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34 Cards in this Set

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immunity
self vs. non-self
protection from infectious disease that's usually indicated by an antibody that's very specific to a single organism
antigen
live or inactivated substance capable of immune response
antibody
protein molecules produced by B lymphocytes to help eliminate antigen
active immunity
protection produced by their own immune system that is usually permanent
passive immunity
protection that is transferred from another person or animal. Temporary protection that decreases with time. transplacental is the most important source in infancy
sources of passive immunity
almost all blood or blood products
homolgous pooled human antibody
homologous human hyperimmune globulin
heterologous hyperimmune serum
Monocolonal antibody
derived from single type or clone, of antibody producing cells
antibody is specific to a single antigen or closely related group of antigens
used for diagnostic and therapy of certain cancers, autoimmune disease and infectious disease
antibody for prevention of RSV
Palivizumab (Synagis)
monoclonal antibody contains only RSV antibody, will not interfere with response to a live virus vaccine
there is not RSV vaccine
Immunity and immunologic memory are similar to natural infection but without risk of disease
Classification of vaccines
live attenuated: viral or bacterial
Inactivated:
-whole: viruses or bacteria
-fractional: protein based, polysaccharide based
General rule of vaccination
the more similar a vaccine is to the disease causing form of the organism the better the immune response to the vaccine
LIve attenuated vaccines
attenuated form of the "wild" virus or bacterium, must replicate to be effective, immune response similar to natural infection, usually produce immunity with one dose
what are the live attenuated vaccines for viruses?
Measles
Mumps
Rubella
Varicella/Zoster
Intranasal influenza
rotavirus
vaccinia yellow fever
what are the live attenuated vaccines for bacteria?
BCG
Oral typhoid
what is an inactivated vaccine?
cannot replicate and generally not as effective as live vaccines
less interference from circulating antibodies than live vaccines
generally requires 3-5 doses with primarily humoral immune response
antibody titer may diminish with time
what are the whole cell live inactivated viral vaccines?
Polio
Hep A
Rabies
INfluenza
what are the whole cell live inactivated bacterial vaccines?
Pertussis
Typhoid
Cholera
Plaque
what are the fractional inactivated vaccines?
Subunit: Hep B, influenza, acellular pertussis, HPV, anthrax
Toxoid: diphtheria, tetanus
Conjugated polysaccharide vaccines
pneumoncoccal
meningococcal
haemophilus influenza b
Pure polysaccharide vaccines
Pneumoncoccal
meningococcal
Salmonella typhi
in the antibody containing vaccines and measles and varicella. How long should you wait until you give one or the other?
Vaccine given first > wait 2 weeks before antibody

Antibody given first > wait 3 months of longer before vaccines
can all vaccines be given in the same visit?
YES
general rule: all vaccines can be administered at the same visit as all other vaccines
whats the general combination vaccine rule?
combination vaccines may be used whenever any components of the vaccine are indicated and vaccines other components are not contraindicated
what is the rule for administration of two live parenteral vaccines?
Non-simultaneous administration of two live parenteral vaccines: interference can occur between two live vaccines given within 28 days
what is the spacing of vaccine combinations not given simultaneously?
Two live injected or intranasal influenza vaccines must be given a minimum of 4 weeks apart
if there is an extended interval of multi-dose vaccines should the series be restarted?
NO
it is never necessary to restart the series or add doses because of an extended interval between doses
what are contraindications to vaccines?
allergy to component
encephalopathy
live vaccines in pregnancy, immunosuppression, any symptomatic person with AIDS
precaution in severe illness and recent blood product
what are invalid contraindications of vaccines?
antibiotic therapy
disease exposure
pregnancy in household
breastfeeding
premature birth
mild illness
allergies to products not in vaccine
FMHx unrelated to immunosuppression
Need for TB testing
Need for multiple vaccines
Low grade fever
URI
Otitis media
Mild diarrhea
influenza vaccine
who gets a live attenuated vaccine?
healthy person 5-49
who gets an inactivated vaccine?
All persons 50+ years
Persons > 6 months of age with chronic disease
Children 6-59 months
Residents of long term facilities
persons 6 months - 18 years on ASA therapy
Pregnant women
who gets the pneumococcal vaccine?
Polysaccharide: adults > 65; >2 years with chronic illness
Conjugate: all children < 24 months: unvaccinated children 24-59 months with high risk condition
what are the recommended doses for pneumococcal vaccine?
doses at 2, 4, 6 months and booster at 12-15 months
first dose as early as 6 weeks
minimum interval between the 1st three doses: 4 weeks
At least 8 weeks b/t dose 3 and 4
how young can you administer the HPV vaccine?
9 years old
what is the recommended age for HPV vaccine?
13-26 years old before sexual activity
3 doses administered:
0, 2, 6 months
4 week & 12 week interval
what HPV types does the HPV vaccine block against?
16
18
6
11