CMN 571 Final
Laws related to administering vaccines: VIS - correct answer All vaccine providers, public or
private, are required by the National Vaccine Childhood Injury Act to give the appropriate VIS to
the patient (or parent or legal representative) prior to every dose of specific vaccines.
The appropriate VIS must be given prior to the vaccination, and must be given prior to each
dose of a multi-dose series. It must be given regardless of the age of the recipient.
What is required to be recorded in the medical record? - correct answer The edition date of
the VIS (found on the back at the right bottom corner).
The date the VIS is provided (i.e., the date of the visit when the vaccine is administered).
The office address and name and title of the person who administers the vaccine.
The date the vaccine is administered.
The vaccine manufacturer and lot number.
Vaccines at birth - correct answer Hep B
Vaccines at 4 months - correct answer D - Dtap
R - Rotovirus
H - HIB
I - IPV
P - PCV
Vaccines at 2 months - correct answer B - Hep B
D - Dtap
R - Rotovirus
H - HIB
I - IPV
,CMN 571 Final
P - PCV
Vaccines at 6 months - correct answer B - Hep B
D - Dtap
R - Rotovirus
H - HIB
I - IPV
P - PCV
Vaccines at 12-15 months - correct answer M - MMR
A - HepA
D - Dtap
H - HIB
P - PCV
V- Varicella
Vaccines at 4-6 years - correct answer VERY - Varicella
D - DTAP
I - IPV
M - MMR
Active immunity - correct answer Resistance developed in response to infection with an agent
resulting in antibody production. Active immunity is usually permanent. Can be either naturally
acquired through exposure and infection with the disease or artificially acquired through
immunization. Onset is 2-4 weeks and duration is years to lifetime.
,CMN 571 Final
Passive Immunity - correct answer A person is given antibodies to a disease rather than
producing them through his or her own immune system. This is short term immunity through
introduction of antibodies to a disease. Can occur naturally as in the passage of antibodies from
the mother to the fetus during pregnancy or artificially acquired through injection of antibodies
such as gamma globulin. Onset is within 24 hours of the dose and duration is about 4-6 months.
Herd Immunity - correct answer This occurs when a significant portion of the population is
vaccinated and that provides a portion of immunity for those that have not developed
immunity. The population (herd) helps prevent disease in the unprotected population. The herd
protects those who can not safely get vaccinations. Generally 90 -95% of the population should
be to be vaccinated to have effective Herd immunity.
Hep B Vaccine - correct answer 3 dose schedule: 1st Should be given within 24 hours of birth
(12 hours if mother + or unknown HBsAg status). 2nd at 2 months and 3rd at 6 months.
Low rate of adverse events.
Contraindications: Do not give to anyone with serious allergic reaction to yeast.
Can be solo vaccine (engerix-B/Recombivax HB) or combined with Dtap & IPV (pediarix)
Rotavirus Vaccine - correct answer Rotavirus is the most common cause of severe
gastroenteritis among young children.
Two vaccines available - RV5 (Rotateq) and RV1 (Rotarix).
RV5 is 3 dose schedule at 2, 4, 6 months. RV1 is 2 dose schedule at 2 & 4 months.
Risks and contraindications: Risk of intussusception, should not be given to infants with history.
RV1 should not be given to infants with severe latex allergy (package is latex). Both vaccines are
contraindicated in SCID. Should be deferred in infants with acute moderate to sever
gastroenteritis.
DTaP Vaccine - correct answer For prevention of diphtheria, tetanus, and pertussis (whooping
cough)
Can be in combo with IPV & HepB, combo with IPV & HIB, or combo with IPV.
, CMN 571 Final
Should be deferred in individuals with progressive neuromuscular disorders until neuro status is
clarified and stabilized.
Moderate to severe systemic effects: fever, inconsolable crying, hypotonic-hyporesponsive
episodes.
HIB Vaccine - correct answer Haemophilus influenzae type B - causes a wide spectrum of
serious infections bacterial illnesses, particularly in young children, including meningitis,
epiglottitis, pneumonia, septic arthritis, and cellulitis. Can be solo vaccine or combo with Dtap
and IPV. Given as series of 3 or 4 doses (depending on formula) OMP is 3 - T is 4.
Not recommended in children over 5 yrs
Should not be given to infants under 6 weeks
Adverse effects are uncommon.
Pneumococcal vaccine - correct answer Streptococcus pneumoniae - leading cause of invasive
bacterial disease in children, causes febrile bacteremia, bacterial sepsis, meningitis, and
pneumonia. Also a common cause of otitis media and sinusitis. Two vaccines in use: PCV13 and
PCV23 (only 2yrs and older).
PCV13 given in 4 doses.
Both vaccines should be deferred during moderate or severe acute illness with or without fever.
Adverse effects: fever, injection site reactions, irritabilit, and increased or decreased sleep.
Not proven - when given in conjunction with flu vaccine increased risk of febrile seizures.
Poliomyelitis - correct answer Polioviruses cause acute flaccid paralysis via destruction of the
motor neurons.
IPV only vaccine available in the US, CANNOT cause polio.
Can be combined wth Dtap, Hep B, or HIB.
4 Dose series
Contraindications/Precautions: Should be deferred during moderate to severe illnesses with or
without fever. Pregnancy is a precaution.
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