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NAPLEX COPY > Immunizations > Flashcards

Immunizations Flashcards

1
Q

What’s active immunity?

A

Protection that’s produced by the persons own immune system.

Active immunity is produced by fighting infection and receiving vaccination

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2
Q

What’s passive immunity?

A

Protection produced by an animal or human and transferred to a human, usually by inj

This wanes w/in a few wks or months

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3
Q

What’s the most common form of passive immunity?

A

Antibodies an infant receives from the mother

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4
Q

What’s live attenuated vaccine?

A

Also called weakened vaccines are produced by modifying a dx-producing “wild” virus or bacterium in a lab.

They retain ability to replicate (grow) and produce immunity, but don’t cause illnes

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5
Q

What’s inactivated vaccine?

A

Can be composed of either whole viruses or bacteria or fractions of either

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6
Q

How long after giving vaccine should we wait b4 giving antibody?

A

2 wks

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7
Q

How long after giving antibody should we wait b4 giving vaccine? Exception?

A

Wait 3 months (may be up to 11 months) b4 giving vaccine

Zoster vaccine - not affected by circulating antibody

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8
Q

Advantages of simultaneous vaccine admin? CI to simultaneous vaccine admin?

A

Increases probability that the child will be fully immunized at the appropriate age

No! There are no CI

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9
Q

Which vaccines are non-simultaneous admin? How long do u wait btw admin?

A

Live parenteral (injected) vaccines e.g MMR, MMRV, varicella, zoster and yellow fever)

Separate by at least 4 wks from

Live Intranasal or influenza vaccine (LAIV)

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10
Q

Effect of increasing interval btw multi-dose vaccine?

A

It may delay more complete protection, but not effectiveness

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11
Q

Effect of decreasing interval btw multi-dose vaccine?

A

May interfere with antibody response and protection

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12
Q

When’s a shorter dosing interval used for Multi-dose vaccines?

A

Following a high risk exposure

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13
Q

What’s the preferred method to avoid a false negative response to the TB skin test?

A

Purified protein derivative (PPD) of tuberculin + live vaccines

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14
Q

If a live vaccine has been recently given, but not on the same day as the PPD, how long should u wait to avoid a false negative TB test result?

A

4 wks

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15
Q

List the categories that vaccine SEs or ADRs fall into?

A

Local

Systemic

Allergic

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16
Q

What’re the most common type of ADRs that are local rxns?

A

Pain

Swelling

Redness at site of inj

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17
Q

What’re the most common type of ADRs that are systemic rxns?

A

Generalized events and include

Fever,

Malaise

Myalgia (muscle pain)

Headache

Loss of appetite

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18
Q

When does systemic rxns typically occur!

A

Usually 7-12 days after vaccine (ie, after an incubation period of the vaccine virus))

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19
Q

What’s Intranasal LAIV? Implication?

A

Cold adapted vaccine ie can replicate in cooler temp of upper airways (nose and throat), but not in the higher temp of the lower airways and lungs

Mild cold-like sx eg runny nose may occur

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20
Q

How can anaphylactic rxn be prevented?

A

By good screening prior to vaccination

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21
Q

What’re the most common type of ADRs that are anaphylactic?

A

Mediated by IgE

S/sx:

Generalized urticaria (hives)
Swelling of the mouth and throat
Difficulty breathing
Wheezing 
Abdominal cramping
Hypotension
Shock
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22
Q

Where should clinically significant AEs be reported to?

A

FDA vaccine adverse event reporting system (VAERS)

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23
Q

What must all providers that provide vaccine have?

A

Emergency protocols + supplies to treat anaphylaxis

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24
Q

What conditions are absolute CI to live vaccines?

A

Pregnancy

Immunosuppression

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25
Q

What’s a steroid-induced Immunosuppression?

A

Corticosteroids use of

20mg/ more per day of Prednisone

2mg/kg or more per day of Prednisone

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26
Q

What vaccine is indicated during pregnancy? When is the optimal time?

A

Tdap

Wk 27-36

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27
Q

List vaccinations for healthcare professionals

A

Hep B

Flu (influenza)

MMR

Varicella (chickenpox)

TdaP (tetanus, diphtheria, pertussis)

Meningococcal

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28
Q

T/F? Anaphylaxis after a previous dose of vaccine is a CI to the vaccine in the future?

A

T

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29
Q

What criteria should be used to determine if a pt can obtain inactivated influenza vaccine?

A

If a pt can eat lightly cooked eggs w/o a rxn

Or

If a pt experiences ONLY hives after eating egg-containing food

Admin vaccine and monitor pt for at least 30 min after admin

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30
Q

Which vaccines can provoke an allergic rxn in persons with an egg allergy?

A

Yellow fever

Rabies

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31
Q

Which vaccine is allergic rxn to egg no longer a consideration?

A

MMR

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32
Q

Which vaccine should not be given to any one with a true gelatin or neomycin allergy?

A

Varicella vaccines (Zostavax and Varivax)

MMR

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33
Q

Which vaccine is CI in streptomycin, Polymixin B and neomycin allergies?

A

Inactivated poliovirus vaccine (IPV)

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34
Q

In what population is DTaP recommended?

A

DTaP series given to children younger than 7 years of age

6 wks to 6 yrs

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35
Q

Brand name of HepA?

A

Havrix

Vaqta

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36
Q

Brand name of HepB?

A

Engerix-B

Recombivax HB

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37
Q

Brand name of HepA-HepB?

A

Twinrix

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38
Q

In what popu is Hep B (Engerix-B, Recombivax HB) recommended?

A

Health workers

MSMs

Anyone with multiple partners

IV drug users

ESRD

Chronic liver

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39
Q

Brand name of HPV2?

A

Cervarix (bivalent vaccine)

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40
Q

Brand name of HPV4?

A

Gardasil

41
Q

When’s the 3 dose series of HPV vaccine indicated for females?

A

Btw the age of 11-12 yrs, with catch up vaccination at age 13-26 yrs

Can begin at age 9 and ideally prior to sexual activity

42
Q

When’s the 3 dose series of HPV vaccine indicated for males?

A

9-26 yrs to reduce the likelihood of genial warts or anal cancers

43
Q

What’s the brand name of live attenuated influenza vaccine (LAIV)?

A

FluMist Quadrivalent

44
Q

What’s the brand name of inactivated influenza vaccine (IIV)?

A

Afluria

Fluarix

Fluarix Quadrivalent

FluLaval Quadrivalent

Flu iron

Fluzone

Fluzone Quadrivalent

Fluzone High-Dose

Fluzone Intradermal

Flucelvex

45
Q

What’s the brand name of RIV (egg-free flu vaccine)?

A

FluBlok

46
Q

Which flu vaccine was licensed for adults >= 65yrs?

A

High-dose (Fluzone)

47
Q

What vaccine is recommended for 18-64 yrs only?

A

Fluzone Intradermal

48
Q

Which flu vaccine is Trivalent (3 strains) and Quadrivalent (4 strains)?

A

Fluzone

Fluarix

FluLaval

49
Q

Which flu vaccine is Quadrivalent (4 strains) only?

A

FluMist

50
Q

Which flu vaccine is completely egg free?

A

FluBlok (recombinant)

51
Q

When does ACIP recommend the use of Afluria?

A

9 yrs and older

52
Q

Which flu vaccine is given intradermally?

A

Fluzone

53
Q

Brand name for 13-valent pneumococcal conjugate vaccine (PCV13)?

A

Prevnar 13

54
Q

Brand name of 23-serotype polysaccharide vaccine (PPSV23)?

A

Pneumovax 23

55
Q

When is single TdaP dose recommended?

A

7-10 yrs for those not fully vaccinated with DTaP series (missed dose in series)

56
Q

What’s TdaP used for?

A

1 time booster for ages 11-64 yrs with no previous record of TdaP, then 1 dose of Td Q10 yrs.

(TdaP x 1 dose; Td Q10yrs)

57
Q

When should adults 65 yrs and older be given TdaP?

A

Those who haven’t received TdaP previously + who have close contact with an infant ages 12 months of less

58
Q

When during pregnancy is TdaP recommended?

A

27-36 wks

59
Q

Brand name of varicella containing vaccine, VAR?

A

Varivax (chickenpox)

60
Q

Brand name of varicella containing vaccine, ZOS?

A

Zostavax (herpes zoster/shingles)

61
Q

How should adults receive varicella vaccine?

A

All adults w/o evidence of immunity to varicella should receive 2 doses of varicella vaccine at least 4 wks apart

62
Q

Potency of Herpes zoster vaccination versus Varicella?

A

Herpes zoster vaccination- potency 14 times greater than varicella

63
Q

Where should varicella containing vaccines be stored?

A

Freezer (all other vaccines are stored in refrigerator) + protect from light (store in original container)

64
Q

Where do u store diluent of varicella containing vaccines?

A

Refrigerator or room temp

65
Q

In which Grp of pts is live vaccine CI?

A

Immunocompromised

Pregnant

Expecting to be pregnant w/in 4 wks

Hypersensitivity to gelatin or neomycin

66
Q

How do u give varicella containing vaccines?

A

Reconstituted

Given by SC

67
Q

How do u give yellow fever?

A

Reconstituted

Given SC

68
Q

If vaccine is to be reconstituted, where should diluent be stored?

A

Refrigerator or at room temp

69
Q

How are most adult vaccine given?

A

IM

70
Q

Which vaccine is given intradermally?

A

Fluzone Intradermal

71
Q

Which vaccine is given SC only?

A

MMR, MMRV, Zostavax, Varivax

Menomune

72
Q

Which vaccine is given SC or IM?

A

Pneumovax

Polio (IPV)

73
Q

When does CDC recommend use of acetaminophen?

A

After immunization to treat pain and fever from vaccination (not recommended b4 or at vaccination)

74
Q

Where should vaccines be stored in the refrigerator?

A

On shelves away from the wall

75
Q

Where should vaccines not be stored in the refrigerator?

A

Door of freezer or refrigerator (temp there is unstable)

76
Q

How often should refrigerator or freezer temp be checked?

A

At least twice each day (in the morning and before the end of the workday)

77
Q

How long should u keep temp logs for?

A

At least 3 yrs

78
Q

What’s the site of IM injections?

A

In the deltoid muscle

79
Q

What size of syringe should adults use?

A

1” syringe

5/8” for persons < 130lbs or 11/2” for women > 200lbs/ men> 260lbs

80
Q

What’s the relationship btw gauge and needle?

A

The HIGHER the gauge, the THINNER the needle

81
Q

What’s the site of SC injections?

A

Fatty tissue above the triceps with a 5/8”, 23-25 gauge syringe at 45 degree angle

82
Q

Which vaccines admin by pharmacists are SC only?

A

Varicella and Zoster (shingles)

83
Q

Which vaccines admin by pharmacists are SC or IM?

A

Pneumococcal polysaccharide vaccine (PPSV23, Pneumovax)

84
Q

Which pts can use flu nasal mist vaccine? (Live vaccine)

A

Healthy (no chronic dx)

Non-pregnant females

Males 2-49 yrs

85
Q

Name the 2 broad types of Influenza viruses

A

Influenza A and B

86
Q

Influenza A viruses are further categorized into subtypes based on what?

A

Surface antigens:,Hemagglutinin and Neuraminidse

87
Q

Effect of hemagglutinin on infection?

A

Immunity to the surface antigens, particularly the hemagglutinin, reduces the likelihood of infection and severity of dx if infection occurs.

88
Q

What’s antigenic drift?

A

Freq dev of antigen variants thru antigenic drift is the virologic basis for seasonal epidemics and the reason for the usual incorporation of 1 or more new strains in each years flu vaccines

89
Q

In what time period do the most dramatic antigenic changes or shifts occur?

A

Approximately every 30 yrs and can result in emergence of a novel influenza virus with the potential to cause a pandemic

90
Q

How does the flu virus typically spread?

A

Person to person, primarily through respiratory droplet transmission

91
Q

Characteristics of uncomplicated flu illness?

A

Abrupt onset of these sx:

Fever
Myalgia
Headache
Malaise
Non-productive cough
Sore throat
Rhinitis
92
Q

How soon does uncomplicated flu illness typically resolve? What may linger?

A

3-7 days

Cough and malaise can persist for more than 2 wks

93
Q

Which needle size is used for IM injections?

A

22-25 gauge, 1-11/2” needle

94
Q

What angle do u admin IM injection?

A

90 degrees

95
Q

Inj site for SC?

A

Fatty tissue over the triceps

96
Q

Needle size used in SC inj?

A

23-25 gauge, 5/8” needle

97
Q

Angle for SC inj?

A

45 degrees

98
Q

If u have to give 2 SC inj, how do u space them out?

A

By a minimum of 1”

99
Q

What does the fed law req that all pts getting vaccines receive?

A

Most up-to-date version of the Vaccine Info Statement (VIS) b4 each vaccine is admin

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