Lec #7 (Wk 2): Vaccinations (Clinician lec)

Question 1

What is the immunization schedule in the State of Qatar?

Answer 1

https://dohafmc.com/vaccinnation/

Question 2

What is the route of administration for most vaccines? Exceptions?

Answer 2

Most are given intramuscularly.
Varicella & MMR are given subcutaneously.
BCG (for tuberculosis) is given intradermally.

Question 3

what are the vaccine preventable diseases?

Answer 3

1- mumps
2- measles
3- rubella
4- polio (IPV vaccine)
5- meningococcal
6- pneumococcal
7- influenza
8- diphtheria
9- pertussis
10- tetanus
11- hepatitis A
12- Hepatitis B
13- human papilloma virus
14- varicella

both hepatitis conditions can cause jaundice.

Question 4

What is Human Papillomavirus?

Answer 4

This is a common virus most commonly seen in teenagers and people in their early 20s. It is the major cause of cervical cancer in women & genital warts in both males & females.

HPV Causes warts. And not all HPV puts u at risk of cervical cancer, only certain ones like HPV-16 & HPV-18.

Question 5

what is measles?

Answer 5

one of the most contagious viral diseases that it is so contagious that just being in the same room after a person w measles left, it can result in infection.
symptoms include:
- red, watery eyes
- runny nose with cough and sore throat
- rashes which usually start in the forehead.

(how to distinguish it from chickenpox? chickenpox doesn’t cause symptoms of sore throat, red eyes and all that).

Question 6

what bacteria causes pneumococcal disease & what are its long term complications?

Answer 6

streptococcus pneumoniae

brain damage & hearing loss.

Question 7

what is polio?

Answer 7

This is a virus that lives in an infected person’s throat & intestines.
in about 1% of cases, polio causes paralysis.

Question 8

what is rubella?

Answer 8

this is a virus spread through coughing and sneezing. in children it causes mild illnesses like fever, swollen glands, and a rash which lasts for 3 days. it rarely causes serious illness or complications BUT it is devastating to the baby if the pregnant woman contracts rubella.
it can lead to:
Miscarriage
Serious heart defects
Mental retardation
Loss of hearing & eyesight.

Question 9

Can we give live attenuated vaccines on the same day?

Answer 9

Yes, LAV must be given on the same day or at least 4 weeks apart.

Question 10

Give examples of:
- LAV
- Inactivated vaccine
- Subunit vaccine
- Toxoid

Answer 10

LAV:
- BCG (For tuberculosis)
- Measles
- Oral polio vaccine (OPV).

Inactived (killed antigen):
- Whole cell pertussis
- Inactivated polio virus (IPV)

Subunit:
- Acellular pertussis
- Haemophilus influenza type B (Hib).
- Pneumococcal
- Hepatitis B

Toxoid:
- Tetanus
- Diphtheria

Question 11

what are toxoids?

Answer 11

prepared by detoxifying the exotoxins of some bacteria rendering them antigenic but not pathogenic.
Adjuvants are used to increase the potency of vaccine.

live vaccines dont need adjuvants, only the inactivated ones do.

Question 12

when do we give Tdap & when for DTaP? What if the pregnant woman didn’t receive Tdap at 27-36 months?

Answer 12

Tdap –> at age 7 years or older & pregnant women.

DTaP –> below years.

If she didnt receive at 27-36 months, should receive a postpartum dose ASAP.

Question 13

what vaccines aren’t given beyond a specific age?

Answer 13

ROTA vaccine; beyond the age of 1 we don’t ever give it.

DTaP is only given to those below 7. 7 and above we give Tdap.

Haemophilus influenza type B; risk of getting this beyond the age of 5 is very low so no need to give to anyone or above the age of 5 even if they never got the vaccine for it in the first place.

Question 14

when is MMR vaccine given? Contraindications?

Answer 14

2 doses; 1 at 12 months and second at 18 months.

• Pregnancy
• Severe immunodeficiency.

Question 15

What is PCV for & why do we have diff numbers for it like PCV 13, PCV 15, & PCV 23?

Answer 15

Pneumococcal vaccine.
We still see pneumonia it hasn’t been eradicated since we have many different strains of pneumonia hence different numbers.

Question 16

What is the route of administration for BCG vaccine, and its contraindications?

Answer 16

BCG is a vaccine given at birth for tuberculosis.

Administrated intradermally.

Contraindications:
- Immunocompromised.
- Pregnancy.
- Past history of Tb.
- Got the vaccine before.
- A positive tuberculin test.
- A previous anaphylactic reaction to vaccine component.
- Acute illnesses with fever or systemic upset.

Whats unique about BCG is that causes adverse effects:
- Keloids
- If given subcutaneously instead of intradermally then it can cause a local infection.
- Abscess formation.
- Regional bone infection.

Question 17

who do we give the meningitis vaccine?

Answer 17

Those going to a country where meningitis is endemic or going to hajj and umrah, or college students.

Question 18

what does a defaulters schedule mean?

Answer 18

This is a schedule for people who failed to comply with the vaccine schedule.
By definition: infants or children from 3 months - 18 years who start vaccination late or have delayed vaccination for more than 1 month according to the national immunization schedule.

Some people they come to Qatar from abroad and forgot their immunization card there, or they do remember what vaccines their child got but don’t have the evidence for it, and finally some come when their child hits 5 bc their school is requesting it.

Question 19

what is the defaulters schedule?

Answer 19

Infants or children from 3 months - 18 years who start vaccination late or have delayed vaccination for more than 1 month according to the national immunization schedule.

MMR: 2 doses.

Varicella: 2 doses.

Hepatitis B: 3 doses.

Hepatitis A: 2 doses
between 12-24 months and above 24 months for those going to an endemic country.

Rotavirus: 2 doses before 6 months.

IPV/OPV: give 1-2 doses of IPV & 3-4 doses of OPV.

DTaP:
give 5 doses for those between 3 months-5 years.
Those between 5-7 years 3 doses.

Tdap:
1 dose above 7 years followed by 2 doses of Td if no doses or incomplete doses of DTaP before 7 years. Booster dose at 13-16 years.

Question 20

What is HPV & its risks?
Are there vaccines for it?

Answer 20

Human Papillomavirus is a sexually transmitted pathogen which can cause cervical cancer & anogenital warts in both males & females.

Yes 3 diff vaccines available.
before the age of 15, we give 2 doses. at or above 15 years, 3 doses.

Question 21

What is a contraindication which is common to all vaccines?

Answer 21

A previous anaphylactic reaction to that vaccine.

Question 22

what are the common conditions that people think is a contraindication for vaccination but isn’t acc a contraindication?

Answer 22

• Diarrhea
• Minor upper respiratory tract illnesses.
• Mild to moderate local reactions to a previous dose of vaccine.
• Taking antibiotics atm.
• Allergy to an antibiotic.
• History of non-anaphylactic reaction to eggs.
• Personal or family history of seizures.
• Family history of unexpected death.
• Family history of an adverse event after immunization.

Question 23

what are contraindications for Tdap or DTaP?

Answer 23

1- Got encephalopathy within 7 days of DTaP or Tdap.

2- Guillain-Barré syndrome within 6 weeks after a previous dose of tetanus toxoid containing vaccine.