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PHAR 7281 IPPE Final Exam

Terms in this set (153)

Patient factors
Provider factors
System factors
Complex adult vaccine schedule

Know that factors Associated With Low Vaccination Among Adults

Innate Immunity

First line of defense

Acquired Immunity

B cells
T cells

humoral immunity

cellular immunity

Mature to antibody-producing cells (plasma cells)

Some cells remain circulating (memory cells)

Circulate from bone marrow

Cytotoxic T cells

2 weeks; 14 days

Know the general time between vaccination and the body's ability to mount an immune response.

Made from viruses or bacteria

Must replicate to work

Replication mimics natural infection to stimulate immune response

Inactivated Vaccines

Made viruses or bacteria, or virus-like particles

Inactivated Vaccines

Do not replicate because they are not live

Inactivated Vaccines

May contain adjuvants to enhance immune response

Get two live vaccines on the _______ day, don't wait, then there is a ____-day interval.

No ______________ between live and inactivated

No _____________ between two inactivated

____________ interval between lives vaccines followed by blood products

_________ interval between live vaccines followed by PPD skin test

Polysaccharide Vaccines

Stimulate T-cell independent immunity

Polysaccharide Vaccines

Short-lived immunity

Polysaccharide Vaccines

No booster effect

Polysaccharide Vaccines

Not consistently immunogenic in children younger than 2 years

Conjugate Vaccines

Protein carrier

Conjugate Vaccines

Stimulate T-cell dependent immunity

Conjugate Vaccines

Helper T cells involved

Conjugate Vaccines

Produce immunologic memory

Conjugate Vaccines

Result in booster effect upon subsequent exposure

Conjugate Vaccines

Increased immunogenicity in children younger than 2 years

True contraindications

Do not vaccinate if vaccine likely to injure patient

True contraindications

Severe allergy (immediate and life-threatening anaphylaxis) to a vaccine component following a previous dose.

False contraindications

False contraindications

Allergies to products not in the vaccine

False contraindications

Allergies that are not immediate and life-threatening

False contraindications

Pregnancy in the household

False contraindications

False contraindications

Premature birth

Delaying Vaccinations

Risks of infection and outbreaks

Delaying Vaccinations

Number of appointments/health care system burden

Delaying Vaccinations

Likelihood that the vaccine schedule will not be completed

Encourage vaccination ________ to pregnancy

_______________ seasonal influenza vaccine if pregnant during influenza season

________ for every pregnancy, ideally during early part of gestational weeks 27 to 36

mRNA COVID-19 vaccine, fully vaccinated for _____________

Avoid live vaccines for _____________

Administer any deferred vaccines after ______________

immunosuppression

Vaccines should be given before _____________________ if feasible

_____________ vaccines: 4 weeks prior to immunosuppression

________________ vaccines: preferable 4 weeks prior to immunosuppression

immunosuppressed

Household contacts living with ________________________ patients can receive inactivated vaccines and most live vaccines

Consult with patient's healthcare provider treating the immunocompromising condition or prescribing the immunosuppressive medication if there is __________________.

most is 28 days

Grace period minimum interval

an acute bacterial infection of the throat and upper respiratory tract

Haemophilus influenzae type B

koplick's spots

a sustained muscular contraction resulting from a rapid series of nerve impulses

Quadrivalent Inactivated Influenza Vaccine

Recombinant Quadrivalent Influenza Vaccine

Quadrivalent Live Attenuated Influenza Vaccine

High-Dose Quadrivalent Inactivated Influenza Vaccine

Cell Culture-based Quadrivalent Inactivated Influenza Vaccine

Adjuvanted Quadrivalent Inactivated Influenza Vaccine

Quadrivalent high‐dose inactivated influenza vaccine (HD‐IIV4)
Quadrivalent recombinant influenza vaccine (RIV4)
Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4)

Recommend a specific influenza vaccine based on the immunization tables and special patient characteristics such as a history of egg allergy, age > 65, and optimal timing of vaccination during the year.

Diphtheria and tetanus toxoids and acellular pertussis adsorbed - childhood (higher dose of diphtheria)

Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis adsorbed

Vaccination of mother transfers antibodies to fetus
One dose every pregnancy Preferably 27-36 weeks gestation
If not given in pregnancy, administer as soon as possible post-partum

Know the Tdap recommendations during pregnancy

Review vaccination of all family members and caregivers of the infant

Live, attenuated vaccine
Children (2-dose series)
Adults (Non-Healthcare Personnel)
- Born in 1957 or later: if no evidence of immunity, give at least 1 dose
Contraindications: Priorix does not contain gelatin, while MMR-II does contain gelatin.

Live attenuated virus vaccine
Children (2 doses)
- 12-15 months
- 4-6 years
Age > 13 years without evidence of immunity
- 2 doses, 4-8 weeks apart

- Recombinant, adjuvanted zoster vaccine
- FDA approved for prevention of herpes zoster in adults aged 50 years and older AND adults 18 years and older who are at increased risk due to immunodeficiency or are immunosuppressed.

16, 18, 31, 33, 39, 45, 51, 52, 58

High-risk types HPV

6, 11, 40, 42, 43, 44, 54

Low-risk types HPV

Pneumovax 23 (Merck)

More efficacious against bacteremia than pneumonia

Not effective in children younger than 2 years

Prevnar 20 (Pfizer)

Builds upon the 13 serotypes of Prevnar 13.

FDA approved for ages > 18 years.

VAXNEUVANCE (Merck)

15 serotypes, 14 contained in PPSV23

1 serotype not contained in PPSV23 (6A)

Prevnar 13 (Pfizer)

12 serotypes same as PPSV23

1 serotype not in PPSV23 (6A)

FDA approved for age 6 weeks and older

For all children 1 to 2 years old
Unvaccinated persons through 18 years
Adult if risk factors are present or for any person for whom immunity against hepatitis A is desired
95%-100% effective
Give 2-dose series at least 6 months apart

All infants
All adolescents who have not been previously vaccinated
All adults 19 to 59 years.
All adults > 60 years of age who are at risk.

Give 1 booster dose of MCV4 at age 16 years if first dose administered before 16th birthday

Children at continued risk for meningococcal disease who were previously vaccinated with MCV4

Persons who have completed the 2-dose primary series and remain at continued risk for meningococcal disease

Persons with persistent complement component deficiency or anatomic or functional asplenia

- Infants and young children
- People with anatomic or functional asplenia
- Recipients of hematopoietic stem cell transplant
- Three conjugated vaccines
- ActHIB and Hiberix requires 3-dose primary series (2, 4, and 6 months) followed by booster (12-15 months)
- PedvaxHIB requires 2-dose primary series (2 and 4 months) followed by booster (12-15 months)

Salk injectable (inactivated) - 1955
Important to keep vaccinating even though polio is limited to only a few countries

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

Pfizer-BioNTech

- 2 doses 3 to 8 weeks apart for healthy individuals
- mRNA vaccine

- 2 doses 4 to 8 weeks apart for healthy individuals
- mRNA vaccine

- 2 doses 3 to 8 weeks apart for healthy individuals
- Recombinant, adjuvanted (protein derived vaccine)

- 1 dose represents a primary series
- Viral vector vaccine

CDC recommends a booster of either Pfizer‐BioNTech or Moderna COVID‐ 19 vaccine.

CDC recommends a ______________ of either Pfizer‐BioNTech or Moderna COVID‐19 vaccine at least 4 months after the 1st booster

Wrong product
Wrong dose/volume
Administered vaccine which was stored inappropriately
Report administration/dosing errors to VAERS

potential risks of COVID vaccine errors

fever, rash, and headache. Positive Herman's sign

Live-attenuated, tetravalent vaccine
Requires reconstitution; Use within 30 minutes
3 subcutaneous doses 6 months apart (0, 6, and 12 months)
82% effective in seropositive persons

Vaccine is only for use in persons 9 to 45 years of age with confirmed previous infection with DENV.

The CDC recommends observing patients for ______ minutes after vaccination

Acute reactions

Allow for fainting without injury, plus access to hard surface if CPR is needed

Acute reactions

Be prepared for anaphylaxis

Acute reactions

Remind patients and caregivers to report any adverse events that happen at home

Sudden or gradual onset of generalized itching

Erythema (redness)

Urticaria (hives)

Angioedema (swelling of the lips, face, or throat)

Severe bronchospasm (wheezing)

Shortness of breath

Abdominal cramping

Cardiovascular collapse

Vasovagal syncope

Brief loss of consciousness or fainting

Vasovagal syncope

Vasovagal syncope

Vasovagal syncope

Coldness of the hands and feet

Vasovagal syncope

Vasovagal syncope

Lightheadedness

Vasovagal syncope

Vasovagal syncope

Vasovagal syncope

Visual disturbances

Authorizes State-licensed pharmacists to order and administer vaccines to individuals ages 3 through 18 years

Authorizes licensed/registered pharmacy interns and technicians acting under their supervision to administer vaccines

Vaccines to individuals ages 3 through 18 years

COVID-19 vaccines to those age 3 years and older

Increase access to vaccines

Decrease the risk of vaccine-preventable disease outbreaks

National Vaccine Injury Compensation Program

Established no-fault insurance for certain adverse reactions

National Vaccine Injury Compensation Program

Removed liability from manufacturers and providers (except in negligence cases)

National Vaccine Injury Compensation Program

Current VIS must be given regardless of patient's age before vaccination

National Vaccine Injury Compensation Program

Must report adverse event to VAERS

Vaccine Adverse Event Reporting System

Vaccine Error Reporting Program

Vaccine stability is only as good as the weakest link in the _________ __________

Have delivery occur only when trained personnel can accept; train everybody

Document breaks in the cold chain
Notify supervisor
Take action

what to do if there is a break in the "cold chain"

Place vaccines in ___________ fridge space, contained in original packaging, inside designated storage trays positioned ____ to ____ inches from refrigerator walls.

Required documentation for all vaccines covered by VICP:
- Patient name
- Date vaccine administered
- Vaccine manufacturer and lot number
- Name, address, title of person administering the vaccine
- Date printed on the VIS
- Date the VIS is given to the vaccine recipient or the recipient's legal representative

federal requirements for documentation

________ licenses vaccines based on results of clinical studies and other data submitted by the vaccine manufacturer

_________ looks at clinical trials from FDA licensure and other clinical studies

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