CMN 571 Final Exam Questions with Complete
Solutions
Passive Immunity 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 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 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 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 For prevention of diphtheria, tetanus, and pertussis (whooping cough)
Can be in combo with IPV & HepB, combo with IPV & HIB, or combo with IPV.
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 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 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 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.
No serious adverse reactions described.
Influenza Occurs each winter-early spring, often associated with significant morbidity and
mortality in certain high risk groups.
Annual vaccination is recommended for all persons over 6 months.
Fluzone for over 6 months. (fluvirin >4yrs and fluarix >3yrs, and afluria >9yrs)
Intranasal not currently recommened
Optimal time to vaccinate is as soon as the vaccine is available in early fall.
Two doses are recommended for children under 9yrs who did not recieve two doses in the past.
Non type 1 egg allergies can still recieve the vaccine, type 1 egg allergies may be eligible after
allergist assessment.
Adverse affects - few have fever, malaise, and myalgia.
Solutions
Passive Immunity 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 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 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 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 For prevention of diphtheria, tetanus, and pertussis (whooping cough)
Can be in combo with IPV & HepB, combo with IPV & HIB, or combo with IPV.
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 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 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 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.
No serious adverse reactions described.
Influenza Occurs each winter-early spring, often associated with significant morbidity and
mortality in certain high risk groups.
Annual vaccination is recommended for all persons over 6 months.
Fluzone for over 6 months. (fluvirin >4yrs and fluarix >3yrs, and afluria >9yrs)
Intranasal not currently recommened
Optimal time to vaccinate is as soon as the vaccine is available in early fall.
Two doses are recommended for children under 9yrs who did not recieve two doses in the past.
Non type 1 egg allergies can still recieve the vaccine, type 1 egg allergies may be eligible after
allergist assessment.
Adverse affects - few have fever, malaise, and myalgia.
