Test 4 Immunization

Question 1

Difference in polysaccharide and conjugate polysaccharide vaccines in children younger than 2 years

Answer 1

• polysaccharide: not consistently immunogenic in children younger than 2 years
• conjugate polysaccharide: increased immunogenicity in children younger than 2 years

Question 2

Universal contraindication for all vaccines

Answer 2

Severe allergy (immediate and lifethreatening anaphylaxis) to a vaccine component following a previous dose

Question 3

False contraindications

Answer 3

• Minor illness
• Allergies to products not in the vaccine
• Allergies that are not immediate and life-threatening
• Pregnancy in the household
• Breastfeeding
• Premature birth (time on actual age, not gestational)

Question 4

What are other contraindications?

Answer 4

• do not administer live vaccine if patient has received a live vaccine or blood product within the past 28 days
• do not administer live vaccine if patient is pregnant
• do not administer live vaccine if patient is immunocompromised
• do not administer live vaccine if patient is taking high dose of steroid every day (Prednisone dose of 2 mg/kg/day or more or 20 mg/day for 14 days or more)

Question 5

influenza vaccine target population

Answer 5

• can be given during any time throughout pregnancy
• Children 6 months through 8 years receiving influenza vaccination for the first time need 2 doses, administered at least 4 weeks apart

Question 6

Tdap target population

Answer 6

• given to every pregnant women after 30 weeks of gestation
• If not given in pregnancy, administer as soon as possible post-partum
• Boostrix (GSK) 10 years or older
• Adacel (Sanofi Pasteur) 11 to 64 years
• 65 years and older, recommend Boostrix but can use Adacel if that’s the olny thing in stock
• get it every 10 years

Question 7

Dosing of Influenza Vaccine

Answer 7

• get vaccine soon after it is available; no later than October
• 6 months to 35 months: 0.25 mL IM
• 3 years to 9 years: 0.5 mL IM
• 9 years and older: 0.5 mL IM

Question 8

Pneumovax 23 target population

Answer 8

• All people 65 years and older
• People 19–64 years old who smoke cigarettes
• People 19–64 years old who have asthma
• People at least 2 years old with chronic illness
• For immunosuppressed, asplenia, or sickle cell patients, second dose recommended within 5 years if under 65
• Patients < 65 with cochlear implants or CSF leaks
• Recommend one dose of PPSV23 for patients 65 years and older who received 1 or 2 doses at least 5 years ago

Question 9

Pneumovax 23 dosing

Answer 9

0.5 mL IM (or SC)

Question 10

Prevnar 13 target population

Answer 10

• Indicated for ages 6 weeks through 5 years (Routine schedule: 2, 4, 6, 12 to 15 months)
• ACIP recommended in all adults >=65 years
• No additional PCV13 is needed if a dose was given before age of 65
• ACIP recommended in patients with cochlear implants, CSF leaks, immunosuppression, asplenia, sickle cell disease

Question 11

Pneumovax and Prevnar combination

Answer 11

• if over 65: Give PCV13 followed by PPSV23 one year later

- if vaccinated with PPSV23 at age 65 years or older: Give PCV13 one year after the PPSV23

Question 12

Varicella Vaccine

Answer 12

• Live attenuated virus vaccine

- against chicken pox

Question 13

Varicella target population

Answer 13

• Children get varicella at 12 months and again at 4-6 years

- All adults without evidence of immunity to varicella should receive 2 doses at least 4 weeks apart

Question 14

Zostavax Vaccine

Answer 14

• against shingles

- Live attenuated virus vaccine

Question 15

Zostavax target population

Answer 15

• for ACIP: >= 60

- FDA approved for prevention in 50 and up

Question 16

Shingrix Vaccine

Answer 16

• Non-live, recombinant, adjuvanted vaccine
• for shingles
• 2 dose series 6 months apart

Question 17

Shingrix target population

Answer 17

• adults at least 50 years old

- Recommended in those previously vaccinated w/Zostavax

Question 18

DTaP vaccine

Answer 18

• Diphtheria and tetanus toxoids and acellular pertussis adsorbed
• inactive toxoid vaccine

Question 19

Tdap vaccine

Answer 19

• Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
• inactive toxoid vaccine

Question 20

What is the difference between DTaP and Tdap?

Answer 20

Tdap has lower diphtheria and acellular pertussis dose to avoid local reactions in adults

Question 21

DTaP target population

Answer 21

younger than 7 years

Question 22

Hepatitis A vaccine

Answer 22

inactivated vaccine

Question 23

Hepatitis A target population

Answer 23

• All infants at least 1 year old (For all children 1 to 2 years old)
• People with chronic liver disease
• Men who have sex with men
• Illicit drug users
• People receiving clotting factor concentrates
• Travelers

Question 24

Hepatitis B vaccine

Answer 24

inactivated vaccine

Question 25

Human papillomavirus (HPV9) vaccine

Answer 25

inactivated vaccine

Question 26

Human papillomavirus (HPV9) target population

Answer 26

- 9-14 years get the 2 dose series - 3-dose series is an option for ages 9 through 26 years - 3-dose series is the only option for anyone 15 to 25 years of age - Immunocompromised patients need 3 doses regardless of age - If 2nd dose given prior to 6 months after 1st dose, 3rd dose is needed

Question 27

Measles, Mumps, Rubella Vaccine

Answer 27

- Live-attenuated | - Contraindications: Allergy to gelatin or neomycin, pregnancy, immunosuppression, receipt of blood products

Question 28

Measles, Mumps, Rubella target population

Answer 28

- 2 dose series for children 12-15 months, 4-6 years - Born before 1957 considered immune - High risk patients: •Health care personnel •college students •international travelers •nonpregnant women of childbearing age without evidence of immunity to rubella •patients with HIV if CD4 count adequate or if given before antiretroviral therapy

Question 29

Haemophilus influenzae Type B (Hib) vaccine

Answer 29

inactivated vaccine

Question 30

Polio vaccine

Answer 30

inactivated vaccine

Question 31

Polio target population

Answer 31

all kids

Question 32

Rotavirus Vaccine

Answer 32

- Live attenuated vaccines - Contraindicated in children with moderatesever gastrointestinal problems, severe combined immunodeficiency (SCID) and history of intussusception

Question 33

Rotavirus target population

Answer 33

- Minimum age for first dose: 6 weeks - Maximum age for first dose: 14 weeks 6 days - Maximum age for final dose: 8 months 0 days

Question 34

Rotavirus target population

Answer 34

- don't know about this one