Immunizations

Question 1

What is the link between vaccines and autism?

Answer 1

• NO EVIDENCE
• Thimerosal does NOT cause it (merucry-containing preservative)

Question 2

What is the purpose if the immune system?

Answer 2

• Distinguish self from non-self
• When antigen is detected, antibodies are produced to provide immunity and destroy the antigen

Question 3

What are the two types of Immunity?

Answer 3

• Active: own immune system makes antibodies
• Passive: antibodies from someone esle (mother to baby or IVIG)

Question 4

What are live vaccines?

Answer 4

• weakened vaccines made from modified viruses to replicate and make immunity
• contraindicated in immunocompromised and pregnancy

Question 5

What are inactived vaccines?

Answer 5

• Killed virus that causes a diminishing (over time) immunity
• May need a booster to increase immunity (immunity will decrease over time)

Question 6

What are some of the common live vaccines?

MIRCO-VY

Answer 6

• MMR
• Intranasal Influenza
• Cholera
• Rotavirus
• Oral Typhoid
• Varcella
• Yellow Fever

Others: Tuberculosis, Dengue, Smallpox, Ebola

Question 7

Can vaccines be given simultaneuoly?

Answer 7

• Most live and inactivated vaccines can be given at the same time

Live with other lives: do in same day to wait 28 days between the two

Question 8

What is important to know about getting vaccines in a series?

Increasing or decreaseig time between shots?

Answer 8

• Increaseing interval: diminish the effectiveness & delay protection
• Decreasing interval: interfere with antibody production

Question 9

What are some of the local reactions for vaccines?

Answer 9

• Pain
• Swelling
• Redness

Why we need to tell them to wait the 15 mins before leaving

Question 10

What are some systemic reactions for vaccines?

Answer 10

• Fever, Malaise, Muscle Pain, Headache
• Flu shot can NOT give you the flu (its inactivated)
• Live vacs could cause reactions in 3 - 21 days
• Intranasal flu vac may cause cold-like symtpoms

Question 11

What are some contraindications for getting a vaccine?

Answer 11

• Pregnancy and Immunosuppression for LIVE vaccines
• If gotten a anti-body blood product (i.e.; getting blod transfusion or monoclonal antibodies) - MMR/Varicella = wait 3 months to 11 months

Question 12

What are some invalid contraindicatoins for gettting a vaccine?

Answer 12

• Mild acute illness (slight fever, mild diarrhea)
• Current antibiotic treatment
• Previous mild-moderate skin reactions
• allergy or penicillin
• Pregnancy (Except LIVE)
• Recent TB skin test
• Immunosuppressed person in household
• Family history

Question 13

What vaccinations are recommended in Infants and Children?

Answer 13

• 3 doses of Hep B at birth
• RSV if mom didnt get it
• Pneumo, DTaP, Hib, Polio, Rota at 2 months
• MMR, Varicella at > 1 year

Question 14

What vaccinations are recommended in adolescents and young adults?

Answer 14

• Meningococcal - especially 1st year college
• HPV
• Tdap - around 11 yo (then every 10 years after)

Question 15

What vaccinations are recommended in Pregnancy?

Answer 15

• NO LIVE VACCINES
• Inactivated Flu
• RSV at 32 to 36 weeks
• Tdap x1 at 27 to 36 weeks

Question 16

What vaccinations are recommended in Older adults?

Answer 16

• Shingrix at > 50 yo; 2 - 6 months apart
• Pneumococcal at > 65yo

Question 17

What vaccinations are recommended in diabetics?

Answer 17

• Pneumococcal (20 or 15 –> 23)
• Hep B at > 60 yo (if not gotten already)

Question 18

What vaccinations are recommended for healthcare professionals?

Answer 18

• Flu
• Hep B, Varicella, MMR if not immune

Question 19

What vaccinations are recommended in Sickle Cell Disease & Other casues of asplenia?

Answer 19

• Hib
• Pneumococcal (20 or 15 –> 23)
• Meningococcal (Quad & B)

Question 20

What vaccinations are recommended in Immundeficiency?

Answer 20

• NO LIVE VACCINES
• Pneumococcal (20 or 15 –> 23)
• Shingrix at > 19 yo
• Meningococcal Quad, Hep A & B

Question 21

When should adults get the flu shot?

Answer 21

• Annually

Question 22

When should adults get the Tdap, Td?

Answer 22

• Every 10 years

Question 23

When shoudl adults get shingles shot?

Shingrix

Answer 23

• > 50 yo or > 19 yo if immunosuppressed
• 2 doses (2 - 6 month apart)

Question 24

When should adults get the HPV shot?

Answer 24

• < 26 yo who did not complete the series 0, 1-2, 6 m apart)

Question 25

When should **Adults** get the **pneumococcal shot**?

Answer 25

- *19 - 64 yo with specific medical condition* or **> 65 yo**: PCV20 x 1 or PCV15 then PCV23 8w later ## Footnote *alcohol use disorders, cigarette smoking, diabetes; heart, lung or liver disease, sickle cell disease, HIV....*

Question 26

When shoudl **Adults** get the **Hep B shot**?

Answer 26

- All 19 - 59 yo and > 60 yo with risk factors - Can be given alone or with Twinrix (Hep A & B)

Question 27

When should **adults** get the **Hep A shot**?

Answer 27

- When traveling to endemic area - Cen be given alone or with Twinrix (Hep A & B)

Question 28

What are the **COVID** Vaccines

Answer 28

- Comirnaty (Pfizer) - Spikevax (Moderna)

Question 29

What are the **administration recommendations** for **COVID** vaccine?

Answer 29

- Age > 12 yo; 1 dose in a 2 dose series about 3 - 8 weeks apart

Question 30

What are the **Diphtheria Toxid** vaccines

Answer 30

- DTaP: Daptecal, Infanrix - DTaP-IPV: Kinrix, Quadracel - **DTaP-HepB-IPV: Pediarix** - DTaP-IPV/Hib: Pentacel - DTaP-IPV-Hib-HepB: Vaxelis - Td: Tenivac, TDVax - **Tdap: Adacel, Boosterix** ## Footnote **TDaP** = Pediatric **Td** = Adult

Question 31

What are the **administration recommendations** for **Diphtheria Toxoid** vaccine?

Answer 31

- DTaP: 5 doses given at 2, 4, 6, 15-18 months and 4-6 years (**under 7 yo**) - Td or Tdap: Every 10 years; wound prophy (if more than 5 years); every pregnancy

Question 32

What are some of the **Hepatitis containing** vaccines

Answer 32

- **Hep A: Harvirx, Vaqta** - **Hep B: Engerix-B, Heplisav-B** - Hep A & B: Twinrix - **DTaP-HepB-IPV: Pediarix** - DTaP-IPV-Hib-HepB: Vaxelis

Question 33

What are the **administration recommendations** for **Hepatitis contianing** vaccines?

Answer 33

- Hep A: 2 dose at 1 - 2 yo or adults: men who have sex with men, chronic liver disease - Hep B: 24 hours after birth at 0, 1-2, 6-18 months; adults no previously vaccinated (at 19 - 59 yo) - Hep A & B: 3 doses from 0, 1, 6 months apart

Question 34

What are the **HPV** vaccines?

Answer 34

- **HPV 9 or Gardasil 9**

Question 35

What are the **administration recommendations** for **HPV** vaccine?

Answer 35

- Age 9 - 26 yo: 11-12 yo start time is recommended - **Before 15 yo** = 2 doses (0 to 6-12 months apart) - **After 15 yo** = 3 dose (0, 1-2, 6 months apart)

Question 36

What are some **Flu Vaccine Tips**

Answer 36

- All have "Flu" in the name - 6m to 8y (give 2 separate doses 1m apart) - Egg allery (can get - FLublok is egg free) - Pregnancy (NO LIVE) - > 65 yo = Fluzoen high dose

Question 37

What are the **flu** vaccines?

Answer 37

- **Afluria, Fluarox, FluLaval, Fluzone** (Quad INACTIVATED) - **Flucelvax** (Quad Inactivated; Egg Free) - Flubok (Quad Inactivated; Egg Free) - **Fluzone High-dose** (Quad Inactivated; > 65 yo only) - **Flumist** (Quad LIVE; only for healthy 2 - 49 yo)

Question 38

What are the **administration recommendations** for **Flu** vaccine?

Answer 38

- As soon as its is available (outbreaks occur in Feb) - Live: NOT for pregnany

Question 39

What are the **Measle, Mumps, Rubella** vaccines

Answer 39

- **MMR: M-M-R II** - **MMRV: ProQuad** (+ Varicella) ## Footnote **LIVE VACCINES**

Question 40

What are the **administration recommendations** for **MMR** vaccine?

Answer 40

- Kids: 2 dose series at 12-15 months and 4-6 years - ProQuad for those 12m to 12y - Adults: if no ebidence of immunity - NOT in pregnancy or immunosuppressed

Question 41

What are the **administration recommendations** for **Meningococcal** vaccine?

Answer 41

- Adolescents: 2 doses at 11-12 yo and 6 yo - Special Pops: travelers (african meningitis belt), > 2m with asplenia/sickle cell disease, 1st year college students

Question 42

What are the **Meningococcal** Vaccines?

Answer 42

- **MenACWY: MenquadFi, Menveo** - **Men B: Bexsero, Trumenba** - **MenABCWY: Penbraya**

Question 43

What are the **pneumococcal** vaccines?

Answer 43

- **Conjugate Vaccine: Prevnar 20 (PCV20) or Vaxneuvance (PCV 15)** - **Polysaccharide Vaccine: Pneumovax 23 (PPSV23)**

Question 44

What are the **administration recommendations** for **Penumococcal** vaccine?

Answer 44

- Kids: 4 doses of PCV15 or PCV20 at 2, 4, 6 and 12-15 months - Adults: never gotten before - 19 - 64 y = **PCV20** or **PCV15 x1 + PPSV23 x1 > 12 moths later**

Question 45

What are the **Polio** vaccines?

Answer 45

- **IPV: IPOL** - DTap-IPV: Kinrix, Quadracel - **DTaP-HepB-IPV: Pediarix** - DTaP-IPV/Hib: Pentacel - DTaP-IPV-Hib-HepB: Vaxelis

Question 46

What are the **administration recommendations** for **Polio** vaccine?

Answer 46

- 4 doses at ag 2, 4, 6-18 months and 4-6 years

Question 47

What is the **Rotavirus** vaccines?

Answer 47

- RV1: **Rotarix** - RV5: **RotaTeq** ## Footnote **Given Orally**

Question 48

What are the **administration recommendations** for **Rotavirus** vaccine?

Answer 48

- Infant series (DO NOT start after 15 weeks) - RV1: 2 doses at 2 and 4 months - RV5: 3 doses at 2, 4 and 6 months

Question 49

What are the **RSV** vaccines?

Answer 49

- **RSV Vaccine: Abrysvo** - **RSV Monoclonal Antibodies: Nirsevimab (Beyfortus) & Palivizumab (Synagis)**

Question 50

What are the **administration recommendations** for **RSV** vaccine?

Answer 50

- Pregnant at 32 - 36 weeks; 1 dose to prevent RSV in infant - Adults > 60 yo - Neonates or Infants < 8m born during or entering 1st RSV: 1 dose of Nirsevimab

Question 51

What are the **Varicella** vaccines?

Answer 51

- **Varicella Virus Vaccines:** (for chickenpox) **Variax** - **MMRV: ProQuad** - **Shingles/Herpes Zoster: Shingrix** ## Footnote **Allergy to gelatin = NO**