[01.14a] Childhood Immunizations (Part 1) V2.pdf

Induces immunity against a specific disease, prevents disease, decreases severity/complications, and reduces community transmission

What are the four primary goals of immunization?

One of the most beneficial and cost-effective disease prevention measures available

How is immunization characterized in terms of public health value?

Active immunity

What type of immunity is achieved by stimulating the immune system via a prolonged humoral or cellular response?

Passive immunity

Which type of immunity involves the administration of an antibody-containing preparation?

Mimic the infection with little to no risk

What is the design goal of active immunity vaccines?

More long-lasting

How does the duration of active immunity compare to passive immunity?

Immediate yet transient protection

What is the nature of the protection provided by passive immunity?

Weeks to months

How long does passive immunity typically last?

Immunodeficient children, post-exposure prophylaxis, or as part of disease treatment

In what three situations is passive immunity commonly utilized?

Whole inactivated microorganisms, parts of organisms, polysaccharide capsules, live-attenuated, toxoids, and mRNA

What are six examples of active immunity preparations?

Transplacental passage of maternal IgG and breastfeeding IgA

What are two examples of natural passive immunity?

IVIG, IMIG, SCIG, and specific Ig preparations like HepB Ig or Rabies Ig

What are four examples of artificial passive immunity?

Attenuated or modified microbes

What is the core content of a live vaccine?

Inactivated, subunit, toxoids, and recombinant vaccines

What are the four main types of non-live vaccines?

Live vaccines

Which vaccine type produces a response nearly identical to a natural infection?

Non-live vaccines

Which vaccine type usually requires boosters because the immunity is not as long-lasting?

Circulating antibodies in the body

What can interfere with the replication of live vaccines?

Live vaccines

Which vaccine type is usually contraindicated in immunocompromised patients?

Orally or subcutaneously

What are the two common routes for live vaccines?

Intramuscular

What is the standard route for non-live vaccines?

BCG, Oral cholera, Oral typhoid, Oral rotavirus, Oral polio, MMR, MMRV, Varicella, JEV, and LAIV

What are ten examples of live vaccines?

DTaP/Tdap, HepB, IPV, HiB, HPV, Meningococcal, Pneumococcal, Rabies, and Inactivated Flu

What are nine examples of non-live vaccines?

Influenza and Hepatitis A

Which two vaccines have both live and non-live formulations?

Actual vaccine component consisting of a virus, bacteria, or toxoid

What is an immunizing antigen?

Sterile water, saline, or complex fluid

What constitutes the suspending fluid of a vaccine?

Inhibit bacterial growth and prevent degradation from heat or pH changes

What is the purpose of preservatives, stabilizers, and antimicrobial agents?

Adjuvants

Which vaccine component is added specifically to enhance the immune response?

Proteins chemically combined with polysaccharide antigens to increase the immune response

What are vaccine conjugates?

Ethylmercury

What type of mercury is found in the preservative Thimerosal?

No correlation

What does scientific evidence say about the link between ethylmercury and autism?

Aluminum

What common vaccine adjuvant is safe and comparable to amounts found in breastmilk or formula?

Proper hand hygiene

What is considered sufficient preparation for vaccine administration instead of wearing gloves?

15 minutes

How long is the recommended observation period after vaccination?

Anaphylaxis and syncope

What two conditions are monitored for during the post-vaccination observation period?

At least 1 inch

If giving multiple injections in the same limb, how far apart should the sites be?

HPV and MMR

Which two vaccines should be administered last in a series because they are more painful?

Anterolateral thigh

What is the general injection site for smaller patients and infants?

Deltoid

Which site is used more frequently as the child grows older?

LAIV

Which specific vaccine is administered via the intranasal route?

One side of the inside of the cheek between the cheek and gum toward the back of the mouth

What is the specific technique for oral vaccine administration to prevent choking?

OPV and Rotavirus

What are two common oral vaccines?

BCG and Rabies

Which two vaccines are given via the intradermal route?

10 to 15 degrees

What is the correct needle angle for an intradermal injection?

Formation of a wheal

What should be the visible result of a successful intradermal injection?

Measles, MMR, Varicella, MCV, and JEV

What are five examples of vaccines given subcutaneously?

45 degrees

What is the correct needle angle for a subcutaneous injection?

Upper triceps or anterolateral thigh

What are the two sites for subcutaneous injections?

90 degrees

What is the correct needle angle for an intramuscular injection?

Anterolateral aspect of the middle to upper thigh

Where is the IM injection site for children younger than 2 years?

Deltoid area

Where is the IM injection site for children aged 2 years and older?

5/8 inch

What is the recommended needle length for IM injection in a newborn?

1 inch

What is the recommended needle length for IM injection in an infant aged 1 to 12 months?

1 to 1 1/4 inch

What is the recommended needle length for IM injection in a toddler aged 1 to 2 years?

5/8 to 1 inch

What is the recommended needle length for a deltoid injection in children aged 3 to 18 years?

Tactile stimulation like rubbing the site before and after

What physical technique is known to lessen injection pain?

Asking the parent to hold the child, breastfeeding, or sweet-tasting solutions

What are three pain management strategies for children 3 years and younger?

Sitting up and using distraction

What are two strategies for children 3 years and older?

Prolongs the procedure and heightens pain without safety benefit

Why is aspirating for blood no longer recommended?

Affects efficacy and does not lessen pain

Why is warming a vaccine by rubbing your hands not recommended?

EMLA

What is an example of a topical anesthetic that can be applied 30 minutes before an injection?

Shot blocker

What is the name of the plastic tool that uses blunt tips to distract from injection pain?

Infancy

At what life stage are children at highest risk for severe diseases like influenza and measles?

At the earliest opportunity

When should catch-up vaccinations be administered?

Combination vaccines

What is preferred over separate injections to reduce the number of needles needed?

Never

When is it acceptable to mix individual vaccines in the same syringe if not formulated that way?

May be administered simultaneously or at any interval

What is the spacing rule for two or more non-live vaccines?

May be administered simultaneously or at any interval

What is the spacing rule for a combination of live and non-live vaccines?

28-day minimum interval

What is the spacing rule for two or more live vaccines if not given simultaneously?

Live oral vaccines

Which type of live vaccine can be given at any interval relative to other vaccines?

PCV first, followed by PPSV 8 weeks later

What is the specific spacing rule for PCV and PPSV23?

MenACWY-D before or at the same time as DTaP

What is the rule for spacing Menactra and DTaP?

Not before 2 years of age

When should Menactra be given if a child is also receiving PCV?

4 days or fewer

How many days before the minimum age or interval is a vaccine dose still considered valid?

5 days or more

If a dose is given this many days early, it is not counted and must be repeated.

Continue the series without restarting

What should be done if the interval between doses is longer than recommended?

Use the brand with the higher number of doses

If brands in a series require different dose counts, what is the rule for completion?

Anaphylactic reaction to a prior dose or constituent

What is the absolute general contraindication for vaccines?

Moderate to severe acute illness

In what clinical situation should vaccination be deferred?

Vaccinate as scheduled

What is the rule for children with mild illnesses like colds?

Generally treat as unvaccinated

What is the rule for a child with an unknown vaccination history?

No harm

Is it dangerous to repeat a series of vaccines if the history is unknown?

Hepatitis A, Hepatitis B, Varicella, and Measles

For which four diseases is serologic testing an option to confirm immunity?

Inactivate certain live-virus vaccines and reduce immunogenicity

How do antibody-containing products affect live vaccines?

Live intranasal and live oral vaccines

Which live vaccines are not affected by antibody-containing products?

Any time

When can non-live vaccines be given in relation to antibody-containing products?

No interval; can administer vaccines

What is the rule for live vaccines after receiving washed RBCs?

3 to 4 months

How long should live vaccines be delayed after receiving hyperimmune globulins?

11 months

How long should live vaccines be delayed after high-dose IVIG for Kawasaki disease?

Tdap, Influenza, COVID-19, and RSV

What four vaccines are routinely recommended for pregnant women?

Contraindicated

What is the status of live vaccines during pregnancy?

Contextual, individual/group, and vaccine-specific influences

What are the three categories of the WHO Vaccine Hesitancy Matrix?

2017 Dengvaxia controversy

What local event in the Philippines is a major factor in vaccine hesitancy?

High standard of safety because they are given to healthy individuals

What should physicians emphasize about vaccine safety to parents?

Presumptive format

What communication style uses close-ended statements to recommend vaccines?

Your child is due for several vaccines today

What is an example of a presumptive statement?

Only a small portion

Does vaccination use a large or small portion of the immune system's memory?

No link

What does scientific evidence say about vaccines causing autism or SIDS?

Strengthens

Do vaccines weaken or strengthen the immune system?

Early infancy

When do many vaccine preventable diseases occur, making delays dangerous?

Cold chain

What system must be maintained to ensure vaccine efficacy?