Immunizations

Question 1

What is active immunity?

Answer 1

protection produced by the person’s own immune system (usually permanent)

Question 2

What is passive immunity

Answer 2

protection transferred from another person or animal (temporary)

Question 3

What is a antigen?

Answer 3

a live or inactivated substance capable of producing an immune response

Question 4

What is a antibody?

Answer 4

protein molecules produced by B lymp to help eliminate an antigen

Question 5

What is most important in infancy?

Answer 5

transplacental passive immunity

Question 6

How do you get passive immunity

Answer 6

blood products
human antibody (immune globulin)
human hyperimmune globulin
heterologous hyperimmune serum (anti-toxin)

Question 7

What is a monoclonal antibody

Answer 7

antibody specific to a single antigen derived from single cell

Question 8

What are monoclonal antibodies used for?

Answer 8

diagnosis and therapy of certain cancers and autoimmune dx

Question 9

What antibody is used for prevention of RSV?

Answer 9

Palivizumab (Synagis)

Question 10

What type of antibody is Palivizumab?

Answer 10

monoclonal
contains RSV antibody
no interference w/ live virus vaccine

Question 11

Vaccine produce what type of immunity

Answer 11

active

Question 12

How does a vaccine relate and contrast with natural immunity

Answer 12

it gives a memory response similar to infection, WITHOUT risk of disease

Question 13

What are two types of live attenuated vaccines?

Answer 13

viral

bacteria

Question 14

What are the two classifications of vaccines

Answer 14

live attenuated

inactivated

Question 15

What are three forms of inactivated vaccines

Answer 15

whole
fractional (protein based)
polysaccharide-based

Question 16

What is a general rule of vaccines?

Answer 16

the more similar to the disease the better the immune response to the vaccine

Question 17

A live attenuated vaccine is what?

Answer 17

“weakened” form of the wild virus or bacterium

Question 18

A live attenuated vaccine usually requires

Answer 18

one dose

Question 19

What are some live viral attenuated vaccines?

Answer 19

measles
mumps
rubella
varicella zoster
yellow fever
rotavirus
intranasal influenza
rotavirus
vaccinia

Question 20

What are some live bacteria attenuated vaccine

Answer 20

BCG* (not available in US)

oral typhoid

Question 21

Which is more effective live or inactivated?

Answer 21

live

Question 22

How many doses are required for inactivated vaccines

Answer 22

3-5 doses

Question 23

With inactivated vaccines, antibody titers….

Answer 23

diminish with time

Question 24

What are whole cell viral inactivated vaccines

Answer 24

polio, hepatitis A, rabies, influenza (not in US)

Question 25

What are whole cell bacteria inactivated vaccines

Answer 25

pertussis, typhoid, cholera, plague

Question 26

What are fractional vaccines subunit

Answer 26

hep B, influenza, acellular pertussis, human papillomavirus, anthrax

Question 27

What are toxoid fractional vaccines

Answer 27

diphtheria, tetanus

Question 28

What are pure polysaccharide vaccines

Answer 28

pneumococcal meningococcal Salmonella Typhi (Vi)

Question 29

What are conjugate polysaccharide

Answer 29

haemophilus influenzae type b pneumococcal meningococcal

Question 30

pure polysaccharide vaccines are not consistent in whom

Answer 30

children younger than 2 yrs of age

Question 31

What is the general rule of inactivated and live vaccines

Answer 31

inactivated vaccines are NOT affected by circulating antibody Live are affected

Question 32

When it comes to antibodies and vaccines... when should vaccines be given

Answer 32

wait 2 weeks before giving antibody

Question 33

When it comes to antibodies and vaccines... when should antibody be given

Answer 33

wait 3 months or longer before giving vaccine

Question 34

What does RBC w/wo washed have

Answer 34

antibody content

Question 35

What is the general rule of admin vaccines

Answer 35

all vaccines can be admin at the same visit

Question 36

Two live injected vaccines should be given how far apart?

Answer 36

4 weeks

Question 37

Intranasal influenza vaccine should be given how far apart

Answer 37

4 weeks

Question 38

For asplenic children what two vaccines must be give 4 weeks apart

Answer 38

pneumococcal conjugate and Menactra brand meningococcal conjugate vaccines

Question 39

T/F interference can occur between two live vaccines given less than 28 days (4wks) apart?

Answer 39

TRUE

Question 40

If two live vaccines or live intranasal influenze is given less than 28dy apart what should be done

Answer 40

the second vaccine given should be repeated

Question 41

The only vaccines that can be given less than 28d apart is ?

Answer 41

yellow fever after measles vaccine

Question 42

T/F increasing the interval between multidose vaccines will interfere with its effectiveness?

Answer 42

FALSE

Question 43

Decreasing the interval between doses of multidose vaccine will interfere w/ protection

Answer 43

TRUE

Question 44

TWO RULES regarding admin of vaccines

Answer 44

1- shouldn't be given less than minimum intervals | 2- or earlier than minimum age

Question 45

The ACIP can valid a vaccine if it is

Answer 45

given up to 4 days before minimum requirements

Question 46

If given more the minimum requirements who might not accept it?

Answer 46

immunization programs or school entry requirements

Question 47

Is it necessary to add or restart series bc of extended intervals between doses

Answer 47

NO

Question 48

What causes adverse reactions?

Answer 48

effect caused by vaccine | side effect

Question 49

What causes adverse event

Answer 49

any event following vaccination may be true adv rxn or coincidental

Question 50

S/S of local adverse rxn to vaccine

Answer 50

pain, swelling, redness at site of injection | mild and self limited

Question 51

Adverse rxn are common with what vaccines

Answer 51

inactivated vaccines

Question 52

S/S of systemic adverse rxn to vaccine

Answer 52

fever, malaise, headache nonspecific unrelated to vaccine

Question 53

What must live attenuated vaccines do to produce immunity

Answer 53

replicate (mild) occurs 7-21dys after incubation period

Question 54

S/S of allergic adr to vaccine

Answer 54

vaccine or vaccine component rare risk minimized by screening

Question 55

Precaution to vaccines means?

Answer 55

a condition the person has that might increase adr or compromise ability of vaccine to produce immunity

Question 56

What are the 4 permanent contraindications to vaccination?

Answer 56

- severe allergic rxn - encephalopathy not due to another cause occurring 7 DAYS pertussis vaccination - Severe combined immunodeficiency - hx of intussusception

Question 57

allergy to component

Answer 57

contraindicated in both

Question 58

encephalopathy

Answer 58

contraindicated in both

Question 59

pregnancy

Answer 59

live contraindicated in women | inactivated if need except HPV

Question 60

immunosupression

Answer 60

live contraindicated | inactivated if need

Question 61

severe illness

Answer 61

precaution in both

Question 62

recent blood product

Answer 62

live precaution only MMR or varicella not zoster | inactivated if need

Question 63

Should live vaccines be given to pregnant women

Answer 63

NO

Question 64

Should HPV given to preggo?

Answer 64

no

Question 65

When should Tdap be admin to the preggos?

Answer 65

during late 2nd or third after 20wks IF NOT immediately after postpartum

Question 66

Should live vaccines be admin to immunosuppressed

Answer 66

NO

Question 67

Should inactivated vaccines be admin to immunosuppressed?

Answer 67

YES- but response might be decreased

Question 68

What is considered a immunosuppression disease

Answer 68

congenital immunodeficiency leukemia or lymphoma generalized malignancy

Question 69

What is considered a immunosuppression due to chemotherapy

Answer 69

alkylating agents antimetabolites radiation

Question 70

What Vaccines should be given to asymptomatic HIV/AIDS patients

Answer 70

Varicella MMR yellow fever consider

Question 71

What vaccines should NOT be given to asymptomatic HIV/AIDS patients

Answer 71

Zoster MMRV LAIV Rotavirus

Question 72

What vaccines should NOT be given to symptomatic HIV/AIDS patients

Answer 72

ALLL OF THEM!!!!!

Question 73

For HCT recipients when should vaccines be re-admin

Answer 73

6-12mo post transplant

Question 74

What are HCT recipients at an increased risk for?

Answer 74

pneumococcal disease

Question 75

When should Stem cell transplant ppl be re-admin

Answer 75

inactivated influenza = 6mo inactivated DTap/Td, IPV, hep b Hib, PCV, PPV = 12m MMR and varicella = 24m

Question 76

Healthy household contacts of immunosuppressed persons should

Answer 76

receive MMR and Varicella and annual flu

Question 77

What are not good reasons to get a vaccine?

Answer 77

Mild illness Antimicrobial therapy Disease exposure or convalescence Pregnant or immunosuppressed person in the household Breastfeeding Preterm birth Allergy to products not present in vaccine or allergy that is not anaphylactic Family history of adverse events- only your vaccination accounts Tuberculin skin testing

Question 78

Should vaccines be admin during a acute illness?

Answer 78

Yes, but best to delay until after improvement