Vaccines

Question 1

Protection from the DtaP vaccine provides diptheria protection for how many years? What is a shortcoming of the diptheria vaccine?

Answer 1

Protection lasts ten years but does not eliminate carriage of Corynebacteria diptheriae in nasopharynx or skin

Question 2

Tetanus primarily affects which population now? Exclusively affecting who?

Answer 2

Adults; Unvaccinated or inadequately vaccinated

Question 3

Pertussis used to be fatal to infants and children, now it is targetting who?

Answer 3

Adults

Question 4

How are the diptheria and tetanus toxoids prepared?

Answer 4

Formaldehyde treatment

Question 5

Acellular pertussis formulated due to what previous adverse effect with the vaccine?

Answer 5

Encephalitis/Encephalopathy

Question 6

Dosing for DTaP

Answer 6

2,4,6 months, 4th dose 6-12 months after 3rd, boosters before school, tetanus/diptheria boosters every 10 years

Question 7

Acetaminophen is often given by physicians to lessen fever and irritability with what vaccine?

Answer 7

DTaP

Question 8

The 4th or 5th dose of the acellular pertussis vaccine is associated with what adverse effect? What is the treatment?

Answer 8

Intense swelling, erythema, pain at injection site; Resolve without sequelae

Question 9

Haemophilus influenza type b was the leading cause of what in children?

Answer 9

bacterial meningitis and other invasive bacterial disease in children

Question 10

What type of vaccine is Hib and what advantage does this vaccine offer?

Answer 10

Conjugation of PRP polysaccharide with protein confers T-cell dependant characteristics and enhanced immunologic response to the vaccine

Question 11

True False Boosters are recommended for Hib vaccine?

Answer 11

False

Question 12

Major adverse effect of live polio vaccine, what form of polio vaccine do we use?

Answer 12

acute flaccid paralysis; inactivated polio vaccine

Question 13

True False Inactivated polio vaccine gives mucosal immunity

Answer 13

False

Question 14

Dosing for Inactivated Polio Vaccine (IPV)

Answer 14

2,4,6-18 months, school enrollment

Question 15

Risk of perinatal Hep B infection

Answer 15

10-85 percent, based on HbeAg status

Question 16

Infants with perinatal infection have what percentage of chronic infection, death of chronic liver disease?

Answer 16

90 percent; 25 percent

Question 17

What is the current vaccine recommendation for HBV?

Answer 17

All infants

Question 18

What type of vaccine is Hepatitis B vaccine and how is it made?

Answer 18

recombinant; HbsAg synthesized by Saccharomyces cerevisiae (baker`s yeast) due to plasmid insertion

Question 19

Where is the vaccine administered and what vaccination site has lower immunogenicity for Hep B vaccine?

Answer 19

Adults -deltoid, Children - Anterolateral thigh; buttock

Question 20

Dosing regimen for Hep B vaccine

Answer 20

Birth, 1-3, 6-18 months, 4th dose if first injection right after birth

Question 21

What type of vaccine is the Pneumococcal vaccine? How is the low immunogenicity of bacterial polysaccharides improved?

Answer 21

Conjugate vaccine; each capsular polysaccharide is conjugated to a nontoxic variant of diptheria toxin (CRM 197) to make the antipolysaccharide response T-dependent

Question 22

Populations pneumococcal vaccine is recommended for are:

Answer 22

Children: 2-23 months and 24-59 months who are at increased risk for disease (sickle cell, HIV, immunocompromised

Question 23

Dosing schedule for pneumococcal vaccine

Answer 23

2,4,6 and 12-15 months

Question 24

MMR - measles mumps rubella vaccine dosing schedule

Answer 24

12-15 months, school entry

Question 25

What type of vaccine is MMR? Why is it important?

Answer 25

live, attenuated vaccine; should not be given to pregnant women or immunocompromised patients except for clinically well HIV patients

Question 26

Adverse effects of MMR vaccine

Answer 26

Fever in 10-15 percent, no association with autism and MMR vaccine, incidence of encephalitis is very low

Question 27

What type of vaccine is the varicella zoster vaccine and how long does it protect for?

Answer 27

Oka strain of live attenuated virus, 7-10 years

Question 28

What makes this vaccine unique?

Answer 28

There is a minimal risk of transmission of the vaccine virus but may be elevated in 3.8 percent of children and 5.5 percent of adults who received the vaccine developed varicella-like rash

Question 29

What should be avoided up to 6 weeks after receiving the vaccination?

Answer 29

Salicylates to avoid Reye`s syndrome (also avoid vaccine in immunocompromised)

Question 30

Pneumonia and influeza are the fifth leading cause of death in what population?

Answer 30

Elderly, this population also makes up 80-90 percent of all influeza-associated deaths

Question 31

True False, Influeza vaccination reduces rates of hospitalization among elderly with greatest risk but is not cost effective.

Answer 31

False, it is cost effective

Question 32

What are the different antigenic types in Influenza A? Is this seen in Influenza B?

Answer 32

Hemagglutinin (H1,H2,H3) and Neuraminidase (N1,N2); antigenic variability is seen but less frequently in Flu B

Question 33

What percentage in residential settings is considering sufficient to provide herd immunity?

Answer 33

80 percent

Question 34

Who should be vaccinated with influenza out of everyone at high risk or who can transmit it to high risk patients?

Answer 34

Nursing home/long term care residents, people with chronic bronchopulmonary disorders, and people who required regular medical care in the last year, followed by chronic metabolic disease patients

Question 35

Long term aspirin therapy patients who are young adults or younger should receive the flu vaccine why?

Answer 35

To avoid Reye syndrome

Question 36

Recently added to the recommended list for flu vaccine

Answer 36

children: 2-23 months, pregnant women, 50-64 years old

Question 37

What type of vaccine is the flu vaccine and what is Flumist?

Answer 37

inactivated preparation; live, cold-adapted attenuated vaccine for 5 to 49 y.o.

Question 38

Case-fatality ratio for meningococcal disease

Answer 38

10 percent

Question 39

Highest rate of meningococcal disease was seen in what populations?

Answer 39

Infants

Question 40

What serogroups for meningococcal disease are covered by the vaccine? Which are not?

Answer 40

A, C, Y, W135 (Menomune); B

Question 41

What type of vaccine is the meningococcal vaccine Menactra? When is vaccination recommended?

Answer 41

Polysaccharide conjugated to diptheria toxoid; preadolescent age (11-12), if not given then, recommended at entry to high school

Question 42

Meningococcal is also recommended for these populations:

Answer 42

College freshman in dorms, microbiologists, U.S. military recruits, Endemic area travelers, Splenectomy or splenic disorder, terminal complement deficiency, outbreak exposure