Immunizations Flashcards
What is the difference between active and passive immunity?
Active: Protection produced by persons own immune system. Permanent. Surviving an infection or vaccination
Passive: Protection by antibody containing products of from passage from mom to baby, immunity usually weans over time
Which vaccines are live?
MMR, MMRV (MMR w/ varicella), varicella, zostavax, yellow fever, flumist, rotavirus, cholera, Vivotif
Polysaccharide vaccines should not be given to? Why?
Infants and young children because their immune system isnt fully developed yet and these vaccines do not provide effective immune response in children < 2 YO
Live vaccines and antibody products can diminish immune response but is most concerning for MMR and varicella. How far apart should you separate these?
If you give the vaccine, wait 2 weeks before giving AB products.
If you give AB, wait 3-11 months before giving live vaccine
Consult the pink book.
Multiple live vaccines must be given on the same day or they must be spaced out by how many weeks?
4
All live vaccines except oral rotavirus
If a vaccine requires multiple dose series, can the intervals between doses be shortened or lengthened?
They can be lengthened but never shortened.
In patients with asplenia, Prevnar and Menactra should be separated by how many weeks?
4
Live vaccines can interfere with the tuberculin skin test (false negative). What can be done to prevent this interference?
Administer the live vaccine on the same day as the PPD skin test
What are the 3 types of adverse reactions to vaccines?
Explain them
Local: Pain, swelling, redness at site (80%) -mild, self limited
Systemic: Fever, malaise, muscle pain
Allergic: Anaphylaxis, this is why we screen
What are the 2 biggest contraindications to live vaccines?
Pregnancy and immunosuppression
What dose of prednisone is considered immunosuppressed and thus shouldn’t receive vaccination?
Systemic steroids equivalent to prednisone 20mg/day for 14 days or longer
Which vaccines are contraindicated in HIV patients with CD4 count < 200?
MMR and varicella
Which vaccines are recommended during pregnancy?
Seasonal influenza, TDAP (3rd trimester), live vaccines are contraindicated
Which vaccines are recommended in asplenia?
HiB, prevnar then pneumovax, menactra/menveo + bexsero/trumemba
Which form of Tdap is given to children under the age of 7? When should it be given?
DTaP x 5 doses: 2, 4, 6, 12-18 months and 4-6 years, then Tdap x 1 at 11-12 years
When should HiB be given?
As part of routine childhood vaccination and to adults after splenectomy
Hep A and B vaccine schedule?
3 dose series given at 0, 1, and 6 months
Who should Gardasil-9 be given to?
Females 9-26 (ideally before sexual activity) ages 11-12 recommended
Males 9-26 (ages 11-21 and up to 26 recommended in HIV and men-men sex)
Regimens: If started before age 15 - 2 doses (0 and 6-12 mos)
If started after age 15 - 3 doses (0, 1-2, 6 mos)
How is influenza virus spread?
Person to person through respiratory droplets
Who is recommended to receive flu vaccine?
> 6 months unless there is contraindication
Flu vaccine recommendations for patients age 6 months-8 YO who have never been vaccinated?
2 doses, 4 weeks apart
What flu vaccine can patients with egg allergy recive?
FluBlok, only if they are over 18 YO
Which 2 flu vaccines are recommended for age >65?
Fluad (adjuvanted influenza) Fluzone HD
What is the difference between tri and quad valent flu vaccines?
Trivalent: 2 a strains, 1 b strain
Quad: 2 A, 2 B strains
