Immunization

Question 1

all vaccines are given in -1- volume exept -2-

Answer 1

1. 0.5 mL

2. flu

Question 2

Hep B - 1st dose, given at -1-
Hep B + mom: vax & HBIG w/in -2- of birth; test for antigen/body after -3- of vax series
Unknown: HBIG w/in -4-
Third dose: -5-

Answer 2

1. birth
2. 12 hours
3. 3+ doses
4. 1 week
5. 6 months of age or sooner

Question 3

Rotavirus - administrated -1-
at ages -2-
Not administered after -3-

Answer 3

1. orally
2. 2 months & 4 months (and maybe 6 months)
3. 32 weeks (8 months)

Question 4

Dtap (vs Tdap)
> -1- corresponding with the -2-
> -3- doses
> none after -4- of age or for -5-

Answer 4

1. more immunization material
2. capital/first letter (diphteria and tetanus respectively)
3. 5
4. 7 years
5. Pregnant women

Question 5

Tdap - at -1- old; every -2-: booster

> ACIP recommends -3- of Tdap during -4-

Answer 5

1. 11 years
2. 10 years
3. routine immunization
4. all pregnancies (pref. 3rd trimester, but any time is safe, if needed sooner)

Question 6

Hib: -1- series w/ booster in -2-
As early as -3-
No older than -4-

Answer 6

1. 3-dose
2. toddlerhood
3. 6 weeks
4. 5 years

Question 7

PCV13 schedule: -1-

PCV23 - can be given as young as -2- if patient has -3- such as -4-; but is made for -5-

Answer 7

1. 3 infant, 1 toddler
2. 2 years
3. immune problems
4. HIV, sickle cell, hemoglobinopathy
5. older children and adults

Question 8

Polio is an -1- type of immunization, and is given -2-

Answer 8

1. Inactivated

2. Intramuscularly (not orally anymore)

Question 9

MMR & Varicella - both are -1- series
They are -2- 
Given at -3-
Space MMR out from -4-
Give them as individual formulations at -5-

Answer 9

1. 2 dose
2. LIVE VACCINES (two/three along with rotavirus)
3. 12-15 months (MMR - travelling to endemic area: early as 6 mo., doesn’t count toward the series)
4. PPD
5. the first dose; the second dose can be/is combined

Question 10

HepA: -1- series
Caveats: -2-

Answer 10

1. 2-dose

2. none

Question 11

Meningitis ACWY: -1- if started at -2-

If started at -3-, no booster required

Answer 11

1. 2-dose
2. 11 (booster at 16)
3. 16+

Question 12

Men B: -1- dose(s), starting age -2- for -3- groups, e.g. -4-

Answer 12

1. one
2. 16-18
3. high-risk
4. college students, sickle cell (other immunocompromised)

Question 13

HPV: as early as -1- (-2- dose(s) up to age 15; -3- dose(s) if started after 15 yo)
protects against -4- strain(s) of the virus
Caveat: possible -5-

Answer 13

1. 9 yo
2. 2
3. 3
4. 9
5. vasovagal response (rest for 15 minutes after administration)

Question 14

What to consider when administering catch-ups:

-1- and what -2-; not what -3-

Answer 14

1. Current age
2. they should currently have on board
3. they’ve “missed”

Question 15

Contraindications
Polio: -1-
Varicella: -2-

Answer 15

1. streptomycin allergy

2. streptomycin allergy and pregnancy

Question 16

The -1- for children two years and older with underlying -2- put them at risk for invasive pneumococcal disease caused by -3- acquired by otherwise healthy children.

Answer 16

1. PPSV23 (23-valent pneumococcal polysaccharide vaccine) is recommended
2. medical conditions that
3. serotypes not usually

Question 17

Medical conditions that put children 2+ at increased risk for -1- include sickle cell disease, hemoglobinopathies, congenital -2-, HIV infection, chronic -3-, -4- syndrome, and other illnesses associated with -5- and immunodeficiency.

Answer 17

1. invasive pneumococcal disease
2. and acquired asplenia
3. renal failure
4. nephrotic
5. immunosuppressive medications

Question 18

In particular, if -1- or elective splenectomy is planned or -2- is expected, the PPSV23 should be administered -3- before the planned procedure.

Answer 18

1. cochlear implant
2. immunosuppressive therapy
3. two weeks

Question 19

A second dose of PPSV23 is administered -1- after the first for those individuals with a condition that causes -2-, including -3-.

Answer 19

1. five years
2. immunocompromise
3. asplenia

Question 20

There are no indications for PPSV23 related to -1-. While immunization of -2- immunity, there are no special indications for this vaccine related to -3-.

Answer 20

1. travel
2. groups offers herd
3. siblings with HIV

Question 21

Medical conditions that put -1- at increased risk for invasive pneumococcal disease include -2-, particularly those associated with -3-, chronic lung diseases including asthma requiring -4-, diabetes mellitus, -5-, & cochlear implants.

Answer 21

1. children 2+
2. chronic heart disease/failure
3. cyanosis
4. high-dose steroid therapy
5. cerebrospinal fluid leaks

Question 22

Vaccination for protection against MMR and varicella is -1- with the primary dose given at 12-15 months of age. If the MMR vaccine is administered for -2- months of age, it is not counted toward -1-.

The combination vaccine MMRV -3- for -1-; however, the MMRV vaccine is associated with the possibility of a -4- and a two-fold increase in febrile seizures as compared to MMR and varicella administered as -5- on the same day.

Answer 22

1. a/the 2-dose series
2. travel before 12
3. can be used
4. subsequently higher fever
5. separate vaccinations

Question 23

Because of the risk of -1-, the ACIP recommends separate MMR and varicella vaccines for -2- unless the caregiver understands and -3-. For children with a personal or family -4-, the ACIP recommends separate vaccination on the same day -5- of the series.

Answer 23

1. high fever/febrile seizures
2. the primary dose
3. prefers the MMRV
4. history of seizures
5. for both doses

Question 24

Contraindications to MMR and varicella vaccines include -1-, untreated tuberculosis, -2- state, or -3- to any component of the vaccines. Live vaccines, if not administered on -4-, need to be separated by at least 30 days to -5-.

Answer 24

1. pregnancy
2. immunocompromised
3. anaphylaxis
4. the same day
5. be valid/provide protection

Question 25

If for some reason -1- has never been vaccinated against MMR and varicella, and there is -2- of seizures, the child may receive the MMRV for the -3- as the occurrence of a -4- in -1- is uncommon.

Answer 25

1. a 4-year old 2. no personal/family history 3. primary dose 4. first febrile seizure

Question 26

Vaccinations have -1- the incidence, prevalence, -2- of a number of -3- in the Western world. It is estimated that -4- childhood immunizations for an annual U.S. birth cohort -5- million illnesses and over 40,000 deaths and saves nearly $70 billion in costs.

Answer 26

1. significantly reduced 2. morbidity and mortality 3. communicable diseases 4. administration of recommended 5. prevents approximately 20

Question 27

Proof of immunization is -1- for child care and school attendance in -2-. -2- provide -3- from required immunization for -4-, such as allergy to or a history of a -5- to a vaccine or its components, and underlying health conditions such as immunosuppression.

Answer 27

1. required by law 2. all U.S. states (and the District of Columbia) 3. for exemption 4. medical reasons 5. significant reaction

Question 28

-1- allow exemptions from vaccinations based on -2-, and -3- allow exemptions based on philosophical or personal beliefs. Evidence supports that -4- of vaccine exemptions correlate with -4- of -5-.

Answer 28

1. Most states 2. religious beliefs 3. almost half 4. higher rates 5. vaccine-preventable illnesses/disease outbreaks

Question 29

Herd immunity, also known as -1- immunity, provides -2- for -3- by decreasing the incidence of vaccine-preventable illnesses and their -4- in communities with -5- of immunized individuals.

Answer 29

1. population or community 2. indirect protection 3. unimmunized individuals 4. subsequent spread 5. sufficient numbers

Question 30

-1- vaccinated children are at greater risk for -2-. Children who are -3- for medical reasons increase the -4- individuals in a population, thus contributing to decreased herd immunity.

Answer 30

1. Unvaccinated or incompletely 2. contracting vaccine-preventable diseases 3. exempted from vaccination 4. number of susceptible

Question 31

The AAP supports -1- for immunization for childcare and school attendance, and -2- for specific vaccines for individual children. The AAP, along with the American Medical Society and the Infectious Diseases Society of America, supports -3- nonmedical exemptions for childhood vaccines. As stated in its policy statement, the AAP regards nonmedical vaccine exemptions as -4-, public health, and -5-.

Answer 31

1. legal requirements 2. medically indicated exemptions 3. elimination of all 4. inappropriate for individual 5. ethical reasons

Question 32

Male and female adolescents should receive the following vaccinations: -1-, -2-, and the -3-. The American Academy of Pediatrics immunization charts recommend yearly -4- vaccinations for all ages, not just adolescents. The -5- vaccines are recommended for children with certain health conditions that predispose them to serious diseases, but not for all children.

Answer 32

1. Tdap 2. MenACWY (MC4) 3. human papillomavirus vaccine 4. influenza 5. PPSV23 (23PS) and HepA

Question 33

Although the -1- is usually given to children eleven to twelve years of age, according to the AAP 2012 immunization schedule, children between the ages of -2- should be given the -1- if their immunization history is unknown. -3- are recommended for children seven years of age or younger. -4- is administered for tetanus wound management. The -5- is used as a booster only after the initial -1- has been administered.

Answer 33

1. Tdap vaccine 2. seven and ten 3. DTaP vaccines 4. Tetanus immune globulin 5. Td vaccine

Question 34

Since an inactivated polio vaccine contains trace amounts of -1-, there is a possibility of hypersensitive reactions, such as anaphylaxis or anaphylactic shock, in anyone who has ever had a life-threatening allergic reaction to -2-, such as -1-, and -3-.

Answer 34

1. streptomycin and neomycin 2. antibiotics 3. polymyxin B

Question 35

-1-, or allergies to -2-, -3-, or -4- are cause for concern in the smallpox vaccine, DTaP (rarely), the flu vaccine, and nothing respectively, they are not relevant allergen considerations when administering the polio vaccine.

Answer 35

1. Eczema 2. milk 3. eggs 4. pollen