Immunization Flashcards by Mikayla Sroda

What is immunization?

renders a person protected from an infectious disease

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how does immunity happen naturally? how does it work?

exposure to the disease once, giving the immune system a memory of the disease

on second exposure, the adaptive immune system elicits a faster, stronger rxn

don’t become clinically ill

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What are the two ways to provide immunity?

passively

- actively

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What is passive immunity?

the transfer of active humoral immunity (ready made Ab) from one person to another

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what is an example of passive immunity involving infants?

maternal Ab transferred to fetus through placenta and breast feeding

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How can passive immunity be induced artificially?

with high levels of humor (or horse) Ab (IgG)w specific for a pathogen or toxin transferred to non-immune individuals

can be used to counteract the effects of a toxin

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when are 2 times passive immunity is used?

when there is a high risk of infection and insufficient time for the body to develop it’s own immune response
to reduce symptoms of ongoing or immunosuppressive disease

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what are the benefits of passive immunity?

faster than active

- protects during incubation period

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what are the cons of passive immunity?

short term solution
can get disease after IgG gone
not as effective as active

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How is disease specific IgG created?

prepared by exposing humans or animals to the disease and than harvesting the Ab they make in response to disease

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why is human IgG preferred to animal IgG?

less rxns

- lasts longer (3 wks)

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If you are using animal IgG what do you need to do before administering the dose?

test for hypersensitivity

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what animal causes the least amount of allergic rxns with passive immunizations?

rodents/mice

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What diseases do we have IgGs available for? Human (7) and horse (3).

Human: 
- Hep A
- Hep B
- Measles
- Rabies
- Rubella
- Varicella
- Tetanus 
Horse:
- botulism
- snake bite
- black widow

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What is active immunization?

introduction of immunity after exposure to an antigen

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How is active immunity achieved?

Through vaccines; Ab created by the recipient in response to vaccine and may be stored permanently

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How are active immunizations delivered?

series of injections over time

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T/F: everyone who receives a vaccine for the chicken pox will be immune?

F; not everyone who receives a vaccination is immune.

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What do vaccines usually contain?

agents that resemble disease-causing microorganisms

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What are vaccines usually made from (4 materials)?

weakened microbes
killed microbes
microbe toxins
microbe surface proteins

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What are the 3 different types of vaccines available today?

live attenuated
killed, inactivated
toxoids

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What materials do live attenuated vaccines?

weakened microbes

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How do live attenuated vaccines work?

weakened microbes replicated after administration to induce an immune response

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What type of materials do viral vaccines usually use?

live viruses that have been chemically modified to decrease its virulence

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how does chemically modifying live viruses benefit administration of live attenuated vaccinations?

doesn't cause serious disease in healthy immune systems

Benefits of live attenuated vaccines?

- good response | - 1-2 doses for lifetime immunity

what live attenuated vaccine do we have to administer annually?

the flu vaccine

Who should not receive live attenuated vaccines?

Immunocompromised: pt that can't tolerate even a mild form of the disease

What is the downside of live attenuated vaccines?

1. can revert to more pathologic form and cause disease 2. most contraindications 3. pt can shed live virus after vaccine 4. most S/E

List 5 types of live attenuated vaccines.

- intranasal influenza - small pox (not since '72) - Measles, mumps, rubella (MMRII) - varicella vaccine - varicella-zoster vaccine

how are killed, inactivated vaccines made?

by inactivating, or killing, the virus during the process of making the vaccine

are killed, inactivated vaccines made from whole bacteria/viruses or fractional antigenic components?

both

what are fractional, killed, inactivated vaccines made from?

protein or polysaccharides

what are the disadvantages of killed vaccines?

- higher dose than live | - multiple doses needed to build & maintain immunity

what are the advantages of killed vaccines?

can't cause disease and are not contagious

What are conjugate vaccines?

sugar (polysaccharides) + protein of bacterium

what are examples of killed vaccines? (10)

- Tetanus, diptheria (Td) - Tetanus, diptheria, acellular pertussis (Tdap) - HPV - influenza - pneumococcal - hep A - hep B - hep A/B - meningococcal - flu

why are polysaccharides important for conjugate vaccines?

necessary to elicit t-cell response; help immune system develop response

what are examples of conjugate vaccines?

- Pneumovax 23 (pneumococcal conjugated) - many strains used - Prevnar (protein conjugated)

why shouldn't children

- coating disguises Ag - hard to recognize Ag - won't develop immune response to it

what conjugated vaccine can you use with kids under 2 for pneumococcal immunity?

prevnar

Compare prevnar to pneumovax.

prevnar - can use w. kids under two - fewer strands (13)

What are toxoid vaccines?

prevent disease caused by bacteria that produce toxins

how are toxoid vaccines created?

toxins of bacteria are weakened

what metal helps to prolong absorption of toxoids?

aluminum; prolongs exposure to immune system and increases its response

what are examples of toxoid vaccines?

- tetanus | - diphtheria

how are vaccines administered?

- IM - SQ - PO - intradermally - intranasally

what is seroconversion? why is it used?

development of Ab in the blood that are measured after vaccination to see if immune; not all vaccines are successful

why isn't seroconversion used sometimes?

not all vaccines produce Ab to measure

how are vaccinations normally administered? why?

in a series; each one boosting memory and immune response

T/F if you miss a dose during a scheduled vaccination series you are less immune.

F; just give next dose at next appointment.

You should not give vaccinations early if you can avoid it. Why?

previous dose may not have had time to acquire memory, there by decreasing its efficiency

why are some vaccines combine in one dose?

to decrease number of injections

what are the S/E of vaccines?

- inflammation at injection site - malaise - fever - chills - HA - myalgia - febrile illness - seizures - anaphylaxis - somnolence

what s/e of live attenuated do the other vaccines not share?

possible development of mild case of disease vaccinating against

what are the contraindications of vaccinations?

- anaphylactic rxn - immunodeficiency - pregnancy - encephalopathy after Dtap

what vaccines commonly cause anaphylaxis due to containing neomycin?

- inactivated polio vaccine - MMR - varicella

what vaccines contain egg protein?

- MMR | - influenza

what vaccines should be avoided with immunodeficient patients?

live attenuated vaccines: - PO polio vaccine - MMR - varicella

What vaccines are especially avoided during pregnancy?

live attenuated vaccines - MMR - varicella - influenza

What vaccines are allowed during pregnancy?

- inactivated influenza - Tetanus-diphtheria (Td) - Tetanus-diphtheria-pertussus (Tdap)

when should tetanus-diphtheria (Td) vaccine be administered during pregnancy?

if unimmunized or booster due @ 0, 4, 6-9 months pregnant

when should tetanus-diphtheria- pertussus (Tdap) vaccine be administered during pregnancy?

if unionized to pertussis After 20 weeks gestation

when should Dtap and Tdap be held from patients?

if they developed encephalopathy within 7 days after administration of previous dose

What are some examples of when vaccinations are not contraindicated?

- mild to moderate local rxns - mild acute illness - during Abx use - prematurity - family Hx of adverse rxn - diarrhea - breast feeding

what is the national vaccine injury compensation act?

compensates individuals who undergo injury from vaccines

what is a requirement of healthcare providers, under the national vaccine injury compensation act?

must report all events requiring medical attention within 30 days of a vaccination only must describe injuries temporal relationship to vaccine

When do you give passive immunization?

- rapid response | - use when pt at risk for disease before normal vaccine would work

What are commonly given passive vaccinations?

- hep A - varicella - tetanus - rhogam

what is rhogam? what does it do and prevent?

passive IGIV immunization given to Rh - mother prevents Rh- mother from mounting an immune response to the Rh + child prevents hemolysis in the new born

when would you give a passive and active immunization?

- Rabies (due to severity) - infant born to Hep B+ mom - Tetanus (if never finished original series)

What should be done after passive immunization (IgG) is given?

F/U with vaccination because passive immunity is short term solution

Research says giving active and passive immunity at the same time may not be a great idea... why?

potential for Ag in vaccine to bind to Ab in passive immunity, decreasing immune response

T/F if you are giving a shot for active and passive immunity they should be done in the same location on the body.

F; give them at different parts of body

Are infants born to mother's with Hep B given a vaccine or IgG at birth?

both, they greatly reduce transmission

How many vaccines make up the original series for tetanus prophylaxis?

Pt presents with tetanus prone wound; their full vaccine series finished 15 years ago. How should you proceed?

Administed booster

Pt presents with tetanus prone wound; their full vaccine series finished 3 years ago. How should you proceed?

No further action needed

Pt presents with tetanus prone wound; the never finished their full vaccine series. How should you proceed?

Give complete series and immunoglobulin (active & passive) Toxins are produced within 5 days and it takes

Pt presents with clean wound; they can't remember if they finished their tetanus series. How should you proceed?

give complete series

Pt presents with clean wound; they finished their complete series of tetanus vaccinations 15 years ago. How should you proceed?

booster

Immunization Flashcards

(81 cards)