immunizations Flashcards

Question

what are the 2 types of polysaccharide-based vaccines?

Answer 1

pure and conjugate

Answer 2

A type of vaccine in which a weakly immunogenic antigen (usually a polysaccharide) is chemically linked to a strongly immunogenic antigen (usually a protein). This combination dramatically increases the immune response to the polysaccharide, especially in infants and toddlers, in whom the polysaccharide alone would not produce sufficient immunization. Examples of polysaccharide vaccines are: Haemophilus influenzae B, meningococcal, and pneumococcal conjugate vaccines

Answer 3

1) Whole inactivated or dead virus/bacteria, that cannot replicate, examples are: - -polio (Salk; inactivated vaccine) - -Hepatitis A - -Rabies - -Pertussis (cellular vaccine) - -Cholera - -Japanese encephalitis

Answer 4

Fractional vaccines include subunits (hepatitis B, influenza, acellular pertussis, human papillomavirus, anthrax) and toxoids (diphtheria, tetanus). It can be protein based (subunit, toxoid) and polysaccharide based

Answer 5

Polysaccharides induce a relative T cell-independent B-cell response and therefore achieve sufficient immunization only in adults and older children. In conjugate vaccines, the carrier protein activates T-cells, which stimulate a more rapid and long-lasting immune response, especially in infants and toddlers.

Answer 6

``` Viral: • Polio • Hepatitis A • Rabies • Influenza • Japanese encephalitis Bacterial: • Whole cell pertussis • Typhoid ```

Answer 7

``` Subunit • Hepatitis B • Influenza • Acellular pertussis Toxoid • Diphtheria • Tetanus ```

Answer 8

1) up to the 90 percent of vertically infected infants may becme chronic carriers 2) 2-20% infected addult become carriers 3) cariers may develop chronic hepatitis, cirrhosis or HCC 4) HBV infection is a major economic burden worldwide

Answer 9

1) 1st dose; minimum age 6 weeks 2) 2nd dose and 3rd dose at 4 and 6 months respectively 3) 4th dose at 15-18 months 4) 5th dose 4-6 years 6) Booster doses of Td every 10 years 7) All pregnant women should receive a single dose of Tdap at 27–36 weeks of gestation regardless of the interval since the last Tdap or Td vaccination.

Answer 10

``` a)Birth HepB: Ideally, the first dose is given within 24 hours of birth, but kids not previously immunized can get it at any age. Some low birth weight infants will get it at 1 month or when they're discharged from the hospital. b)1–2 months HepB: The second dose should be given 1 to 2 months after the first dose. c)2 months DTaP, Hib, IPV, PCV, RV d)4 months DTaP, Hib, IPV, PCV, RV e)6 months DTaP, Hib, PCV, RV f)6–18 months HepB, IPV g)12–15 months Hib, MMR, PCV, Chickenpox (varicella) h)12–23 months HepA i) 15–18 months DTaP j)4–6 years DTaP, MMR, IPV, Varicella k)11–12 years HPV l) 16-18: MenB ```

Answer 11

•Females seronegative for rubella – MMR •Previously non-immunized individuals – Tetanus •Pregnant women – varies in different countries – Influenza, tetanus toxoid x2, pertussis (DTaP) •Individuals in specific high-risk groups – HBV, influenza, pneumococcal, typhoid •Those traveling abroad – Country-dependent may include hepatitis A, typhoid, Men ACWY

Answer 12

Influenza, tetanus toxoid x2, pertussis (dTaP)

Answer 13

Country-dependent, may include hepatitis A, typhoid, Men ACWY

Answer 14

1)Hepatitis B 2)Hepatitis A 3)(BCG – no licensed vaccine available at present in this country) 4)Influenza – Front line staff – immunize those involved in the long term care of the elderly 5)Pertussis (dTaP) – For those caring for infants, pregnant women and the immunocompromised

Answer 15

laboratory staff performing faecal cultures

Answer 16

no | • Resume as soon as possible; it is not necessary to repeat the course

Answer 17

* It should not be considered as part of the primary series as there may be a sub-optimal immune response. * The dose should be disregarded and another dose is given at the recommended time, at least 1 month after the disregarded dose

Answer 18

1)All vaccines: – Anaphylaxis to the vaccine or vaccine components 2)Live vaccines: – Pregnancy – theoretical risk to the fetus – Some immunocompromised conditions – Rotavirus: don’t give after 8 months (risk of intussusception), contraindicated in infants who previously had intussusception or who have an uncorrected GI malformation that may predispose to intussusception (IMPORTANT)

Answer 19

don’t give after 8 months (risk of intussusception), contraindicated in infants who previously had intussusception or who have an uncorrected GI malformation that may predispose to intussusception (IMPORTANT)

Answer 20

1)Acute severe febrile illness –defer until recovery 2)Recent IVIG –may impair the efficacy of MMR & varicella live attenuated virus vaccines 3)Topical immunomodulators e.g., tacrolimus 4)Previous type III hypersensitivity reaction –severe swelling & erythema involving most of the diameter of the upper arm after vaccination: usually occurs in adults following tetanus or diphtheria containing vaccines

Answer 21

Yes but not always | may impair the efficacy of MMR & varicella live attenuated virus vaccines

Answer 22

no Conditions that are NOT contraindications to vaccination • Minor infection with fever <38°C • Prematurity • Family or personal history of convulsions • Short term corticosteroid treatment or long-term with less than 20mg/day (0.5mg/kg/day) • Mild food allergy – MMR is safe in egg allergy • Asthma/eczema/hayfever

Answer 23

False | MMR is safe in egg allergy

Answer 24

False Live vaccines are contraindicated 1)Avoid live vaccines in pregnancy because of the theoretical possibility of harm to the fetus –However, when there is a significant risk of exposure to poliomyelitis (e.g., travel to an endemic area), the need for immunization outweighs any possible risk to the fetus –Some inactivated vaccines are/may be given –e.g., tetanus toxoid (2 doses in the first pregnancy, 1 dose in subsequent pregnancies - Malaysia) –inactivated influenza vaccine (many countries, every pregnancy) 2)Pertussis immunization (as dTaP) is now recommended in several countries including Ireland (27-36 weeks, in every pregnancy)

Answer 25

no, it is recommended, lie vaccines are CI

Answer 26

* Should receive all routine vaccinations (+ some additional vaccines) with the EXCEPTION of BCG * The timing of vaccination depends on the type of vaccine and the level of immune suppression * Administration of Live Vaccines (MMR, varicella) should be delayed until the patient is receiving antiretrovirals (ARVs) and the CD4 count has returned to >200 * Oral polio vaccine is not recommended in HIV positive patients because of an increased risk of paralytic poliomyelitis with OPV in immunocompromised individuals

Answer 27

polio and BCG

Answer 28

1)Adverse events following immunization may be: – programme-related e.g. due to wrong dose, incorrect storage, expired vaccine – vaccine-induced e.g. fever, rash, anaphylaxis – coincidental – unknown 2)Harmful effects on immunodeficient hosts e.g. disseminated BCG infection in HIV infected individuals

Answer 29

due to wrong dose, incorrect storage, expired vaccine

Answer 30

Perinatal Transmission • Due to blood exposure during labour and delivery • Risk of infant acquiring HBV is 70-90% when the mother has a high viral load – reduces to 5-20% when the viral load is low • Many low prevalence countries (including Ireland) now give routine neonatal HBV immunisation, commencing at 2 months of age – with a birth dose to infants of carrier mothers or mothers who had acute HBV in this pregnancy (+/- HBIG) – High and Intermediate prevalence countries – immunisation schedule starting at birth

Answer 31

An inactivated, polysaccharide-based conjugate vaccine. Recommended for children at 11-12 and 16 years of age, as well as for patients at risk for meningococcal infections (e.g., patients with asplenia).

Answer 32

Travelers aged ≥ 2 years going to Saudi Arabia on a pilgrimage to Mecca are required by the Saudi government to provide proof of vaccination with a quadrivalent meningococcal vaccine in the last 3 years. Documentation of 2 doses of a meningococcal vaccine against serogroup A is required for travelers aged 3 months to 2 years.

Answer 33

1)Included as part of routine schedule in some countries and in defined populations 2)Polysaccharide (PS) meningococcal vaccines are no longer recommended 3)MenACWY conjugate vaccine – travel to high risk areas with epidemics or hyperendemic disease – Routine schedule Ireland – adolescent booster – US, 2 doses; 11-12 and 16 years 4)Meningococcal B Vaccine (4C MenB) – multicomponent protein vaccine – routine childhood schedule in Ireland and UK 5)MenC conjugate vaccines (MenC, Hib/MenC) – routine childhood schedule in several countries including Ireland, the UK, Spain, Netherlands

Answer 34

Number of polio-endemic countries in 2019 = 3(Pakistan, Afghanistan and Nigeria) • The transmission of polio (faecal-oral route of spread), can only be stopped if the immunisation coverage reaches over 95%. The risk cannot be mitigated as long as some children are not vaccinated and especially during an outbreak.

Answer 35

16,18 and 31 are themost important ones

Answer 36

The genital HPV infection is the most common sexually transmitted infection worldwide; usually cleared by the immune system

Answer 37

Females • 12-13 years of age as part of the national HPV vaccination programme • May be given to females from 9 years of age up to 26 years • Ideally, should be administered before the onset of sexual activity Males • HPV4 and HPV9 vaccines may be given from 9 to 26 years • Should be considered for men who have sex with men (MSM) 3 doses of nine-valent HPV vaccine should be administered for all unvaccinated individuals between the ages of 27 and 45 years.

Answer 38

9-valent vaccine (Gardasil®9): protection against high-risk HPV types 16, 18, 31, 33, 45, 52, and 58, as well as against low-risk types 6 and 11

Answer 39

False • 30% of cervical cancers are caused by HPV types not prevented by the available HPV vaccines • Vaccinated females could subsequently be infected with non-vaccine high-risk HPV types • Sexually active females could have been infected prior to vaccination • Cervical cancer screening recommendations have NOT changed for females who receive the HPV vaccine

Answer 40

– US and UK recommend vaccination of all children (from 6 months US; 2 years UK) – Any individual > 6 months of age at increased risk of influenza or its complications – Those at increased risk of transmitting influenza to a person at high risk for complications •Healthcare workers •Family, carers, household contacts of patients at increased risk – Pregnant women and up to six weeks postpartum

Answer 41

• Inactivated virus should be given each year in advance of the influenza season (Sept/Oct) • Seasonal influenza vaccines contain x 3 influenza serotypes, 2 serotype A and 1 serotype B (‘trivalent’) THIS IS AN INACTIVATED VACCINE THEREFORE IT DOES NOT CAUSE “THE FLU” • Influenza antibodies take from 10-14 days to reach protective levels following vaccination • [Live vaccine (intranasal) available in North America and UK (children)]

immunizations Flashcards

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