Peds Test #2- Immunization Powerpoint

When is the meningococcal vaccine recommended?

11-12 years old with a booster at 16 years

When is hepatitis A vaccine recommended?

12-23 months with second dose 6 months later

At what ages is the pneumococcal conjugate vaccine routinely offered?

2, 4, 6, & 12-18 months.

When is the rotavirus vaccine recommended?

2, 4, and 6 months of age.

When is the human papilloma virus vaccine (HPV) recommended?

3 dose series started at 11-12 years of age

How many total doses are recommended for the diptheria, tetanus & acellular pertussis (DTaP) vaccine?

5 total (2, 4, 6, 15-18 months, 4-6 years) Booster is given as TDaP @ 11-12 years if TD booster has not been given.

The MMR and Varicella vaccines are given at what ages? A. 12-15 months & 4-6 years B. 2, 4, & 6 months C. 11 months & 11 years D. Birth, 1 month, & 6-18 months.

A

Which of the following is a contraindication for giving the rotavirus vaccine (RV)? (select all) A. >32 weeks old B. Previous fever of 100.0 w/ last vaccination C. History of intussusception D. Previous injection site swelling w/ last vaccination

A & C

Which of the following are examples or characteristics of passive artificial immunity? (select all) A. Lasts approximately 6 weeks B. HBIG C. Gives immediate protection D. DTaP

A, B, C (D- is active artificial immunization (diptheria, tetanus, and acellular pertussis)

Which of the following children should the nurse question an order to give the MMR vaccine to? (select all) A. The 5 month old admitted for projectile vomiting. B. The 1 year old admitted for pneumonia receiving IV steroids C. The 18 month old who has never received MMR vaccine. D. The 15 month old who has never received the MMR vaccine and has a white blood cell count of 900.

A, B, D (C- This child would be appropriate to give the vaccine to. The child who is 5 months old is too young to receive this live vaccine (not to be given until 12 months old). Steroids lower the immune system's response to antigens so this child should not receive this vaccine for another 3 months after steroids are completed. The 15 month old needs it but cannot receive it due to a very low white blood cell count. (normal is 4500 to 10,000).

Which of the following are characteristics or examples of inactivated vaccines? (select all) A. Requires multiple doses. B. First dose only primes the immune response C. Provides long-term immunity without boosters D. Haemophilus influenzae type B vaccine (Hib) E. Passive artificial immunity

A, B, D (C- some of the inactivated vaccines require boosters. For example, a tetanus booster is needed if injury or burn occurs and it has been >10 yrs since last tetanus vaccine. E- It is active artificial immunity because you are receiving an injection (making it artificial) and your body is making antibodies, even though it is slower than response to live-attenuated vaccines.)

Which of the following are characteristics of passive natural immunity? (select all) A. Typically lasts 4-6 months B. Requires mother to have previously had the disease or immunization C. Should not be given to people who are immunocompromised or pregnant. D. Protection from measles via this route can last up to 1 year

A, B, D (C-this is not a vaccination) This occurs whenever antibodies are transferred to the fetus from the mom through the placenta. The mother cannot transfer antibodies if she has not had the disease or been vaccinated against it because she doesn't have antibodies to it in that case.

Which of the following immunizations are typically given at 4-6 years of age? (select all) A. DTaP B. MMR C. Hib D. HepB E. IPV F. Varicella

A, B, E, F

Which of the following are characteristics or examples of active artificial immunity? (select all) A. Immunizations such as MMR, LAIV, Varicella, DTaP B. Provides immediate protection C. Some cannot be given to persons who are immunocompromised or pregnant D. Provides long-term protection

A, C, D (B- this describes passive artificial immunity such as an immune globulin injection.) Active artificial immunity refers to immunizations, live or inactivated. Protection is longer term with live and inactivated immunizations than with immune globulin injections because of memory cells in the immune system forming whenever your body produces its own antibodies rather than just receiving antibodies through an injection. Live vaccines, one form of artificial immunity, are not given to people who are immunocompromised or pregnant.

Which of the following are minor expected reactions to vaccinations? (select all) A. Redness at injection site B. Angioedema C. Decreased appetite D. Low-grade fever E. Inconsolable crying F. Hives

A, C, D (B- this is swelling of the skin and may indicate allergic reaction. E- crying is expected but should be able to console the child. F-Hives indicate an allergic reaction.)

Varicella vaccine protects against which of the following? A. Chickenpox B. Measles C. Haemophilus influenzae type B D. Polio

A- Chickenpox

Children receiving immune globulin or blood products should wait how long before receiving MMR or Varicella vaccines?

At least 3 months

The mother of the child is questioning why the child is recommended to receive the MMR and Varicella vaccines again at his 1 year old well-child visit whenever he received them already at 6 months old. Which of the following is an appropriate response? A. The MMR and Varicella vaccines are given at 6 months and again at 12-15 months. B. The MMR and Varicella vaccines are not supposed to be given before 12 months of age because the child still has mother's immunity and the vaccine was most likely neutralized. C. The MMR and Varicella vaccines have recently changed because the old vaccines were not working. D. Apologize for the mistake because the mother is right; these vaccines are not indicated at this time.

B

A child is at their 4 year well-child visit and is due for their next Polio vaccine. Which of the following are not recommended? (select all) A. IPV B. OPV C. Giving polio vaccine to child w/ anaphylactic allergy to neomycin, streptomycin, or polymixin B. D. Giving the polio vaccine at 4 years old.

B & C (A- This is the form of this vaccine that is to be given. OPV is oral polio vaccine, which has caused vaccine associated paralytic polio & is only given if child is going to endemic area in less than 4 weeks and is given to people to control mass outbreak. Polio vaccine is recommended at 2, 4, 6-18 months, & at 4-6 years old. )

Which of the following are true regarding vaccinations? A. If a child has missed one vaccination in the series, you need to start the series over. B. There is no evidence to suggest that giving multiple vaccinations in one visit is harmful. C. Parents need educated on the moderate risk of autism after vaccination. D. Some diseases such as German measles no longer exist so it is not as important to receive a vaccine for them.

B is true. (A- you do not have to start the series over, just pick up where it left off. C- there has been no evidence to suggest that vaccinations cause autism. D- the diseases we vaccinate for do still exist, but are not prevalent in our country because of immunity through vaccinations)

Which of the following are characteristics or examples of live-attenuated vaccines? (select all) A. TDaP B. Replicate so produce a more effective immune response C. Closely resembles disease D. Provides longer lasting immunity than inactivated vaccines E. Active natural immunity

B, C, D (A- TDaP is an inactivated vaccine. E- It is active artificial immunity because it is a vaccine but our body is producing antibodies)

Which of the following are contraindications for receiving a vaccination? (select all) A. 4 months of age or less B. Anaphylactic reaction to previous immunization or substance in immunization C. Encephalopathy without known cause within 7 days of administration of DTP, DTaP, or Tdap D. Currently immunocompromised or altered immune system receiving live vaccine

B, C, D (A- immunizations are given to children < 4 months of age including HepB, RV, DTaP, Hib, PCV, and IPV.)

Which type of immunity is achieved when antigens injected into the body stimulate production of antibodies? A. Passive artificial immunity B. Active artificial immunity C. Passive natural immunity D. Active natural immunity

B- The body is actively making antibodies but the source of antigen was artificial (given through vaccination).

Which type of immunity involves antibodies made synthetically or from animal serum that are injected to give rapid immunity? A. Active artificial immunity B. Passive artificial immunity C. Active natural immunity D. Passive natural immunity

B- The person receiving this immunity did not have to form their own antibodies, making it passive. The antibodies are preformed and injected into the individual, which is not a natural process, making it artificial.

The 11 year old just received their first Gardisil shot. Which of the following would be recommended? A. Scheduling her second shot in 1 month and third shot in 3 months. B. Scheduling her second shot in 2 months and her third shot in 6 months C. Scheduling her second and third shots in 6 months D. Scheduling her second and third shots in 3 months

B- There needs to be a 24 week (6 month) interval between the 1st HPV vaccine and the last one.

A mother who is hepatitis B surface antigen positive has just given birth to a 7 lb 8 oz baby boy. Which of the following would be appropriate regarding his vaccinations? A. He needs HepB vaccine within 12 hours of birth and HepB vaccine at 1 month and again at 6-18 months old. B. He needs HepB vaccine within 12 hours of birth along with HepB immune globulin within 12 hours of birth and then HepB vaccine at 1 month and again at 6-18 months old. C. He needs HepB vaccine plus HepB immune globulin at 1 month then HepB vaccine again at 6-18 months. D. He needs HepB vaccine at 1 month then HepB vaccine again at 2 months and again at 6-18 months old.

B- This is recommended for infants of mothers who are HBsAg positive. (A- this is the recommendation for infants of mothers who are known to be HBsAg negative or if their status is unknown. C-Not one of the recommendations. D-Not one of the recommendations.)

After offering a parent the varicella vaccine for their 1 year old child, the parent states that they do not want the child to get it because she heard that it gives the child the chickenpox anyway. Which of the following responses would be most appropriate? A. That cannot happen because this isn't a live vaccine. B. You should really reconsider vaccinating because the chickenpox could kill your child. C. A small percentage of children do get the chicken pox after receiving the vaccine, but it is a milder case than without the vaccine. D. The vaccine contains a weakened form of the virus that cannot cause the child to get chickenpox.

C- 3-5% of children do get a mild case of the chickenpox from the vaccine.

Which type of immunity involves production of antibodies after natural invasion of the pathogens and lasts a lifetime? A. Active artificial immunity B. Passive artificial immunity C. Active natural immunity D. Passive natural immunity

C- Active natural immunity means that you got sick and your body produced antibodies to the antigen that caused you to get sick. You did not receive a vaccination.

During the well-child visit in April for a 1 year old boy, the immunization records indicate that he has received all of the following: @ 2 months- HepB, RV, DTaP, Hib, PCV, IPV. @ 4 months- RV, DTaP, Hib, PCV, IPV. @ 6 months- HepB, RV, DTaP, Hib, PCV, IPV, MMR & Varicella. What immunizations are recommended at this time? A. HepB & DTaP B. Hib & HepB C. MMR, Varicella, Hib, PCV, HepA D. MMR, Varicella, HepB, PCV, HepA

C- These are all recommended at this time.

A 15 year old is in your clinic for a physical for the school soccer team. You review immunization records to verify that the adolescent is up to date. You notice that they have not received the chickenpox vaccination before, nor have they ever had the chickenpox. Which of the following would be recommended? A. Do not offer the vaccine. It is not recommended for those older than 5 years of age. B. Give 2 doses of the vaccine during this visit. C. Give 1 dose of the vaccine during this visit and ask them to schedule an appointment in 1 month to get the second dose. D. Give 2 doses of the vaccine during this visit, but choose different injection sites.

C- This is the recommended catch up schedule for the varicella vaccine after 13 years of age.

When is the varicella vaccine given? A. @ 2, 4, and 6 months B. @ birth, 1 month, and 12-15 months C. @ 12-15 months and 4-6 years D. @ 6 months and 4-6 years

C- Varicella is a live vaccine and is not given until after the 1 year mark. MMR is given on the same schedule of 12-15 months and again at 4-6 years.

Which of the following is the most powerful and persistent barrier to receiving routine vaccinations? A. Ignorance B. Unwillingness C. Religious beliefs D. Poverty

D (According to the notes, poverty is the most powerful and persistent barrier to receiving vaccinations.)

Which type of immunity involves antibodies transferred across placenta to fetus from mother? A. Active artificial immunity B. Passive artificial immunity C. Active natural immunity D. Passive natural immunity

D- The baby did not have to produce its own antibodies (making it passive) because they were transferred through the placenta from their mother's blood (natural process).

What site is recommended for children under 3 years old to give immunizations in? A. Deltoid B. Gluteus maximus C. Ventrogluteal D. Vastus lateralis

D- Vastus lateralis

True or False: Smallpox vaccine is recommended for all healthcare personnel.

False- Smallpox vaccine is currently only recommended for smallpox response team members because benefit of vaccination currently does not outweigh the risk.

How many times is the haemophilus influenzae type B vaccine given and at what ages?

Given 4 times total @ 2 mo. , 4 mo., 6 mo., & 12-15 mo.

For healthy children who have not received the haemophilus influenzae type B (Hib) vaccine by 5 years old, is it recommended to give?

No, not unless the child is immune compromised

True or False: Varicella vaccine is a state requirement prior to attendance to a daycare facility.

True