Vaccines Flashcards
group of medical and public health experts convened by CDC to develop vaccine recommendations
Advisory Committee on Immunization Practices (ACIP)
provides free vaccines for all children who are uninsured, medicaid eligible, Native American, or Alaska Native
Vaccines for Children Program (VFC)
public and private childcare facilities and publuc and private schools must have a valid ____ for all enrolled children
SC Certificate of Immunization
three types of exemptions to vaccine in SC
medical exemption
religious exemption
special exemption
medical contraindications as determined by a licensed health care provider
medical exemption
exemption signed by school principle issued to transfer students while awaiting arival of medical records from former residence → only issued once and valid for only 30 days
special exemption
familes who refuse to vaccinate their child must sign this form EACH visit with their provider
Refusal to Vaccinate Form
when can a provider end a relationship with a patient who refuses vaccination?
after another physician assumes responsibility for patient or the parents have been given reasonable notice they intend to terminate the relationship
exposure to disease organism triggers the immune system to produce antibodies to the disease
active immunity
two types of active immunity
natural immunity
vaccine induced immunity
What is good about active immunity?
long lasting → may be lifelong
person is given antibodies to a disease rather than producing them through their own immune system
passive immunity
what is good about passive immunity?
immediate protection (but only lasts weeks - months)
Passive immunity obtained through antibody containing blood products such as HBIG or VZIG which may be given when immediate protection is needed
Immune Globulin
three categories of vaccine adverse reactions
local (pain, swelling, redness_
systemic (fever, malaise, HA, myalgia)
allergic (anaphylactic, IgE mediated hives, mouth swelling, can’t breathe, hypotension, shock)
all clinically significant adverse events following immunizations are reported to
vaccine adverse event reporting system (VAERS)
individuals can file a clain after adverse reaction due to vaccine and get financial assistance
national vaccine injury compensation program (VICP)
condition in recipient that increases the chance of serious adverse reaction
contraindication
condition in recipient that might increase the chance of adverse reaction
precaution
minor illness taking antibiotic at the time pregnancy or immunosuppression in the house breatfeeding premature birth non-vaccine related allergies nonanphylactic allergy to vaccine
Things that are NOT contraindications to vaccine
low grade fever
URI
otitis media
mild diarrhea
“minor illness”
can still get vaccination
Two true contraindications to vaccines
anaphylaxis
encephalopathy that occurs within 7 days of vaccine
If a child has an egg allery what 2 vaccines will they be concerned about getting? What do you do?
flu and MMR
give MMR and inactive flu vaccine
two temporary contraindications to vaccines
pregnancy
immunosuppression
MMR and varicella vaccines can be given to HIV children under what conditions
asymptomatic
mild s/sx (age sepcific CD4 lymphocyte percentage >15%)
When is the LAIV (live active influenze vaccine) contraindicated?
immunocompromised household and patient
which steroid type can be a contraindication to vaccine?
systemic steroid use
when should a child on steroid treatment not receive live vaccines?
> 2 mg/kg/day
20 mg/day for MORE THAN 14 DAYS
can get vaccine when steroid stopped for at least one month
How long should you wait to give MMR and Varicella vaccines in a patient who just received a blood transfusion?
5-6 months
How long should you wait to give MMR and Varicella vaccines in a patient who just received IVIG?
11 months
pediatric diptheria-tetanus toxoid
DT
diptheria and tetanus toxoid and acellular pertussis vaccine
DTaP
adults tetanus-diptheria toxoid
Td
adolescent preparation for those who have completed the childhood series and not received TD booster
Tdap
when is DTaP vaccine given?
2, 4, 6, 15 months, 4 yers
3 contraindications for DTaP
anaphylaxis
encephalopathy
progressive neurologic disorder
adverse reaction to DTaP
fever > 104.8 within 48 hours
what portion of the DTaP causes febrile seizures
pertussis vaccine
Child develops a nodule after getting DtaP, most likely caused by?
tetanus portion
when should adolescent get Tdap?
11 - 12 year visit
When should pregnant women get Tdap?
each pregnancy → 27 - 36 weeks gestation
If woman doesn’t get Tdap during pregnancy when should she get it?
immediately postpartum
when does a baby get monovalent Hepatitis B vaccine?
within 24 hours of birth
when do you give combination Hep B vaccine?
2, 4, 6 months
Treatment for infants born to HbsAg (+) mothers
Hep B vaccine and HBIG at different site on body
within 12 hours of birth
complete the series by 6 months, check for therapy success at 9 - 12 months
What form of poliovirus vaccine is given now?
inactivated (IPV)
PCV13 vaccine is routine for all children age
< 24 months
When is PPSV23 given to a child?
When is booster given?
over 2 yo (not effective if < 2 years)
booster at 5 years
who is the inactive influence vaccine recommended for?
everyone over 6 months of age
If a child is under 9 years old and never had a flu vaccine what do they get?
2 doses of vaccine 1 month apart
How old must child be to get LAIV?
at least 2 years old
who should not get the LAIV?
chronic pulmonary conditions (asthma, wheezing)
cardiac disorders
sickle cell
history of Guillain-Barre Syndrome
When should you get Meningococcal disease vacine (A,C,Y, W-135)?
When booster?
11-12 years
booster @ 16 years
Can you vaccinate a 2 year old against meningococcal disease?
yes → high risk persistent complement deficiencies anatomic or functional asplenia HIV traveling or live in high risk area
When is first and second dose of MMR given?
first → 12 - 15 months
second → 4 -6 years
third if at increased risk for mumps in outbreak
Adverse reaction to MMR and when it presents
fever up to 103
6 - 12 days after vaccine
Patient may havejoint complaints 7 - 21 days after MMR vaccine due to
rubella
when should you postpone MMR vaccine?
high dose steroids
pregnant
IVIG in last 11 months
blood products in last 5 - 6 months
Can you give PPD with MMR on same day?
yes → no mitigation of effect
when do you give varicella vaccine?
12 - 15 months
school entry
Contraindications to varicella vaccine
pregnancy
prior allergic rxn
immunocompromised (except mild or asymptomatic HIV)
when can you give varicella zoster immune globulin in infant?
newborn of mother with onset 5 days prior - 48 hours after delivery
three available live virus vaccines
Flu
VAR
rotavirus
Contraindications to rotavirus vaccine
SCID (severe combined immunodeficient)
history of intussusception
Dosing schedule for Hep A vaccine
first > 12 months → second dose 6 - 18 months after first
HPV is routine vaccine for girls and boys ages
11 - 12 years old
When can you administer HPV vaccine in case of sexual abuse?
9 years
What is a side effect of HPV vaccine?
syncope
