Pediatric Vaccination

Front 1

If you give a vaccine, how long do you have to wait before giving an antibody?

Back 1

2 weeks

Front 2

If you give an antibody, how long do you have to wait before giving a vaccine?

Back 2

3 months or longer

Front 3

If someone has a contraindication to a vaccine, should you give it?

Back 3

NO

Front 4

If someone has a precaution to a vaccine, should you give it?

Back 4

depends--at the discretion of the health care provider

Front 5

In terms of Dtap, IPV, varicella, Hib, prevnar, MMR, what are your administration options?

Back 5

give together OR

wait 4 weeks between live vaccines!

Front 6

What is the minimum interval that you must wait between 2 live injected or intranasal influenza vaccines?

Back 6

4 weeks!

Front 7

What is the minimum interval you must wait when administering all other combinations of live oral vaccines?

Back 7

none

Front 8

What happens if 2 live (injected or intranasal) vaccines were given less than 28 days apart?

Back 8

interference

Front 9

What should you do if 2 live vaccines were given less than 28 days apart?

Back 9

the second vaccine should be repeated

Front 10

After the series has been completed, does increasing the interval between doses of a multidose vaccine diminish the effectiveness of the vaccine?

Back 10

NO

Front 11

What is the effect of decreasing the interval between doses of a multidose vaccine?

Back 11

interference with antibody response and protection

Front 12

When a person is behind schedule or if a vaccination series needs to be accelerated, what information should you refer to?

Back 12

minimum intervals and ages

Front 13

Is it ever okay to administer a vaccine at less than minimal intervals or earlier than the minimum age?

Back 13

NO

Front 14

According to the ACIP, vaccine doses given prior to the minimum interval or age are counted as valid within what time frame?

Back 14

4 days prior to the minimum interval or age

Front 15

Is it possible for the state law to override federal ACIP guidelines?

Back 15

yes---immunization programs and/or school entry requirements may not accept all doses given earlier than the minimum age or interval

Front 16

Although all permutations of all vaccine schedules have not been studied, have existing studies of extended intervals shown a significant difference in a final titer?

Back 16

NO

Front 17

Is it necessary to restart the series or add doses due to an extended interval between doses?

Back 17

no

Front 18

What is a contraindication? Give an example

Back 18

a condition in a recipient that greatly increases the chance of serious adverse reaction

ex: encephalopathy as a result of the Tdap vaccine

Front 19

What is a precaution?

Back 19

A condition in a recipient that might increase the chance or severity of an adverse reaction OR

might compromise the ability of the vaccine to produce immunity

ie: a high fever after the vaccine

Front 20

What are 2 permanent contraindications to vaccination?

Back 20

1. severe allergic reaction to a vaccine component or following a prior dose

2. encephalopathy not due to another identifiable cause occurring with 7 days of pertussis vaccination (applies ONLY to pertussis-containing vaccines)

Front 21

What contraindications are associated with live vaccines? (3)

Back 21

1. allergy
2. pregnancy
3. imunosuppression

Front 22

What precautions are associated with live vaccines? (2)

Back 22

1. severe illness
2. recent blood product**(MMR, VZ, and rotavirus vaccines only)

Front 23

What 2 contraindications are associated with inactivated vaccines?

Back 23

1. allergy to component
2. encephalopathy

Front 24

What precaution is associated with inactivated vaccines?

Back 24

severe illness

Front 25

Is it okay to administer an inactivated vaccine during pregnancy, immunosuppressed periods, or recent blood product receipt?

Back 25

yes

Front 26

Which inactivated vaccines should you definitely NOT give a pregnant woman (exceptions to rule)?

Back 26

1. HPV
2. Tdap (unless outbreak?)

Front 27

Why is it ok to give an inactive influenza vaccine to a pregnant woman?

Back 27

the risk of the disease outweighs the risk of the vaccine

Front 28

If a woman is thinking about becoming pregnant, should she receive a single dose of Tdap?

Back 28

YES

Front 29

When should pregnant women who have not received Tdap get vaccinated?

Back 29

in the immediate postpartum period

Front 30

If tetanus and diphtheria protection is required during pregnancy, which vaccine does the ACIP recommend?

Back 30

Td vaccine

Front 31

Is pregnancy a contraindication for the Tdap vaccine?

Back 31

NO

Front 32

When might a clinician choose to administer Tdap to a pregnant woman?

Back 32

in certain circumstances, such as during a community pertussis outbreak

Front 33

What are 3 causes of immunosuppression?

Back 33

1. disease
2. chemo
3. corticosteroids

Front 34

In general, what is the problem with administering a vaccine to an immunosuppressed patient?

Back 34

in general, do not respond to vaccines

Front 35

Give 3 examples of diseases that cause immunosuppression.

Back 35

1. congenital immunodeficiency
2. leukemia or lymphoma
3. generalized malignancy

Front 36

Give 3 examples of chemo agents that cause immunosuppression?

Back 36

1. alkylating agents
2. antimetabolites
3. radiation

Front 37

Do aerosols, alternate day, short course, or topical corticosteroids cause immunosuppression?

Back 37

no

Front 38

Which corticosteroid circumstances cause immunosuppression?

Back 38

1. 20 mg or more per day of prednisone for over 2 wks
2. 2 mg/kg or more per day of prednisone for over 2 wks

Front 39

If a person is severely immunosuppressed, which vaccines should NOT be administered to them?

Back 39

live vaccines!

Front 40

Which vaccine may a patient with an isolated B-cell deficiency receive?

Back 40

varicella vaccine

Front 41

Are inactivated vaccines safe to give to an immunosuppressed person?

Back 41

yes, but the response to the vaccine may be decreased

Front 42

What vaccines should healthy household contacts of immunosuppressed patients receive?

Back 42

1. MMR
2. Varicella
3. annual influenza

Front 43

What is the list of invalid contraindications to vaccination?

Back 43

1. mild illness
2. antimicrobial therapy
3. disease exposure or convalescence
4. pregnant or immunosuppressed person in the household
5. breastfeeding
6. preterm birth
7. allergy to products not present in vaccine or allergy that is not anaphylactic
8. family hx of adverse events
9. tuberculin skin testing
10. multiple vaccines

Front 44

What vaccines are contained in Pediarix?

Back 44

1. Hep B
2. DTap
3. IPV

Front 45

What vaccines are contained in Pentacel?

Back 45

1. DTap
2. Hib
3. PCV-13
4. IPV

Front 46

Which vaccines are present in Comvax?

Back 46

1. Hib
2. Hep B

Front 47

Describe the relationship between acute illness and vaccination.

Back 47

no evidence that acute illness reduces vaccine efficacy or increases vaccine adverse reaction

Front 48

What should you do if a patient has an acute illness and needs a vaccine?

Back 48

delay vaccine until illness improves

Front 49

Is mild illness, such as otitis media or an URI, a contraindication to vaccination?

Back 49

NO