Immunizations

Question 1

Zoster:

Answer 1

Single dose ≧ 60 years of age

*must have had chickenpox perviously

Contraindicated in Pregnancy

Prevents: Neuralgia, scarring, ocular abnormalities

Question 2

ADRs for “Varicella”

Answer 2

**Do not give salicylates for 5 weeks: Risk of Reye’s Syndrome

**Maculopapular rash 5-26 days after vaccination; usually only 2-5 lesions.

Question 3

Varicella: Post-Exposure prophaysis

Answer 3

Vaccine - 90% effective if administered within 3-5 days

Varicella Zoster immunogloblin (VZIG)

Question 4

Varicella: Combination

Answer 4

MMR + V or MMRV

higher risk of febrile seizures

Question 5

Measels Mumps Rubella (MMR)

Answer 5

Given at ≧ 12 months

Live Vaccine

No evidence of MMR with Autimsm

Question 6

MMR why?

Answer 6

Measles: Upper respiratory and neruologic

Mumps: sterilization of adult male

Rubella: taratogenic disease

Question 7

Meningococcal: Contraindications

Answer 7

Allergy to any component of the vaccine including diptheria and tetanus toxid

Question 8

Special indications: Meningococcal

Requires Booster q 5years

Answer 8

Asplenia

Sickle cell

Microbiologists??

Question 9

Meningococcal: AE

Answer 9

GBS (rare)- higher in adolescent males

Syncope

Question 10

Meningococcal: Preventes

Answer 10

Menigotilus infections

Question 11

Meningococcal: Adminstration

Answer 11

ages ≧ 2 mo to 10 years if at risk

first dose at 11-12 years then booster at age 16

one dose if given at 12-18

can catch up dose at 19-21

Question 12

Human Papillomavirus Vaccine (HPV):

Contraindications

Answer 12

Allergy to any component of the vaccine

Immediate hypersensitivy response to yeast

HPV2 vaccine - latex allergy

Question 13

HPV: AE

Answer 13

rare: Gullian-Barre Syndrome (GBS)-Thromboembolic disorder w/other risk factors

Common: HA, N, local rxn, Synocope–Patient must sit or lie down for 15 minutes.

Question 14

HPV: Dosing - Administration Schedule

Answer 14

3 doses between 9 - 26 years:

between 1st and 2nd -> 1-2 months ( mim, interval 4 wks)
between 2nd and 3rd- 12 wks
between 1st and 34d –> 6 months

Question 15

Should women with HPV still recieve vaccine?

Answer 15

Yes, if already infect there are still other stains which the patient can catch.

Question 16

HPV4

Answer 16

Gardasil: all 4 types: 6,11,16,18

Question 17

Types 6,11 associated with?

Answer 17

Genital Warts

Question 18

Tyeps 16 and 18 associated with?

Answer 18

Vaginal, cervical, and penile cancers (leisons)

Question 19

HPV2 - Bivalent vaccine

Answer 19

Cervarix: 16,18

Only approved for woemn

Question 20

HPV- 9

Answer 20

Covers 9 strians

approved for males 9-15

females 9-26

Question 21

HPV: indications

Answer 21

All females at 11-12 yrs up to 26

Males: Recommend 11-12 years
Immunize all males 13-21 years

May immunized 22-26 years

Question 22

Why immunize Pneumococcal?

Answer 22

bacterial disease not only causes pneumonia.

Symptomatic: Septicemia, and meningitis
non-invasive: pneumonia, sinus infections, otitis media

Incident greatest in adults > 65 years

Question 23

Pneumococcal Vaccines:

Answer 23

Conjugate -> PCV-13

Polysaccharide - > PPSV23

Question 24

Pneumococcal indications: children

Answer 24

4 doses of PCV-13 if < 2 years

one dose if PCV-13 if < 5 years and did not recive first series

PCV13 + PPSV23:

Patients with anatomical functional asplenia including patient with sickle cell disease.**

CSF Leak**

Cochlear implants***

Question 25

Pneumococcal indications: Adults

Answer 25

1 dose each at age ≧ 65 PCV13 -recommended if immuncompormeed PPSV23 - recommended in all adults ≧ 65

Question 26

Pneumococcal: Special populations

Answer 26

PPSV23 + Booster: all immunocomporomised PCV13 + PPSV23: CSF leak, cochler implants PCV13 + PPSV23+ booster: Sickle cell, ESRD, aslenia, nephrotic syndrome

Question 27

Pneumococcal: Timing

Answer 27

if both indicated: PCV-13 first then PPSV23 ≧ 8 weeks later Do not administer both at same visit if already received PPSV23 must wait 1 year to get PCV13 If patient require revaccination with PPSV23 the second dose is administered 5 year after first

Question 28

What immunize Diptheria, Tentanus, pertussis vaccines?

Answer 28

D: Myocarditis, neuritis , death T: Muscle ridgity P: whooping cough, asfriction

Question 29

DTP: Capital letter

Answer 29

Higher dose for vaccination

Question 30

DTP: lower case letter

Answer 30

lower for boosters

Question 31

DTP: DTaP

Answer 31

Children < 7 years

Question 32

DTP: DT

Answer 32

< 7 years with contraincicattion to pertussis component

Question 33

DTP: Td

Answer 33

People ≧ 7 years, decrease AE

Question 34

DTP: Tdap

Answer 34

booster=> also givin in 3rd trimester Adminster on dose of Tdap in adolescetn 11 or 12 years of age. Boostrix for ≧10 years (good for people passed 64 years) Adacel for ages 11-64 years - backup

Question 35

Tdap dosing schedule

Answer 35

one time for all adults

Question 36

Tdap dosing: pregnacy

Answer 36

one dose in each pregnancy (preferred 27-36 weeks of gestation) -regardless of interval

Question 37

Interval: Tdap

Answer 37

Tdap can be given at any interval to Td dose

Question 38

DTP: AE

Answer 38

common: rxn on site 3-5% fever Pertussis (rare) : high fever, febrile seizure, hypotonic hypo-responsive episode, persistant cry spells, encephalopathy with 7 days of vaccine

Question 39

DTP: contraincation

Answer 39

Severe allergy to components Encophalophaty within 7 days of vaccine of Pertussis vaccine (rare)

Question 40

DTP: precaustions

Answer 40

uncontolled seizures (pertussis) Chaning neruologi condtions

Question 41

LIve Atteunated vaccines Mr.V.Z Mapsy"

Answer 41

Replicate normal infectoins ``` Measles/Mumps/Rubella Rotavirus oral Oral typhoid capsules Varicella(chicken pox) Herpes Zoster (shingles) Yellow fever ```

Question 42

Recumbivent influenza: RIV3

Answer 42

Flublok approved 18-64 years

Question 43

High dose influenza vaccinee

Answer 43

Fluozone ≧ 65 yr

Question 44

Live Attenuated Vaccine (LAIV)

Answer 44

Flu Mist Cold adapted vaccine Intranasel

Question 45

Inactivated and Live influenza: Adult and Children ≧ 9

Answer 45

one dose

Question 46

Inactivated and Live influenza: Childern < 9

Answer 46

use two doses the first year who have not been vaccinated in past, given 4 wks apart

Question 47

IIV

Answer 47

inactivated

Question 48

LAIV

Answer 48

Live

Question 49

IIV influenza: Route

Answer 49

IM

Question 50

LAIV influenza: Route

Answer 50

Intranasal

Question 51

IIV influenza: age

Answer 51

≧ 6 months

Question 52

LAIV influenza: age

Answer 52

2-49 years

Question 53

IIV influenza: contraIND

Answer 53

- -Egg Allergy (See section on Egg Allergy) | - History of Guillain­Barré Syndrome (GBS)

Question 54

LAIV influenza: contraIND

Answer 54

--Egg Allergy (See section on Egg Allergy) - History of Guillain­Barré Syndrome (GBS High risk condition Children receving asprin pregnant women, immunosuppreed

Question 55

Egg allergy

Answer 55

O