Approach to Pediatric Immunizations

Question 1

What is a vaccine?

Answer 1

product that stimulates a person’s immune system to produce immunity to a specific disease & protect them from that disease

initiates the immunization process

Question 2

What is a vaccination?

Answer 2

starting the process of giving a vaccine into body that results in immunity

Question 3

How can you give a vaccine?

Answer 3

needle or nose

Question 4

What is immunity?

Answer 4

person is protected from getting a disease (via humor or cell immune system) by receiving a vaccine or previously having the disease

Question 5

What is immunization?

Answer 5

person is immune or resistant to a disease

Question 6

What are the 2 main benefits of vaccination?

Answer 6

individual immunity

herd immunity

Question 7

What is community immunity?

Answer 7

even people who are unvaccinated, they will be protected from a disease if a certain % of rest of population is vaccinated/immune to that disease

Question 8

How do disease outbreaks tend to occur?

Answer 8

community vaccination rates drop below threshold of herd immunity

people who do not get vaccinations tend to live together

Question 9

When do people receive the most vaccines?

Answer 9

in first 2 years of life (most vulnerable time period)

most concentrated series of vaccines

Question 10

What is a major reason for vaccination?

Answer 10

one of most cost-effective clinical preventive services

Question 11

What is active immunization?

Answer 11

when an antigen is administered to host

induces formation of antibodies (humoral) & cell-mediated immunity (T cells)

Question 12

What are the desirable features of an ideal immunogen?

Answer 12

complete prevention of disease

prevention of carrier state of disease

prolonged immunity w/ fewest immunizations

absence of toxicity

suitability for mass immunization (cheap & easy to give)

Question 13

Why is active immunization preferable to passive?

Answer 13

active immunization almost always lasts longer than passive

Question 14

What is passive immunization?

Answer 14

transfer of immunity to a host using pre-formed immunologic products (immunoglobulins or products of cellular immune system)

Question 15

When is passive immunization useful?

Answer 15

individuals unable to form ABs

prevent of disease post-exposure

treat of disease prevented by immunization (tetanus)

treatment for conditions when active immunization is unavailable or impractical (snake bite!)

Question 16

What are complications of human ABs?

Answer 16

transient hypotension & pruritis, occasional hypersensitivity rxn

Question 17

What are complications of animal ABs?

Answer 17

anaphylaxis b/c serum sickness

Question 18

What is required before using animal ABs?

Answer 18

must test for hypersensitivity to animal serum prior to administration

Question 19

How long do exog Abs last?

Answer 19

human IgG lasts 23 days & animal IgGs last 5-7days

Question 20

What are credible internet resources for vaccine information & recommendations?

Answer 20

CDC (cdc.gov)

Red Book

Question 21

What vaccine best stimulates immune responses?

Answer 21

vaccines w/ sub-unit antigens (w/ the parts that are the best stimulators)

Question 22

What are conj vaccines?

Answer 22

pathogens are surrounded by polysaccharide to increase immunogenic power

Question 23

What are live attenuated vaccines?

Answer 23

version of microbe weakened in lab

stronger mucosal immunity develops but may have some minor side effects

Question 24

What are contraindications of live attenuated vaccines?

Answer 24

person is immunocompromised OR if have received blood products in recent past (affects immunogenicity)

Question 25

What are inactivated/killed vaccines?

Answer 25

pathogen is killed but immunogenicity is retained

Question 26

What are inactivated toxin vaccines?

Answer 26

for diseases that are caused by toxin produced from bacteria toxin is inactivated but bacteria still stimulates immune response

Question 27

What 2 factors determine when a vaccine will be given?

Answer 27

when body's immune system will work best balanced w/ need to provide protection to infants & children @ earliest age possible

Question 28

When is the only time you would give a vaccine early?

Answer 28

only w/ a specific CDC mandate (if outbreak of disease)

Question 29

What is the vaccine protocol for influenza?

Answer 29

yearly vaccine (1 dose if over 9 & 2 doses for 6month-9yo) important for very young, very old & chronically ill pts

Question 30

What is the vaccine protocol for meningococcal vaccines?

Answer 30

2 conjugate vaccines that protect v 4 strains 2 non-conj vaccines that protect v strain B of meningitis

Question 31

When is a non-conj, 23 valent pneumococcal vaccine used?

Answer 31

for high risk pts w/ chronic lung disease, chronic cardiac/renal/liver disease, diabetes, immunocompromising conditions

Question 32

What is Hib vaccine used for?

Answer 32

Hib was leading cause of bactermia, meningitis & epiglottitis

Question 33

When is the HepB vaccine series started?

Answer 33

infections in newborn results in chronic carrier state

Question 34

What do HepB & HepA cause?

Answer 34

acute & chronic liver disease, hepatocellular carcinoma & death

Question 35

What is DTaP vaccine used for?

Answer 35

protects v diphtheria (causes respiratory obstruction) & whooping cough & tetanus

Question 36

What is tetanus?

Answer 36

causes severe muscle spasms provoked by neurotoxin that can progress to respiratory failure

Question 37

What is the type of polio vaccine used in US?

Answer 37

use of IPV in US b/c polio has mostly been eradicated

Question 38

What do the HPV vaccines protect against?

Answer 38

protect against 2 most common HPV types (16 & 18 that cause cervical cancer)

Question 39

What does the MMR & varicella vaccines protect against?

Answer 39

measles, mumps, rubella & varicella give 2 doses of both vaccines @ 12 months & 4-6yo (live virus) has largely caused decline in these diseases

Question 40

What is the risk assoc w/ the rotavirus vaccine?

Answer 40

live virus so small risk of intussusception vaccine requires 2 to 3 doses

Question 41

Why has there been a rise in measles?

Answer 41

resurgence due to globalization & vaccine hesitancy

Question 42

How do pockets of disease tend to develop?

Answer 42

globalization leads to people bringing disease to new area where those are under-vaccinated

Question 43

What is an endemic?

Answer 43

a disease occurs @ a predictable & constant rate in population

Question 44

What are the 4 myths about vaccines?

Answer 44

MMR causes autism people w/ egg allergy cannot get the flu vaccine vaccines cause the disease not getting immunizations decreases overall lifetime risk for child

Question 45

What is important about giving vaccines?

Answer 45

education!! risk of getting disease from going thru life is much greater than the risk of a vaccine