Immunization

Question 1

What is the schedule for the DTaP-IPV-Hib vaccine in infants and children?

Answer 1

Dose at 2, 4, 6, and 18 months.

Question 2

What is the schedule for the pneumococcal conjugate 13 valent vaccine (Pneu-C-13) in infants and children?

Answer 2

Dose at 2, 4, and 12 months

Question 3

What is the schedule for the rotavirus vaccine in infants and children?

Answer 3

Dose at 2 and 4 months

Question 4

What is the schedule of the MMRV vaccine

Answer 4

Dose at 12 months and 2nd dose at 4-6 years

Question 5

What is the schedule of the meningococcal C conjugate (Men-C-C) vaccine

Answer 5

One dose at 12 months

Question 6

Schedule of the Tdap-IPV vaccine in infants and children

Answer 6

one dose at 4-6 years

Question 7

Adults need a dose of what vaccine every 10 years?

Answer 7

Tetanus & diphtheria (Td) vaccine

Question 8

Adults who have not received a pertussis containing vaccine in adulthood need a single dose of what vaccine

Answer 8

Tetanus, diphtheria, pertussis (Tdap) vaccine

Question 9

What vaccine is given as a single dose in grade 4 (after receiving one at 12 months)

Answer 9

Meningococcal C conjugate (Men-C-C) vaccine

Question 10

What vaccines are given as 2 doses in grade 6?

Answer 10

Hep B vaccine
HPV vaccine (boys and girls)

Question 11

What vaccine is given in 2 doses to boys born between 2002-2004 at age 14-16

Answer 11

HPV vaccine

Question 12

When is Tdap vaccine in school immunization schedule?

Answer 12

14-16 years old, one dose

Question 13

Flu shot should be given to everyone, but what populations should especially get it?

Answer 13

Seniors >65y
Children 6m-59m
Chronic illnesses
HCPs and first responders
Residents of long-term care homes
Pregnant women
Aboriginals
Severely overweight
Or if determined by HCP

Question 14

Who should be given a pneumococcal shot (PPV23)? (one dose for most adults)

Answer 14

>65y
Long term care home
CSF leak
Cochlear implants
Cardiac/pulmonary disease
Diabetes
Kidney or liver disease
Sickle cell/ other hemoglobinopathies
Immunodeficiencies
Asplenia
HIB
Transplant
Neurological condition
Leukemia/lymphoma
Nephrotic syndrome
Homeless
Illlicit drug users

Question 15

Who should be given a second dose of pneumococcal vaccine after 5 years?

Answer 15

Highest risk of invasive pneumococcal disease:
Asplenia
Sickle cell
Hepatic cirrhosis
Chronic renal failure
Immunosuppression (disease or therapy)
HIV
Nephrotic syndrome

Question 16

What are the benefits of vaccines

Answer 16

The disease incidence drops

Question 17

What are the 3 types of vaccines?

Answer 17

Inactivated (killed)
Live attenuated
Purified/recombinant

Question 18

What are examples of inactivated vaccines?

Answer 18

Poliovirus (IPV)

Flu (influenza)

Question 19

What are examples of live-attenuated vaccines?

Answer 19

MMR
Varicella
Yellow fever
Oral Typhoid
Oral Cholera

Question 20

What are examples of purified/recombinant vaccines?

Answer 20

DTaP
Hib
HBV
Pneumococcal
Meningococcal

Question 21

What are characteristics of inactivated vaccine

Answer 21

Broad
Weaker immunity
Adverse effects to unwanted components

Question 22

What are characteristics of live attenuated virus

Answer 22

Broader

Stronger and longer immunity

Question 23

Characteristics of purified/recombinant vaccine

Answer 23

(protein, polysaccharide, or both)
Weaker immunity
Requires multiple dose`

Question 24

List the points about simultaneous administration

Answer 24

Use separate syringes at separate sites
Administer pneumococcal + influenza together when both indicated
Separate vaccine for same disease by >8 weeks
Live vaccines given on same day or separated by 4 weeks
MMR increases false negative tuberculin test (TB) - should be given same day, or delay TB test 4-6 weeks

Question 25

What are contraindications to inactivated vaccines?

Answer 25

Anaphylaxis/hypersensitivity to previous dose or any component Guillain-Barre syndrome within 6 weeks of receiving vaccine Immunosuppressive therapy - may need to delay 1-3 months after finishing therapy

Question 26

What are contraindications to live vaccines?

Answer 26

``` Anaphylaxis LAIV - severe asthma or severe wheezing in 7 days prior to vaccine Rotavirus - malformmations of GI tract Guillain barre Immunosuppressive therapy Pregnancy Active TB ```

Question 27

What are the (3) systems for surveillance of vaccine-associated adverse effects?

Answer 27

Pre marketing: phase 1, 2, and 3 clinical studies. Passive reporting to provincial health authority (PHAC) Active reporting through Immunization Monitoring Program ACTive (IMPACT)

Question 28

What are the limitations of population-based epidemiologic studies (ad hoc) linking vaccines to conditions like autism and MS?

Answer 28

Exposure is not random Biased, confounded results Temporal associations Attributable risk

Question 29

What are cohort studies?

Answer 29

Compare adverse event rate in immunized vs. non-immunized

Question 30

What are case-control studies?

Answer 30

Compare population of cases with adverse event and controls without adverse event who were exposed to vaccine

Question 31

What are the common local adverse effects of vaccines?

Answer 31

Soreness Swelling Redness

Question 32

What are the common systemic adverse effects of vaccines?

Answer 32

``` Tiredness Irritability GI Fever Seizures ```

Question 33

What are the common allergic adverse effects of vaccines?

Answer 33

``` Urticaria Angioedema Rhinitis Bronchospasm Anaphylaxis (hypotension) ```

Question 34

What are the principles of effectively communicating about immunization?

Answer 34

Communicate current knowledge Respect difference of opinion about immunization Represent the risks and benefits of vaccines fairly and openly Adopt a patient-centered approach Make the most of each opportunity to present clear, evidence-based messages regarding vaccinations