vaccines Flashcards
What does infectious disease remain a major cause of?
death and disability
what are vaccines?
immunizations containing weakened or altered protein antigens that stimulate the formation of antibodies against a specific disease
how does adaptive or passive acquired immunity occur?
through exposure to an antgigen or through vaccination that provides immunization; development of memory cells
how often does the CDC publish recommended immunization schedules for the coming year?
annually
what can failure to vaccinate lead to?
increased risk of contracting disease
resurgence of infectious disease once thought eradicated
What are factors contributing to emerging infectious disease?
- change in human demographics & behaviors
- technology advances and modification of industry practices
- changes in land use patterns & economic development
- significant changes in the amount and speed of international travel
- microbial evolution
- a disruption in public health capacity
What is the definition of vaccine hesitancy?
delay in acceptance or refusal of vaccines despite availability
What is the harm of vaccine hesitancy?
impacts the ability to achieve herd immunity
What is the role of the nurse when it comes to vaccine hesitancy?
dispel myths & misinformation
What is herd immunity?
when a high percentage of the population have had the disease and survived or have been vaccinated; percentage needed varies
What is acquired immunity?
occurs when the person mounts an immune response to an antigen
- produced by the host’s own immune system to develop an immunologic response
- development of memory cells that are long-lasting
How is acquired immunity acquired?
What is passive immunity?
protection by an antibody or anti-toxin produced by an animal, human or biotechnology that is transferred from one source to another ( mother to infant)
How is passive immunity usually acquired?
typically administered by injection
- artificial passive immunity comes from injected antibodies
What are some cons of passive immunity?
past working but wane over time
- short term protection
- do not develop memory cells
- works for some infectious diseases but not all equally
How can passive immunity be provided?
- blood products
- immunoglobulin
-anti-toxins (ex. rabies) - certain monoclonal antibodies
How long is baby protected with maternal IgG from placenta or breastmilk?
3-6 months
What do DTaP & TDaP protect from?
tetanus, diptheria & pertussis
What age group gets Dtap?
young children
When should DTap be administered?
- 2 months
- 4 months
- 6 months
- between 15-18 months
- between 4-6 years
DTaP is needed prior to a child starting __________.
school
How many doses is DTaP?
5 doses
When should Tdap be given?
- ages 11-12
- during the 27-36th week of each pregnancy
- anytime for those who have never recieved it
- every 10 years (or sooner if indicated)
Who is most affected by H Influenzae Type B (HIB)?
- mostly infants and children 5 years or younger
- also in adults 65 or older
- people with certain medical conditions: sickle cells, asplenia (no spleen), HIV, antibody & complement deficiency syndromes, those undergoing cancer tx
What can HIB cause in infants & children?
meningitis & pneumonia
When should infants be vaccinated for HIB?
- 2 months
- 4 months
- 6 months
- 12-15 months
How many does is a HIB vaccine for adults?
1 to 3 doses depending on indication
How is hepatitis A typically contracted?
via the fecal-oral route
- often due to contaminated water or milk
- shellfish in contaminated water
What is the incubation period for HepA?
14-28 days
What can HepA lead to?
end-stage liver disease & death
How may doses is HepA administered in?
2 doses
Who is the HepA vaccination recommended for?
- international travelers to regions with poor sanitation or high incidences of Hep A
- children 12-18
What can hepatitis B lead to?
- infections
- cirrhosis
- liver cancer
- liver failure
who is at increased risk for contracting HepB?
- IV drug users
- those with multiple sexual partners
- homosexual males
- healthcare workers
what is a special consideration for the HepB vaccine?
some people may be resistant and may not build immunity after multiple rounds of vaccination
What is the vaccination schedule for HepB?
infants & children: 3 doses
- birth
- 1-2 months
- 6-18 months
administration of 4th dose is permitted when a combination vaccine containing HepB is used after the birth dose
- minimum age for final (3rd or 4th dose): 24 months
How many strains of cancer-causing HPV exist?
13
Why is the human papilloma virus (HPV) vaccine given?
to prevent certain types of cancers & infection
- causes cervical cancer
When should HPV vaccine be given?
2-3 dose series starting ages 11-12 for both boys and girls; may be given as early as 9
- should be completed before 15
When should HPV vaccine not be given?
- after 26
- during pregnancy
What are the three FDA-approved HPV vaccines?
- gardasil
- cervarix
- gardasil 9
which HPV vaccine is used in the US?
Gardasil 9
- only one used in the US
- protects against 9 strains of HPV
what does the influenza vaccine protect against?
protects against various types of influenza (A, B, & C)
When is the flu shot recommended?
annually for anyone over 6 months
What kind of vaccine can the flu shot be?
inactivated or live-attenuated
When should caution be used with the flu shot?
with those with egg allergies
What does the flu shot decrease the risk of?
heart attack by 30% - related to inflammation
What does the MMR vaccine protect against?
measles, mumps & rubella (german measles)
How are MMR spread?
through respiratory droplets or sharing food/drink with an infected person
What is the vaccine schedule for MMR?
2 dose series
- 12-15 months
- 4-6 years old
what is the other option for MMR vaccine?
MMRV vaccine which is MMR + varicella (chickenpox), liscensed for use in children 12 months to 12 years old
Who should also be UTD with MMR vaccines?
teens & adults
MMR is needed prior to what?
a child beginning school
Which vaccine was claimed to cause autism?
MMR
does the MMR vaccine cause autism?
no; there is no evidence to support the linkage of MMR to the development of autism according to the CDC
What is the bacteria that causes meningitis?
Neisseria meningitidis
What can neisseria meningitidis cause?
can lead to meningitis (infection of the lining of the brain & spinal cord) & infection of the blood
What is the meningitis B vaccine protecting against?
prevents infection caused by serogroup B meningococcal bacteria
What is meningitis spread by?
- respiratory droplets when an infected person coughs or sneezes
- live on things the infected person has touched
- through kissing, sharing a drin/food with an infected person
Who is at highest risk for meningitis?
young adults
What is the death reate of bacterial meningitis?
10-15%
what is the vaccine schedule for meningitis B?
- may be given at age 10, with a booster at 16
- recommended for 19-23 year olds; 2-3 dose series depending on vaccine & indication
- adults who are at increased risk fo meningococcal disease
What causes most meningococcal disease?
serogroups A, C, W, & Y
what is the vaccine schedule for meningococcal (MCV04- ACYW)?
2 doses
- 11-12 years old
- booster at 16
Who is recommended to have the MCV04-ACYW vaccine?
- those with complemebt componnent deficiency
-those taking complement inhibitors - have a damaged or absent spleen
- HIV
- traveling to an area where disease is common
- part of a population at increased risk for disease outbreak: living in dorms or in the military
When was polio basically eliminated in the US?
1979
What is the vaccine schedule for polio?
4 doses
- 2 months
- 4 months
- 6-18 months
- 4-6 years old
adults at increased risk of exposure to poliovirus & who previously completed vaccine can receive one lifetime booster dose
is polio vaccine needed before start school?
yes
What form is the polio vaccine in?
inactivated form of vaccine
- oral vaccine no longer available in the US
When does the pneumococcal conjugate (PREVNAR-13 or PVC 13) vaccine protect against?
protects against 13 types of pneumococcal bacteria & ear infections
Who is the pneumococcual conjugate vaccine recommended for?
- all children under 2
- people 2 and older with certain medical conditions
- adults 65 and older also can discuss & decide to get PCV13
What is the vaccine schedule for PVC13?
children: 4 doses
- 2 months
- 4 months
- 6 months
- 12-15 months
children 6 to 17: single dose
adults: single dose
who is the pneumococcal polysaccharide (PPSV-23 or Pneumovax13)vaccine recommended for?
- all adults 65 or older
- people 2-64 with certain medical conditions
- adulta 19-24 who smoe cigarettes
What is the vaccine schedule for pneumococcal polysaccharide vaccines?
adults younger than 65: 1-2 doses, depenidng on indications
65 or older: 1 dose
What is rotavirus?
a contagious viral illness causing severe, watery diarrhea leading to severe dehydration
- leading cause of childhood death worldwide
What is the vaccine schedule for rotavirus?
2 or 3 doses beginning at 2 months
rotateq: given at 2 months, 4 months & 6 months
rotarix: given at 2 & 4 months
first dose should be given before 15 weeks of age
all doses should be given before turning 8 months
What kind of vaccine is the rotavirus vaccine and how is it administered?
a live vaccine; given orally
What is chicken pox?
a highly contagious disease caused by varicella-zoster virus
What kind of vaccine is the varicella vaccine?
live-attenuated vaccine
what is the vaccine schedule for the varicella vaccine?
two dose series
- 12-15 months
- 4-6 years
adolescents & adults (w/o evidence of immunity), also receive 2 dose series 4 to 8 weeks apart
what vaccine can varicella be given with?
MMR
Is varicella needed for school?
yes
What is shingles?
a painful rash that occurs in people who have had chickenpox
- lies dormant just outside spinal cord
- reactivation of varicella-zoster virus
- hot burning neuropathic pain
how is shingles transmitted?
via airborne droplets or direct contact with open blisters
what is the vaccine schedule for shingles?
2 doses: 2 to 6 months apart for anyone over 50
what can the shingles vaccine help prevent?
helps decrease risk of dementia
- helps mitigate risk of CV or stroke event that may happen due to the inflammatory response to shingles
What is a live attenuated vaccine?
micro-organism in vaccine is alive but has been weakened
how many doses do live vaccines usually require?
1-2
with what population should live vaccines be avoided?
immunodeficient
true or false:
immune response to live- attenuated vaccines is virtually identical to that produced by the infection
true
What vaccines are examples of live vaccines?
- MMR
- varicella
- typhoid
- cholera
- BCG
What live vaccines may you be given if traveling to a country with high incidence of disease?
- dengue
- yellow fever
- smallpox
- ebola
- adenovirus
How can non-live vaccines be produced?
by inactivating microbe or vaccine produced through genetic technology
- can be composed of whole or part of the organism
- can be either protein based or polysaccaride-based
What are cons of non-live vaccines?
- require multiple doses to achieve immune response
- may require supplemental doses (booster)
What are examples of non-live vaccines?
- polio
- HePA
- some influenza vaccines
- pertussis
- HIB
- pneumococcal
- meningococcal
- rabies
- anthrax
- Japanese encephalitis
What are MRNA vaccines?
recombinant vaccines produced by genetic engineering technology
- use MRNA created in a lab
- a gene for a vaccine protein is inserted into another virus or type of cell
- when the carrier virus or cell reproduces, the vaccine protein is also reproduced
- non-live vaccines
-cause a person to create antibodies
What are examples of MRNA vaccines?
- covid
- HepB
- HPV
- shingles
- certain flu vaccines
What is the role of a booster?
given to adults to stimulate the immune system antigen memory
- to give or keep full immunity
- promote long-lasting immunity
when can boosters be given?
- when the first vaccine did not work(little to no serum level)
- during an outbreak of disease
What are examples of vaccines that have boosters?
tetanus, MMR
what are adverse effects to vaccines associated with?
the immune or inflammatory response
What can adverse effects to vaccines be?
- localized (up to 80%): pain, swelling, redness at injection site; typically mild
- systemic: fever, malaise, muscle pain, headache
- severe hypersensitivity is rare
What are contraindications for vaccines?
- the presence of an immune deficiency
- pregnancy
- known allergy to component of the vaccine
- pt receiving immunoglobulin
- pts who have received blood or blood products within the last 3 months
- acute infections
what medications should a vaccine not be given with?
- immunosuppressants
- corticosteroids
With what conditions should you be cautious when giving a vaccine?
- children with hx of febrile convulsions or cerebral injury
- any condition in which a potential fever would be dangerous
What information should patients be given when getting a vaccine?
- all patients/parents should be given a vaccine information sheet (VIS)
What vaccines should healthcare workers have?
- Hepatitis B
- infuenza
- MMR
- varicella
- TDap
- meningococcal
