VACCINES Flashcards
What vaccines are required for a child to enter kindergarten in Maine?
5DTP, 4 polio, 2 MMR, and 1 varicella
What part of the immune system is involved in vaccines?
Adaptive (memory) – why you need repeat exposure
How do we measure the effectiveness of a vaccine, what are the downfalls of that?
Antibody levels – only correlates somewhat
We need LARGE field trials to measure effectiveness
What disorder causes flaccid paralysis? Spread via poor sanitation
Polio – via the anterior horn damage
What preventable disease presents with a prodrome period including a fever of >103, cough, coryza, conjunctivitis, and koplik spots (white spots in the mouth)?
Measles
How is measles spread?
Respiratory
What does the rash period of measles look like?
Maculopapular begins at the hairline, lasts 5-6 days, infectious period is 4 days before & after
What is the schedule of the measles (MMR) vaccine for children?
1st @ 12-15 months of age
2nd @ 4-6 years of age (at least 28 days after 1st dose)
Can be given to a child after 6 months of age if traveling outside the US
What disease causes sterility in males and causes parotid gland swelling?
Mumps
What disease can a pregnant woman not be exposed to in the first 20 weeks of pregnancy due to genetic malformation?
Rubella
What is the technical name for whooping cough and what is the bacteria that causes it?
pertussis & Bordetella pertussis
what are the 3 stages of pertussis?
Catarrhal (watery eyes, low grade fever)
Paroxysmal (cough during exhalation with an inspiratory whoop, post-tussive cyanosis, and vomiting)
Convalescent (gradual improvement, recur with respiratory infections)
How do you diagnose & treat pertussis?
PCR to diagnose & Abx if onset 21 days
What is considered a close contact for a child with pertussis?
Had face-to-face exposure within 3 feet; had direct contact with respiratory or nasal secretions; shared same confined space for >1 hour.
How would you treat a close contact of a pertussis child?
If symptomatic treat the same
If not symptomatic – consider chemoprophylaxis x 5 days
How do you prevent pertussis?
Universal childhood vaccination with Tdap
DTaP = 2,4,6, 15-18 months & 4-6 years. Tdap = adult booster
What disease involved a thick grey coating on the back of the throat and a “bullneck” appearance, that if left untreated can cause a child to suffocate?
Diptheria
Can diphtheria just effect the throat?
No (but throat is most common), it can involve any mucous membrane
Besides suffocation, what are the most common complications of diphtheria?
myocarditis & neuritis (5-10% death rate)
What do we have to do as soon as we suspect diphtheria in a child? Where does the vaccine come from?
Consult the CDC ASAP
Vaccine comes from horses
IF a child presents with an abrupt onset of fever, hypotension, with a rash, and stiff neck – what diagnosis? What bacteria?
Meningococcal disease (either meningitis or meningococcemia) Neisseria meninitidis
If meningococcal infection gets into the blood stream, what does it present with and what is it called?
Presents with fever, hypotension, purpuric rash, and multiorgan failure
Known as Meningococcemia
How do you diagnose Meningococcal disease?
Bacterial culture, gram stain, non-culture (antigen detection in CSF and serology)
When do you give the meninfococcal vaccine?
All children aged 11-12 with booster at 16
How many chicken pox vaccines do you need for immunity?
2 – but you only need one to go to school…
Would you use acyclovir in a child with chicken pox?
Not routinely recommended
At what age do you need to get a zoster vaccine?
60! Whether or not they’ve ever reported a case of shingles
If you see a side effect of a vaccine, where do you report it to?
VAERS
