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DipHIV > Vaccines > Flashcards

Vaccines Flashcards

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1
Q

At what CD4 count is there an increased risk of vaccine-associated disease with replicating vaccines?

A

<200

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2
Q

What is the recommended time for spacing between administration of replicating vaccines?

A

4 weeks

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3
Q

If blood products are or have been administered when can replicating vaccines be given?

A

FOURTEEN days before transfusion
or
THREE months after

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4
Q

What impact does CD4 have on the response to non-replicating vaccines?

A

REDUCED response

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5
Q

What impact does vaccination have on viral load?

A

transient INCREASE

no clinical significance

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6
Q

Which type of vaccines can be given in pregnancy?

A

NON-REPLICATING

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7
Q

What organism causes ANTHRAX?

A

Bacillus anthracis

Gram positive bacterium

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8
Q

How is ANTHRAX acquired?

A

Handling of infected herbivorous animals live or dead

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9
Q

When is ANTHRAX vaccine recommended for PLWHIV?

A

if significant risk of anthrax exposure

  • occupational
  • member of ministry of defence
  • as part of post exposure prophylaxis
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10
Q

What is the recommended ANTHRAX vaccine regimen?

A

FOUR doses + BOOSTER
0, 3, 6 WEEKS
SIX months
ANNUAL booster

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11
Q

What organism causes CHOLERA?

A

Vibrio cholerae
Non-invasive toxin secreting
Gram negative bacterium

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12
Q

How is the CHOLERA vaccine administered?

A

ORAL

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13
Q

What is the recommended CHOLERA vaccine regimen?

A

TWO doses oral
1 week apart
+
single BOOSTER

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14
Q

When is CHOLERA vaccine recommended for PLWHIV?

A

if significant risk of cholera exposure and unable to take adequate precautions

  • assisting in disaster relief
  • visiting remote areas
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15
Q

What organism causes DIPHTHERIA?

A

Corynebacterium diphtheriae or ulcerans

Gram positive bacterium

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16
Q

What two other vaccines is diphtheria given in combination with?

A

TETANUS toxoid

Inactivated POLIO vaccine

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17
Q

What is the recommended DIPHTHERIA vaccine regimen?

A 
Combination diphtheria/tetanus/polio
THREE doses
1 month apart
then
TWO BOOSTERS 5 & 10 years
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18
Q

Vaccinated individuals who are then exposed to diphtheria what is the recommended post exposure prophylaxis?

A

Antibiotics
+
BOOSTER dose vaccine

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19
Q

What organism is HAEMOPHILUS INFLUENZAE SEROTYPE b?

A

Gram negative coccobacillus

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20
Q

When is Hib vaccine recommended for PLWHIV?

A

Asplenia
Splenic dysfunction
Complement deficiency

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21
Q

What is the recommended Hib vaccine regimen?

A

ONE dose

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22
Q

What is the recommended hepatitis A vaccine regimen for PLW HIV?

A

CD4 >350
TWO doses 0 & 6 months
CD4<350
THREE doses 0, 1 & 6 months

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23
Q

What difference does CD4 count make to hepatitis A vaccination schedule?

A

THREE doses if CD4<350, 2 doses if >350

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24
Q

If a PLWHIV has CD4<200 and requires urgent PRE-EXPOSURE prophylaxis to hepatitis A what should be given?

A

Human immunoglobulin
and
Vaccination

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25
What is the POST-EXPOSURE prophylaxis regimen for hepatitis A?
Vaccination within FOURTEEN days | if CD4 <200 add IMMUNOGLOBULIN
26
What is the recommended regimen for HEPATITIS B vaccination?
``` FOUR doses 0, 1, 2 and 6 months Double dose ENGERIX 40mcg or Fendrix 20mcg ```
27
When can ultra-rapid hepatitis B vaccination be considered in PLW HIV?
CD4 >500
28
When should HBsAb be checked after hepatitis B vaccination?
4-8 weeks after last dose
29
If HBsAb is <10 after full course of vaccination what is the next step for PLW HIV?
THREE further doses DOUBLE dose 40mcg or Fendrix 20mcg
30
When should hepatitis B revaccination of non-responders be delayed?
If CD4<350, wait until increased
31
If HBsAb is 10-100 after full course of vaccination what is the next step for PLW HIV?
ONE further DOUBLE dose
32
Which PLW HIV are recommended to have HPV vaccine?
Unvaccinated - men + women aged up to 26 - MSM to 40 yrs - Women to 40 yrs
33
What is the recommended HPV vaccine course for PLW HIV?
THREE doses | 0, 1 and 6 months
34
What are the 3 types of INFLUENZA?
A, B, C
35
Which INFLUENZA types cause the most disease?
A and B
36
When is the INFLUENZA season in Northern hemisphere?
October to May
37
When is the INFLUENZA season in Southern hemisphere?
April to September
38
When is the INFLUENZA season in the tropics?
ALL year round
39
What are the two types of flu vaccine formulation used in the UK?
Inactivated and Live attenuated
40
How is the live attenuated flu vaccine administered and to whom?
INTRANASAL | to children
41
What allergy needs to be screened for before administering inactivated flu vaccine?
EGG allergy | vaccine cultured inside hen egg
42
When in the year is the optimum timing for flu vaccination?
September to November | benefit until March
43
Which flu vaccine type is recommended for PLWHIV?
QUADRIvalent
44
In which regions of the world can Japanese encephalitis virus occur?
South east Asia | Western pacific
45
What is the vaccination schedule for Japanese encephalitis?
TWO doses 1 month apart then BOOSTER 12 months
46
How might MEASLES present differently in people with advanced HIV?
No RASH | complications DELAYED up to several months from initial infection
47
What type of vaccine is the MMR?
replicating LIVE attenuated
48
What is the MMR vaccine schedule for ADULTS?
TWO doses | 1 month apart
49
What is contraindicated following the MMR vaccine?
PREGNANCY for 1 month
50
Who is the MMR contraindicated in?
Severe immunocompromised - CD4 <200 Pregnant
51
What is the post exposure prophylaxis for contact with MEASLES?
``` within THREE days CD4 >200 -check Measles IgG -if negative, give human normal IG CD4 <200 - give IG regardless of measles IgG ```
52
Which PLW HIV should be given the MMR?
IgG negative - CD4 >200 - established on ART
53
What is the recommendation for meningococcal vaccination in PLW HIV?
Follow national guidance - <25 years + never vaccinated - asplenia - travel risk
54
What is the MENINGOCOCCAL vaccine schedule?
TWO doses | 2 months apart
55
What THREE other vaccines is PERTUSSIS combined with?
DIPHTHERIA TETANUS POLIO
56
What is the recommendation for pertussis vaccination for PLW HIV?
National guidance - pregnant ONE dose
57
What TWO pneumococcal vaccines are used in the UK?
Pneumococcal polysaccharide vaccine (PPV) 23 and Pneumococcal protein-conjugated vaccine (PCV) 13
58
How many serotypes are covered with pneumococcal vaccine PCV 13?
THIRTEEN
59
What is the recommended pneumococcal vaccination schedule for PLW HIV?
SINGLE dose PCV-13 then PPV-23 as per national guidance (>65 years old)
60
Should pneumococcal vaccination be repeated?
NO | however should receive PPV23 when older
61
What is the recommended POLIO vaccination schedule for PLW HIV?
``` if never/uncertain vaccinated - THREE doses 1 month apart then TWO doses 5 & 10 years ```
62
Is rabies vaccine inactivated or live?
INACTIVATED
63
What is the RABIES vaccination schedule?
THREE doses | 0, 7 and 28 days
64
What is the RABIES post-exposure prophylaxis recommendation for PLW HIV?
No previous vaccine FIVE doses 0, 3, 7, 14, and 30 days (ie roughly double interval between each) and Immunoglobulin around bite site in select cases
65
At what CD4 count level might response to RABIES vaccine be reduced?
CD4 <500
66
What is the recommendation for people with CD4 <500 and receiving rabies vaccine?
Check serology 2-4 weeks after third dose | Ab<0.5 IU/mL offer BOOSTER (DOUBLE dose)
67
What is the TETANUS vaccination schedule?
``` FIVE doses total THREE 1 month apart then 5 & 10 years ```
68
What is post exposure prophylaxis for TETANUS?
Vaccination if >10 years since last dose | If high risk wound add immunoglobulin
69
What is the TICK-BORNE ENCEPHALITIS vaccination schedule?
THREE doses 0, 1 and 2 months then BOOSTER 9-12 months
70
What is the recommended vaccination schedule for SALMONELLA TYPHI (typhoid)?
NON REPLICATING ONE dose 2 weeks before risk
71
What is the recommendation for BCG vaccination in PLW HIV?
DO NOT give increased risk of local and systemic complications no clear benefit of vaccine
72
How is chickenpox spread?
RESPIRATORY or direct contact with skin LESIONS
73
What type of vaccine are the VARICELLA vaccines?
LIVE replicating vaccines
74
How many VARICELLA vaccines are there?
TWO | chicken pox and shingles
75
What are the UK national guidelines for SHINGLES vaccination?
Vaccinate >70 yrs old + immunocompetent
76
What is the recommendation for VARICELLA vaccination in PLW HIV?
``` If seropositive - NATIONAL age based shingles vaccine If seronegative + CD4>200 - TWO dose CHICKENPOX vaccine 3 months apart ```
77
Which group of PLW HIV are recommended to have YELLOW FEVER vaccination?
Travel to high risk country Age <60 CD4 >200
78
Why is YELLOW FEVER vaccine contraindicated in PLW HIV with CD4 <200 or age >60?
Higher risk of | VACCINE INDUCED NEUROLOGICAL DISEASE

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