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NAPLEX 25 > Chapter 20: Immunization > Flashcards

Chapter 20: Immunization Flashcards

(115 cards)

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1
Q

What does the FDA approve regarding vaccines?

A

The indication for a vaccine based on demonstrated safety and efficacy

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2
Q

Who provides the recommendations for vaccine administration?

A

The Advisory Committee on Immunization Practices (ACIP)

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3
Q

Which organization approves ACIP recommendations?

A

The Centers for Disease Control and Prevention (CDC)

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4
Q

Where does the CDC publish ACIP recommendations?

A

In the CDC’s Morbidity and Mortality Weekly Report (MMWR) and The Pink Book

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5
Q

What are Vaccine Information Statements (VISs)?

A

Documents prepared by the CDC for each vaccine explaining benefits and risks for patients in simple words

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6
Q

What does federal law require regarding VISs?

A

A VIS must be handed to the patient (or parent) before vaccination

This ensures patients are informed about the vaccine they are receiving.

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7
Q

What is the medical term for antibody?

A

Immunoglobulin.

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8
Q

What happens when an antigen is detected in the body?

A

Antibodies are produced to provide immunity and destroy the antigen.

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9
Q

True or False: Active immunity can be developed through vaccine administration.

A

True

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10
Q

What is Active Immunity?

A

When a person’s own immune system creates antibodies in response to a vaccine or infection. Lasts a long time, often a lifetime.

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11
Q

What is Passive Immunity?

A

Received from someone else, such as receiving immunoglobulins (Ig) pooled from other people, or through transfer from a mother to baby.

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12
Q

What is Intravenous immunoglobulin (IVIG)?

A

Provides already made antibodies and can be used for quick immunity after exposure to an antigen.

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13
Q

What are Live attenuated vaccines?

A

Produced by modifying a disease-producing virus or bacterium, able to replicate and produce immunity but usually do not cause illness.

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14
Q

Live attenuated vaccines are contraindicated in which patients?

A
  • Immunocompromised
  • Pregnant
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15
Q

What are Inactivated vaccines composed of?

A

Either killed whole virus or bacterium, or fractions of either. Inactivated vaccines do not replicate but may require booster doses.

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16
Q

What is a potential drawback of inactivated vaccines?

A

Immunity resulting from an inactivated vaccine can diminish with time, requiring supplemental (booster) doses.

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17
Q

List live vaccines

A
  • MMR
  • Intranasal influenza
  • Cholera
  • Rotavirus
  • Oral Typhoid
  • Varicella
  • Yellow fever
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18
Q

At what age do polysaccharide vaccines fail to produce a strong immune response?

A

In children under 2 years of age.

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19
Q

How are polysaccharide molecules utilized in conjugate vaccines?

A

They are joined to carrier proteins

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20
Q

What is the effect of conjugation on the immune response in infants?

A

It increases the immune response

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21
Q

What is the effect of increasing the interval between doses of a vaccine given in a series?

A

It does not diminish the effectiveness of the vaccine after completion of the series, but may delay complete protection.

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22
Q

What happens if the interval between doses of a vaccine is decreased?

A

It can interfere with the antibody response and is generally avoided.

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23
Q

In what situation can the interval between doses of a vaccine be shortened?

A

For high-risk patients, such as immunocompromised patients.

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24
Q

What can interfere with live vaccine replication?

A

Antibodies in some blood and IVIG products.

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25
What is the separation interval between an antibody-containing product and a live vaccine?
3 -11 months.
26
What is the separation interval between a live vaccine and an antibody-containing product?
At least 2 weeks
27
What is the effect of maternal antibodies on an infant's response to live vaccines?
Maternal antibodies reduce the infant's response to live vaccines.
28
At what age are most live vaccines withheld from infants?
Most live vaccines are withheld until the child is 12 months of age.
29
What is the exception for live vaccines given to infants?
The live rotavirus vaccine is given to infants.
30
When can inactivated vaccines be given to infants?
Inactivated vaccines can be given at any time, started at two months old
31
Which inactivated vaccine is given at birth?
Hep B
32
What are the options to reduce the risk of a false negative TST result after a live vaccine?
1. Give the live vaccine on the same day as the TST. 2. Wait 4 weeks after the vaccine to preform TST 3. Administer the TST first, waith 24h the give the vaccine.
33
Fill in the blank: Multiple live vaccines can be given on the same day or spaced ______ apart.
4 weeks
34
What is the recommended spacing between a vaccine and an antibody-containing product?
* Vaccine → 2 weeks → antibody-containing product. * antibody-containing product → 3-11 months → Vaccine
35
What are the symptoms of a systemic adverse reaction to a vaccine?
allergic reactions, syncope, dizziness, or falls.
36
How long should a patient be monitored after vaccination?
At least 15 minutes
37
What should be done if a patient experiences adverse reactions after vaccination?
Report to the patient's healthcare provider and the FDA's Vaccine Adverse Event Reporting System (VAERS)
38
What are common local reactions to vaccines?
Pain, swelling, redness
39
When can mild systemic reactions occur after live vaccines?
3 - 21 days after the vaccine is given
40
What treatments are available for minor allergic reactions to vaccines?
Diphenhydramine or hydroxyzine
41
What is the onset time for anaphylactic reactions after vaccination?
30 - 60 minutes ## Footnote Anaphylactic reactions are IgE-mediated.
42
How many adult (0.3 mg) auto-injectors should be available at pharmacies?
At least three ## Footnote This ensures adequate supply for potential multiple doses.
43
How many doses of epinephrine may most adults require during anaphylaxis?
1 - 3 doses administered every 5 - 15 minutes.
44
What is a contraindication?
A condition that significantly increases the potential of a serious adverse reaction
45
Name two important contraindications to the use of live vaccines.
* Pregnancy * Immunosuppression
46
What is a contraindication to any subsequent doses of the same vaccine?
A severe or anaphylactic reaction following a vaccine dose
47
What is a precaution for all vaccines?
Moderate to severe illness
48
What is a contraindication for varicella vaccine?
Severe allergic reaction to gelatin or neomycin
49
What is a precaution for varicella vaccine?
Use of "cycloviors" 24hr before or 14 days after
50
What is a contraindication for yellow fever vaccine?
Severe allergic reaction to eggs or gelatin
51
What age group is indicated to receive COVID-19 and influenza vaccine?
All patients age >= 6 months
52
Which age group should receive 2 doses of COVID-19 vaccine?
age >= 65 yo
53
53
Who is indicated to receive 2 doses of influenza vaccine and how far apart?
Age < 8yo previously received only 1 dose in their lifetime. 2 doses should be separated by 4 weeks
54
RSV vaccine is indicated in:
* Older adults (60-74 yo at high risk or >75 yo) * Pregnant 32-36 weeks gestation during RSV season * Infants
55
Which RSV vaccine is approved for pregnant people?
Abrysvo only
56
How often should patients receive RSV vaccine?
only 1 lifetime dose
57
Which flu vaccine is contraindicated in pregnant patients?
FluMist
58
Which flu vaccines are preferred in older adults and can decrease flu-related hospitalization?
* Fluzone High Dose * Fluad * Flublok
59
Who is FluMist indicated for?
Only for healthy patients age 2-49 yo
60
How is FluMist given?
Given intranasally divided between two nostrils
61
How are inactivated flu vaccines given?
IM
62
Which flu vaccines are Egg-free?
* Flublok (18 yo and up) * Flucelvax
63
64
What are the available PCVs?
1. PCV15: Vaxneuvance 2. PCV20: Prevnar 20 3. PCV21: Capvaxive
65
What is the available PPSV?
PPSV23: Pneumovax
66
How are PCVs are given?
IM
67
How can PPSV23 be given?
IM or SC
68
What are the 2 PCVs approved for childres?
* PCV15 * PCV20
69
What adult population are indicated to receive pneumococcal vaccine?
1. Age 19-49 with risk condition 2. Age >= 50yo
70
What are the 3 regimen available for adults for pneumococcal vaccine?
1. PCV20 x 1 dose 2. PCV21 x 1 dose 3. PCV15 + PPSV23 (12 months later or 8weeks for immunocompromized)
71
At what age does Hep A vaccine given?
It's part of the routine childhood vaccine and it's given at 12 months (1 year)
72
Hep B vaccine brand names?
* Engerix-B * Heplisav-B * Recombivax-B
73
Hep A vaccine brand names?
* Havrix * Vaqta
74
Which vaccines are included in Pediarix?
* DTap * HepB * IPV
75
Patients with illicit drug use should receive (Hep A/Hep B)
Hep A
76
Patients with IV drug use and blood exposure should receive (Hep A/Hep B)
Hep B
77
What is the vaccine that covers both Hep A and Hep B vaccine?
Twinrix
78
79
Varicella vaccine should be should be administred within ____ after reconstitution.
30 Minutes
80
What is the population recommended to receive vaccine?
* All adults age >= 50 yo * age 19-49 who are immunocpmpromized
81
How many doses are Shingrix?
2 doses 2-6 months apart
82
How is Varivax given?
SC
83
How is Shingrix given?
IM
84
How is indicated to receive Tdap?
* All patients 11-12 yo * Booster every 10yrs * Pregnant ppl with each pregnancy * Close contant with infants * Wound ppx if more than 5 years
85
Tdap brand names?
* Adacel * Boostrix
86
MenACWY brand name
* MenQuadfi * Menveo
87
Who is indicated to receive MenACWY?
* All patients age 11-12 years and 16 years * Travel to endemic area * Lab workers * College students
88
89
Who is indicated to receive MenB?
High-risk patients only: * Asplenia or SCD * Lab workers * outbreaks * college students
90
Vaccine brand name that includes all MenABCWY?
Penbraya
91
Brand name for HPV?
Gardasil 9
92
Who is indicated to recommended to receive HPV?
* All patients age 9-26 yo (rec start 11-12 yo)
93
How many HPV doses is required if starting before 15 yo?
2 doses
94
How many HPV doses is required if starting after 15 yo?
3 doses
95
What condition requires Hib vaccine?
Asplenia
96
How is Rotavirus vaccine given?
Orally
97
What is the brand name for MMR+Varicella?
ProQuad
98
List vaccines recommended for older adults?
1. RSV 2. Shingrix 3. Pneumococcal 4. Influenza (annually) 5. Tdap (every 10 yrs)
99
What vaccines should be given at birth?
1. Hep B 2. RSV antibodies if mom didn't get the vaccine
100
What vaccines are given at 2 months old?
1. DTaP 2. Hib 3. Pneumococcal 4. IPV 5. Rotavirus
101
What vaccines are recommended at 1 year of age?
1. Hep A 2. MMR 3. Varicella
102
What vaccines are recommended for patients with SCD & asplenia?
* Hib * PCV * MenABCWY
103
What vaccines are recommended for immunocompromized patients?
1. PCV 2. Herpes zoster 3. If HIV: MenACWY and Hep A & B
104
What vaccines are given during pregnancy?
1. Flu 2. Tdap 3. RSV 32-36 weeks during RSV season (once only)
105
What vaccines are recommended in diabetes patients?
1. PCV 2. Hep B
106
What is the rabies vaccine regimen post-exposure for patients without previous vaccination?
4 doses plus 1 dose of rabies immune globulin with the first vaccine dose
107
What vaccine is given SC only?
Yellow fever
108
At what angle should IM injections be administered?
Inject at a 90-degree angle.
109
Where should IM injections be administered in adults?
Inject into the deltoid muscle above the level of the armpit and below the shoulder joint.
110
What is the recommended needle length for most adults according to ACIP guidelines?
A 1 inch needle is acceptable for most adults.
111
What needle length is recommended for males over 260 pounds or females over 200 pounds?
A 1.5 inch needle is recommended.
112
What length needle should be used for subcutaneous (SC) injections?
5/8" needle at a 45-degree angle.
113
Where should SC injections be administered in adults?
Inject into the fatty tissue over the triceps.
114
How long should the temperature record be kept?
3 years

NAPLEX 25 (33 decks)

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