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120 Cards in this Set
- Front
- Back
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What type of vaccines contain a version of the living microbe?
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live attenuated: MMR, varicella
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An inactivated vaccine is produced by ___ the microbe with heat, chemicals or ___
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killing; radiation
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Which type of vaccines use only the antigen that best stimulates the immune system?
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Subunit
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When is a toxoid vaccine used?
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when the toxin is the main cause of disease. (tetanus, diphtheria)
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How does conjugate vaccines work?
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Linkage of an "unrecognizable" polysaccharide to one that is recognized and can help boost immunity.
Ex: Hib, pneumoccocal-13 |
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Describe a recombinant vector vaccine.
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A carrier "vector" used which is similar to the DNA vaccines
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ToF: according to the infectious disease society of 2009, all indicated vaccines should be administered simultaneously.
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true: when appropriate and feasible
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What are the conditions in giving combination vaccines ?
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-any component of the combo are indicated
-other components of the combo are not contraindicated -the US FDA has licensed the vaccine for that dose of the series. |
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ToF: vaccines not given at the recommended age should be given at a subsequent visit and possibly restarting the series if too far apart.
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FALSE: do not restart the series
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Where should the clinician report adverse immunization events?
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Vaccine adverse event reporting system
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Vaccine information statements for patients and parents are required for each vaccine covered by the ...
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national childhood vaccine injury act
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What are the age ranges for the 3 immunization schedules?
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0-6 years
7-18 years "Catch-up" -4months through 6 years --7- 18 years |
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ToF: the length of the needle does not cause decrease in redness and swelling.
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FALSE, it does
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ToF: Tylenol should be given before a child gets vaccinations to prevent a fever afterwards?
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FALSE: It may interfere with seroconversion, not recommended
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What is an example of cognitive behavioral methods to reduce pain of vaccine?
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use of pinwheel or popup book
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What is the cause of diphtheria?
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The toxin released by the diphtheria bacterium after infection
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The incubation period of diphtheria is __ to __ days
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2 to 5
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What are the symptoms of diphtheria?
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Sore throat, fever, chills, difficulty swallowing and growths at throat and other body orifices
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ToF: there is a high rate of mortality from diphtheria in the very old and very young
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True
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Pts with diphtheria remain contagious for ___ after treatment
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48 hours
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Tetanus is caused by the toxin produced by the __ __ __ found in soil and __ of animals
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bacterium C. tetani; stool
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what is the method of transmission for tetanus?
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dirt getting into a puncture wound
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ToF:Once a person is exposed to diphtheria they are immune?
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false
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List the symptoms of tetanus.
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-spasm of the jaw, neck, abdomen, fever sweating, elevated BP and HR
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The complications of tetanus include ...?
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laryngospam, infection, death
-spasm can continue for month |
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ToF: the incubation period of tetanus depends on the closeness to the CNS
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True
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What causes pertussis?
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Bordetella pertussis
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What is the transmission method of pertussis?
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droplet; highly contagious
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ToF: pertussis can lead to death or disability, espeically in infants
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true
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What are the complications of pertussis?
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pneumonia, seizure, encephalopathy and death
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ToF: adults are the long term carriers of pertussis and are the ones to infect infants
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true
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What is the vaccine of choice for tetanus for children?
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DTaP ages 6 weeks to 7 yo in 4 doses
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When is DTaP administered?
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2, 4, 6, and 15-18 weeks. minimum interval between 3 and 4 is 6 months
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ToF: if a 4th dose of DTaP is given before the child is 4 years old then they do not need any others
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False: they need another dose between 4-6 years
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What are the subsequent boosters for tetanus after the 5th DTaP?
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Tdap is given at 11-12 years and then Td every 10 years thereafter
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ToF: Tdap is approved for pediatric children?
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false:L adolescent and adult
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How many doses of DT or DTaP are required if the first dose is given at 1 year?
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3
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ToF: the 4th and 5th dose of DT is not needed at school entry if the pertussis vaccine is not being administered
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True
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What is the 6 before 7 rule?
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the ACIP recommends no more than 6doses of DT containing vaccine before the 7th birthday
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What is KINRIX?
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Combination drug approved for 5th dose of DTaP and 4th dose of IPV for children 4-6 yo
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What were the prior DTaP combo brand doses if a child is receiving KINRIX?
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Infanrix or Pediarix
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ToF: the use of Kinrix for any dose except the 5th dose of DTaP and 4th dose of IPV should be considered a vaccine admin error.
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True
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What is the pentacel vaccine?
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DTaP, IPV, Hib
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ToF: pentacel can be used for the 5th dose of DTAP in children 5 or over
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false
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What is the pentacel schedule?
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4 doses at ages 2, 4, 6, and 15-18 months
each of the first 3 should be separated by 4 weeks -4th dose needs a 6 month interval |
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What is the cut off age for pentacel?
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should not be used for the 5th dose of DTaP
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What is Pediarix?
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Combo drug of DTaP, Hep B and IPV
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What is the minimum age to give pediarix and what is it approved for?
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minimum age is 6 weeks. Approved for 3 doses at 2, 4, 6 months.
-not approved for boosters. -6 weeks to 7 years of age |
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ToF: pediarix containing hep B can be give at 2, 4, and 6 months but not if the child received a Hep B at birth
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False: it can be given even if the child received hep b at birth. (4 doses total)
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ToF: Pediarix may not be used on infants whose mothers are HBsAg positive or status unknown.
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FALSE: it may be given
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How is pentacel made?
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contains lyophilized Hib vaccine that is reconstituted with a liquid DTaP-IPV solution
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ToF: a child that has documented having pertussis can still receive the vaccine?
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FALSE: do not need additional doses, but should get recommended Tdap
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List the adverse reactions to DTaP?
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-local (pain, reddness, swelling)
-Temp of 101 or higher -local reactions more common following 4th and 5th doses |
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ToF: there have been reports of swelling around the injection site of DTaP?
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False: of the entire limb
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ToF; if extensive swelling occurs after the 4th DTaP, a 5th is contraindicated.
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False
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What are the contraindications of DTaP?
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-severe allergic reaction
-encephalopathy not due to another identifiable cause occurring within 7 days after vaccination |
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Children with underlying neurologic disorder must be __ and __ to receive the pertussis vaccine.
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treated; stable
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What are the DTaP precautions?
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-Mod or severe acute illness
-temp > 105 within 48 hours -collapse or shock-like state within 48 hours -persisten inconsolable crying lasting > 3 hours with 48 hours -convulsions with or without fever occuring within 3 days |
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What is the tetanus vaccine for children over 7?
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Tdap
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What must a child over age 7 get in terms of tetanus vaccine if never previously vaccinated?
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-3 shot series, first 2 by 4 weeks, 2nd and 3rd by 6 months, with one being Tdap
-booster of Td every 10 years |
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If a person was unable to receive the tetanus vaccine, they will need __ __ with invasive high risk injuries
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tetanus immunoglobulin
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List the side effects of Tdap.
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-local reddness and swelling at injection site are common with nodules and even abscesses occuring
-peripheral neuropathy, guillian barre, urticaria -fever and systemic symptoms are uncommon |
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What are the 2 brand names for Tdap?
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boostrix and adacel
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What are the most serious and common types of invasive infections caused by Hib?
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-meningitis: leads to death and disability 25%
-epiglottis, joint, skin and bone infections |
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what is the death and disability rate from Hib even with treatment?
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5-15%
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ToF: getting Hib gives immunity and vaccine is not needed.
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False
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What type of vaccine is Hib?
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inactivated vaccine
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What is the recommended age for Hib?
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under 5
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What are the HIb containing vaccine names?
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-PedVaxHIB
-Comvax: combo with hep b -pentacel: with DTaP and IPV -Hiberix: booster awaiting MMWR for MenHibrix |
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ToF: a child under 6 weeks of age is contraindicated for getting HIb?
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True
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What are the side effects of Hib?
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-few
-5-30% have local irritation -one out of 20 have fever > 101 |
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What is Menhibrix?
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for 6 weeks to 18 months for N. meningitidis C and Y and Hib
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How many doses will be given for MenHIbrix?
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4 at 2, 4, 6 and 12 to 15 months
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How early can the first dose of menhibrix be given?
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as early as 6 weeks
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How is polio spread?
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fecal oral
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ToF: 95% of people infected with polio have no symptoms
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true
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what are the symptoms if expressed, of polio?
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sore throat, fever, malaise, nausea, non-paralytic aseptic meningitis with stiffness of the neck, back and legs; and flaccid paralysis with permanent disability of the legs, arms or both
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ToF: IPV is a live vaccine?
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false: it is inactivated
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What are the contraindications for polio vaccine?
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Severe allergic reaction to neomycin, polymixin B, streptomycin the vaccine contrains trace amounts of these
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ToF: IPV can be given for 18 and older
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False: not recommended in the US
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What are the most common infections related to strep pneumoniae?
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otitis media, bacterial pneumonia, bacteremia, meningitis
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What is the transmission of pneumococcus?
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respiratory
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What are the conditions that increase risk for pneumococcal disease?
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-decrease immune function
-asplenia -chronic heart, pulmonary, liver or renal disease -cigarette smoking -CSF leak |
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How many serotypes does prevnar cover?
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13
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How many doses of prevnar are scheduled
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4 starting at 2, 4, 6, and 12 to 15 months
children should end series with PCV 13 |
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if a child received first dose of prevnar after 7 months, how many doses does he/she need?
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2 doses and 1 booster
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ToF: cochlear implant patients should not receive a supplemental dose of PV 13 between 6-18 years of age
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false: they should because they are at increase risk for invasive pneumococcal disease
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What can PCV 23 be given?
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after age 2 in pts with risk factors with a minimum of 8 weeks between the last dose of PCV 13 and the fist dose of PCV 23
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Who are the groups that are eligible for the pneumococcal polysaccharide vaccine reactivation?
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-over 2 years old with
-asplenia (Functional anatomic) -immunocompromised -chronic renal failure -nephrotic syndrome |
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Which one of the pneumococcal vaccines causes more local ractions?
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polysaccharide
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which of the 2 pneumococcal vaccines causes more fever and myalgia?
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conjugate
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What can Hep B cause in the long run?
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life long infection, cirrhosis, cancer, liver failure and death
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What causes Hep B?
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infected blood of one person entering the blood on an uninfected person
-unprotected sex, needles, injuries at work or infants of infected mothers |
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What are the symptoms of hep B?
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fatigue, malaise, loss of appetitie, light stools, jaundice, headache, abd pain, liver failure, death
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what type of vaccine is Hep B?
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recombinant DNA
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What % and how many doses is needed for lifelong immunity from Hep B?
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90% have lifelong in 3 doses
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How much must an infant weigh to receive the Hep B vaccine?
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2000g
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What are the side effects of Hep B vaccine?
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Soreness and low grade fever
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What are infants who are born to Hep B + mother's given
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0.5mL of HBIG within 12 hours of birth
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What is the most common cause of severe diarrhea in infants?
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rotavirus
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ToF: rotavirus is nearly a universal infection by age 5
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true
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What strain of rotavirus accounts for 75% of infections?
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G1
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where does rotavirus replicate?
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in epithelium of SI
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__ and __ antigens of rotavirus define the virus serotype and induce neutralizing antibody
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VP7; VP4
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How does rotavirus spread?
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fecal oral and through fomites
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what are the clinical features of rotavirus?
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-short incubation period
-first infection after age 3 months generally more sever -may be asymptomatic or result in severe diarrhea with vomiting and fever -GI symptoms resolve in 3-7 days |
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What are the complications of rotavirus?
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-severe diarrhea
-dehydration -electrolyte imbalance -Metabolic acidosis -immunodeficient children may have more severe or persistent disease |
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what is the temporal pattern for rotavirus?
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fall and winter
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when is rotavirus most contagious?
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2 days before to 10 days after the onset
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What age rage of children infected with rotavirus have the most severe symptoms?
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3-24 months
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What are the risk groups for rotavirus?
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-children in care centers
-children in hospital wards -caretakers, parents of these children -children, adults with immuno-deficiency released disease (SCID, HIV, BMT) |
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what is the name of the rotavirus vaccine?
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RotaTeq
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ToF: RotaTeq contains preservative and thimerosal?
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false to both
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what is the schedule for rotaTeq?
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First dose: 6 weeks to 14 weeks and 6 days
the minimum interval is 4 weeks -all doses must be given by 8 months and 0 days |
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Which infants cannot be given RotaTeq?
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with allergy to latex
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What are the contraindications to RotaTeq?
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-latex allergy
-SCID -hx of intussusception |
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ToF: Rotateq cannot be given if the child has had a recent blood transfusion?
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FALSE:
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What are the ACIP recommendations of the rotavirus vaccine in preterm infants?
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-chronolgic age should be at least 6 weeks
-clinically stable -administered at time of discharge or after discharge fro NICU or Nursery |
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ToF: infants living in households with immunocompromised or suspected immunocompromised family members cannot be vaccinated for rotavirus
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FALSE; they can
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ToF; infants living in households with pregnant women should be vaccinated for rotavirus.
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TRUE
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