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Vaccines Flashcards

Immunizations + Travel vaccines (77 cards)

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1
Q

FDA vs ACIP vs CDC

A

FDA - approves indication
ACIP - provides recommendations
CDC - approves ACIP recommendations and publishes them in the MMWR & pink book

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2
Q

Live-attenuated vaccines are contraindicated in..

A

Immunocompromised
Pregnancy

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3
Q

Common Live Vaccines

A

MMR
Intranasal influenza
Cholera
Rotavirus
Oral Typhoid
Varicella
Yellow fever
MICRO-VY

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4
Q

Polysaccharide vaccines

A

Do NOT produce a good response in children under 2 yrs

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5
Q

Conjugate vaccines & infants

A

Increases immune response in infants

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6
Q

Live vaccines & age

A

Most live vaccines withheld until 12 months of age
EXCEPTION: rotavirus

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7
Q

Inactivated vaccines & age

A

Started when babies are 2 months old
EXCEPTION: Hep B vaccine (given at birth)

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8
Q

Live vaccines and TB skin test: effect

A

Can cause a false negative

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9
Q

Ways to reduce risk of Live vaccines causing false negative on TB skin test

A
  1. Give live vaccine same day as the TST
  2. Wait 4 weeks after live vaccine
  3. Administer the TST first, wait 2-3 days to get the results, THEN get the live vaccine
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10
Q

Live vaccines & antibodies timing

A
  1. Vaccine –> 2 weeks –> antibody product
  2. Antibody product –> 3 months + –> vaccine
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11
Q

The only REAL contraindications to vaccines

A

Live vaccines: immunocompromised, pregnant
Inactivated vaccines: anaphylaxis (to the same vaccine)

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12
Q

Vaccines for adults

A

Influenza: ≥ 6 months
Tdap x1 then Td or Tdap every 10 years
Shingrx ≥ 50 or ≥ 19 (if immunocompromised)
HPV ≤ 26 yrs who did not complete the HPV series
Pneumonia ≥ 65 or ≥ 19 with medical conditions
Meningococcal
Hep B: All 19-54 yrs, 60+ yrs with risk factors
Hep A: traveling, risk factors (same as hep B)

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13
Q

Pneumonia vaccine options

A

PCV20 x1 or
PCV15 followed by PPSV23 ≥ 12 months later (or 8 weeks later if immunocompromised)

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13
Q

Risk factors for Hep B

A

Liver disease, HIV infection, exposure via sexual activity, IVDU, travel to endemic areas, blood exposure

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14
Q

Vaccinations for infants & children

A

3-dose hep B at birth
2 months: PCV13 or PCV15, DTaP, Hib, polio, rotavirus
≥ 12 months: MMR, varicella (live vaccines)
No polysaccharide vaccine before 2 yrs of age

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15
Q

Vaccinations for healthcare professionals

A

Flu shot
Hep B
Tdap
Varicella
MMR

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16
Q

Vaccines for adolescents & young adults

A

Meningococcal: 1 dose at 11-12 yrs and 1 dose at 16 years. First yr college students at residential housing if not previously vaccinated: 1 dose
HPV vaccine: 11-12 yrs (2-3 doses depending on when started)
TDaP: 1st dose at 11-12 yrs

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17
Q

Vaccinations for Sickle Cell Disease/Asplenia

A

H. influenzae (Hib)
Pneumococcal: either PCV20 x1 or PCV15 then PPSV23 ≥ 8 weeks later
Meningococcal vaccines

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18
Q

Vaccinations for pregnancy

A

NO LIVE VACCINATIONS
Influenza
TDaP x1 each pregnancy (weeks 27-36 optimally)

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19
Q

Vaccinations for Immunodeficiency

A

NO LIVE VACCINATIONS
Pneumococcal vaccine
Herpes zoster vacines
Additional for those with HIV: Meningococcal, Hep A, Hep B

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20
Q

Vaccinations for diabetes

A

Pneumococcal vaccine
Hep B: age ≥ 60 yrs (if not previously vaccinated)

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21
Q

Egg-free influenza vaccines

A

FluBlok (18+)
Flucelvax

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22
Q

What forms of the pneumonia vaccine should those < 2 yrs NOT get?

A

Pneumovax 23 (PPSV 23)

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23
Q

Typhoid oral vaccine: administration

A

Take with empty stomach with cold/lukewarm water

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24
When to give the Typhoid vaccines?
Oral - 1 week prior to exposure then every 5 yrs IM - 2 weeks prior to exposure then every 2 yrs`
25
Yellow fever: contraindications
Severe allergy to eggs or gelatin Immunosuppression, breastfeeding, pregnant Age < 6 months
26
cholera vaccine: when to give
≥ 10 days prior to exposure
27
Cholera vaccine: storage
Freezer. Remove no more than 15 mins prior to administration
28
Which vaccines need to be in the freezer? (-50 to -15 degrees celcius)
Varicella, MMRV, oral cholera **M-M-R II can be stored in either the refrigerator or freezer**
28
How long to keep temp logs
3 years+
29
Which vaccine is given SC only?
Yellow fever
30
Which vaccines are given either SC or IM?
MMR, MMRV, Varicella, PPSV23
31
Which vaccines are given oral?
Typhoid (Vivotif) Cholera Rotavirus (RotaTeq, Rotarix)
32
DTaP vs TDaP
DTaP (Peds formulation) have 3-5 times the diphteria component **DTaP given in < 7 yrs of age**
33
When to give HPV9 (Gardasil 9) vaccine?
11-12 (May be started at 9 yrs if hx of sexual abuse)
34
HPV 9 regimen
Started before 15: 2 doses (6-12 months apart) Started at 15+ or immunocompromised: 3 doses (2-3 months apart)
35
Travel vaccination should be documented in:
International certificate of vaccination or prophylaxis (ICVP) AKA "Yellow card"
36
Dysentery definition
If blood is mixed with stool Often accompanied by systemic symptoms such as fever **Classified as severe**
37
TD: prophylaxis
Bismuth Salicylate **Reduces incidence of TD by 50%**
38
Who should you avoid bismuth salicylate in:
Aspirin allergy, pregnancy, renal insufficiency, gout, ulcer, anyone taking anticoagulants, probenecid, methotrexate
39
Antibiotic prophylaxis for TD
NOT recommended for most (except immunocompromised, significant comorbidites) Preferred: Rifaximin ALT: Azithromycin, Rifamycin
40
TD treatment
Hydration Loperamide (Max dose 16mg/day or OTC 8mg/day) x2 days Bismuth subsalicylate Antibiotics (only for moderate/severe): Azithromycin or quinolone (low resistance) OR Rifaximin
41
Which antibiotic is preferred for severe TD & dysentery?
Azithromycin
41
Typhoid fever: transmission
Food or water contaminated by feces of someone with acute or chronic asymptomatic carrier
42
Cholera: most common symptom
Rice-water stools
43
Travel vaccines
Hep A, Hep B, Japanese encephalitis, meningococcus, Polio, Typhoid (IM = inactivated, PO = live), Cholera-PO, Yellow fever-SC
44
Hep B Vaccine prior to travel
3 doses, takes 6 months to finish **Don't forget that Hep B can also be transmitted by tattoos & piercings**
45
Highest risk of meningitis
Meningitis belt of africa during the dry season
46
Meningitis & Saudi arabia
The government of Saudi arabia requires meningococcal vaccine for travel during the annual Hajj & Umrah pilgrimages
47
Type of meningococcal vaccines recommended for travels
Quadrivalent vaccines (Menactra, Menveo, MenQuadfi)
48
Mosquitoes can act as vectors and transmit the following diseases:
Japanese encephalitis, yellow fever, dengue, malaria, zika virus
49
Severe Dengue (5%)
Shock, severe bleeding, organ failure
49
Dengue: treatment
Supportive care Dengvaxia - for those with past dengue infection
50
Japanese encephalitis: complications
encephalitis with rigors, seizures, coma & death
51
Who is the Ixiaro (JE) vaccine particularly recommended to?
Those traveling to asia with plans to spend extended exposure to the outdoors or spend 1+ month during JE transmission season
51
Malaria: transmission
Anopheles mosquito
52
Malaria: classic symptoms
Shaking, chills, high fever, flu-like illness
52
Which is the most common malaria species?
P. vivax **contributes to half of cases in India**
53
Which malaria species is the most deadly?
P. falciparum
54
Malaria ppx- quick starts (1-2 days prior)
Doxycycline daily: Stop 4 wks after travel Atovaquone/Proquanil: Stop 1 week after travel Primaquine: stop 1 week after travel. Avoid in G6PD deficiency **Avoid all these in pregnancy**
55
Malaria ppx- advance starts (1-2 weeks prior)
Chloroquine weekly - stop 4 wks after Mefloquine: start ≥ 2 weeks prior and stop 4 weeks after **BOTH SAFE IN CHILDREN, PREGNANCY**
56
Chloroquine: side effects
Retinal toxicity/visual changes
57
Do not use Mefloquine in
Underlying psych conditions Seizures Arrhythmias
58
Yellow fever: treatment
symptomatic relief with fluids, analgesics & antipyretics **ASA and other NSAIDs can't be used d/t inc risk of bleeding**
59
Zika virus: complications
Fever, maculopapular rash, arthralgia, conjunctivitis **INFANTS BORN WITH MICROCEPHALY (small head)**
60
Acetazolamide: contraindication
sulfa allergy
61
Engerix-B
Hepatitis B vaccine
62
When should loperamide NOT be used for TD?
When bloody diarrhea is present
63
What could interfere with the effectiveness of a dose of Varivax?
Systemic antivirals with effectiveness against herpes (Valtrex, Acyclovir) - 24 hrs before or 14 days after Live vaccines - separate 4 weeks (if not given on same day)
64
The presence of a ESRD would qualify a patient for which of the hepatitis vaccines?
Hep B
65
age indications for FluMist?
Healthy patients 2-49 yrs old
66
What is an contraindication to receiving the Varicella vaccine?
Gelatin or neomycin allergy
67
Vaxchlora
Cholera vaccine Live Administered orally Supplied as a powder & reconstituted with water Stored in freezer
68
Children 6 months to 8 years: Flu vaccine recommendation if they have never received one
2 doses, separated by 4 weeks
69
Serogroup meningococcal vaccine is indicated for
ages 10-25 years old exposure to N. meningitidis asplenia/sickle cell disease during outbreak season
70
VAQTA, Havrix
Hep A vaccines
71
ProQuad
measles, mumps, rubella, and varicella

TOP 300 drugs - NAPLEX (12 decks)

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