immunization pt 2

Question 1

childhood immunizations are promoted by…

Answer 1

federal recommendations from NACI (national advisory committee on immunizations, experts on vaccines)

Question 2

government departments responsible for health do what w these recommendations from NACI

Answer 2

they can implement these recommendations in the provinces. affected by resources, policies, priorities, and incidence
- provinces differ
- may be given at hospitals, clinics, etc
this has greatly reduced childhood morbidity and mortality

Question 3

effects of age on vaccinations

Answer 3

• maternal antibody may affect response in babies
• immature immune system decreases response (polysac. vac. not effective in babies)
• some vaccines have short lived responses in the young
• poor response to vaccines in the very old

Question 4

why do vaccine program fails?

Answer 4

many programs do not reach the target of 95%
- missed opportunities to immunize by healthcare workers and caregivers
- improper vaccine storage results in ineffective immunization
- vaccine hesitancy

Question 5

why are there outbreaks of vaccine preventable diseases?

Answer 5

• vaccine may not be in routine use
• may occur in unvaccinated/undervaccinated populations
• religious/cultural reasons
• missed immunizations
• vaccine failures themselves
• misconception of risk of immunization, benefit vs risks / side effects

Question 6

current vaccine targets

Answer 6

diphtheria toxoid / tetanus toxoid / pertussis (DTaP)
- primary immunization at 2,4,6 months and boosters at 18mo and 4-6 yo
- often combined w poliovirus and haemophilus influenzae type b

Question 7

polio vaccine is available as…

Answer 7

inactivated (IPV, Salk) and live oral (OPV, Sabin)
- opv induced a natural immunity with advantages of secretory-IgA production but shedding through GI tract offered opportunity for vaccine-assoc. infections by mutated virus
- primary immunizations at 2,4,6 mo w boosters at 18mo and 4-6 yo

Question 8

polio vaccine in the future

Answer 8

may no longer be necessary in future decades if poliovirus infection is eradicated
- oral polio vaccine no longer used in na

Question 9

haemophilus type b vaccine was the…

Answer 9

most common cause of meningitis and epiglottitis in canada prior to 1995

Question 10

the haemophilus type b vaccine consists of…

Answer 10

• polysaccharide conjugated to a protein
• conjugation to a protein activates t-cell dependent
• Hib vacc can be given in conjunction w polio and DTaP
• very little side effects less than 5%

Question 11

MMR vaccine is a …

Answer 11

live attenuated virus

Question 12

immunizations for mmr

Answer 12

• primary immunization at age 12-15 months
• 2nd dose rec. at 18mo or 4-6 yo
• 5-10% have rash or fever as side effects

Question 13

influenza vaccine is a …

Answer 13

inactivated whole or split-virus vaccine
- attenuated live vaccine available orally
vaccine changed annually depending on circulating strains - vaccine contains two influenza a strains and two influenza b strains
- recommended yearly for high-risk and high-risk transmitting individuals

Question 14

high risk groups who need to be vaccinated for influenza

Answer 14

• chronic cardiac or pulmonary disorders
• residents of nursing homes and chronic care facilities
• age above 65 yos
• chronic conditions such as diabetes, anemia, cancer
• children and adolescents
  they want everyone to be vaccinated

Question 15

hep b vaccinations

Answer 15

3 doses at 0,1, and 6 months
- booster not recommended
- made from bacterial cells and then purify the antigen and it is purified HBsAg (recombinant)

Question 16

individuals infected w hep b at an earlier age have greater risk of:

Answer 16

liver failure, cirrhosis, and carcinoma

Question 17

the first pneumococcal vaccine is…

Answer 17

1. polysaccharide vaccine (23 valent) which will induce immunity against 90% of pneumonia strains of s. pneumoniae
   - rec to repeat every 5 years
   - rec for old, no spleen, high risk, cerebrospinal fluid leaks

Question 18

the second pneumococcal vaccine is…

Answer 18

2. the pneumococcal conjugate vaccine (13 valent)
   - conjugated to diphtheria toxoid
   - can be given 2,4,6,12-15 months
   - provides better immunity in small children
   this gives a better immune response than the 1st one, and it gives better cell mediated immunity

Question 19

varicella vaccine is

Answer 19

a live attenuated virus vaccine
- given at age 12 months, if given before 12 yo, requires two doses
- extremely safe vaccine, 95% effective in preventing
- has the potential to make varicella uncommon in na
- recombinant vzv used in older ppl to reduce shingles

Question 20

hpv vaccine is a …

Answer 20

subunit vaccine (protects against 9 kinds of hpv)
- given to children aged 9-13 (14-26 may benefit)
- given in 3 does 0, 2, 6 months
- safe, effective, hope to decrease incidence of cervical cancer and also some genital warts

Question 21

covid19 vaccines info…

Answer 21

large number of vaccines developed quickly
- include many strategies: rna (pfizer) and non-replicating viral vector (j&j)
- gen highly effective preventing severe disease

Question 22

immunity can conferred either through:

Answer 22

1. natural infection
2. passively via administration of antibody
3. active immunization

Question 23

the current vaccine schedule has…

Answer 23

dramatically reduced childhood morbidity and mortality

Question 24

the what of a vaccine depends on what and can be enhanced by…

Answer 24

the immunogenicity of a vaccine depends on multiple factors and can be enhanced by adjuvants and hapten conjugates