Immunizations

Question 1

VIS

Answer 1

Vaccine Information Statement

Question 2

Who prepares VISs?

Answer 2

CDC-Center for Disease Control

Question 3

T/F: Thimerosal is found in single-dose flu vaccines.

Answer 3

False

It is found in multidose vials (MDV)

Question 4

What groups may not want vaccines due to gelatin?

Answer 4

Muslims
Jews
7th day Adventists

Question 5

____ Immunity from the person’s own immune system that lasts a long time, often a lifetime

Answer 5

Active

Question 6

___ Immunity received from someone else that may decrease over time

Answer 6

Passive

Question 7

What patients may not have a good immune response after receiving a polysaccharide vaccine?

Answer 7

Patients less than 2 years

Question 8

What vaccines are LIVE?

Answer 8

Cholera
COZY IV RM
Intranasal influenza
MMR
Oral typhoid
Rotavirus
Varicella
Yellow fever
Zoster

Question 9

What is the interval between an antibody-containing product and MMR or varicella-containing vaccine?

Answer 9

A minimum of 3 months and up to 11 months

Question 10

How long are live vaccines withheld in children?

Answer 10

Until they are 12 months of age

Question 11

At what age is the hepatitis B vaccine series started for babies?

Answer 11

**at birth

Inactivated vaccines started at 2 months

Question 12

What is a potential problem with TST (Tuberculin Skin Test) and live vaccines?

Answer 12

Live vaccines can cause false negative

• -to reduce this risk,
• —-give live vaccine on SAME day as TST
• —-wait 4 weeks after live vaccine for TST
• —–administer skin test first, wait 48 hours to get result, then give vaccine

Question 13

What are the general rules for vaccine spacing and timing?

Answer 13

Generally, all vaccines can be given at the same time.

–multiple live vaccines can be given on same day, if not same day space 4 weeks apart

–if series requires >1 dose, intervals can be extended without restarting series, but generally can’t be shortened

• -MMR and varicella vaccine [not zoster] require separation from antibody-containing product:
  - vaccine THEN wait 2 weeks, then give antibody product
  - wait 3 months or longer, then vaccinate

–In patients with asplenia, Prevnar and Menactra should be separated by 4 weeks

Question 14

What are some examples of INVALID CI to vaccinations?

Answer 14

• mild acute illness [slight fever, mild diarrhea]
• current antimicrobial tx [exceptions: varicella, zoster, oral typhoid vc]
• previous local skin reaction
• allergies: bird feather, penicillin, products not in vaccine
• pregnancy [except LIVE vaccines]
• breastfeeding
• preterm birth
• recent TST Follow proper spacing for live vaccines
• Immunosuppressed person in household
• Recent exposure to disease
• convalescence family history to AE to vaccine

Question 15

Tdap Vaccination-Indication and Contraindication

Answer 15

Indication: Pertussis [protect newborns]
CI: encephalopathy not attributable to another cause within 7 days of receiving vaccine

Question 16

HBV vaccine Contraindication

Answer 16

hypersensitivity to yeast

Question 17

Flu vaccine-Contraindication

Answer 17

Live Attenuated Influenza Vaccine–LAIV

• severe egg allergy [anaphylaxis]
• use of ASA containing products in children/adolescents
• use of flu antivirals in the last 48 hours
• children age 2-4 with asthma or wheezing episode in last 12 months
• close contact with immunosuppressed person

Question 18

Shingrix-CI

Answer 18

pregnancy and lactation

Question 19

CI for varicella vaccine

Answer 19

history of anaphylaxis to gelatin or neomycin

Question 20

Rotavirus vaccine CI

Answer 20

history of intussusception

Question 21

Yellow fever vaccine CI

Answer 21

severe allergic reaction to eggsl