Immunization

Question 1

What is a vaccine?

Answer 1

A suspension of antigen intended to produce protective immunity.

Question 2

What is a toxoid?

Answer 2

A modified toxin rendered non-toxic but still immunogenic.

Question 3

What is the function of an adjuvant?

Answer 3

Enhances immune response; e.g., aluminium salts.

Question 4

What is a live attenuated vaccine?

Answer 4

Live non-virulent microorganisms that retain their infectivity (multiply) and immunogenicity (antigenic) in the host

Question 5

What type of immunity do live vaccines confer?

Answer 5

Cellular and adaptive immunity; often lifelong.

Question 6

What is a killed vaccine?

Answer 6

Purified extracts incapable of replication, inducing short-term immunity.

Question 7

Which vaccines are live in Malaysia’s MOH schedule?

Answer 7

MMR, BCG, OPV.

Question 8

What is the preferred injection site for infants?

Answer 8

Anterolateral aspect of the thigh.

Question 9

What is the preferred injection site for adults?

Answer 9

Upper arm.

Question 10

What is the absolute contraindication to any vaccine?

Answer 10

Severe anaphylaxis to prior dose or vaccine component.

Question 11

Can mild illness with no fever delay vaccination?

Answer 11

No, it is not a contraindication.

Question 12

What is an absolute contraindication to live vaccines?

Answer 12

Immunosuppression, chemotherapy, pregnancy.

Question 13

Can topical steroids affect live vaccine administration?

Answer 13

No, not if used locally or for <2 weeks.

Question 14

What should be the interval between two live vaccines?

Answer 14

4 weeks if not given simultaneously.

Question 15

Is prematurity a contraindication for vaccination?

Answer 15

No, vaccinate according to schedule.

Question 16

What are side effects of BCG?

Answer 16

Local papule, ulcer, scar; rare adenitis.

Question 17

What is a rare complication of OPV?

Answer 17

Vaccine-associated paralytic polio.

Question 18

What is the common side effect of DPT?

Answer 18

Swelling, fever, and rarely encephalopathy.

Question 19

What is the interval for HPV doses?

Answer 19

0, 1, and 6 months.

Question 20

What is given to exposed immunocompromised children against measles?

Answer 20

HNIG 0.25-0.5 ml/kg.

Question 21

What to do if a child has no immunisation record?

Answer 21

Give BCG, HBV, DTaP-IPV-Hib, MMR at different sites.

Question 22

Should primary immunisation be restarted if delayed?

Answer 22

No, continue from the missed dose.

Question 23

Why was OPV replaced by IPV in Malaysia?

Answer 23

To prevent vaccine-induced paralytic polio.

Question 24

What are the contraindications for MMR?

Answer 24

Severe reaction to eggs or neomycin.

Question 25

What are BCG contraindications?

Answer 25

Symptomatic HIV infection.

Question 26

What is the timing of maternal IgG transfer?

Answer 26

After 36 weeks gestation.

Question 27

What are common side effects of rubella vaccine?

Answer 27

Rash, lymphadenopathy, arthralgia.

Question 28

When to use IPV instead of OPV?

Answer 28

In immunocompromised children and contacts.

Question 29

How to manage febrile seizure risk post-vaccination?

Answer 29

Give PCM prophylaxis every 4–6h for 48h.

Question 30

What is the preferred vaccine in asplenic patients?

Answer 30

Pneumococcal, meningococcal, Hib.

Question 31

What is the schedule for hepatitis B in newborns of positive mothers?

Answer 31

HBV vaccine and HBIG within 12–48h.

Question 32

Is breastfed status a contraindication?

Answer 32

No.

Question 33

Can MMR be given with other vaccines?

Answer 33

Yes, at different sites or combined.

Question 34

Can a child with eczema be vaccinated?

Answer 34

Yes, avoid injection in affected area.

Question 35

What is a conjugate vaccine?

Answer 35

A vaccine linked to a protein to enhance immunogenicity.

Question 36

What is Hib vaccine used for?

Answer 36

Prevention of Haemophilus influenzae type B infection.

Question 37

What is the route for rotavirus vaccine?

Answer 37

Oral.

Question 38

What is the role of cold chain?

Answer 38

Maintains vaccine efficacy from production to administration.

Question 39

What vaccine leaves a scar?

Answer 39

BCG.

Question 40

What is given post-splenectomy for lifelong protection?

Answer 40

Penicillin prophylaxis.

Question 41

What is SSPE and which vaccine prevents it?

Answer 41

Subacute sclerosing panencephalitis; measles vaccine.

Question 42

What is a common post-MMR symptom?

Answer 42

Fever or rash 5–10 days post-vaccination.

Question 43

What is the preferred schedule if OPV was given <4 weeks ago?

Answer 43

Delay other live vaccines by 4 weeks.

Question 44

Can a breastfeeding mother affect infant vaccination?

Answer 44

No, breastfeeding does not interfere.

Question 45

Why is measles given at 6 months in Sabah?

Answer 45

Due to high incidence.

Question 46

Which vaccine uses intradermal injection?

Answer 46

BCG.

Question 47

What is the site for BCG injection?

Answer 47

Left deltoid area.

Question 48

What is the minimal interval between vaccine doses?

Answer 48

1 month.

Question 49

Can vaccines be administered during minor infections?

Answer 49

Yes, if no systemic symptoms.