Immunization

Question 1

The influenza vaccine is a vaccine of what antigens primarily?

Answer 1

• hemagglutinin and neuramidase antigens

inactivated virus- effective in 2 weeks, lasts for under 12 months

Question 2

How long do influenza vaccines usually last in the elderly?

Answer 2

• only around 4 months usually

Question 3

What are the three viruses that are involved in the influenza vaccine?

Answer 3

• H1N1 like virus
• H3N2 like virus
• B/phuket/3073/2013 like virus

— this is known as a trivalent vaccine

Question 4

What is the 4th virus that is added to make the vaccine quadrivalent? What is the purpose of this?

Answer 4

• Brisbane/60/2008 like virus

- this is added because it provides extra protection from another strain of the virus

Question 5

What groups of people is the annual flu shot most important for?

Answer 5

• seniors aged > 65
• children 6 months to 59 months
• those with chronic illness
• health care workers and their first responders
• residents of personal care homes or long term care facilities
• pregnant women
• individuals of aboriginal ancestry
• people who are severely overweight

Question 6

Can you give the influenza vaccine to someone will egg allergies?

Answer 6

• yes! can give all to someone with egg allergies

Question 7

What is the inactivated (killed) vaccine?

Answer 7

• broader, weaker immunity, adverse effects to unwanted components
  eg. whole cell pertussis
• eg. pollovirus, flu virus

Question 8

What is the live attenuated flu vaccine? (weakened)

Answer 8

• broader, stronger, and longer immunity

eg. MMR, varicella, yellow fever, oral typhoid, oral cholera

Question 9

What is a purified or recombinant subunit as protein, polysaccharide, or PS protein - weaker immunity requiring multiple dose or adjuvant (aluminum)?

Answer 9

-DTaP, HiB, HBV, pneumonococcal, meningococcal

Question 10

What is a DTaP-IPV-Hib vacine?

Answer 10

• not polyvalent against multiple strings or serotypes

Question 11

What are the advantages of combination vaccines?

Answer 11

• easier storage, easier administration, potential increase in vaccine uptake, reduces exposure to adjuvants/additives

Question 12

What are the disadvantages of combination vaccines?

Answer 12

• more complex pre-approval, antibody response interaction, production issues with one component may lead to vaccine shortages for multiple diseases, difficult to determine the component responsible for adverse event, increased cost

Question 13

Where are ID injections usually administered?

Answer 13

• usually the flexor surface of the forearm - creates a small bleb

Question 14

Where are SC injections usually administered?

Answer 14

injected at 45 degrees into the upper triceps areas of the arm

Question 15

Where are the IM injections usually administered?

Answer 15

• at 90 degrees into vests lateralis muscle (anterolateral thigh) in infants < 1 year, deltoid muscle in over 1 year

Question 16

What timing of the vaccine is important to keep in mind?

Answer 16

• interuption of the vaccine series for any reason does not require starting the series over again, regardless of the interval that has elapsed
• doses given at less than recommended interval may result in a less than optimal antibody response and should not be counted as part of the primary series

Question 17

It is strongly recommended that both the _____ and ____ vaccines be given simultaneously when both are indicated

Answer 17

pneumonococcal and influenza vaccines

Question 18

Vaccines against the same disease ________ be given simultaneously, but separated instead by over 8 weeks

Answer 18

should not

Question 19

Live vaccines should be given on the same day or ________

Answer 19

separated by 4 weeks (MMR and varicella)

Question 20

MMR increases the rates of false negative results for the tuberculin test for TB, and should therefore be _________

Answer 20

given on the same day of the tuberculin test or delay the tuberculin test for 4-6 weeks

Question 21

What makes up vaccine safety surveillance during pre-marketing?

Answer 21

• passive reporting to the provincial health authority -> PHAC (centre for infectious disease prevention and control)
• active reporting through the immunization monitoring program ACTive by 12 hospitals, 90% ped beds

Question 22

What is a cohort study?

Answer 22

• comparing the adverse event rate in immunized vs non-immunized

Question 23

What is a case-control study?

Answer 23

• compare the proportion of cases with AE and controls without AE who were exposed to the vaccine

Question 24

What are the most common AE associated with immunizations?

Answer 24

• local (soreness, swelling and redness)
• systemic (tiredness, irritability, GI, fever, seizures)
• allergic (urticaria, angioedema, rhinitis, bronchospasm, anaphylaxis (hypotension)

Question 25

What is all in a DTaPP?

Answer 25

- diphtheria, acellular pertussis, tetanus, and polio