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53 Cards in this Set
- Front
- Back
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What is an antigen?
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-live or inactivated substance capable of producing an immune response
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What is an antibody?
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-protein molecules produced by B lymphocytes to help eliminate an antigen
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What is a vaccine?
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-antigenic preparation used to produce active immunity to a disease, in order to prevent the effects of infection by a natural organism
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What are live attenuated vaccines?
What are some examples? |
-wild viruses or bacteria that are weakened
-req replication -only 1 dose needed for response -will interfere with circulating antibody (wait 3 months after Ab products) Examples: Measles, Mumps, Rubella |
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What are inactivated viruses?
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-whole or subunits of viruses or bacteria that have been inactivated by heat or chemicals
-req multiple doses -cannot cause disease -mostly humoral response |
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What is the difference between a polysaccharide and a protein antigen source?
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Polysaccharide: capsule that produces T cell independent immune responses; cannot use in children <2yo
Protein antigen: surface proteins that cause T cell dependent immunse responses; can use in children > 2months old |
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Why should we immunize?
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-to eradicate disease
-to prevent disease -young children may be affected more by disease -herd immunity |
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Where can you view immunization schedules? What is an alternative immunization schedule?
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-CDC website
-Dr. Bob's selective vaccine schedule |
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What are CI to immunizations?
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-anaphylaxis
-previous severe response to pertussis-containing vaccine (inconsolable crying x 3 hr; sz w/in 3 days of dose) -severe acute illness (live vaccine) -pregnancy (live vaccine) -recently received Ab product (live vaccine) -immunosuppression (MMR, varicella) |
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What are possible local, systemic, and allergic adverse reactions to vaccines?
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-local: pain, swelling, redness at site of injection
-systemic: fever, malaise, myalgia, HA -allergic: rare |
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When should acetaminophen be admin with vaccines?
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-admin after vaccine if pt is complaining of sx
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When should the Hepatitis B vaccine be given?
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3 shot series at 0, 1, and 6 months of age (give w/in 12 hrs of birth if mother has HepB)
-Recombivax 5mcg or 10mcg(>20yo) -Energix B 10mcg or 20mcg (>20yo) |
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Who should be given a Hep B vaccine?
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-MSM
-pts with STDs -in contact with HBs-AG + persons -IVDA -healthcare/ public safety workers -international travelers -pts with HIV |
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When should an infant be given Hep B immunoglobulin (HBIG)?
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-if mother is positive for HepB
-give at same times at Hep B vaccine |
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When should the Rotavirus vaccine be given? What are some precautions to giving it? What are the ADR?
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-live vaccine Rotarix at 2, 4 months or RotaTeq at 2,4,6 months
-do not initiate in pts>15 wks Precautions: immunosuppression, preexisting GI disease, intussusception -ADR: V/D, fever, irritability |
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When should the Diptheria, tetanus, and pertussis vaccine be given?
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-DTaP at 2,4,6 months, 15-18months, and booster at 4-6y prior to school entry
-Tdap at age 11-12 if not pertussis booster -Td booster every 10 yrs |
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What are precautions to the DTaP vaccine? What are possible ADRs?
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-Precautions: temp> 105, collapse or shock-like state, inconsolable crying>3hr, sz within 3 days
-ADR: local rxns, fever, drowsiness (can use ibuprofen or acetaminophen to manage) |
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What are the precautions of the Tdap vaccine? What are the possible ADRs?
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-Precautions: hx of Guillain-Barre syndrome w/in 6 wks of dose, progressive neurologic disorder (encephalopathy, epilepsy)
-ADRs: HA, inj site pain/ redness |
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When should the Haemophilus influenzae type B vaccine be given?
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-admin at 2,4,6 months + booster 12-15months old
-ActHIB: 2,4,6 months + booster -PedvaxHIB: 2, 4 months + booster -Hiberix: Only booster |
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When should the Pneumococcal vaccine be given?
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Prevnar 13 (conjugate vaccine) at 2,4,6 months + booster at 12-15 months
-give booster if pt given prevnar 7 previously and age 14-59 months -Pneumovax (23 polysaccharide vaccine) at >65yo or >2yo w/ chronic illness -revaccinate 5 yrs after 1st dose if <10, 3yrs after 1st dose if >10 or >5yrs and vaccine given before 65th B-day |
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When should the Polio vaccine be given?
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-oral vaccine not used in US
- inactivated polio at 2, 4, 6-18months and 4-6yo -min interval b/tw doses 3 and 4 is 6 months -min interval b/tw doses 1 and 2 and 2 and 3 is 4 wks |
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What are the 4 stages of measles infection? What are the sx of each?
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-incubation: respiratory sx, fever, rash
-prodrome: fever, malaise, anorexia, conjunctivitis -exanthem: Koplik's spots(characteristic), maculopapular/ blanching rash -recovery: cough may last 1-2 wks after infection |
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When should the MMR vaccine be given? What are the ADRs?
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-live attenuated vaccine at >1yo, 4-6yo
-contains gelatin -suppresses rxn to PPD test -ADRs: fever, joint sx (Rubella) |
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When should the Varicella vaccine be given?
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-live attenuated vaccine at 12-15months and 4-6yrs
-min interval is 3 months -gelatin and neomycin |
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When should the Herpes Zoster vaccine be given?
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give to adults > 60yo
-contains gelatin and neomycin |
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When should the Hepatitis A vaccine be given?
Who should receive the Hep A vaccine? |
-given at > 12months, two doses at least 6 months apart (Vaqta, Havrix)
-if change from Havrix to Vaqta, wait 12 months apart Give to MSM, IVDA, international travelers, persons receiving clotting factor conc., persons who work with HAV, chronic liver disease |
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When should the meningococcal vaccines be given?
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Menectra at 11-12yo or 2-10 if high risk
-Menveo is acceptable if MCV4 not available; normally used in pts>55yo |
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When should the HPV vaccine be given?
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Quadrivalent vaccine admin 1st dose at age 11-12; followed by 2nd and 3rd doses at 2-6 months later
admin to all females 11-26 yo |
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What is the difference between Influenza A and Influenza B?
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-A: H1N1; antigenic shift and antigenic drift are possible; mod-severe illness, affecting all ages
-B: yamagata, victoria; less antigenic drift; mild illness affecting children |
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When should the influenza vaccine be given? What are the ADRs?
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trivalent vaccine admin IM to people >6 months old
ADR: soreness at inj site; fever, chills, muscle aches, HA live attenuated influenza vaccine (LAIV) intranasally in people 2-49 ADR: mild illness |
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What vaccines does Comvax contain?
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-Hep B
-HIB |
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What vaccines does Kinrix contain?
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-DTaP
-Polio |
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What vaccines does Pediatrix contain?
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-HepB
-DTaP -Polio |
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What vaccines does Pentacel contain?
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-DTaP
-HIB -Polio |
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What vaccines does ProQuad contain?
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-MMR
-Varicella |
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What vaccines does TriHibit contain?
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-DTaP
-HIB |
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What vaccines does Twinrix contain?
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-HepB
-HepA |
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How should two inactivated vaccines be given?
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-simultaneously
-any interval |
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How should 2 live vaccines be given?
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-simultaneously
-must wait 4 wks in between admin |
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How should an inactivated and a live vaccine be given?
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-simultaneously
-inactivated can be given at any interval |
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How should an IVIG and a live vaccine be given?
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-not recommended if pt is immunocompromised
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How should an IVIG and an inactivated vaccine be given?
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-give inactivated 6 months after a small dose (400mg/kg IVIG) or 11 months after a large dose (1000mg/kg IVIG)
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Which immunizations are CI in pregnancy? Which immunizations are recommended?
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CI: MMR, Varicella
Recommended: Td or Tdap, influenza, (pneumococcal, HepA/B, meningococcal if high risk) |
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What immunizations are recommended for healthcare workers?
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-Td or Tdap
-Influenza -HPV -Hep B -MMR -Varicella -Pneumococcal -Hep A -Meningococcal |
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What immunizations are CI in immunocompromised pts? What immunizations are recommended?
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CI: MMR, varicella
Recommended: Td/ Tdap, influenza, HPV, pneumococcal, Hep A/ B, meningococcal (Asplenia) |
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What is palivizumab (Synagis)? How is it used? What are the ADRs?
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-humanized murine monoclonal Ab for respiratory syncytial virus (most common cause of URTI)
-anti-f glycoprotein immunoglobulin -fusion (f) surface glycoprotein used to infect cells -Px only; 15mg/kg IM every 30 days (5 doses max) between Nov-March -ADR: anaphylaxis, HSS- both rare |
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When is IVIG used?
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-primary immunodeficiencies
- immune-mediated thrombocytopenia - Kawasaki disease - Hematopoietic stem cell transplant pts>20yo -Chronic B-cell lymphocytic leukemia -pediatric HIV type 1 infection |
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What are the ADR for IVIG?
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-infusion rxns: pretx w/ tylenol +/- diphenhydramine
-renal impairment -HSS |
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When should Hep A IVIG be given?
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-pre-exposure px
-post-exposure in non vaccinated pts w/in 14 days |
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When should Rubella IVIG be given?
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-px during pregnancy
-w/in 72 hrs of exposure |
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When should measles IVIG be given?
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-w/in 6 days of exposure
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When should varicella IVIG be given?
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-w/in 72 hrs of exposure
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When should IgG deficiency IVIG be given?
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- every 3-4 wks
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