Immune globulins and vaccines

___ is administration of antigen to the host to induce antibodies formation and cell-mediated immunity

Active immunization

properties of an ideal immunogen

- complete prevention of disease

- prevention of carrier state

- production of prolonged immunity w/ minimum immunizations

- absence of toxicities

- suitability for mass immunizations

What are some reasons that active immunization is preferred?

- higher antibodies for longer time

- less frequent immunization

- concurrent cell-mediated immunity

duration of immunity is longer with live/inactivated active immunizations

live

T or F: immunity can be lifelong w/ live vaccines

T

Which vaccines should be given before 2 months old?

Hep B

What is the difference in administration of hep B vaccine for seronegative vs seropositive mothers?

Seronegative >2000g: 24 hours after birth, then 1-2 months

Seronegative <2000g: 1 dose at age 1 month

Seropositive: first dose within 12h, 3 additional doses beginning at 1 month

Which vaccines should be given at 2 months?

DTap, IPV, HiB, PCV, RV, HBV (at least 4 weeks after 1st dose)

Which vaccines should be given at 4 months?

DTaP, Hib, PCV, RV, IPV

Which vaccines should be given at 6 months?

DTaP, HiB, PCV, RV(only if RV-5 used)

Which vaccines should be given from 6-18 months?

HBV, IPV, influenza

Which vaccines should be given at 12-15 months?

MMR, Hib, PCV, varicella

Which vaccines should be given at 15-18 months?

DTaP

Which vaccines should be given at 12-23 months?

Hep A (2 doses >6 months apart)

Which vaccines should be given at 4-6 years old?

DTaP, IPV, MMR, varicella

Which vaccines should be given at 11-12 years old?

HPV (3 or 2 doses), Tdap (pregnancy), MCV

Immunoglobulins are used to provide ___ immunity

passive

Which populations of people need passive immunization?

- individuals unable to form antibodies (agammaglobulinemia)

- prevention of disease when time does not permit active immunization (post exposure prophylaxis)

- for diseases normally prevented by vaccination (tetanus)

- conditions where active immunity is impractical (snake bite)

What are some complications from administration of human immunoglobulins?

- transient hypotension

- pruritis

- hypersensitivity to Ig in patients w/ IgA deficiency

What are some complications from non-human immunoglobulins?

hypersensitivity (anaphylaxis/serum sickness)

What are the advantages of human immunoglobulins?

- longer half life

- smaller doses

Which vaccinations are recommended for travel?

- tetanus

- polio

- measles

- diphtheria