Vaccines Flashcards

1
Q

what vaccines must be given to preschoolers< 5-6

A

Hib and PCV13

Pneumococcus and hemophilus important for preschoolers

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2
Q

when is Men-C-ACWY given?

A

in adolescence

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3
Q

how old before giving HPV

A

> 9

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4
Q

what vaccines are necessary for everyone

A

3 doses of T-D-IPV-P
2 doses of MMR
1 dose of Men C

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5
Q

what are the contraindications for LAIV (6)

A

<24 months
severe asthma (current high-dose inhaled steroids or systemic steroids)
medically attended wheezing in the past 7 days
immunodeficiency
pregnancy
ASA treatment

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6
Q

what influenza vaccine is recommended for children?

A

quadrivalent inactivated (2a’s and 2b’s)

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7
Q

who is at high risk for severe disease with influenza

A
all children aged 6-59 months
anyone with the following conditions:
- neuromuscular
- cardiac or pulmonary disorders (including asthma)
- malignancy, immunocompromised
- diabetes and other metabolic disorders
- morbid obesity (BMI>40)
- renal disease
- anemia or hemoglobinopathy
- require salicylate therapy

all indigenous
all residents of chronic care facilities
anyone that lives in the same household as someone with one of the medical conditions
anyone that lives in the same household as a young infant
all pregnant women
adults >65 years

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8
Q

what are some contraindications for vaccines

A
allergy
- anaphylaxis
pregnancy
- live vaccines
immunodeficiency
- some vaccines are not given
others:
GBS <6 weeks post- vaccination
intussusception ( don't give rotavirus)
severe asthma or recent wheezing (don't give LAIV)
active TB (don't give MMR or varicella)
SJS/TEN
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9
Q

is zoster a live vaccine??

A

NO!

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10
Q

what are some live vaccines? (3)

A

MMR
varicella
rotavirus (rotateq and rotarix)

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11
Q

patients with asplenia or hyposplenia are at increased risk of what infections?

A

Hib
pneumococcus
meningococcus

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12
Q

what vaccines for patients with asplenia or hyposplenia

A

PCV 13
PPSV23 >8 weeks post PCV13, age 2+
give Men-C-ACWY-____+ 4CMen B
- specific vaccine, #doses, time of boosters all depend on age
if >5 yo at diagnosis another dose HiB even if previously fully immunized

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13
Q

vaccines after bone marrow transplant

A
inactivated:
PCV13 x 3 then PPSV23
influenza
diphtheria, tetanus, polio, HiB, pertussis x3
Hep B x3
HPV x3
(meningococcal vaccine- routine)

live:
consider MMR and or varicella >24 months post if well
all other contraindicated (yellow fever if risk of exposure high)

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14
Q

after a solid organ transplant what vaccines should be given?

A

all inactivated vaccines not given pre transplant

no live vaccines!

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15
Q

What vaccines should be give pre solid organ transplant

A
routine vaccinations (ensure all completed, especially MMR and V)
PCV13 x 1 then PPSV23 x 1
Hib x1 if >5
if travel planned: Hep A, yellow fever
may need higher dose Hep B
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16
Q

how long do you wait after immunosuppressive (chemotherapy) therapy for vaccination?

A

wait 3 months after immunosuppressive therapy ends prior to vaccination

17
Q

if systemic steroids >2mg/kg/day dosed for 14 days, when can you give vaccines?

A

wait 1 month

for all other regimens (longterm alternate day, low dose, topical, intraarticular etc) no delays**

18
Q

after rituximab when can you vaccinate?

A

wait until they have b cells

19
Q

for all congenital and or acquired immunodeficiencies who else should you immunize?

A

IMMUNIZE ALL CLOSE CONTACTS

20
Q
For which of the following is PEP not achieved primarily through vaccination?
measles
hemophilus influenza b
hepatitis a
hepatitis b
varicella
A

hemophilus influenza b- prophylaxis with antibiotics

21
Q

when should you give PEP for measles and varicella

22
Q

PEP hep A

A

anytime, ideally <14 days

23
Q

PEP hep B

A

<12 hours in neonates, as soon as possible for all others

24
Q

PEP meningococcus

A

as soon as possible

chemoprophylaxis more urgent for close contacts

25
what would be considered significant exposure to varicella
household contact touching a lesion in same room >1 hour face to face contact >15 min
26
who should get VZIG
susceptible pregnant women neonates whose mother developed varicella 5 d before to 2 d after delivery some other neonates in NICU susceptible immunocompromised patients HSCT ideally <96 hours, can give up to 10 days after exposure
27
when should rotavirus be given?
usually recommended starting at 6 weeks with the first dose NO LATER THAN 15 WEEKS SERIES NEEDS TO BE COMPLETED BY 8 months
28
Name 3 contraindications for rotavirus?
intussusception maternal use of biologic during pregnancy immunocompromised not contraindicated in children with a history of rotavirus infection fine for premature infants if they are healthy
29
Those at high risk for pneumococcal infection should have what vaccines
PCV13- undiagnosed in infancy then 4 doses if dx later on ensure PCV13 was given PPSV23- if diagnosed in infancy then 1 dose at age 2 if later on then 1 dose at least 8 weeks after PCV13
30
what is the most common serogroxup for meningococcus
B!! (used to be C) | highest case fatality- C
31
what vaccine for meningococcus should be given for infants at high for for IMD
Men-C- ACWY- CRM 4CMenB boosters q3y until age 7 then every 5 years
32
who is considered at high risk for IMD
``` high risk of severe disease: asplenia hyposplenia complement deficiencies primary antibody deficiency HIV ``` high risk of exposure: travel (meningitis belt, Hajj) lab worker, barracks living
33
what types of HPV cause genital warts
HPV 6 and 11
34
what types of HPV cause anogenital Ca
16,18
35
HPV vaccine is recommended for who?
females 9-45 | males 9-26 (HPV 4/9)
36
how many doses of HPV for immunocompetent girls/boys age 9-14
2 dose series of any HPV vaccine ideally same product for all doses except those with advanced HIV and immunodeficient conditions then they need 3 doses regardless of age
37
strategies for vaccine hesitant parents
listen to concerns, ask to see literature/references/websites provide resources not vaccinating is not only putting their own child at risk but other in the community discuss herd immunity (doesn't work for tetanus for example)