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Immunization program Flashcards

1
Q

What are the 13 immunizations that are under BUMEDINST 6230.15A?

A
  1. Anthrax
  2. Cholera
  3. HEP A
  4. HEP B
  5. JE
  6. MMR
  7. Meningococcal
  8. Plague
  9. Polio
  10. Rabies
  11. TDAP
  12. Typhoid
  13. Yellow Fever
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2
Q

Who sets the policy for implementing Anthrax vaccine immunization program?

A

DOD or USCG

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3
Q

Dosages for Anthrax:

A 
0.5ml IM @ 0
4 weeks
6 months
12 months
18 months 
Yearly boosters
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4
Q

Dosages for Cholera:

A

when required by host country, 0.5ml sub q/ IM

X6 months in highly endemic areas

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5
Q

Dosages for HEP A:

A

IM deltoid
Havrix (SmithKline Beecham)
Vaqta (Merck + company)

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6
Q

Dosages for Havrix:

A

1-18y/o 1st dose 720 el.u/0.5ml, booster720 el.u/0.5ml

19y/o and older 1st dose 1440 el.u/1.0ml
booster 6-12 months since 1st dose 1440 el.u/1.0ml

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7
Q

Dosages for Vaqta:

A

1-18y/o 1st dose 36 u/0.5ml, booster 25u/0.5ml 6-18 months after 1st dose

19y/o and older 1st dose 50u/1.0ml
booster 50u/1.0ml 6 months after 1st dose

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8
Q

Dosages for HEP B:

A

3 doses: 1st dose, 2nd at least 1 month, 3rd at least 5 (6 months from 1st dose)
*no max interval

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9
Q

When should immunity be checked for HEP B?

A

1-6months after 3rd dose

if failure to demonstrate protective level of anti-HBs f/u with possible further immunizations

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10
Q

Dosages for JE:

A

prior to going to endemic areas or have started series
3 doses 1.0ml sub q on days 0, 7, and 30
periodicity: every 3 years

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11
Q

Dosages for MMR:

A

live virus, all DOD/CIV

0.5ml sub q, one time only

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12
Q

What are the exceptions for administering MMR?

A

documented of 2 MMR doses
Serological immunity on MMR
Pregnant

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13
Q

How many days should women be advised to avoid of becoming pregnant?

A

28 days

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14
Q

Who is required to get HEP B?

A

high risk personnel, occupational exposure to blood, healthcare workers, all students in hospitals, persons in contact to sexually transmitted diseases, high-risk HEP B endemic areas

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15
Q

Dosages for meningococcal:

A

freeze dried, bacterial polysaccharides of serotypes

all AD traveling to endemic areas, 0.5ml sub q

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16
Q

Dosages for plague:

A

deploying to endemic areas,

  1. 0ml IM
  2. 2ml 1 month later
  3. 2ml 3-6 moths after 2nd dose
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17
Q

Dosages for polio:

A

inactivated poliovirus 0.5ml sub q

singled dose no booster

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18
Q

Dosages for rabies:

A

1.0ml IM human diploid cell on 0, 3, 7, & 14 days

Human rabies immune globulin (HRIG)

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19
Q

What are the species for consideration of post exposure prophylaxis (rabies vaccine)?

A

wild and tamed

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20
Q

What incident/circumstances is considered for administration of rabies vaccine?

A

provoked and unprovoked

bite, non bite (scratch/abrasion), exposure to saliva

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21
Q

Dosages for TDAP:

A

0.5ml IM all AD, every 10yrs

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22
Q

Dosages for typhoid:

A

overseas and deployed to endemic areas

0.5ml IM every 2yrs

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23
Q

Dosages for yellow fever:

A

live virus, all alert forces/AD traveling to endemic areas

0.5ml sub q every 10yrs

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24
Q

When should you discard yellow fever vaccine?

A

multi-dose vial after 1hr of reconstitution

25
How should you store yellow fever vaccine?
32-41F (0-5C)
26
What are the storage requirements for MMR?
46-58F, store in dark place, discard if not in use within 8hrs of reconstitution
27
What are the requirements for immunizations for members that deploy to an endemic area on very short notice?
administer 1st dose | make arrangements to complete series
28
Yellow fever immunization is required for Navy personnel assigned to units within how days of notification to deploy to yellow fever endemic areas?
10 days
29
Who is required to receive typhoid immunization?
alert forces: fleet units deployed scheduled or situational basis to foreign country
30
What are alert forces?
fleet units deployed scheduled or situational basis to foreign countries except Canada
31
What immunization is required for alert forces such as Navy + military sealift command + CIVMAR?
Typhoid
32
What immunization is required for medical department personnel assigned to Mobile Medical Augmentation Readiness Teams and others, including reservists subject to deploy? and within how many days of notification?
Typhoid | 10 days
33
What is required to be provided information regarding certain immunizations prior to receiving it?
VIS- Vaccine Information Sheet
34
When should you provide VIS?
Immediately before the immunization or days before
35
What will providers use to provide patients information regarding immunizations prior to receiving it?
VIS only
36
Who are VIS prepared by?
Dept. of Health and Human Services, CDC + Prevention
37
What should you check for prior to administering immunizations?
allergies and hypersensitivities
38
If patients are hypersensitive to eggs what vaccines should you not administer?
vaccines prepared by cultivation: Influenza Yellow Fever MMR (anaphylactic)
39
If a patient is Prego what is required prior to administering vaccines to include live vaccines?
if Prego exclude and refer to PCM ask females if pregnant, pregnancy test not required may administer live virus vaccines only if specified by provider, usually for traveling
40
When can Polio and yellow fever be administered to Prego patients?
when risks of contracting illness outweigh potential complications
41
What is the necessary equipment to treat anaphylactic shock?
``` O2 Administration apparatus Airways IV fluid apparatus Appropriate medications ACLS Defibrillator/cardiac monitor ```
42
In order to treat anaphylactic shock at an immunization site, what is required for a Physician, IDC, PA, Dentist, and Nurse to have?
BCLS required, ACLS preferred | May administer vaccine
43
Where should immunization clinics be located?
near ER or sickbay, or ready ambulance available with MTF Physician <10min away
44
Who selects members of the ACIP committee and what guidance do they use?
Secretary of Dept. of Hlth + Human Services | Under guidance to Ass. Secretary for Health + CDC Prevention on control of vax preventable diseases
45
What is the role for the Advisory Committee on Immunization Practices (ACIP)?
provide advice to reduce incidence of vaccine preventable diseases in the US and increase safe use
46
What is included in the ACIP written recommendations?
age for vaccine administration # of doses and dosing interval precautions + contraindications
47
When is it ok for Navy Immunization Programs to not follow recommendations from CDC and ACIP?
when there's a militarily relevant reason to do otherwise
48
What instruction governs immunizations not to be given while underway?
COMNAVSURFORINST 6000.1 Sec. 5606
49
Why are routine immunizations not given while underway?
may lead to anaphylactic reactions
50
When can immunizations be given when at sea or ashore?
@ discretion of MDR and concurrence of CO
51
Which immunization can only be conducted in port during normal working hours and concurrence of local ISIC / RSG/Group MO/ or presence of an MO?
Yellow fever
52
What are the provisions of medical exemptions for specific vaccines?
contraindication relevant to a specific vaccine may be temporary (up to 365 days)or permanent PCM grants exemption
53
What are some medical exemption examples? and what is immunity evidence based off of?
underlying health condition individuals clinical case is complex/not readily definable immunity is evidence based on serologic test + documented infection
54
What are some types of immunization administrative exemptions?
separation/retirement within 180days if not deployed or mission essential religious reason with CMD + medical/chaplain advice
55
What form is adult health record immunization record?
NAVMED 6230/4
56
What form is International Certificate of Vaccination?
PHS or CDC 731
57
What identifies and notifies personnel due for required/specific vaccinations?
IMMZ roster
58
Where do you record evidence of prior immunization or serological immunity for recruits?
NAVMED 6230/4 PHS 731 Electronic database

PREVMED TEST 3 (4 decks)

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