FNP board: Vaccines

What is the most common risk factor for breast cancer in women aged 50 years or older?

Age 50 years or older is the most common risk factor for breast cancer.

What genetic mutations increase breast cancer risk?

BRCA1 or BRCA2 gene mutations increase the risk of breast cancer.

What history increases the risk of breast cancer related to radiation therapy?

A history of high-dose radiation therapy to the chest at a young age, such as treatment for Hodgkin lymphoma, increases the risk.

What type of family history is a risk factor for breast cancer?

Having two or more first-degree relatives with breast cancer is a risk factor.

How does early menarche and late menopause affect breast cancer risk?

Early menarche and late menopause, along with nulliparity, increase the risk due to longer exposure to estrogen.

What lifestyle factor related to weight contributes to breast cancer risk?

Obesity is a risk factor as adipose tissue can synthesize small amounts of estrogen.

What are the main risk factors for cervical cancer?

Multiple sex partners, younger age of onset of sex, immunosuppression, and smoking are main risk factors for cervical cancer.

How does having multiple sex partners affect cervical cancer risk?

Having more than four lifetime partners increases the risk of cervical cancer.

How does age of sexual debut impact cervical cancer risk?

Younger age of onset of sex makes the cervix easier to infect, increasing cervical cancer risk.

What conditions increase the risk for colorectal cancer?

History of familial polyposis, first-degree relative diagnosed with colon cancer at younger than 60, and history of chronic inflammatory bowel disease increase risk.

What is a significant risk factor for prostate cancer related to age?

Being age 50 years or older is a significant risk factor for prostate cancer.

What personal history can contribute to prostate cancer risk?

Having a first-degree relative with prostate cancer is a contributing risk factor.

What behaviors increase the risk of sexually transmitted infections (STIs)?

Having anal, vaginal, or oral sex without a condom, being under the influence of alcohol or drugs, and having multiple sexual partners increase STI risks.

What is the dosing schedule for the Hepatitis B Vaccine?

The Hepatitis B Vaccine is administered in three doses: at 0, 1, and 6 months, with the first dose given at birth (monovalent hepatitis B vaccine).

What is the minimum interval between the first and second doses of the Hepatitis B Vaccine?

A minimum interval of 4 weeks is required between the first and second doses of the Hepatitis B Vaccine.

What should be done if the Hepatitis B Vaccine series is not completed?

If the series is not completed, catch up by administering doses until the three-dose series is completed; restart of the hepatitis B series is not recommended by the CDC.

Where can you find the CDC immunization recommendations for adults age 19 years or older?

Refer to the lesson "Table 4.3 CDC Immunization Recommendations for Adults and Teens Age 19 Years or Older (2023)" for a summary of CDC immunization recommendations for hepatitis B and other conditions in adults.

What should be done if a patient has only one dose of the Hepatitis B vaccine and is off the recommended schedule?

Do not restart the hepatitis B series. If only one dose has been received, give the second dose and catch up until the three-dose series is completed.

What is the primary series schedule for the COVID-19 vaccine?

The primary series for COVID-19 includes two doses given at 0 and 3-8 weeks, depending on the manufacturer.

When should a booster dose for COVID-19 vaccine be administered?

Refer to www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html for up-to-date information on COVID-19 booster doses.

What is the dosing schedule for the Hepatitis B vaccine?

Hepatitis B may require two, three, or four doses depending on the vaccine or condition.

What should be done if a patient has had one dose of the Hepatitis B vaccine and the series is incomplete?

If a patient had one dose, give the second dose during the visit; if they had two doses, give the third dose.

What is the vaccination schedule for Td and Tdap?

Tetanus/diphtheria (Td) is given every 10 years for a lifetime. Substitute one-time Tdap for Td booster (once in a lifetime).

What should be done for "dirty" wounds if the last Td dose was over 5 years ago?

Give a tetanus booster if the last dose was more than 5 years ago; if unvaccinated or not completed the primary series, administer TIG (tetanus immune globulin) for prophylaxis.

What is the recommended influenza vaccine schedule?

The quadrivalent flu vaccine should be given once a year, preferably in the fall/winter season.

Who should receive the live attenuated influenza vaccine (LAIV)?

LAIV is appropriate for healthy persons age 6 months to 49 years (not pregnant).

What are the Varicella vaccination recommendations for those born in 1980 or later?

Two doses are required: the first dose at age 12–15 months and the second dose at age 4–6 years.

What is the Zoster vaccine schedule for healthy adults aged 50 and older?

Healthy adults aged 50 years or older should receive two doses of the Zoster recombinant vaccine (RZV, Shingrix), with the second dose separated by 2–6 months.

What is the recommended schedule for Meningococcal A, C, W, Y (MenACWY)?

One or two doses depending on indication; a booster may be required for those aged 19-23 years and others at higher risk.

What is the Meningococcal B (MenB) vaccination recommendation?

Two to three doses are recommended for adolescents and young adults aged 16–23 not at increased risk for meningococcal disease.

What is the pneumococcal vaccination recommendation for adults aged 65 or older?

Administer one dose of PCV15 followed by PPSV23 or one dose of PCV20 if they have not previously received a dose of PCV 13, 15, or 20.

When should the seasonal influenza vaccine be administered each year?

Start giving the influenza injection at the end of October of each year (fall to winter season).

What does the 2023 CDC guidance say about influenza vaccination?

As long as influenza viruses circulate, vaccination should continue to be offered, even into January or later.

Why is it important for healthcare personnel to get vaccinated annually?

All healthcare personnel should get vaccinated annually to protect themselves and their patients from influenza.

What is the recommendation for people with egg allergies regarding the influenza vaccine?

If a person with an egg allergy only experiences hives, an influenza vaccine can be administered.

What forms of the influenza vaccine are available?

Influenza vaccines can be inactivated, recombinant, trivalent, or quadrivalent formulations, administered via injection, intradermal, or nasal routes.

What do high-dose influenza vaccines target?

High-dose trivalent influenza vaccine (Fluzone High-Dose) is designed for people age 65 years or older.

What is the age limit for administering live attenuated influenza vaccine (LAIV)?

LAIV is approved for use in nonpregnant healthy persons age 2 to 49 years.

What is the recommendation regarding antivirals before receiving the LAIV?

Some antivirals (amantadine, rimantadine, zanamivir, or oseltamivir) should be avoided 48 hours before vaccination, as they interfere with antibody production.

What conditions are contraindications for the LAIV?

Pregnancy, chronic diseases (e.g., asthma, COPD, renal failure, diabetes), children on aspirin therapy aged 2-17, and children aged 2-4 with asthma or a history of wheezing are contraindications.

What are contraindications for all types of influenza vaccines?

Infants aged 6 months or younger and people with severe, life-threatening allergies to components of the vaccine, not related to an egg allergy, should not receive it.

What should be done if a severe allergic reaction occurs after eating eggs?

The influenza vaccine should be administered in a medical setting under healthcare provider supervision if severe reactions occur after eating eggs.

How long does it take for the flu vaccine to become effective?

It takes about 2 weeks after vaccination to develop antibodies.

How long does immunity from the influenza vaccine last?

Protection is thought to persist for at least 6 months after vaccination.

What is the risk of early influenza vaccination?

Early vaccination (in July or August) may result in suboptimal immunity before the end of the influenza season, especially in older adults.