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PHM 790: Topics in Pediatry > Week 3 Immunizations > Flashcards

Week 3 Immunizations Flashcards

1
Q

Passive Immunization and when its useful

A
  • Immunoglobulons like Palivizumab
  • temporary immunity prior to or after exposure
  • use when active immunization not available (RSV) or when a vaccine was not admin before exposure (rabies)
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2
Q

what is active immunization and its moa

A

vaccines; they contain antigens that are recognized by body’s immune system causing an immune response. Activating T cells or B cells. B cells cause antibody formation which attack antigens. Memory B and T cells are formed.

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3
Q

primary vs secondary response to vaccination

A
  • Primary is in response to vacc, slow and not as strong
  • Secondary is in response to infection that vaccine had antigens of, more rapid and stronger
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4
Q

Immediate vs Ultimate goal of vacc

A

Immediate: prevention
Ultimate: Eradication ex smallpox

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5
Q

live vaccines

A

Influenza (LAIV)
Measles
Mumps
Polio
Varicella
Rubella
Rotavirus
(I’M Probably Very Right)

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6
Q

4 Inactivated Vaccines

A

Hep A
Influenza (IIV)
Pertussis
Polio (IPV)
(HIPPA)

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7
Q

Recombinant vaccines

A

Hep B
HPV
RSV
Zoster (RZV)
Novavax
veryvery very bright

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8
Q

2 Toxoid Vaccines

A

Diphtheria
Tetanus

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9
Q

3 conjugated/ polysaccharide

A

Hib
Meningococcal
Pneumococcal

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10
Q

Pediarix components

A

Dtap + IPV+ Hep B
- dec vaccine load

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11
Q

Vaxelis components

A

DTap+ IPV+ Hib + Hep B

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12
Q

Pentacel and clinical pearl

A

Dtap + IPV + Hib
- dec vaccine load= dec aes

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13
Q

when is it appropriate to have gap between vaccines

A

with 2 or more live vaccines, 28 day minimum interval if not given at the same time

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14
Q

Cons of decreasing vs increasing interval between vaccines

A
  • decreasing can reduce antibody response/ protection
  • increasing can delay protection *give at next visit do not restart series
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15
Q

when do we not count vaccine as valid dose and repeat it

A

When vacc admin 5 or more days before the minimum dosing interval or age

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16
Q

when should we avoid/ postpone immunization

A
  • pts with mod to severe illness
  • Hx of anaphylaxis to vacc or its components
  • avoid live vaccines in certain immunodeficiencies (luekemia, lymphoma, cancer, radiation, HIV, prednisone)
  • in pregnancy LIVE vaccines CONTRAINDICATED, inactivated okay in 2nd tri
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17
Q

Pregnancy vaccinations; recommended and contraindicated

A

Recommended cocooning effect
- Inactivated Influenza
- Tdap
- covid
- rsv
CI
- live vaccines
*HPV not recommended
*no evidence that vacc cause fertility problems

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18
Q

Chemotherapy and Live vaccines

A

vaccinate 2 weeks before OR 3 months after treatment

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18
Q

Corticosteroids and Live vaccines

A

High dose: >2mg/kg/d or >20mg/d pred for 14 or more days

wait one month

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18
Q

When is it okay to vaccinate children during corticosteroid therapy

A
  • topical therapy or local injections
  • physiologic maintenance therapy
  • low/mod dose systemic corticosteroids
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18
Q

When is it okay to vaccinate children after corticosteroid therapy

A
  • high dose corticosteroids less than 14 days; vacc immediately or wait 2 weeks
  • high dose corticosteroids 14/more; must wait 1 month to vacc
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19
Q

Immune globulin w/ live vaccines

A
  • live vaccine should be admin 14 days b/f immoglubulin. if IVIG given b/f must revaccinate
  • do not give live vaccine <3 months after immunoglobulin
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20
Q

PPD testing w/ live vaccines

A

Give at same time or wait 4-6 weeks to place PPD

21
Q

adverse effect of live vacc

A

mild form of the natural illness

22
Q

vaccines available as SQ

A

MMR
Varicella
PPV23
Polio
Meninogoccocal
zooster

23
Q

SQ sites infants vs 1yo and older

A

infants : thigh
>1 : upper outer triceps
45 deg

24
Q

IM sites

A

<3 yrs : anterolateral thigh
>3 years: deltoid
BUTT not useful= inadequate immune response/ risk of injury

25
Q

Intranasal

A

do not redose if pt sneezes

26
Q

oral vaccine options

A

Oral polio (OPV)
- if pt vomits w/in 10 minutes REDOSE
Rotavirus
- pt vomits do not redose

27
Q

4 Vaccine Myths

A
  • Lack of appreciation for/fear of the severity of these disease
  • false sense of security
  • lack appreciation for the benefits of vacc, think they are ineffective
  • certain/all vaccines are not worth the risk
28
Q

parental perspectives on vaccines

A
  • painful for child to receive multiple shots during single visit
  • too many in first 2 years of life
  • may cause learning disabilities
29
Q

Diphtheria occurence/severity

A

Infection most common and severe in non/incompletely immunized individuals

30
Q

Tetanus what is it and Risk factors

A
  • Toxin binds in CNS leads muscle rigidity/spasms, 30% fatality
    -RF: Puncture wounds, IV drug use
31
Q

Pertussis

A

Whooping Cough *extremely contagious
50% of hospitalizations in infants

32
Q

Pertussis Stages

A

Stage 1- catarrhal stage; last 1-2 weeks very contagious
Stage 2 - Paroxysmal Stage lasts 1-6 weeks; fits of rapid coughing with whoop sound
Stage 3 - Convalescent Stage last 2-3 weeks; gradual recovery

33
Q

Routine immunization Diph/Tetanus

A

<7= DTap or DT
7 and up= TD
11 and up= Tdap

34
Q

Boosters Diph/Tet/Pret

A
  • Diph every 10 years
  • Tetanus every 10 years if no inury, every 5 years if at risk, and severe injury 1 year after last dose
  • Pert give 1+ booster dose following DTaP series
    Pregnancy Tdap every preg
35
Q

Hib Vaccine high risk patients

A

Chemotherapy/Radiation
Immunodeficiency
Asplenia (sickle- cell disease)

36
Q

Hep A formulations and indications

A

Havrix, Vaqta
- universal admin to all children 12-23 months
- 2 dose series
Twinrix (HAV+HBV)
- for 18 and older
- 3-4 dose series

37
Q

Hep A vacc for high risk groups

A

International travel
male male sex
clotting disorders
chronic liver disease
drug use

38
Q

Hep B maternal HBAG status

A

determines vaccination schedule of infants
- including weight and if mother is positive, unknown or neg
- child is premature and mother ststus unknow or positive give IVIG w/in 12 hrs with 3 additional vaccine doses
- child is >2kg and mother neg: vaccine in 24 and follow regular doing schedule

39
Q

HPV Gardasil; complication, indication, schedule, AE,

A
  • major complication: cervical cancer
  • Indicated in females and males 9-45 yo to prevent cancer and genital warts
  • 2 dose series for 9-14 yo; now then 6-12 mon later
  • 3 dose series for 15 and up OR immunocompromised; now, 1-2 mon, 6 mon
  • AE: fever, syncope
40
Q

antigenic drift

A

gradual changes in protein due to mutations, substitutions and deletions

41
Q

Antigenic shift

A

drastic protein changes in hemagglutinin or neuraminidase. causes epidemic and pandemics

42
Q

IIV who eligible, doses, AE

A

6 months and older; 1-2 doses
- 2 doses if 1st lifetime dose or if <9 yo with 2 or less doses, separate by 4 weeks
- ae local rxns

43
Q

LAIV who is eligible, AE, CI

A

2 years- 49 years
- AE: rhinorrhea
- CI: Childen <2, adults >50, pregnancy, child 2-4 with asthma or hx of wheezing, on aspirin, has csf leaks

44
Q

MMR pearl and special situations

A

Immunity life long
- International travel; pt 6-12 get 1 dose (doesnt count as schedule), >12mons receive 2 doses prior to travel

45
Q

Varicella primary infection and dosing schedule

A
  • chickenpox
  • <13 yo 2 doses >3 months apart s
    ->13 yo 2 doses >4 weeks apart
46
Q

pneumococcus vaccines

A

pcv15 and pcv20 are conjugated, good for <2 years
pcv23 broader coverage; recommended for high risk children >2 yos

47
Q

covid 19 complications

A
  • Multisystem inflammatory syndrome in children (MIS-C) RARE
  • Diabetes
  • Myocarditis 5-18yo
48
Q

Latex allergy contraindication

A

Rotarix (2 dose)

49
Q

which vaccines are sensitive to light

A

ProQuad
reconstituted MMR
zooster
LAIV
Novavax

50
Q

antiviral agents and live vaccines

A

if treated w/in 48 hrs to live vaccine wait 14 days a/f vacc to start antiviral again

51
Q

Proquad AE

A

febrille seizures

52
Q

Covid 19 options for 6 mon-4 yo including colors, doses and se

A

moderna 2 doses- dark blue/green
pfizer 3 doses- yellow
ae- inj site rxn and fever

53
Q

Covid 19 options for 5yo-11 yo including colors, doses, and se

A

moderna 1 dose- dark glue/green
pzifer 1 dose- blue cap
ae- inj site, fatigue

54
Q

Covid 19 options for 12 yo+ including colors, doses and se

A

Moderna 1 dose - blue/blue
Pzifer 1 dose- grey
novavax 2 doses- blue/blue

PHM 790: Topics in Pediatry (4 decks)

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