Vaccines 2

Question 1

What have childhood immunizations reduced?

Answer 1

childhood morbidity (disease) and
mortality.

Question 2

Who makes the federal recommendations of immunizations

Answer 2

MOHs and other experts make up National Advisory Committee on Immunizations (NACI)

Question 3

What are the government departments responsible for health and wellness? What is it affected by and and where are they given?

Answer 3

1. Implement these recommendations in the provinces however Provinces differ in the programs
2. Affected by resources, policies, priorities, and incidence
3. May be given at hospitals, public health clinics, physicians’ offices, or other sites

Question 4

What effects can vaccines have on different ages

Answer 4

1. Maternal antibody may affect response in babies
2. Immature immune system decreases response
   a) Polysaccharide vaccines not effective in <2 year olds
3. Some vaccines have short lived responses in
   the young
4. Poor response to vaccines in the very old

Question 5

Why do vaccine programs fail

Answer 5

1. Many programs do not reach the target
   of 95%.
2. Missed opportunities to immunize by health-
   care workers and care-givers.
3. Improper vaccine storage results in
   ineffective immunization.
4. Vaccine hesitancy

Question 6

How are vaccines used during outbreaks?

Answer 6

1. Vaccine may not be in routine use
   a) Incidence too low, vaccine too expensive
2. May occur in unvaccinated/”under-vaccinated”
   a) Religious/cultural reasons
   b) Missed immunization (sick, travelling, etc)
   c) Not all immunized become immune
   i) May require multiple doses for highest efficacy
   ii)May have received ineffective vaccine
   iii) May not respond to immunization
3. Misconception of risk of immunization: benefits vs. risks, side-effects
   a) Result of press coverage causing fear.
   b) Vaccine hesitancy
   c) The anti-vaccine ‘fringe’.

Question 7

Describe what the vaccine for Diphtheria / Tetanus / Pertussis targets, what is the specific age group, what is it combinded with,

Answer 7

1. Diphtheria toxoid, tetanus toxoid, and acellular pertussis vaccine (DTaP)
2. young children
3. Often combined in a pentavalent form (contains 5
   vaccines in one) with poliovirus and Haemophilus
   influenzae type B vaccines.

Question 8

What is the Tdap boost composed of what age group is it given? When do you have to receive another booster?

Answer 8

1. Diphtheria toxoid and tetanus toxoid has less diphtheria toxoid to decrease adverse reactions
2. given in teens and need another booster every 10 years

Question 9

What forms is the pilo vaccine come in and which one is commonly used ?

Answer 9

1. Available as inactivated (IPV, Salk) [live
   oral (OPV, Sabin) – now obsolete]

Question 10

what age group reveices the polio vaccine and are boosters required

Answer 10

Infants 2-6 months old need a booster at 6

Question 11

Why is the oral polio vaccine no longer used in North America

Answer 11

due to growing immunosuppressed population, and vaccine-associated paralytic polio.

Question 12

What is the Haemophilus Type B vaccine used against and what are the adverse reactions

Answer 12

1. Haemophilus influenzae type B
2. Adverse reactions: fever, local redness, and
   swelling in < 5%

Question 13

What is the Haemophilus Type B vaccine made with and how does it work

Answer 13

1. The current vaccine consists of Polysaccharide
   conjugated to a protein (4 preparations exist).
2. Conjugation to a protein activates T-cell dependant immunity (immunogenic in infants and improved
   memory).

Question 14

What type of vaccine is measles, mumps, and rubella and how many dosages are required

Answer 14

1. Live-attenuated vaccine
2. 2 dosages on at 12-15 month 2nd at 18months 0r 4-6 years

Question 15

What are the adverse reactions with the measles, mumps, rubella vaccine and what are the contraindications

Answer 15

1. Adverse reactions: rash and fever 5-10%.
2. Contraindications: severe acute illness or
   immunosuppression (not egg allergy).

Question 16

What type of vaccine is the influenza vaccine/ is there other forms? Does the vaccine change often? Whatis it made of?

Answer 16

1. Inactivated whole or split-virus vaccine.
   a) (attenuated live vaccine is available)
2. The vaccine changes annually depending on
   circulating strains.
3. Vaccine contains two influenza A strains
   (H2N3-like, H1N1-like) and 2 influenza B
   strains

Question 17

who gets the influenza vaccine

Answer 17

1. High Risk Groups who need to be vaccinated for influenza:
   a) Chronic cardiac or pulmonary disorders.
   b) Residents of nursing homes and chronic care facilities
   c) Age > 65 yrs.
   d) Chronic conditions such as: Diabetes mellitus, cancer, immunosuppression, renal disease, anemia, hemoglobinopathy, HIV.
   e) Children and adolescents
   requiring long-term aspirin
2. those capable of transmitting influenza to
   those at high risk (i.e. health care workers)

Question 18

For hepatitis B, which age group has the greater risk of encountering liver failure, cirrhosis, and carcinoma and hwen did cases start to increase in canada

Answer 18

1. Individuals infected at an earlier age
2. The 80’s

Question 19

What is the Heapatitis B vaccine made of? How many dosages are required? Is a booster recommended?

Answer 19

1. Purified HBsAg (recombinant)
2. 3 doses at 0,1 and 6 months IM
3. No booster recommended

Question 20

For hepatitis B what are the seroconversion rates in immunicompetent individuals

Answer 20

90-95%

Question 21

What are the two different types of Pneumococcal vaccines and who are included in the recommended usage?

Answer 21

1. polysaccharide and conjugated
2. Recommended usage:
   a) Age over 65 yrs.
   b) No spleen, splenic dysfunction or sickle cell disease.
   c) Cerebrospinal fluid leaks.
   d) All “high-risk” persons who require influenza vaccine.

Question 22

Describe the characteristics of the Pneumococcal polysaccharide vaccine: including what it protects against, how effective it is, and whether or not a booster is needed

Answer 22

1. Polysaccharide vaccine (23-valent) which will induce immunity against 90% of pneumonia strains of S. pneumoniae.
2. Efficacy ~ 80% in healthy adults.
3. Recommended to repeat vaccinations every 5 years.

Question 23

Describe the Pneumococcal Conjugate Vaccin: included what it is conjugated to, what ages group it van be givem an what does it do that the polysaccharude vaccine doesnt?

Answer 23

1. 15-20 valent conjugated vaccine/Conjugated to diphtheria toxoid
2. Can be given 2-6
3. Provides better immunity in small children
4. Improves memory via cell mediated immunity
5. May decrease carriage of covered pneumococci
6. May result in fewer infections in the elderly
   a) An unexpected benefit
   b) Children are a source of organisms for infection of their grandparents

Question 24

What are the two types of Neisseria meningitidis vaccines, what does it protect against across the different age groups, and is the men B a routine vaccine?

Answer 24

1. Monovalent and quadrivalent conjugated
   vaccines
2. Childhood: protection against MenC strain
3. Adolescence/young adulthood Protection against Men A, C, Y, W strains
4. not included in routine
   vaccines, but is available (sometimes free)
   https://www.dal.ca/campus_life/health-and-wellness/my-health/health-promotion/meningitis-b.html

Question 25

Describe what type of vaccine is Varicella, when is it given, how hany dosages are required, how effective is it, is it safe? what are the recombiant VYZ vaccines used for

Answer 25

1. Live attenuated virus vaccine. 2. Given at age 12 months. 3. If given >12 yrs of age, requires 2 doses. 4. Extremely safe with < 5% of children developing several varicella lesions. 5. Over 95% effective in preventing severe varicella infections. 6. Has the potential to make varicella an uncommon disease in North America. 7. Recombinant VZV vaccine used in 60 + people to reduce shingles

Question 26

Describe what the Human Papillomavirus vaccine, when is it given, how many dosages are required, what are the adverse reactions, what does it protect against and what is it hoped to reduce

Answer 26

1. Subunit vaccine containing protein of up to 9 types of HPV (6,11 16,18 etc) 2. Given to children aged 9-13 (14-26 may benefit) 3. Given in 3 doses;0,2,6 months (or 2 doses 0,6 months) 4. Safe, pain at site, swelling, redness, itching 5. Effective against HPV infection of the groups included 6. Hope to decrease incidence of cervical cancer, also some genital warts

Question 27

What are the two different types of covid vaccines / how produced them and are they effective?

Answer 27

1. RNA (Pfizer BioNTech; Moderna) 2. Non replicating viral vector (Oxford/Astra- Zeneca; Johnson & Johnson) 3. Generally highly effective