Vaccines Quiz Review for Health Assessment

Most flu vaccines are THIMERASOL-free or thimerosal-reduced and some are EGG-free.

True

1 multiple choice option

What kind of flu vaccine should older adults 65 and up recieve?

A higher dose or adjuvinated

What are the 3 kinds of flu vaccines for older adults?

FLUZONE High-Dose Quadrivalent, FLUBLOK Quadrivalent, or FLAUD Quadrivalent

Why should older adults who are 65 and up receive a higher dose or an adjuvinated flu vaccine?

For this age group, these vaccines are potentially MORE EFFECTIVE than standard dose unadjuvinated vaccines.

Generally, when should most older adults and pregnant people in the 1st and 3rd trimester NOT get vaccinated?

EARLY (in July or August), because protection may decrease over time. However, early vaccination can be considered for ANY person who is unable to return at a later time to be vaccinated.

Who can recieve the nasal spray flu vaccine?

Individuals aged 2-49 years

Should individuals equal to or more than 6 months of age with an egg allergy get the flu vaccine?

Yes, any influenza vaccine (egg or non-egg based) that is otherwise appropriate for the recipient's age and health status can be used.

Severe and life-threatening reactions to vaccines can occur with any vaccine and in any vaccine recipient, regardless of allergy history.

True

1 multiple choice option

What are precautions taken in case there are any severe and life-threatening reactions to a vaccine?

They are administered in settings in which personnel and equipment needed for RAPID RECOGNITION and TREATMENT of acute hypersensitivity REACTIONS are available.

Before a vaccine is administered to an individual with a history of a severe allergic reaction (such as anaphylaxis) to any component of that vaccine, what must be done?

They must be CONTRAINDICATED.

At what age should individuals recieve the RSV vaccine?

Those who are 60 and older, especially if they have a WEAKENED immune system.

An individual who has a cold CANNOT receive their RSV vaccine.

False

1 multiple choice option

What are the two types of RSV vaccines?

RSVPreF3 (Arexvy) and RSVpreF (Abrysvo)

Is the RSV vaccine single or triple dose?

Single dose

What are some side effects of the RSV vaccine?

Pain, redness, swelling where the shot was given, fatigue, fever, headache, nausea, diarrhea, and muscle/joint pain

When is the best time to get the RSV vaccine?

In the LATE summer and EARLY fall, which is just before RSV usually starts to spread.

Which populations are at higher risk for a severe RSV infection?

Older adults

Adults w/ chronic heart or lung disease

Adults w/ weakened immune systems

Adults w/ certain other underlying medical conditions

Adults living in nursing homes or long-term care facilities

When is someone contraindicated for the RSV vaccine?

If they have had an ALLERGIC REACTION to any of its components.

What symptoms do adults get when they have an RSV infection?

Mild COLD-LIKE symptoms but some may develop pneumonia or a lung infection

What can RSV lead to?

A worsening of serious conditions such as Asthma, COPD, and CHF.

What does Shingrix do?

Prevents Herpes-Zoster or shingles

Which people should get a Shingrix vaccine?

Individuals aged 50 and over and adults aged 19 and over with WEAKENED immune systems.

If you have had shingles, received Zostavax, received the varicella (chickenpox) vaccine, then you should NOT get the Shingrix vaccine.

False

1 multiple choice option

How does the Shingrix (recombinant zoster) vaccine work?

It is given in 2 doses, 2 to 6 months apart.

What are contraindications for the Shingrix vaccine?

A severe allergic REACTION to any component of the vaccine or after a previous dose.

What virus causes both chickenpox and shingles?

The varicella-zoster virus because it can REACTIVATE years later.

How long does immunity stay strong for after recieving the Shingrix vaccine?

At least 7 years after

Who should get the pneumococcal vaccine?

Adults 65 years or older

Adults 19-64 years with certain risk conditions

What are the 3 different types of pneumococcal vaccines?

Pneumococcal conjugate vaccines: PCV15 and PCV20

Pneumococcal polysaccharide vaccine: PPSV23

For adults 65 and older who have never received a pneumococcal vaccine:

Option 1: Give 1 dose of PCV15, followed by PPSV23 at least 1 year later.

Option 2: Give 1 dose of PCV20 (no PPSV23 needed).

For adults with certain risk conditions such as immunocompromised, cochlear implant, and cerebrospinal fluid leak:

Give 1 dose of PCV15, PCV20, or PPSV23.

PCV20 dose should be given at least 1 year after PCV13.

PPSV23 dose should be given at least 8 weeks after PCV13 or PCV15.

If given PCV20, a PPSV23 dose is not needed.

For those who have previously received PPSV23:

Give 1 dose of PCV15 or PCV20 at least 1 year after the most recent PPSV23 vaccination.

For those who have previously received PCV13 (Prevnar 13):

Give 1 dose of either PCV20 or PPSV23 at least 1 year after it is given.

For those who received PCV13 at any age and PPSV23 before the age of 65:

1 dose of PCV20 or PPSV23 is complete.

A PCV20 dose is given at least 5 years after the last pneumococcal vaccine.

A PPSV23 dose is given at least 5 years after the last PPSV23 dose and also given at least 1 year after the last PCV13 dose.

PPSV23 dose given at least 5 years after the last PPSV23 dose and also given at least 8 weeks after the PCV13 dose (if immunocompromised, cochlar implant, or cerebrospinal fluid leak)

What is the Tdap vaccination guideline for those who have never received one?

1 dose of Tdap then a booster every 10 years.

What is pertussis?

AKA whooping cough

HIGHLY COMMUNICABLE disease that causes uncontrollable and violent COUGHING that makes it hard to eat, drink, and breathe. Symptoms also include post-tussive (coughing) VOMITING. It is on the rise with increasing mortality and morbidity and is extremely serious in BABIES and YOUNG CHILDREN since it can cause pneumonia, convulsions, brain damage, or death. In teens and adults, it can cause weight loss, loss of bladder control, passing out, and rib fractures from severe coughing.

What is diptheria?

Symptoms include a sore throat, low fever, and an ADHERENT MEMBRANE (pseudomembrane) on the tonsils/pharynx/nasal cavity. This can lead to difficulty breathing, heart failure, paralysis, and death.

What is tetanus?

Symptoms include painful stiffening of the muscles are caused by TETANOSPASM, a neurotoxin and often involves a cut or deep puncture WOUND. Can lead to serious health problems including being unable to open the mouth, having trouble swallowing/breathing, and death.

What is important to remember about wound management with Tdap?

For CLEAN and MINOR wounds, administer Tdap if it has been 10 years since the last dose.

For ALL OTHER wounds, administer Tdap if the last dose was given 5 or more years ago.

Which COVID-19 vaccines does the CDC recommend for 2023-2024?

Pfizer-BioNTech, Moderna, or Novavax

Who should get a COVID-19 vaccine?

EVERYONE aged 5 years or older should get 1 dose of an updated vaccine to protect against serious illnesses.

People who are moderately or severely IMMUNOCOMPROMISED may get ADDITIONAL doses of the updated vaccine.

For adults aged 65 years and older who received 1 dose of any updated 2023-2024 COVID-19 vaccine:

Give 1 additional dose of an updated COVID-19 vaccine at least 4 months after the previous dose.

What are the responsibilities of nurses regarding vaccinations?

Ensure correct STORAGE to maintain potency.

Check for correct ADMINISTRATION (needle size).

Check for correct documentation of site, manufacturer, and lot #.

If 2 are given, use SEPERATE sites, and note which immunization in which leg.

VIS should be given to all patients/parents before administration. Teach parents about care after immunizations.

What are VIS?

Vaccine Information Statements describe risks, benefits, and side effects of vaccines.

What are some common and potential reactions to vaccines?

Usually erythema, tenderness at the injection site, and a low-grade fever. In children, there may be BEHAVIORAL changes such as crying, irritability, drowsiness, fretfulness, and eating less.

When should the Hep B vaccine be given to children?

At birth, at 1-2 months, and at 6 to 18 months.

Where should the Hep B vaccine be given to children?

In the vastus lateralis

Why is it important to know whether the mother is HbsAg positive or not?

This means that they have an ACTIVE hepatitis B infection, thus, the infant is at high risk of acquiring it during birth. To prevent transmission, the infant should receive the Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG) shortly after birth.

When and how is the Hep A vaccine given to children?

1st at 1 years old and a 2nd dose at least 6 months later up to age 23 months.

What are symptoms of rotavirus in children?

Diarrhea, vomiting, and dehydration

When is rotarix (RV1) given to children?

At 2 and 4 months

When is RotaTeq (RV5) given to children?

This is a THREE-DOSE series at 2, 4, and 6 months. This should be completed before 8 months of age.

When and how is the DTaP vaccine given to children?

It is a FIVE-DOSE series given at 2, 4, 6, 15-18 months, and 4-6 years.

When is the Tdap booster given to children?

Ages 11-12

At what age should a child get the DTap vs. the Tdap vaccine?

If they are 7 and younger, then they get the former.

If they are greater than 7 years old, then they are the latter.

When and how is the HIB (haemophilus influenzae type b) vaccine given to children?

TWO OR THREE-DOSE series between 2-6 months depending on which vaccine.

When is the HIB booster given to children?

12-15 months

What does the HIB vaccine do?

Protects against meningitis

Should the HIB vaccine be given to a child more than 5 years old?

It is generally not given if at this age or more unless a consult with a pediatrician is done due to certain conditions.

Which type and when are pneumococcal vaccines given to children?

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

What does the pneumococcal vaccine do for children?

Prevents meningitis, otitis media, sinusitis, and penumonia

When both pneumococcal vaccines are needed, they are given at the same time.

False

1 multiple choice option

For children with certain conditions who have recieved recommended doses of PCV13 or PCV15 but nothing else:

They benefit from extra protection offered by PCV20 or PPSV23.

For children with certain conditions who have only had PPSV23:

They can receive important protection from PCV15 or PCV20.

What is polio?

Also called POLIOMYELITIS and is a crippling and potentially deadly infectious disease caused by th e POLIOVIRUS. It spreads from person to person and can invade an infected person's BRAIN and SPINAL CORD, causing PARALYSIS.

How and when is the polio vaccine given to children?

This is a FOUR-DOSE immunization given at 2, 4, 6-18 months, 4-6 years, and then the FINAL dose at least 6 months after the previous dose.

When is the influenza vaccine given to children?

Every YEAR in the fall starting at 6 months.

Which children need 2 doses of the influenza vaccine?

Children 6 months-8 years old who are receiving their FIRST vaccine who have not previously had a TOTAL OF TWO or more doses in their lives or whose influenza vaccination history is UNKNOWN.

What are contraindications for the flu vaccine?

Guillain Barre from the vaccine and an egg allergy. Most vaccines are egg-based, but there are some that are not.

How and when is the MMR (Measles, Mumps, and Rubella) vaccine given to children?

This is a TWO-dose series at ages 12-15 months and 4-6 years.

For children aged 12-47 months, it is recommended to administer the first dose of MMR and varicella vaccines separately. Though, MMRV may be used if parents or caregiver express a preference.

True

1 multiple choice option

When and how is the MMRV vaccine given to children?

This is a TWO-dose series that can be given to children 12 months to 12 years of age usually. The FIRST dose is given at 12-15 months and the SECOND dose is given at 4-6 years old. Some children may be separate shots of MMR and varicella, though.

What are the symptoms of measles and what can it lead to?

This is a common and viral RESPIRATORY tract infection. It causes fever, cough, runny nose, red watery eyes, and a rash commonly covers the whole body. It can lead to SEIZURES (often associated with fever), ear infections, diarrhea, and pneumonia. Rarely, it can cause brain damage or death.

What are the symptoms of mumps and what can it lead to?

This is a viral infection that affects the salivary glands. It can cause fever, headaches, muscle aches, tiredness, and loss of appetite. It can lead to deafness, swelling of the brain and/or spinal cord covering, painful swelling of the testicles/ovaries, and, very rarely, death.

What are the symptoms of rubella and what can it lead to?

This is a contagious and viral infection characterized by a distinct RED RASH. It can cause fever, sore throat, rashes, headaches, and eye irritation. It can cause ARTHRITIS in up to half of teenage and adult women. If a person gets this while pregnant, they could have a MISCARRIAGE or the baby could be born with serious BIRTH DEFECTS.

What are the symptoms of varicella and what can it lead to?

Also called "CHICKENPOX" and is highly contagious. It can cause an itchy rash, fever, tiredness, loss of appetite, and headaches. It can lead to skin infections, pneumonia, inflammation of the blood vessels, swelling of the brain and/or spinal cord covering, and infection of the blood/joints/bones. Some people who get this also get a painful rash called SHINGLES (also known as herpes-zoster) later in life.

How and when is the varicella vaccine given to children?

This is a TWO-dose series at ages 12-15 months and 4-6 years. VAR or MMRV may be administered. The SECOND dose may be given as early as 3 months after the FIRST dose, although a dose administered inadvertently after at least 4 weeks may be counted as valid.

What is the meningitis vaccine for children called?

MenACWY

When and how is the MenACWY given to children?

TWO-dose series at ages 11-12 years and 16 years

What causes meningitis, bacteremia, or septicemia?

Neisseria meningitidis

Which children may need multiple COVID-19 vaccines including at least 1 dose of the updated COVID-19 vaccine?

6 months to 4 years

What is the specific COVID-19 vaccine recommendation for children aged 6 months to 4 years?

TWO (Moderna) or THREE (Pfizer) doses of the updated vaccine depending on which they receive.

Define RSV.

Respiratory syncytial virus and is a common RESPIRATORY virus that usually causes MILD COLD-like symptoms. Most people recover in a week or two, but it can become severe in INFANTS and OLDER ADULTS who may need hospitalization.

What are monoclonal antibody products used for?

These can be used to protect infants and young children from severe RSV.

What is the RSV vaccine for children called?

nirsevimab

For all infants younger than 8 months born during or entering their 1st RSV season and infants/children 8-19 months old who are at increased risk for severe RSV disease who are entering their 2nd season:

ONE dose of nirsevimab

For all infants younger than 8 months born during the RSV season or entering their 1st season:

Except in rare circumstances, most do not need this if they were born 14 OR LESS days after their mother got the vaccine.

Define contraindication.

Conditions in a recipient that increases the RISK for a serious ADVERSE reaction. ALLERGIES to the ingredients of vaccines should be assessed and parents should notify the provider of any previous reactions prior to administering the vaccine.

Young children who receive the flu shot along with the pneumoccocal vaccine (PCV13) and/or DTap vaccine at the same time might be more likely to have a siezure caused by a fever.

True

1 multiple choice option

What is important for the nurse to communicate with parents about vaccines?

Provide FACTUAL information about disease prevention from appropriate immunization.

Clarify MISCONCEPTIONS as needed.

Most immunizations may cause slight DISCOMFORT and possibly a FEVER.

Ask about any severe allergic REACTIONS to a vaccine or its component.

Severely IMMUNOCOMPROMISED individuals should not be given LIVE vaccines.

What are contraindications for the rotavirus vaccine?

History of severe combined immunodeficiency or intussusception (intestinal obstruction that is a medical emergency)

What are contraindications for a pertussis-containing vaccine?

Development of ENCEPHALOPATHY within 7 days of the previous dose

What are PRECAUTIONS (NOT contraindications) for immunization administration?

Presence of a moderate to severe illness with or w/o a fever

Progressive NEUROLOGICAL illness (DTap)

Person or family history of SIEZURES (MMRV)

What is a nursing intervention for a sore injection site?

Applying a cool compress

What should the nurse NOT give for fever or discomfort after administering a vaccine?

Aspirin or any other aspirin-containing products

What can the nurse give for a fever (100.4 F/38 C or more) or discomfort after administering a vaccine?

Acetaminophen (Tylenol) or ibuprofen (Advil) PRN q4 hr