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99 Cards in this Set
- Front
- Back
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What is a formulation of whole, or fractionated microorganisms or portions of them?
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vaccine
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What is a nontoxic modified bacterial toxin that retains the ability to stimulate antitoxin formation?
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toxoid
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What type of vaccine consists of whole microbes or isolated components?
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killed
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Which vaccines contain altered or weakened virulent organisms?
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live or attenuated
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What type of vaccine contains sugar fragments purified from capsules of bacteria?
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polysaccharide
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What type of vaccine consist of whole or fragmented bacteria or virus?
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conjugated
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What types of vaccines generally prodice longer immunity
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-live attenuated
-conjugated |
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What type of vaccine should always be used in children < 2 years?
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conjugated
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What childhood vaccination should be administered differently in premature infants < 2kg?
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Hep B
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How should pregnant women be vaccinated?
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-don't use live vaccines
-wait until second trimester |
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What constitutes limited immune deficiency?
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-diabetes
-renal disease -liver disease -asplenia |
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If a patient has limited immune deficiency and is not on immunosuppressants can they recieve vaccines?
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yes
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What is considered to be sever immunodeficiency?
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-congenital immunodeficiency
-antimetabolite therapy -radiation therapy -high dose prolonged corticosteroids |
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What types of vaccines can be given to patients with severe immunodeficiency?
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inactivated vaccines
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What vaccinations should closecontacts and healthcare workers of severely immunocompromised patients recieve?
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MMR
Varicella Rotavirus |
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What vaccines should not be given to close contacts and healthcare workers of the severly immunocompromised?
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OPV
smallpox |
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When can leukemia, lymphoma, and other cancer patients recieve live vaccines?
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-remission and 3 months since last chemo
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Can patients on <20 mg/day corticosteroid for < 2 weeks recieve live vaccines?
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yes
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Can patients on >20 mg/day of prednisone or equivalent for >2 weeks recieve live vaccines
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no
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Do patients on long term, alternate dosing steroids with short acting agents, maintenance phsyiological doses, topical, aerosol, intrarticular, bursal, or tendon injection be on live vaccines?
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yes
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How long after the last dose of immunosuppressing agents should a patient wait before recieving live vaccines?
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-at least 3 months
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What vaccines should patients with functional or anatomical asplenia recieve?
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-pneumonococcal, meingococcal, and Hib
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What vaccines should be given to patients recieving HSCT?
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-inactivated vaccines 12 months after
-influenza vaccine 6 months after -MMR 24 months after |
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What vaccines should be given using the standar schedule for HIV patients < 16 years?
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-Hepatitis B
-DaTP -HIB -IPV -other killed viruses if required |
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When is MMR not recommended in children with HIV?
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-CD4 < 200
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Which HIV patients should recieve varicella vaccine?
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-asymptomatic or mildly symptomatic children
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Which HIV patients should recieve the pneumococcal vaccine?
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-all patients > 2
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When can yellow fever be used in HIV patients?
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only if absolutely necessary
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What vaccines should be avoided in HIV patients?
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live vaccines other than specifically recommended
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What is the causative organism for diptheria?
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corynebacteriam diptheriae
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What is the route of admin for diptheria (D or d)?
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IM suspension
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What are the AE of the diptheria vaccine?
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injection site reaction
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What type of vaccine is diptheria?
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toxoid
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What is the causative organism for tetanus (T)?
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clostridium tetani
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What type of vaccine is tetanus?
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-toxoid
-toxoid absorbed (preferred) |
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What is the route of administration of tetanus (t or T)?
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IM
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What are the AE of tetanus?
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injections ite reaction, fever, malaise, aches, and pains
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What is the causative organism of pertussis?
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bordatella pertussis
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What is the route of administration of pertussis?
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IM
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What is the benefits of the acellular form of pertussis (aP)?
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decrease in inconsolable crying in infants and other AE
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What are the AEs of the pertussis vaccine?
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injection site reactions, fever, seizure, persistant crying, hypotonic hyporesponsive episodes
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What are CI to the pertussis vaccine?
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encephalopathy without known cause after 7 days of vaccination
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What is the route of administration of Hep B?
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IM
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What vaccine is available for Hep B?
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hepatitis B surface antigen (HBsAG)
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What factrs are associated with lack of an immune response to Hep B vaccine?
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age >50
increased BMI male *hemodialysis and immunocompromised patients have lower response rates and require higher doses |
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What should be added to HBsAg if giving for postexposure prophylaxis?
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HbIg
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What AE are associated with HBsAg?
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fever, diarrhea, vomiting, injection site reaction
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Who should recieve the Hib vaccine?
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-all infants and children < 2 year
-not for children > 5 |
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What is the route of administration for haemophilus influenza vaccines (Hib)?
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-IM
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What products are available for vaccination against Hib?
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-HibTITER, OmniHIB = series of 3 doses, may sub 1 titer with TriHiBit
-PedvaxHIB, Comvax = 2 dose series plus booster -TriHiBit = (Dtap-Hib) booster in children > 12 months |
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when is the Hib vaccine used in adults?
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-sickle cell disease
-HIV -leukemia -asplenia |
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What are the AE of HIb vaccines?
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injection site reaction, fever, diarrhea, vomiting
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How is MMR administered?
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SC
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What are contraindications to MMR?
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-pregnancy
hx of sever hypersensitivity -reaction to Neomycin -immunocompromised |
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What interactions can occur with the measels vaccine?
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-wait at least 30 days for live vaccines not given concominantly
-may suppress positive TB test for up to 6 months |
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Where is the measels vaccine derived from?
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chick embryo fibroblasts
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Where is the mumps vaccine derived from?
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chick embryo cultures
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What are AE to the mumps vaccine?
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stinging at injection site, rash, itching
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What is another name for rubella?
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german measels
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What can occur if a pregnant woman is infected with rubella?
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-auditory, cardiac, and neurologic defects
-miscarraige -stillbirth |
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Where is the rubella vaccine derived?
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human cell culture
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What AEs are associated with the rubella vaccine?
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lymphadenopathy
rash urticaria fever malaise sore throat HA myalgias paresthesias of estremeties *usually occur 7-12 days post vaccination and last 1-5 days |
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What vaccine is available for polio?
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-IPV (inactivated polis virus)
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What is VAPP?
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-vaccine associated paralytic polio
-this is why the OPV is no longer available |
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What are CI to the polio vaccine?
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-hx of allerfy to streptomycin, polymixin B, and neomycin
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What AE are associated with the polio vaccine?
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injection site reaction
fever greater than 100.4 |
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What is the pneumococcal vaccine protective against?
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invasive S. pneumoniae
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What products are available for pneumococcal vaccine?
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-Prevnar (PCV7), primary immunization for children
-Pneumovax-23 (PPV23) |
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When is PPV23 used?
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-COPD
-DM -chronic CV dx -chronic liver dx -alcoholism -chronic renal failure -nephrotic syndrome -asplenia -immunosuppression -cochlear implants -CSF leaks -HIV -Alaska native -certain American Indian populations -residents of LTC facility -revaccination in 5 years if less than 65 at time of vaccination or if >65 and recieved >5 years ago |
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What AE are associated with the pneumococcal vaccine?
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-erythema
-swelling -fever -injection site reaction |
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What vaccine is available for varicella?
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Viravax - live attenuated
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What are the CI to Viravax?
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-pregnancy
-immunocompromised state -history of allergy to neomycin -persons recieving blood, plasma, or immune globulin products in the last 5 months |
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What are AE associated with varicella vaccine?
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-injection site reaction
-varicella like rash |
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What products are available against Hep A?
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-Havrix
-Vaqta |
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What is the route of admin for Viravax?
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SC
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What is the route of admin for Hep A vaccines?
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IM
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What are the CI to Hep A vaccine?
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hx of sever rxn to vaccin
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What are the AE associated with Hep A vaccine?
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injection site reactions
headaches |
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What products are available for vaccination against influenza?
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-trivalent inactivate (TIV) Fluzone
-line attenuated (LAIV)Flumist |
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What is the causative organism for measles?
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paramoxyvirus
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What is the route of admin for Flumist?
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IN
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What is the route of admin for Fluzone?
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SC
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Who should not recieve the flu vaccine?
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-pts with egg allergy
-pts with thimerosal hypersensitivity |
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What AE are associated with the flu vaccine?
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injection site reaction, local pain and swelling, fever, malaise, myalgias
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What is the causative organism for meningococcus?
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N. Meningitidis
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What serious reaction has been associated with Meonmune?
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Guillain-Barre Syndromw
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-What products are available for meningococcus vaccination?
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-Monomune MPSV4, polysaccharide
-Menactra MCV4, conjugate |
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What is the benefit to the Menactra (MCV4) meningococcal vaccine?
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-polysaccharides conjugated with diptheria toxoid
-longer immunity -more predictable response |
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AE of meningococcal vaccines
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-fever, injection sire reactions
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What is the route of admin for Menactra?
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IM
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what is the route of admin for Menommune?
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SC
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What product is available for vaccination against HPV?
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Gardasil
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What are the CI to Gardasil?
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pregnant
hypersensitive to yeast |
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What is the route of admin of Gardasil?
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IM
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What product is available for vaccination of herpes zoster?
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Zostavax
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What is the route of admin of Zostavax?
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SC
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When is Zostavax CI?
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-allergy to gelatin or neomycin
-hx of immunodeficiency states -pregnancy -children |
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After which age should the rotavirus vaccine not be started?
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12 weeks
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When is the rotavirus vaccine contraindicated?
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-severe illness with or without fever
-allergy to vaccine components -previous intussusception -current acute gastroenteritis |
