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T/F: Active immunity comes from infections and vaccinations. It is a permanent immunity.
T/F: Passive immunity is caused by blood products and monoclonal antibodies. It is a permanent immunity.
F: It wanes over time, like an infant loses immunity over time and its why we need booster shots.
"Non-virulent virus/bacterium" are_________ vaccines that are _______-dosed while "modified wild virus/bacterium" are____________ vaccines that are ________ dosed.
- Inactivated, Multi-dosed
- Live Attenuated, Single dosed
There are too many "Inactivated" vaccines to mention, so name all of the "Live attenuated" vaccines(7):
- Measles, Mumps, Rubella
- Varicella, Zoster, Rotavirus
If the patient needs multiple vaccines, how long do you need to separate the different types of vaccines listed below?
- Live Attenuated-Live Attenuated:
- Live Attenuated-Inactivated:
- 2 weeks if vaccine is 1st, 3 months if antibody is 1st
- Same day or separate by 4 weeks
- Same day, no minimum interval
If you give a multidose vaccine series to a patient (age approprate)and they come in early to recieve the next dose, how many days early can you give the vaccine and have it still "count?"
Decreasing the interval has what effect?
Increasing the interval (longer than scheduled) has what effect?
- max of 4 days, 5 days or more is too early and "NOT-counted"
- It interferes with immune response and is "NOT-counted"
- Has no effect on immune response, is "counted" , DO NOT RESTART Series
What are the local, systemic and allergic adverse events of vaccines?
- Local: most common include: injection site pain, swelling, redness; within a few hours but are self-limiting
- Systemic: fever, malase, myalgias, headache, loss of appetite; between 7-21 days and are self-limiting
- Allergic: RARE-anaphylactic reaction within minutes and is a medical emergency
What are some contraindications of getting vaccine shots?
- Allergies to eggs, gelatin, neomycin, or latex
- Pregnancy- with Live attenuated vaccines
- Immunosuppressed (by disease or drugs)-with Live attenuated vaccines
What types/classes of drugs are contraindicated for vaccines?
- Antimetabolite (cancer),
- Prednisone (>= 20mg QD or 2mg/kg for 14 days or longer)
Which of the following can be "valid" contraindications?
A. Slight fever, cold, or otitis media
B. Anti-biotics or anti-fungal medications
C. Breastfeeding, Upper respiratory infection or TB skin test
D. Working with pregnant women, immuncocompromised or nursery age children
E. Each choice has at least one valid contraindication
F. None of the above are valid contraindications
F. None are vaild contraindications
Influenza: Name the organism, how many types, which one is dangerous? How is it transmissited and the clinical presentation? Complications? High risk groups?
- Influenza virus- 3 types A, B, and C
- Type A- hemagglutinin (H) and neuraminidase (N)
- Respiratory droplets
- Fever, myalgia, sore throat, nonproductive cough, headache
- Secondary bacterial pneumonia
- Infants and eldery, co-morbid conditions
Name the brand name influenza vaccine that is used in the elderly (≥ 65) and why would you not want to give it to a 10 year old? Which brand would be appropriate for anyone ≥ 6 months?
- Fluzone High-Dose- contains 4x the antigen because the elderly need that much more to create an adequate immune response
- Fluzone (regular)
Flu season campaign begins _________ and ends _________.
What is the proper administration of the vaccine in a first time child under the age of 9?
- Mid-October to late-December
- 2 doses separtated by 28 days
Pneumococcal Disease: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Streptococcus pneumoniae
- Respiratory droplets
- pneumonia, bacterema, meningitis
- bacterial meningitis
- Elderly, immunocompromised, asplenia, chronic heart, pulmonary or renal disease, smoking, CSF leak, diabetes, cirrhosis
Which of the Pneumococcal vaccines(2) is a polysaccharide vaccine and which is the conjugate vaccine?
How are each dosed?
- PPSV23- ploysaccharide vaccine contains 23 types, does not protect , minimum age 2years, dosing interval of 5 years
- PCV13 (Prevnar)- conjugate vaccine, 6 weeks to 6 years and over 50 years, 4 doses separated by 4 weeks
Diphtheria: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Corynebacterium diphtheriae
- Respiratory droplets
- most common site: pharynx and tonsils (extreme swelling)
- myocarditis, neuritis, and death
Tetanus: Name the organism. How is it transmissited? The clinical presentation? Complications?
- Clostridium tetani (exotoxin)
- Wound entry
- generalized rigidity and convulsive spasms of skeletal muscles
- starts with lockjaw -> stiff neck -> rigid abdominal muscles -> rest of body
- laryngospasm, respiratory muscle spasms, spine or long bone breakage, aspiration pneumonia
Pertussis: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Bordtella pertussis
- Respiratory droplets
- 3 stages: catarrhal (adult cold like), Paroxysmal (child heavy cough, whooping), Convalescent (recovering, milder cough-whoop)
- 2nd bacterial pneumonia, seizures, rib fracture, difficult sleeping
- Children at higher risk
Name the (3) brands of DTaP vaccines for children.
Name the (2) brands of Tdap vaccines for adults.
What is the difference between DTaP, DT and Tdap?
- Infanix, Tripedia, Daptacel
- Boostrix (≥10 yrs) and Adacel (11-64 yrs)
- DTaP- Children:(newer/safer) higher concentration of diphtheria and acellular pertussis
- DT- Children: higher diphtheria
- Tdap- Adults: older need a 1 time booster
How often do you need a Td booster and Tdap booster?
How long is the separation time between Td and Tdap?
What is the special contraindication/precaution for DTaP, DTap vaccines?
- Td booster every 10 years
- Tdap booster needed 1 time
- No minimum time needed
- Encephalopathy or epilepsy
Herpes Zoster: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Herpes Zoster
- No transmission
- Painful rash with or without vesicles
- Postherpetic neuralgia, occular nerve damage
What is the name brand Zoster vaccine, type of vaccine, age and dosing requirements?
- Live attenuated
- minimum age of 50
- dose: 0.65 mL
Hepatitis A virus: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Hepatitis A virus
- Jaudice, fever, malaise, anorexia, nausea, abdominal discomfort, dark urine
- Fuminant hepA (encephalopathy, coma)
- International travelers, illegal drug users, men-men sex
Hepatitis B virus: Name the organism. How is it transmissited? The clinical presentation? Complications? High risk groups?
- Hepatitis B virus
- Blood, serous fluids, perinatal
- 3 phases: Preicteric(prodromal), Icteric (symptomatic), Convalescence
- Chronic HBV
- Illegal drug users, Men-men sex, Health Care workers
Name the (2) HepB vaccines, age requirements and dosing.
- Recombivax HB- any age
- Engerix-B- age specific
- 3 dose series- 0, 1, 6 months