Immunization Exam 1 Extensive Quizlet

What is the pathogen that causes influenza?

Influenza virus.

How is Influenza A classified?

By surface proteins Hemagglutinin (H) and Neuraminidase (N).

How is Influenza B classified?

By lineage: Victoria and Yamagata.

Which Influenza B lineage has not been seen clinically since COVID onset?

Yamagata lineage.

What illness does the influenza vaccine prevent?

Influenza infection.

What complications can influenza vaccination help prevent?

Pneumonia, bronchitis, sinus infections, ear infections, death.

How is influenza transmitted?

Spread via coughing, sneezing, or contact with respiratory secretions.

Which age groups are at higher risk for severe influenza?

Children under 5 (especially under 2) and adults over 50 (especially over 65).

Which pregnancy-related group is at high risk for severe influenza?

Pregnant individuals and those less than 2 weeks postpartum.

Which types of chronic diseases increase influenza risk?

Asthma, COPD, heart disease (not isolated hypertension), diabetes, kidney, liver, neurologic, hematologic diseases.

Which immunocompromised groups are at higher risk for influenza complications?

HIV, cancer, transplant, or those on immunosuppressants.

Which children are at higher risk for severe influenza complications?

Children under 18 taking aspirin.

Which BMI group is considered high risk for influenza?

Individuals with BMI over 40.

Which racial/ethnic groups are at higher risk for severe influenza?

American Indian/Alaska Native populations.

What are the main categories of influenza vaccines?

IIV, RIV, LAIV

What is IIV?

Inactivated influenza vaccine (standard, high-dose, adjuvanted, cell culture-based).

What is RIV?

Recombinant influenza vaccine (egg-free).

What is LAIV?

Live attenuated influenza vaccine, intranasal.

Name examples of inactivated influenza vaccines.

Afluria, Fluarix, Flulaval, Fluzone, Flucelvax.

What is the dose and route for IIV?

0.25-0.5 mL IM, age-based.

What recombinant influenza vaccine is available?

Flublok, 0.5 mL IM, ≥9 years.

What is the adjuvanted influenza vaccine for older adults?

Fluad, 0.5 mL IM, ≥65 or ≥18 post-transplant on immunosuppressants.

What is the high-dose influenza vaccine for older adults?

Fluzone High-Dose, 0.5 mL IM, ≥65 years.

What is the intranasal live attenuated influenza vaccine?

Flumist, 0.2 mL IN, ages 2-49, healthy, non-pregnant.

How should influenza vaccines be stored?

Refrigerator at 35-46°F (2-8°C). Do not freeze.

From what age is influenza vaccination recommended?

At or older than 6 months for most IIV vaccines.

What is the age cutoff for Flublok?

At or older than 9 years.

Which influenza vaccines are specifically indicated for those above 65 years?

Fluad and Fluzone High-Dose.

What is the age range for Flumist (LAIV)?

2-49 years, healthy, non-pregnant.

Who should receive influenza vaccine annually?

All individuals ≥6 months old without contraindications.

What does the AAP recommend for children 3-17 with Hematopoietic Cell Transplant?

Two doses of Fluzone High-Dose (28-42 days apart). Not FDA-approved, but recommended by AAP.

What are common local adverse effects of influenza vaccines?

Injection site soreness and redness.

What are common systemic adverse effects of influenza vaccines?

Low-grade fever, fatigue, myalgia, headache.

What rare but severe adverse event is associated with influenza vaccine?

Anaphylaxis

What neurologic condition is a precaution after influenza vaccination?

Guillain-Barré syndrome within 6 weeks after a prior flu shot.

Which antivirals interact with LAIV and should be avoided before or after vaccination?

Oseltamivir/zanamivir (avoid 48h), peramivir (avoid 5 days), baloxavir (avoid 17 days).

Which allergen in influenza vaccines is not a contraindication?

Egg protein

What allergens are present in Flumist?

Gelatin

What preservatives may be present in some influenza vaccine vials?

Thimerosal (in multidose vials).

What is the main contraindication for influenza vaccines?

Severe allergic reaction to a prior dose or component (not egg)

What is a general precaution before giving influenza vaccine?

Moderate or severe illness (defer until recovery).

Who should NOT receive LAIV?

Pregnant individuals, children

What is the pathogen that causes pneumococcal disease?

Streptococcus pneumoniae (pneumococcus)

How is Streptococcus pneumoniae classified?

By capsular polysaccharide serotypes (>100 identified)

What invasive diseases are prevented by pneumococcal vaccination?

Meningitis, bacteremia, bacteremic pneumonia, osteomyelitis, peritonitis.

What non-invasive diseases are prevented by pneumococcal vaccination?

Non-bacteremic pneumonia, otitis media, sinusitis

How is pneumococcal disease transmitted?

Respiratory droplets (coughing, sneezing, secretions)

How else can pneumococcus spread aside from active illness?

From nasal carriage to invasive disease.

What percentage of adults are asymptomatic carriers of pneumococcus?

About 10%

What percentage of children are asymptomatic carriers of pneumococcus?

20-60%.

Which age groups are at higher risk for severe pneumococcal disease?

Children under 5 and adults over 65 years.

Which chronic diseases increase risk for pneumococcal disease?

Diabetes, lung disease, liver disease, heart disease, kidney disease.

Which lifestyle factors increase pneumococcal risk?

Alcoholism and tobacco use.

Which immunocompromised conditions increase risk?

Cancer, radiation therapy, HIV infection, immunosuppression, transplant

Which specific anatomic/functional conditions increase risk?

Cochlear implants, cerebrospinal fluid leak, asplenia, sickle cell disease.

What type of vaccine is PPSV23?

Polysaccharide vaccine.

What type of vaccines are PCV15, PCV20, PCV21?

Conjugate vaccines (T-cell dependent, longer protection).

What is the brand name for PPSV23?

Pneumovax 23.

What is the dose and route for PPSV23?

0.5 mL IM or SQ, covers 23 serotypes.

What is the brand name for PCV15?

Vaxneuvance

What is the dose and route for PCV15?

0.5 mL IM, covers 15 serotypes, contains alum adjuvant

What is the brand name for PCV20?

Prevnar 20.

What is the dose and route for PCV20?

0.5 mL IM, covers 20 serotypes, contains alum adjuvant.

What is the brand name for PCV21?

Capvaxive.

What is the dose and route for PCV21?

0.5 mL IM, covers 21 serotypes, approved for adults 18 years and older.

How should pneumococcal vaccines be stored?

Refrigerate 36-46°F (2-8°C), protect from light, do not freeze.

What is the minimum approved age for PPSV23?

At or above 2 years (risk-based).

What is the approved age range for PCV15 and PCV20?

At or above 6 weeks through adulthood.

What is the approved age for PCV21?

Adults 18 years or older.

What is the routine pneumococcal vaccine schedule for infants?

PCV15 or PCV20 at 2, 4, 6, and 12-15 months.

What are the catch-up recommendations for children?

Can receive catch up vaccine up till age 5 for healthy children and up till age 18 for high-risk children.

What is the recommendation for adults at or above 50 years with no prior PCV?

Give PCV15, 20, or 21.

If PCV15 is used in adults, what additional vaccine is required?

PPSV23, with timing based on risk (8 weeks vs 1 year).

Which adults aged 19-49 should be vaccinated?

Those with high-risk conditions.

What is the timing recommendation for pneumococcal vaccines before certain procedures or therapies?

Vaccinate at least 2 weeks before splenectomy, cochlear implant, or immunosuppressive therapy if possible.

What are the common local adverse effects of pneumococcal vaccines?

Pain, redness, swelling.

What are the common systemic adverse effects of pneumococcal vaccines?

Fever, headache, fatigue, myalgia, decreased appetite or sleep.

What severe allergic reaction can pneumococcal vaccines cause?

Anaphylaxis

Can pneumococcal vaccines be given with other non-pneumococcal vaccines?

Yes, they can be co-administered.

If both PCV15 and PPSV23 are needed, what spacing should be used in immunocompromised patients, those with CSF leak, or cochlear implant?

8 weeks

If both PCV15 and PPSV23 are needed, what spacing should be used in other adults?

1 year

What preservative is in PPSV23?

Phenol

What adjuvants are in PCV15, PCV20, and PCV21?

Aluminum adjuvant.

What additional components are in PCV15 and PCV21?

Polysorbate and histidine

What is the main contraindication for pneumococcal vaccines?

Severe allergic reaction to a prior dose or component.

What is a precaution for pneumococcal vaccines?

Moderate or severe acute illness (defer until recovery).

What pathogen causes COVID-19?

SARS-CoV-2 (RNA virus, Coronaviridae)

What illness is prevented by COVID-19 vaccination?

COVID-19 (mild to severe respiratory illness).

What complications of COVID-19 are reduced by vaccination?

Pneumonia, myocarditis, blood clots, neurologic effects, long-COVID.

How does COVID-19 vaccination benefit pregnancy?

Reduces preterm birth and stillbirth.

How is SARS-CoV-2 transmitted?

Respiratory: airborne particles and droplets (coughing, sneezing, singing).

When is a person with COVID-19 infectious?

From 2 days before symptom onset to 8-10 days after symptoms begin.

Which ages have the highest risk of death from COVID-19?

Ages 75 years and older (highest risk); 65-74 years with comorbidities.

Which age group has the highest pediatric risk from COVID-19?

Less than 6 months.

Which chronic conditions increase COVID-19 risk?

Asthma, COPD, diabetes, CKD, liver disease, CAD, stroke, obesity, smoking, mental health disorders, disabilities.

Which immune and blood conditions increase COVID-19 risk?

Immunocompromised states and blood disorders.

Which populations related to pregnancy and childhood are higher risk for Covid?

Pregnant individuals; infants/young children; older children with chronic conditions.

What are the mRNA COVID-19 vaccines?

Comirnaty (Pfizer), Spikevax (Moderna), mNexspike (Moderna).

What is the protein subunit COVID-19 vaccine?

Nuvaxovid (Novavax, adjuvanted).

What are the Comirnaty (Pfizer) dose volumes and age group strengths?

0.3 mL total volume: 3 mcg for 6 mos-4 yrs; 10 mcg for 5-11 yrs; 30 mcg for ≥12 yrs