 years old and the second 6 months later. Can provide to HIV and pregnant patients because the vaccine contains a killed virus. Provide to patients traveling to or from South America, Africa, Eastern Europe, and Central America.

Question 41

What vaccines are provided for asplenic patients?

Answer 41

PCV15 (followed by PPSV23 8 weeks later) Hib Neisseria meningitidis (including vaccines for serotype B) Influenza Don't forget about prophylactic daily antibiotics (Bactrim).

Question 42

What is the HPV vaccine schedule?

Answer 42

Given to both males and females. 2 doses 6 months apart between ages 9 and 14. 3 doses 6 months apart between ages 15 and 26. Shared decision after 26 up to age 45.

Question 43

How is the vaccination for Neisseria formulated?

Answer 43

A vaccine with capsular polysaccharides of four serotypes of meningococcus with capsular antigens linked to a carrier protein (e.g., diphtheria toxoid). By conjugating the bacterial polysaccharides to a protein carrier, it elicits a robust T-cell-dependent response, leading to longer-lasting immunity. Conjugate vaccines also reduce nasopharyngeal carriage, contributing to herd immunity.

Question 44

When do children get the meningococcal vaccine?

Answer 44

11 years old and 16 years old

Question 45

What are the countermeasures for preventing Neisseria meningitidis when taking immunpsuppressing medications?

Answer 45

Vaccination: Meningococcal vaccines (MenACWY and MenB) prior to starting therapy.

Question 46

What serogroups does the meningococcal conjugate vaccine (MenACWY) protect against?

Answer 46

Serogroups A, C, W, and Y. Administer at age 11-12 years, with a booster at 16 years. It is mandatory for military recruits and travelers to the meningitis belt of sub-Saharan Africa.

Question 47

Who should receive the MenB vaccine?

Answer 47

Adolescents aged 16-18 years (clinical discretion) and high-risk groups (e.g., during outbreaks, individuals with complement deficiencies, or asplenia). Serogroup B is responsible for outbreaks in developed countries, especially in close-living settings like dormitories.

Question 48

Who requires booster doses of the MenACWY vaccine?

Answer 48

Individuals at persistent high risk (e.g., asplenia, complement deficiencies, microbiologists exposed to N. meningitidis). Boosters are given every 5 years. College freshmen living in dormitories are at increased risk and may also need vaccination.

Question 49

What vaccination is recommended for travelers to sub-Saharan Africa?

Answer 49

MenACWY vaccine, as serogroup A outbreaks are common in the meningitis belt. The vaccine is required for Hajj and Umrah pilgrims in Saudi Arabia.

Question 50

What is the public health strategy for managing meningococcal outbreaks?

Answer 50

Targeted vaccination campaigns with MenACWY or MenB vaccines based on the serogroup causing the outbreak. Prophylactic antibiotics (e.g., rifampin, ciprofloxacin) are also used for close contacts of infected individuals.

Question 51

What are the contraindications for meningococcal vaccines?

Answer 51

Severe allergic reaction (e.g., anaphylaxis) to a prior dose or vaccine component. Minor illnesses (e.g., cold) are not contraindications; vaccination should proceed in these cases.

Question 52

What is a mnemonic to remember the Neisseria meningitidis vaccine schedule?

Answer 52

"11-16-Boost": 11 years: First MenACWY dose. 16 years: Booster dose. Boost every 5 years if high-risk.