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Flashcards in Vaccine Deck (18):
0

Why the first released Rotavirus vaccine was removed from the market?

Because of the reports of intussusception occurring in infants within three weeks of vaccination.

1

Varicella vaccine

Is a live vaccine
Is contraindicated during pregnancy

2

Pneumococcal Polysaccharide Vaccine PPV23

Is not effective in children less than 2 years of age
Indications:
- 2 yo or older with chronic pulmonary disease, CV disease
- >65
- for smokers, asthma, DM

3

Pneumococcal Conjugated Vaccine - PVC13 is given to infant as a series of 4 doses

PVC13 is given to infant as a series of 4 doses:
At 2, 4 6 m, and 12 -15 m

4

Adults 65 or older,

- Shoulder receive a dose of PCV 13 first, followed 6-12 months later by a dose of PPSV23.
- If had PPSV23 first, receiving PCV13 at least 1 year after the PPSV23.

5

Live virus vaccines including?

1. MMR
2. Varicella virus
3. Smallpox
4. Yellow fever
5. OPV (not used in US)
6. Shingles
7. Oral typhoid (recombinant)
8. LAIV (Live Attenuated Intranasal Influenza Vaccine)

6

Rabies post-exposure prophylaxis

- 1 dose of immune globulin on day 0 (inject around wound if possible)
- 4 doses of rabies vaccine on day 0, 3, 7 and 14

Those who have been previously vaccinated or are receiving pre-exposure vaccination for rabies should receive only 2 doses of vaccine

7

Live attenuated vaccines

1. Weakened viral or bacterial agents
2. Replicates to produce immune response
3. Often effective with only one or two doses
4. Circulating antibody may blunt the responses
5. Vaccine potency may be unstable
6. Reversion to wild type (eg., polio) may occur and cause disease
7. May be given simultaneously with other live vaccines, but if not, should wait at least 4 weeks

8

Inactivated vaccines

1. Sub classified into whole cell or fractional
2. Not a live agent, therefore cannot replicate or cause disease
3. Usually require three or more doses for response
4. Not affected by circulating antibody
5. Not generally as effective as live vaccines
6. Immunity wanes; booster required
7. May be given simultaneously or together in combination vaccines

9

Pure polysaccharide vaccine

Use complex carbohydrates from cell wall as antigen
- least immunogenicity
- T-cell independent
- No consistent response in children < 2
- No booster response

10

Conjugated polysaccharide vaccine

Combine with more antigenic molecules
- More immunogenic
- T-cell dependent
- Can use in younger-age children

11

Pertussis

Tx: azithromycin

12

Pertussis case control

1. Tx with azithromycin
2. Diagnosed symptomatic cases should be excluded from school or day care until five days on antibiotics or 21 days untreated.
3. Household and other close contacts should also receive antibiotic chemo prophylaxis.
4. Under immunized close contacts under age 7 or over 10 should be vaccinated.

13

Live Attenuated Intranasal Influenza Vaccine (LAIV)

Indications:
Healthy person age 2-49
More immunogenic in school age children
Not indicated in:
- immunosuppressed
- pregnancy
- children on long-term ASS
- GBS

14

Meningococcal Conjugated Vaccine (MCV4)
- quadrivalent for seri group A, C, Y, W135
( no vaccine currently licensed for serogroup B)

- for person between 11-55 yo

15

Meningococcal Polysaccharide Vaccine (MPSV4)

If >55 yo, MPSV4 is the only option

16

Outbreaks of Meningococcal Disease

For adults close contact:
- chemophylaxis within 24 hrs of possible
- ciprofloxacin 500 mg once, or
- centric one 250mg once
- vaccination takes 7-10 days to be effective

17

Post exposure prophylaxis for rabies

- PEP is recommended in all persons exposed to rabies, regardless of previous immunization history.
- PEP of an immunized person consists of 2 doses of vaccine on day 0 and 3. HRIG is not needed
- PEP for an unimmunized person consists of both HRIG and 4 doses of vaccine
- in both cases the wound should be washed with soap and water immediately.