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PHM 790: Topics in Pediatry > Week 3 Immunizations > Flashcards

Week 3 Immunizations Flashcards

1
Q

Passive Immunization and when its useful

A
  • Immunoglobulons like Palivizumab
  • temporary immunity prior to or after exposure
  • use when active immunization not available (RSV) or when a vaccine was not admin before exposure (rabies)
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2
Q

what is active immunization and its moa

A

vaccines; they contain antigens that are recognized by body’s immune system causing an immune response. Activating T cells or B cells. B cells cause antibody formation which attack antigens. Memory B and T cells are formed.

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3
Q

primary vs secondary response to vaccination

A
  • Primary is in response to vacc, slow and not as strong
  • Secondary is in response to infection that vaccine had antigens of, more rapid and stronger
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4
Q

Immediate vs Ultimate goal of vacc

A

Immediate: prevention
Ultimate: Eradication ex smallpox

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5
Q

live vaccines

A

Influenza (LAIV)
Measles
Mumps
Polio
Varicella
Rubella
Rotavirus
(I’M Probably Very Right)

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6
Q

4 Inactivated Vaccines

A

Hep A
Influenza (IIV)
Pertussis
Polio (IPV)
(HIPPA)

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7
Q

Recombinant vaccines

A

Hep B
HPV
RSV
Zoster (RZV)
Novavax
veryvery very bright

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8
Q

2 Toxoid Vaccines

A

Diphtheria
Tetanus

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9
Q

3 conjugated/ polysaccharide

A

Hib
Meningococcal
Pneumococcal

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10
Q

Pediarix components

A

Dtap + IPV+ Hep B
- dec vaccine load

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11
Q

Vaxelis components

A

DTap+ IPV+ Hib + Hep B

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12
Q

Pentacel and clinical pearl

A

Dtap + IPV + Hib
- dec vaccine load= dec aes

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13
Q

when is it appropriate to have gap between vaccines

A

with 2 or more live vaccines, 28 day minimum interval if not given at the same time

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14
Q

Cons of decreasing vs increasing interval between vaccines

A
  • decreasing can reduce antibody response/ protection
  • increasing can delay protection *give at next visit do not restart series
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15
Q

when do we not count vaccine as valid dose and repeat it

A

When vacc admin 5 or more days before the minimum dosing interval or age

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16
Q

when should we avoid/ postpone immunization

A
  • pts with mod to severe illness
  • Hx of anaphylaxis to vacc or its components
  • avoid live vaccines in certain immunodeficiencies (luekemia, lymphoma, cancer, radiation, HIV, prednisone)
  • in pregnancy LIVE vaccines CONTRAINDICATED, inactivated okay in 2nd tri
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17
Q

Pregnancy vaccinations; recommended and contraindicated

A

Recommended cocooning effect
- Inactivated Influenza
- Tdap
- covid
- rsv
CI
- live vaccines
*HPV not recommended
*no evidence that vacc cause fertility problems

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18
Q

Chemotherapy and Live vaccines

A

vaccinate 2 weeks before OR 3 months after treatment

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18
Q

Corticosteroids and Live vaccines

A

High dose: >2mg/kg/d or >20mg/d pred for 14 or more days

wait one month

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18
Q

When is it okay to vaccinate children during corticosteroid therapy

A
  • topical therapy or local injections
  • physiologic maintenance therapy
  • low/mod dose systemic corticosteroids
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18
Q

When is it okay to vaccinate children after corticosteroid therapy

A
  • high dose corticosteroids less than 14 days; vacc immediately or wait 2 weeks
  • high dose corticosteroids 14/more; must wait 1 month to vacc
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19
Q

Immune globulin w/ live vaccines

A
  • live vaccine should be admin 14 days b/f immoglubulin. if IVIG given b/f must revaccinate
  • do not give live vaccine <3 months after immunoglobulin
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20
Q

PPD testing w/ live vaccines

A

Give at same time or wait 4-6 weeks to place PPD

21
Q

adverse effect of live vacc

A

mild form of the natural illness

22
vaccines available as SQ
MMR Varicella PPV23 Polio Meninogoccocal zooster
23
SQ sites infants vs 1yo and older
infants : thigh >1 : upper outer triceps 45 deg
24
IM sites
<3 yrs : anterolateral thigh >3 years: deltoid BUTT not useful= inadequate immune response/ risk of injury
25
Intranasal
do not redose if pt sneezes
26
oral vaccine options
Oral polio (OPV) - if pt vomits w/in 10 minutes REDOSE Rotavirus - pt vomits do not redose
27
4 Vaccine Myths
- Lack of appreciation for/fear of the severity of these disease - false sense of security - lack appreciation for the benefits of vacc, think they are ineffective - certain/all vaccines are not worth the risk
28
parental perspectives on vaccines
- painful for child to receive multiple shots during single visit - too many in first 2 years of life - may cause learning disabilities
29
Diphtheria occurence/severity
Infection most common and severe in non/incompletely immunized individuals
30
Tetanus what is it and Risk factors
- Toxin binds in CNS leads muscle rigidity/spasms, 30% fatality -RF: Puncture wounds, IV drug use
31
Pertussis
Whooping Cough *extremely contagious 50% of hospitalizations in infants
32
Pertussis Stages
Stage 1- catarrhal stage; last 1-2 weeks very contagious Stage 2 - Paroxysmal Stage lasts 1-6 weeks; fits of rapid coughing with whoop sound Stage 3 - Convalescent Stage last 2-3 weeks; gradual recovery
33
Routine immunization Diph/Tetanus
<7= DTap or DT 7 and up= TD 11 and up= Tdap
34
Boosters Diph/Tet/Pret
- Diph every 10 years - Tetanus every 10 years if no inury, every 5 years if at risk, and severe injury 1 year after last dose - Pert give 1+ booster dose following DTaP series Pregnancy Tdap every preg
35
Hib Vaccine high risk patients
Chemotherapy/Radiation Immunodeficiency Asplenia (sickle- cell disease)
36
Hep A formulations and indications
Havrix, Vaqta - universal admin to all children 12-23 months - 2 dose series Twinrix (HAV+HBV) - for 18 and older - 3-4 dose series
37
Hep A vacc for high risk groups
International travel male male sex clotting disorders chronic liver disease drug use
38
Hep B maternal HBAG status
determines vaccination schedule of infants - including weight and if mother is positive, unknown or neg - child is premature and mother ststus unknow or positive give IVIG w/in 12 hrs with 3 additional vaccine doses - child is >2kg and mother neg: vaccine in 24 and follow regular doing schedule
39
HPV Gardasil; complication, indication, schedule, AE,
- major complication: cervical cancer - Indicated in females and males 9-45 yo to prevent cancer and genital warts - 2 dose series for 9-14 yo; now then 6-12 mon later - 3 dose series for 15 and up OR immunocompromised; now, 1-2 mon, 6 mon - AE: fever, syncope
40
antigenic drift
gradual changes in protein due to mutations, substitutions and deletions
41
Antigenic shift
drastic protein changes in hemagglutinin or neuraminidase. causes epidemic and pandemics
42
IIV who eligible, doses, AE
6 months and older; 1-2 doses - 2 doses if 1st lifetime dose or if <9 yo with 2 or less doses, separate by 4 weeks - ae local rxns
43
LAIV who is eligible, AE, CI
2 years- 49 years - AE: rhinorrhea - CI: Childen <2, adults >50, pregnancy, child 2-4 with asthma or hx of wheezing, on aspirin, has csf leaks
44
MMR pearl and special situations
Immunity life long - International travel; pt 6-12 get 1 dose (doesnt count as schedule), >12mons receive 2 doses prior to travel
45
Varicella primary infection and dosing schedule
- chickenpox - <13 yo 2 doses >3 months apart s ->13 yo 2 doses >4 weeks apart
46
pneumococcus vaccines
pcv15 and pcv20 are conjugated, good for <2 years pcv23 broader coverage; recommended for high risk children >2 yos
47
covid 19 complications
- Multisystem inflammatory syndrome in children (MIS-C) RARE - Diabetes - Myocarditis 5-18yo
48
Latex allergy contraindication
Rotarix (2 dose)
49
which vaccines are sensitive to light
ProQuad reconstituted MMR zooster LAIV Novavax
50
antiviral agents and live vaccines
if treated w/in 48 hrs to live vaccine wait 14 days a/f vacc to start antiviral again
51
Proquad AE
febrille seizures
52
Covid 19 options for 6 mon-4 yo including colors, doses and se
moderna 2 doses- dark blue/green pfizer 3 doses- yellow ae- inj site rxn and fever
53
Covid 19 options for 5yo-11 yo including colors, doses, and se
moderna 1 dose- dark glue/green pzifer 1 dose- blue cap ae- inj site, fatigue
54
Covid 19 options for 12 yo+ including colors, doses and se
Moderna 1 dose - blue/blue Pzifer 1 dose- grey novavax 2 doses- blue/blue

PHM 790: Topics in Pediatry (4 decks)

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