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Flashcards in Immunizations Deck (99):
0

What does the fed law req that all pts getting vaccines receive?

Most up-to-date version of the Vaccine Info Statement (VIS) b4 each vaccine is admin

1

What's active immunity?

Protection that's produced by the persons own immune system.

Active immunity is produced by fighting infection and receiving vaccination

2

What's passive immunity?

Protection produced by an animal or human and transferred to a human, usually by inj

This wanes w/in a few wks or months

3

What's the most common form of passive immunity?

Antibodies an infant receives from the mother

4

What's live attenuated vaccine?

Also called weakened vaccines are produced by modifying a dx-producing "wild" virus or bacterium in a lab.

They retain ability to replicate (grow) and produce immunity, but don't cause illnes

5

What's inactivated vaccine?

Can be composed of either whole viruses or bacteria or fractions of either

6

How long after giving vaccine should we wait b4 giving antibody?

2 wks

7

How long after giving antibody should we wait b4 giving vaccine? Exception?

Wait 3 months (may be up to 11 months) b4 giving vaccine

Zoster vaccine - not affected by circulating antibody

8

Advantages of simultaneous vaccine admin? CI to simultaneous vaccine admin?

Increases probability that the child will be fully immunized at the appropriate age

No! There are no CI

9

Which vaccines are non-simultaneous admin? How long do u wait btw admin?

Live parenteral (injected) vaccines e.g MMR, MMRV, varicella, zoster and yellow fever)

Separate by at least 4 wks from

Live Intranasal or influenza vaccine (LAIV)

10

Effect of increasing interval btw multi-dose vaccine?

It may delay more complete protection, but not effectiveness

11

Effect of decreasing interval btw multi-dose vaccine?

May interfere with antibody response and protection

12

When's a shorter dosing interval used for Multi-dose vaccines?

Following a high risk exposure

13

What's the preferred method to avoid a false negative response to the TB skin test?

Purified protein derivative (PPD) of tuberculin + live vaccines

14

If a live vaccine has been recently given, but not on the same day as the PPD, how long should u wait to avoid a false negative TB test result?

4 wks

15

List the categories that vaccine SEs or ADRs fall into?

Local

Systemic

Allergic

16

What're the most common type of ADRs that are local rxns?

Pain

Swelling

Redness at site of inj

17

What're the most common type of ADRs that are systemic rxns?

Generalized events and include

Fever,

Malaise

Myalgia (muscle pain)

Headache

Loss of appetite

18

When does systemic rxns typically occur!

Usually 7-12 days after vaccine (ie, after an incubation period of the vaccine virus))

19

What's Intranasal LAIV? Implication?

Cold adapted vaccine ie can replicate in cooler temp of upper airways (nose and throat), but not in the higher temp of the lower airways and lungs

Mild cold-like sx eg runny nose may occur

20

How can anaphylactic rxn be prevented?

By good screening prior to vaccination

21

What're the most common type of ADRs that are anaphylactic?

Mediated by IgE

S/sx:

Generalized urticaria (hives)
Swelling of the mouth and throat
Difficulty breathing
Wheezing
Abdominal cramping
Hypotension
Shock

22

Where should clinically significant AEs be reported to?

FDA vaccine adverse event reporting system (VAERS)

23

What must all providers that provide vaccine have?

Emergency protocols + supplies to treat anaphylaxis

24

What conditions are absolute CI to live vaccines?

Pregnancy

Immunosuppression

25

What's a steroid-induced Immunosuppression?

Corticosteroids use of

20mg/ more per day of Prednisone

2mg/kg or more per day of Prednisone

26

What vaccine is indicated during pregnancy? When is the optimal time?

Tdap

Wk 27-36

27

List vaccinations for healthcare professionals

Hep B

Flu (influenza)

MMR

Varicella (chickenpox)

TdaP (tetanus, diphtheria, pertussis)

Meningococcal


28

T/F? Anaphylaxis after a previous dose of vaccine is a CI to the vaccine in the future?

T

29

What criteria should be used to determine if a pt can obtain inactivated influenza vaccine?

If a pt can eat lightly cooked eggs w/o a rxn

Or

If a pt experiences ONLY hives after eating egg-containing food

Admin vaccine and monitor pt for at least 30 min after admin

30

Which vaccines can provoke an allergic rxn in persons with an egg allergy?

Yellow fever

Rabies

31

Which vaccine is allergic rxn to egg no longer a consideration?

MMR

32

Which vaccine should not be given to any one with a true gelatin or neomycin allergy?

Varicella vaccines (Zostavax and Varivax)

MMR

33

Which vaccine is CI in streptomycin, Polymixin B and neomycin allergies?

Inactivated poliovirus vaccine (IPV)

34

In what population is DTaP recommended?

DTaP series given to children younger than 7 years of age
(6 wks to 6 yrs)

35

Brand name of HepA?

Havrix

Vaqta

36

Brand name of HepB?

Engerix-B

Recombivax HB

37

Brand name of HepA-HepB?

Twinrix

38

In what popu is Hep B (Engerix-B, Recombivax HB) recommended?

Health workers

MSMs

Anyone with multiple partners

IV drug users

ESRD

Chronic liver

39

Brand name of HPV2?

Cervarix (bivalent vaccine)

40

Brand name of HPV4?

Gardasil

41

When's the 3 dose series of HPV vaccine indicated for females?

Btw the age of 11-12 yrs, with catch up vaccination at age 13-26 yrs

Can begin at age 9 and ideally prior to sexual activity

42

When's the 3 dose series of HPV vaccine indicated for males?

9-26 yrs to reduce the likelihood of genial warts or anal cancers

43

What's the brand name of live attenuated influenza vaccine (LAIV)?

FluMist Quadrivalent

44

What's the brand name of inactivated influenza vaccine (IIV)?

Afluria

Fluarix

Fluarix Quadrivalent

FluLaval Quadrivalent

Flu iron

Fluzone

Fluzone Quadrivalent

Fluzone High-Dose

Fluzone Intradermal

Flucelvex

45

What's the brand name of RIV (egg-free flu vaccine)?

FluBlok

46

Which flu vaccine was licensed for adults >= 65yrs?

High-dose (Fluzone)

47

What vaccine is recommended for 18-64 yrs only?

Fluzone Intradermal

48

Which flu vaccine is Trivalent (3 strains) and Quadrivalent (4 strains)?

Fluzone

Fluarix

FluLaval

49

Which flu vaccine is Quadrivalent (4 strains) only?

FluMist

50

Which flu vaccine is completely egg free?

FluBlok (recombinant)

51

When does ACIP recommend the use of Afluria?

9 yrs and older

52

Which flu vaccine is given intradermally?

Fluzone

53

Brand name for 13-valent pneumococcal conjugate vaccine (PCV13)?

Prevnar 13

54

Brand name of 23-serotype polysaccharide vaccine (PPSV23)?

Pneumovax 23

55

When is single TdaP dose recommended?

7-10 yrs for those not fully vaccinated with DTaP series (missed dose in series)

56

What's TdaP used for?

1 time booster for ages 11-64 yrs with no previous record of TdaP, then 1 dose of Td Q10 yrs.

(TdaP x 1 dose; Td Q10yrs)

57

When should adults 65 yrs and older be given TdaP?

Those who haven't received TdaP previously + who have close contact with an infant ages 12 months of less

58

When during pregnancy is TdaP recommended?

27-36 wks

59

Brand name of varicella containing vaccine, VAR?

Varivax (chickenpox)

60

Brand name of varicella containing vaccine, ZOS?

Zostavax (herpes zoster/shingles)

61

How should adults receive varicella vaccine?

All adults w/o evidence of immunity to varicella should receive 2 doses of varicella vaccine at least 4 wks apart

62

Potency of Herpes zoster vaccination versus Varicella?

Herpes zoster vaccination- potency 14 times greater than varicella

63

Where should varicella containing vaccines be stored?

Freezer (all other vaccines are stored in refrigerator) + protect from light (store in original container)

64

Where do u store diluent of varicella containing vaccines?

Refrigerator or room temp

65

In which Grp of pts is live vaccine CI?

Immunocompromised

Pregnant

Expecting to be pregnant w/in 4 wks

Hypersensitivity to gelatin or neomycin

66

How do u give varicella containing vaccines?

Reconstituted

Given by SC

67

How do u give yellow fever?

Reconstituted

Given SC

68

If vaccine is to be reconstituted, where should diluent be stored?

Refrigerator or at room temp

69

How are most adult vaccine given?

IM

70

Which vaccine is given intradermally?

Fluzone Intradermal

71

Which vaccine is given SC only?

MMR, MMRV, Zostavax, Varivax

Menomune

72

Which vaccine is given SC or IM?

Pneumovax

Polio (IPV)

73

When does CDC recommend use of acetaminophen?

After immunization to treat pain and fever from vaccination (not recommended b4 or at vaccination)

74

Where should vaccines be stored in the refrigerator?

On shelves away from the wall

75

Where should vaccines not be stored in the refrigerator?

Door of freezer or refrigerator (temp there is unstable)

76

How often should refrigerator or freezer temp be checked?

At least twice each day (in the morning and before the end of the workday)

77

How long should u keep temp logs for?

At least 3 yrs

78

What's the site of IM injections?

In the deltoid muscle

79

What size of syringe should adults use?

1" syringe

(5/8" for persons < 130lbs or 11/2" for women > 200lbs/ men> 260lbs)

80

What's the relationship btw gauge and needle?

The HIGHER the gauge, the THINNER the needle

81

What's the site of SC injections?

Fatty tissue above the triceps with a 5/8", 23-25 gauge syringe at 45 degree angle

82

Which vaccines admin by pharmacists are SC only?

Varicella and Zoster (shingles)

83

Which vaccines admin by pharmacists are SC or IM?

Pneumococcal polysaccharide vaccine (PPSV23, Pneumovax)

84

Which pts can use flu nasal mist vaccine? (Live vaccine)

Healthy (no chronic dx)

Non-pregnant females

Males 2-49 yrs

85

Name the 2 broad types of Influenza viruses

Influenza A and B

86

Influenza A viruses are further categorized into subtypes based on what?

Surface antigens:,Hemagglutinin and Neuraminidse

87

Effect of hemagglutinin on infection?

Immunity to the surface antigens, particularly the hemagglutinin, reduces the likelihood of infection and severity of dx if infection occurs.

88

What's antigenic drift?

Freq dev of antigen variants thru antigenic drift is the virologic basis for seasonal epidemics and the reason for the usual incorporation of 1 or more new strains in each years flu vaccines

89

In what time period do the most dramatic antigenic changes or shifts occur?

Approximately every 30 yrs and can result in emergence of a novel influenza virus with the potential to cause a pandemic

90

How does the flu virus typically spread?

Person to person, primarily through respiratory droplet transmission

91

Characteristics of uncomplicated flu illness?

Abrupt onset of these sx:

Fever
Myalgia
Headache
Malaise
Non-productive cough
Sore throat
Rhinitis

92

How soon does uncomplicated flu illness typically resolve? What may linger?

3-7 days

Cough and malaise can persist for more than 2 wks

93

Which needle size is used for IM injections?

22-25 gauge, 1-11/2" needle

94

What angle do u admin IM injection?

90 degrees

95

Inj site for SC?

Fatty tissue over the triceps

96

Needle size used in SC inj?

23-25 gauge, 5/8" needle

97

Angle for SC inj?

45 degrees

98

If u have to give 2 SC inj, how do u space them out?

By a minimum of 1"

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