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Immunizations
Preventive Med Quiz 2
| Question | Answer |
|---|---|
| Immunity | The ability of the human body to tolerate the presence of exogenous material and to eliminate foreign material. |
| Passive immunity | Protection by animal or human products Transferred to another human (injection) Protection WANES |
| Active immunity | Protection produced by a person's own immune system Protection is PERMANENT |
| Barriers to vaccinating | Cost Advanced appointment/planning Lack of insurance/PCP Mistrust Fear |
| Examples of passive immunity | Placenta transfer Post-exposure prophylaxis Immune globin Hyperimmune globulin (vaccine + immune globulin) Heterologous hyperimmune serum/antitoxin Monoclonal antibody products |
| Immune globulin examples | Hep A Measles |
| Hyperimmune globulin examples | Hep B Rabies Tetanus Varicella |
| Heterologous hyperimmune serum/anti-toxin examples | Botulism Diphtheria |
| Monoclonal antibody products examples | RSV exposure |
| Examples of active immunity | Surviving an infection (immunologic memory) Receiving a vaccination |
| Types of vaccines (4) | Live attenuated Inactivated Polysaccharide Recombinant |
| Live attenuated vaccine | "Weakened virus" Virus retains ability to replicate, usually doesn't cause illness - could revert to original disease MMR/MMRV Rotavirus Influenza Yellow fever |
| Inactivated vaccine | Whole or fractions of virus/bacterium Not alive, cannot replicate Requires multiple doses, boosters Polio Hep A Rabies Influenza aPertussis HPV Diphtheria Tetanus |
| Polysaccharide vaccine | Type of inactivated Pure or conjugate Pneumococcal Meningococcal Salmonella typhi Hib |
| Recombinant vaccine | Genetic engineering Insertion of viral gene segment into plasmid Hep B HPV Typhoid Live attenuated influenza |
| Diphtheria | Corynebacterium diphtheriae Involves mucous membranes Exudative pharyngitis |
| Symptoms and complications of diphtheria | Pseudomembrane Respiratory obstruction Myocarditis Neuritis |
| Diphtheria vaccine | Dtap/DT (children), Tdap (adults) 4 doses: 2, 4, 6, and 15-18 months old Boosters: 4-6 (kindergarten) and 11-12 (middle school) years old, then q 10 years |
| Tetanus | Clostridium tetani Bacterium found in soil/animal feces |
| Symptoms and complications of tetanus | Trismus Stiff neck Difficulty swallowing Rigidity Episodes of tachycardia Spasms Interference in breathing Fracture of spine/long bones Arrhythmia |
| Tetanus vaccine | Dtap/DT (children), Tdap (adults) 4 doses: 2, 4, 6, and 15-18 months old Boosters: 4-6 (kindergarten) and 11-12 (middle school) years old, then q 10 years |
| Pertussis | Bordetella pertussis Whooping cough 3 stages Cough lasting >2 weeks --> pertussis |
| Stages and symptoms of pertussis | Catarrhal: runny nose, sneezing, low fever, occasional cough Paroxysmal: bursts of numerous rapid coughs, typical whooping cough sound Convalescent: recovery, 2-3 weeks |
| Complications of pertussis | Pneumonia Seizures Encephalopathy Death |
| Pertussis vaccine | Dtap/DT (children), Tdap (adults) 4 doses: 2, 4, 6, and 15-18 months old Boosters: 4-6 (kindergarten) and 11-12 (middle school) years old, then q 10 years |
| Haemophilus influenzae type b (Hib) | Haemophilus influenzae Colonizes in nasopharynx Can be asymptomatic as carrier |
| Symptoms and complications in Hib | Invasive: Meningitis (50-65% prevaccine era) Epiglottitis Pneumonia Arthritis Cellulitis Hearing loss/neurologic symptoms (15-30%) Fatality (2-5%) |
| Hib vaccine | Hib 3-4 doses: 2, 4, (6), and 12-15 months old |
| Hepatitis A | Spread through fecal-oral transmission |
| Symptoms and complications of Hep A | Fever Malaise Anorexia Nausea Ab. pain Dark urine Jaundice (70% asymptomatic <6 years old) (70% jaundice in older children and adults) |
| Hep A vaccine | HepA 2 doses: 6-12 months apart after 1-year-old |
| Hepatitis B | Blood borne transmission Can live on environmental surfaces for up to 7 days at room temp. |
| Symptoms and complications of Hep B | Acute hepatitis Chronic hepatitis Cirrhosis Cause of 80% of hepatocellular carcinomas |
| Hep B vaccine | HepB 3 doses: birth, 2 months old, and 6 months old |
| Measles | Paramyxovirus Systemic infection Primary site of infection: respiratory epithelium |
| Symptoms and complications of measles | Fever Rash "4 C's": Cough, Coryza, Koplik spots, Conjunctivitis Otitis media (OM) Pneumonia Encephalitis Seizures Death |
| Measles vaccine | MMR, MMRV 2 doses: 12-15 months old and 4-6 years old NOT given during pregnancy |
| Mumps | Paramyxovirus Parotitis (30-40%) |
| Symptoms and complications of mumps | Parotitis Myalgia Malaise Headache Low fever CNS involvement Orchitis Pancreatitis Deafness Death |
| Mumps vaccine | MMR, MMRV 2 doses: 12-15 months old and 4-6 years old NOT given during pregnancy |
| Rubella | German measles, 3-day measles Togavirus |
| Symptoms and complications of rubella | Fever Respiratory symptoms Malaise Rash for 3 days Lymphadenopathy Arthralgia Encephalitis Neuritis Orchitis Congenital Rubella Syndrome (CRS) |
| Rubella vaccine | MMR, MMRV 2 doses: 12-15 months old and 4-6 years old NOT given during pregnancy |
| Congenital Rubella Syndrome (CRS) | Fetal death Premature delivery 85% of infants affected if infection occurs during 1st trimester Deafness Cataracts Heart defects Microcephaly Mental retardation Bone alterations Liver/spleen damage |
| Varicella | Chicken pox Varicella zoster virus |
| Symptoms and complications of varicella | Pruritic rash 3 types of lesions seen: papules, denuded papules, denusions/crusting ... (?) Secondary skin infection Pneumonia CNS manifestations Reye syndrome (aspirin in children) Maternal: 5 days before-2 days after delivery has 30% neonatal fata |
| Varicella vaccine | Varicella, MMRV 2 doses: 12-15 months old and 4-6 years old *Post-exposure prophylaxis: >70% effective if given w/in 3 days of exposure* |
| Pneumococcal disease | Strep. pneumoniae |
| Symptoms and complications of pneumococcal disease | Most common cause of OM Pneumonia: fever, chills, rigor, pleuritic pain, rusty sputum, cough, dyspnea Bacteremia Meningitis |
| Pneumococcal vaccine | PPSV-23: >2 years old (2-6), >65 years old, HIV PCV-13 4 doses: 2, 4, 6, and 15-18 months old Boosters: before school |
| Poliomyelitis | Enterovirus Enters through mouth Hematologic spread to lymphatics and CNS Spreads along nerve fibers Destruction of motor neurons |
| Symptoms and complications of poliomyelitis | Response is highly variable Spinal polio Paralysis Death |
| Poliomyelitis vaccine | IPV: inactivated 4 doses: 2, 4, 6-18 months old, and 4-6 years old |
| Rotavirus | Fecal-oral transmission (Stays in stool ~30 days) |
| Symptoms and complications of rotavirus | Watery diarrhea Severe dehydration (w/fever & vomiting) Fever >103 (1/3 of cases) Electrolyte imbalance Metabolic acidosis |
| Rotavirus vaccine | RV-1 (2 doses) RV-5 (3 doses) 2(or 3) doses: 2, 4, and (6) months old *Contraindicated if hx of intussusception* |
| HPV | Human papilloma virus Most common STD infx in US |
| Symptoms and complications of HPV | Most are asymptomatic STD infx 50% of cervical cancer Anogenital warts |
| HPV screening | Pap test |
| HPV vaccine | HPV-2 HPV-4 (approved in males) 3 doses: as early as 9 (usually 11-12) years old, then 2 and 6 months later *Given before sexually active* |
| Meningococcal disease | Neisseria meningitidis A leading cause bacterial meningitis and sepsis in US Gram(-) diplococci |
| Symptoms and complications of meningococcal disease | Meningococcal meningitis Meningococcemia (fever, rash, hypotension, multi-organ failure) |
| Meningococcal disease vaccine | MCV-4 MPSV-4 (>55 years old) 2 doses: 11-12 years old and 16 years old Boosters: Work/travel in high-risk areas, Military |
| Herpes zoster | Reactivation of latent varicella zoster Shingles |
| Symptoms and complications of herpes zoster | Rash - unilateral, follows dermatome PHN Ramsay-Hunt |
| Herpes zoster vaccine | Herpes zoster (Zostavax) Dosed: >50 years old *Independent of previous hx of shingles* |
| Influenza | Influenza A subtypes (H and N) Influenza B: milder disease Influenza C: rare in humans |
| Influenza pandemic | Antigenic shift Change in subtype |
| Influenza epidemic | Antigenic drift Milder change |
| Symptoms and complications of influenza | Fever Myalgia Sore throat Cough Headache Pneumonia (viral and secondary bacterial) Myocarditis Reye syndrome (aspirin use) |
| Influenza vaccine | Inactivated (TIV): injection Live attenuated (LAIV): nasal spray 2 doses the 1st year given: 6 months old-8 years old After 1st year, give annually (9 years old and older) *No vaccine for <6 months old* |
| Contraindications for LAIV | Pregnancy <2 years old >49 years old Asthma, COPD DM Renal disease Sickle cell, HIV, Immunosuppressed Children taking long-term aspirin Close contact w/immunosuppressed Allergic to eggs |
| Vaccines required before entering kindergarten | Dtap: booster MMR/MMRV: 2nd dose PCV-13: booster |
| Vaccines required at 2 months old | Dtap Hib Heb B: 2nd dose PCV-13 RV-1/RV-5 IPV |
| Vaccines required at birth | Hep B |
| Vaccines required at 4 months old | Dtap: 2nd dose Hib: 2nd dose PCV-13: 2nd dose IPV: 2nd dose RV-1/RV-5: 2nd dose |
| Vaccines required at 6 months old | Dtap: 3rd dose Hib: possible 3rd dose Hep B: 3rd/final dose PCV-13: 3rd dose IPV: may give between 6-18 months old RV-5: 3rd dose Influenza: between 6 months old and 8 years old |
| Vaccines required at 12-15 months old | Hib: 3rd or 4th dose/final Hep A: 2 doses 6-12 months apart MMRV |
| Vaccines required at 15-18 months old | Dtap: 3rd/final dose PCV-13: 4th/final dose |
| Vaccines/Boosters given at 4-6 years old | Dtap MMRV: 2nd/final dose PCV-13/PPSV-23 IPV: 4th/final dose |
| Vaccines/Boosters required at 11-12 years old | Dtap ~HPV MCV-4: 1st dose |
| Vaccines/Boosters required at 16 years old | HPV if not before |
| Vaccine given at or older than 50 years old | Herpes zoster |
| Vaccines required before school entry | DTaP MMR/V IPV Hep B |
| Vaccines required for childcare/headstart (preschool) | Hib PCV Hep A |
| Vaccine required before college entry | MCV |
Created by:
Carrie D.
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