Vaccines- Quiz 2 Flashcards
Attenuated vs Inactivated
Attenuated: “Modified-Live” give more broad, longer lived immunity than inactivated.
Inactivated: “Killed”
- We don’t do live virus immunizations in the US anymore
Key Notes about administration
-Give live virus vaccines at least 28 days apart
-Reduced doses should never be used
-Re-immunization is not harmful
-Space vaccines at least 1 inch apart
-Be aware of and monitor for adverse reactions and respond appropriately
Inactivated Vaccine Examples
-Diphtheria, tetanus, pertussis (DTaP & Tdap)
-Pna
-Meningitis
-Hep A
-Hep B
-Polio (rest of the world uses attenuated)
Contraindications for Inactivated Vaccines
-Anaphylaxis to prior dose
-Allergy to Neomycin, polymyxin B, streptomycin
-Allergy to yeast-> No Hep B or Inactive Polio
-Can’t have a moderate or severe infection for HPV or Hib (H. flu B)
Contraindications for Live Attenuated Vaccines
-Immunocompromised
–HIV
–Chemo
–Prednisone >20mg/day
–IVIG therapy
–Patient on biologics
Recurrent fever, seizures, thrombocytopenia, recent blood transfusion, salicylates
Live Attenuated Vaccine examples
-Baccilus Calmette-Guerin (TB) normally not used in the US
-Measles, Mumps, Rubella, Varicella
-Rotavirus
-Flu (only the nasal spray version)
What is the vaccine recommended for EACH pregnancy around 27-36 weeks?
Tdap
Maximizes the transfer of antibody from mother to baby
Doesn’t matter when last vaccination was given, should still be given during EACH pregnancy to improve transfer of antibody to the baby
What do you give an adult that has no immunity to varicella?
Why?
Shingrix – shingles vaccine
Shingrix is an inactivated vaccine while varicella is a live attenuated so the risks to the adult are less.
What can you give infants that are at high risk of getting RSV as prophylaxis?
—What are the conditions to be high risk?
Palivizumab
–born <29 wks during RSV season
–born <32 wks are <2yo and have chronic lung disease
–<1yo with congenital heart disease
–<1yo with neuromuscular disorder or congenital abnormalities affecting the respiratory system.
Tdap vs DTaP
Tdap- adults and children >7yo, full dose of tetanus but smaller doses of diphtheria, and pertussis
DTaP- children <7 full dose of all tetanus, diphtheria, and pertussis
If a dirty wound occurs, who would need to get a Tdap booster?
-when in doubt boost, revaccination is safe
-if someone has not had a boost in 10 years, OR you don’t know when they had the last, revaccinate
-if <7 without 3 doses of DTaP
Who is a candidate for the pneumonia vaccination?
> 50yo (or 65yo depending on who you ask apparently)
all children <2
children 2-18 IF they have sickle cell, immunodeficiency, heart or lung disease
19-64 IF
heart, lung or kidney disease, DM, ETOH, smoker, cancer, HIV, organ transplant, on immunosuppressive drugs, post splenectomy, sickle cell disease, CSF leaks or cochlear implants
After an acute exposure of an unvaccinated or under vaccinated person what can you do?
Give immunoglobulins (only some diseases are possible)
possible for:
Hep B, CMV, Rabies, RSV, tetanus, varicella, IVIG
What vaccination is given at birth?
Hep B
What age do vaccinations (other than the one at birth) start?
What do they get then?
2 Months
DTaP, Hib (h. influenzae B), IPV (polio), PNA, rotavirus, HepB
What is the route of administration for the Rotavirus vaccine?
Oral
What is a major contraindication for the Rotavirus vaccine?
Severe Combined Immunodeficiency (SCID), intussusception history
What types of Typhoid vaccines are available?
Live (oral) or inactivated (intramuscular)
What medications can interact with oral Typhoid vaccine?
Antibiotics, immunosuppressants
What type of vaccine is Yellow Fever?
Live-attenuated virus
What are the contraindications for the Yellow Fever vaccine?
Immunosuppression, egg allergy, thymus disorders
What is the BCG vaccine used for?
Tuberculosis prevention
Why is BCG contraindicated in immunosuppressed individuals?
It is a live-attenuated vaccine that may cause systemic infection
What types of Influenza vaccines exist?
Inactivated (IM) or live-attenuated (intranasal)
What are precautions for Influenza vaccination?
Egg allergy (certain formulations), Guillain-Barré syndrome history
What is the composition of Diphtheria, Pertussis, and Tetanus (DPT, Tdap, Td) vaccines?
Toxoid (diphtheria, tetanus), inactivated (pertussis)
What are contraindications for Pertussis vaccination?
Severe allergic reaction, encephalopathy
What are the two types of Polio vaccines?
Inactivated (IPV) and live-attenuated (OPV)
Why is OPV contraindicated in immunocompromised patients?
It can cause vaccine-derived poliovirus infections
What are common contraindications for vaccines in general?
Severe allergic reactions, immunosuppression (live vaccines), pregnancy (live vaccines)
How do immunosuppressants impact vaccine efficacy?
They reduce the immune response, making vaccines less effective
