Vaccines And Immunoglobulins

Question 1

Live vaccines

Answer 1

CI: immunocompromised pt, Ig products, MUST BE SPACED OUT BY 28 DAYS IF NOT DONE SIMULTANEOUSLY

Question 2

Adherence to schedule

Answer 2

> 5 days before minimum interval or age not valid

Human derived AB products will neutralize live vaccines (except typhoid, YF, and LAIV)

Question 3

Hep B

Answer 3

Can defer if mother is HepBs Ag - at birth, give 1 month post natal
Within 12hrs, if + HepBs Ag
HBIG
Give asap after birth or exposure to Hep B

Question 4

Rotavirus

Answer 4

I’ve oral

Precautions: pre-existing GI infection, previous he of intussuception

Question 5

DTaP/Tdap/DT/Td

Answer 5

Contra: coma, seizures (encephalopathy), progressive
Precautions: Gullain-Barre < 6wks after vaccine
Pertussis vaccination should not be delayed and Tdap should be administered regardless the interval

Question 6

Pneumococcal vaccine

Answer 6

Recommends both PCV13 and PPSV23 in series to adults > 65yo

Recommend in immunocompromised pts

Question 7

Influenza Vaccine

Answer 7

Live attenuated

Precaution: within 48hr of antiviral drugs do not start influenza antivirals 2 weeks post vaccine

Question 8

MMR

Answer 8

Measles, mumps, rubella

Live attenuated

Question 9

Varicella Zoster

Answer 9

Live attenuated

Precautions: immunosuppressed, pregnancy, moderate or severe acute illness, recent blood product

Question 10

Adenovirus

Answer 10

Live oral
Military recruits entering basic training, high risk military
Live virus shed in stool

Question 11

Rabies

Answer 11

Interventions must be prompt and directed toward local virus neutralization
PEP recommendations: RIG around wound, serial doses of vaccine
RIG: administered once to previously vaccinated and provides rabies virus neutralizing Ab coverage until pt responds to vaccine