Flashcards in Peds Immunizations Deck (22)
What is herd immunity?
-the ability of a community to resist epidemic dz.
Not every persons in a population has to be immunized in order for a community to be resistant to an epidemic dz.
Unvaccinated individuals are indirectly protected by vaccinated individuals.
What are the two types of immunization?
-how long until immunity achieved?
-provides long or short term immunity?
-active: when either live, toxoid, or killed Ag is administered and the body makes its own abys against it.
--meaningful immunity is not achieved until 2-4weeks post vaccination. Provides long term immunity.
-administration of preformed abys (immunglobulins). Results in immediate immunity & is short term.
Give 2 examples of times where passive immunity is used.
Mother HBsAg +, hepatitis B immune globulin is given within 12hrs of birth. (they also get active immunity too, hep B vaccine)
Palivizumab is a RSV immune globulin that is administered to children who are at risk for severe RSV.
What are the 4 live vaccines? Who can we not give live vaccines to?
MMR, Varicella, Zoster (shingles), Nasal-spray flu vaccine, (rotavirus?)
Cannot give live vaccines to infants younger than 12mos and immunocompromised patients (pregnant, older individuals, poor controlled DM, any chronic dz)
What are the common side effects of most vaccines?
-local rxn at site of injection (redness, hematoma)
*may give tylenol after vaccine for pain and fever.
Serum Sickness-Like Rxn
-pathogenesis poorly understood, though pt experiences a non-immune complex mediated rxn to the immunization causing them to feel under the weather.
What are the true vaccine CI?
-previous anaphylactic rxn to a vaccine- avoid revaccination
-hx of anaphylaxis to eggs of egg protein: avoid measles, mumps, influenza, yellow-fever
-previous anaphylaxis rxn to neomycin or streptomycin: avoid MMR
-Hx of severe systemic rxn to the choelra, typhoid or plague vaccine: avoid revaccination of these.
-adults who are immunocompromised as a result of dz or its tx: avoild live vurses
-household members of immunocompromised pts:avoid oral polio
-pregnant women- avoid all live viruses
T/F: it is NOT a CI to administer a vaccine in a patient with MILD resp., intestinal, or flu-like illness, low-grade fever, or hx of recent illness.
T/F: mild/moderate local rxn (tender, red, swelling @ injection site) are NOT a CI to subsequent vaccination?
True & True.
-birth (w/in 12hrs if
HBsAg +, also get hep B immunoglobulin)
Pneumococcal Conjugate Vaccine
-leading cause of what infections worldwide?
aka: PCV13 or Prevnar13
leading cause of pneumonia worldwide and a principal cause of sepsis and meningitis under that age of 2.
Haemophilus influenzae type B (HIB)
-leading cause of which childhood infections?
-not routinely given to children age 5 and older, why?
was leading cause of childhood meningitis, pneumonia, epiglottitis
-Not given to children 5yrs and older b/c they have probably already had it or been exposed to it and have developed immunity to it.
Polio Vaccine (IPV)
*booster at 11-12years if 5 years since last dose
*every ten years thereafter.
-what happens if you miss the vaccine window ?
-associated with increased risk of ?
aka: rotateq(3doses), rotarix (2 dose only)
-6mo (only for rotateq)
if missed vaccine window dont bother getting it, they've probably already had the dz.
Increased risk of intussesception
-how long to develop immunity?
-annually ages 6mo to 18years
*children 6 mo to 8 years require 2 doses (separated by at least 4 wks) for 1st time vaccine.
-2wks to develop immunity
Hep A Vaccine:
-12mo (cannot give less than 1 yr)
-12mo (MUST be exactly 12 mo)
-begin at ages 11-12years, as early as 9 years.
--3 doses; O mo, 2 mo, 6mo apart.
What are the Combo vaccines ?
DTaP, DT, Tdap, Td
Pediarix (DTaP + Hep B + IPV) -2,4,6mo
Twinrix (Hep A + Hep B) only pts greater than 18yrs
Comvax (Hib + Hep B)
TriHIBit (DTaP + Hib) *only used as 4th dose.