Air Force IBT Study Guide: Vaccines and Doses, Exams of Medicine

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Anaphylaxis - correct answer Generalized allergic reaction affecting one or more organ systems Adult/Child EPI doses - correct answer Adult: 1:1000 dilution 0.3mL-0.5mL or EPI Pen 0.3mL Children: .01mg/kg body weight max 0.3mL or EpiPen Jr 0.15mL 1:2000 dilution Who created VAERS? - correct answer National Childhood Vaccine Injury Act of 1986 co sponsored with CDC Who can report to VAERS? - correct answer Anyone can report to VAERS What is the Primary Purpose of VAERS? - correct answer To capture all clinically significant medical events occurring post-vaccination even if the reporter is not certain that the incident is vaccine related. Reportable Events Table - correct answer Specifically outlines which post-

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vaccination events must be reported. The need to report is also based on the amount of time that elapsed between the vaccination and the start of the event NCVIA requires the following events to be reported - correct answer Any reaction that is listed in the Vaccine Injury Table, Any reaction requiring medical attention or hospitalization, any reaction that is not listed in the Manufacturers Package Insert. Anthrax (AVIP) and Smallpox (SVP) differ from this program Gauges of needles to use ID, IM, SubQ - correct answer ID: 26-27G, IM: 22-25G. SubQ: 23-25G 7 Patient Rights - correct answer 1.Right Person

2. Right time/schedule
3. Right Vaccine
4. Right Route
5. Right dosage
6. Right documentation
7. Right Reason

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Correct angles of Injections - correct answer ID: 15 degrees IM: 90 degrees SubQ: 45 degrees Administering Smallpox - correct answer 15 sticks in a 5mm diameter, using a bifurcated needle. Percutaneous sticks. Oral vaccines - correct answer Adenovirus, oral typhoid, Ty Active Immunity - correct answer Naturally acquired: Exposed to live pathogen, develops disease, becomes immune Artificially Acquired: administration of vaccine that contains antigen Passive Immunity - correct answer Naturally acquired: passed from mother to baby through placenta. Antibodies fall quickly after birth

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Artificially acquired: short term immunity through administration by injection or IV. Also known as Immune Globulin or Gamma Globulin. Live virus vaccine examples - correct answer Yellow Fever, Measles, Mumps, Rubella, oral Polio(OPV) Live bacteria vaccines examples - correct answer BCG, oral typhoid Polysaccharides - correct answer long chains of sugar molecules that make up the surface of some bacteria Stabilizers - correct answer help vaccine retain potency even when subjected to unfavorable conditions such as heat, light, acidity, vibration and humidity. Preservatives - correct answer Keeps vaccines from being contaminated and prevent a breeding ground for bacteria, fungi and viruses. Three types of preservatives: Antibiotics (Inhibits growth of bacteria in vaccine vials) Usually uses neomycin and streptomycin,

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Formaldehyde: Only used in Anthrax Thimerosal: Also known as Merthiolate. Should be remanufactured to be Thimerosal free due to health concerns. Detergents - correct answer added to vaccines to prevent adhesion to vaccine molecules to the glass Excipients - correct answer Inert substances that act as diluents or vehicles for a drug or vaccine Adenovirus Vaccine - correct answer Trade Name: Adenovirus Vaccine Type: Live Vaccine Route: Oral Schedule: Single Dose Dose: 2 tabs Booster: None Licensing Age: 17-50yrs old Anthrax - correct answer Trade Name: Biothrax

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Abbreviation: AVA Type: Inactivated Bacteria Route: IM Schedule: Day 0, 4 weeks, 6, 12, 18 months Dose: 0.5mL Booster: Annually as needed for continued immunity Licensing Age: 18-65yrs old Hepatitis A - correct answer Trade Name: Havrix, Vaqta Abbreviation: Hep A Type: Inactivated Virus Route: IM Schedule: Day 0 and 180 Dose: 1-18 = 0.5mL, 19 and older = 1.0mL Booster: None Licensing Age: 12 months and older Hepatitis B - correct answer Trade Name: Engerix-B, Recombivax Abbreviation: Hep B Type: Inactivated Virus

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Route: IM Schedule: Day 0, 30, 180 Dose: Birth-19yrs old = 0.5mL, 20yrs and older = 1.0mL Booster: None Licensing Age: Birth and older Human Papilomavirus - correct answer Trade Name: Gardasil, Cervarix, Gardasil 9 Abbreviation: HPV4(Gardasil), HPV2(Cervarix), HPV9(Gardasil 9) Type: Inactivated Virus Route: IM Schedule: Gardasil/Gardasil 9: Day0, 60, 180 Cervarix: Day 0, 30, 180 Dose: 0.5mL Booster: None Licensing Age: Gardasil: 9-26yrs old Cervarix: 9-25yrs old Gardasil 9: 9-26yrs old (Females), 9-15yrs old (Males) Influenza (Injectable) - correct answer Trade Name: Fluzone(High dose; ID), Afluria, Fluvirin, Fluarix, Agriflu

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Abbreviation: TIV(Trivalent inactivated vaccine, H1N1) Type: Inactivated Virus Route: IM Schedule: Single Dose Dose: 0.5mL Booster: Annually Licensing Age: Fluzone: 6months and older Fluzone ID: 18- Fluzone high Dose: 65 and older Afluria: 5yrs and older Fluvirin: 4yrs and older Fluarix: 3yrs and older Agriflu: 18yrs and older Influenza Vaccine (Intranasal) - correct answer Trade Name: Flumist Abbreviation: LAIV Type: Live Attenuated Virus Route: IN Schedule: Single Dose Dose: 0.2mL Booster: Annually

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Licensing Age: 2-49yrs old Japanese Encephalitis - correct answer Trade Name: IXIARO Abbreviation: JE Type: Inactivated Virus Route: IM Schedule: Day 0 and 28 Dose: Children 2months-2yrs 0.25ml each dose, 3yrs and older 0.5mL Booster: given prior to JE virus exposure if initial is more than 1 year ago Licensing Age: 2 months and older Measles, Mumps, and Rubella - correct answer Trade Name: Measles, Mumps and Rubella Abbreviation: MMR II Type: Live Attenuated Virus Route: SubQ Schedule: Day 0 and 28 Dose: 0.5mL Booster: None Licensing Age: 12 months and older

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**RECONSTITUTED VACCINE CAN STAND FOR 8 HOURS IN

REFRIGERATOR. SWIRL VACCINE UPONE

RECONSTITUTION. DO NOT SHAKE**

Meningococcal - correct answer Trade Name: Memomune, Menactra, Menveo Abbreviation: MPSV4(Memomune), MCV4(Menactra), MCV4(Menveo) Type: Inactivated bacterial Route: Memomune: SubQ. Menactra and Menoveo: IM Schedule: MCV4: first dose age 11 or 12, booster at 16. If given after 16th birthday booster is not needed Dose: 0.5mL Booster: See above Licensing Age: Menomune:2yrs and older, Menactra: 9months-55yrs old, Menveo: 2-55yrs old Polio - correct answer Trade Name: Ipol Abbreviation: IPV Type: Inactivated Viral Route: IM

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Schedule: For previous unvaccinated people: Day 0, 1- 2months, 6-12 months Dose: 0.5mL Booster: Recommended for adults with greater risk of exposure to polio virus Licensing Age: 6 weeks and older Pneumococcal Polysaccharide - correct answer Trade Name: Pneumovax 23 Abbreviation: PPSV Type: Inactivated Bacterial Route: SubQ or IM Schedule: Give one dose if unvaccinated or vaccination history is unknown. Dose: 0.5mL Booster: 1 time revaccination to people 65 and older if 1st dose was prior to age 65 and 5 years elapsed, or 19 through 64yrs old who are at high risk and 5 years elapsed since vaccination. Licensing Age: 2yrs and older Pneumococcal Conjugate - correct answer Trade Name: Prevnar Abbreviation: PCV

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Type: Inactivated Bacterial Route: IM Schedule: give at ages 2months, 4months, 6months and 12-15months. One shot after 65yrs old Dose: 0.5mL Booster: None Licensing Age: 6 weeks through 5 years of age and 65yrs or older Rabies - correct answer Trade Name: Imovax Rabies, RabAlert Abbreviation: N/A Type: Inactivated Viral Route: IM Schedule: Pre exposure: Day 0,7,21- Post exposure(Previous vaccination): Day 0 and 3 Post exposure(NOT previously vaccinated): Days 0, 3, 7, and 14 Dose: 1.0mL Booster: 2-5years Licensing Age: All Age Groups

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Herpes Zoster - correct answer Trade Name: Zostavax Abbreviation: ZOS Type: Live Attenuated Vaccine Route: SubQ Schedule: One time dose Dose: 0.65mL Booster: N/A Licensing Age: 50 years and older ZOSTRAVAX HAS A 30 MIN SHELF LIFE AFTER RECONSTITUTION Smallpox - correct answer Trade Name: ACAM Abbreviation: None Type: Live Attenuated Virus Route: Percutaneous Schedule: Single Dose Dose: 15 jabs Booster: DoD Policy: Every 3 yrs for those with high risk exposure Licensing Age: Follow DoD Policy

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Tetanus Diphtheria - correct answer Trade Name: Decavac, Tenivac, Generic Abbreviation: Td Type: Inactivated Bacterial Toxoids Route: IM Schedule: Adults who haven't been vaccinated: Day 0, 4 weeks, 6-12 months Dose: 0.5mL Booster: 10 years Licensing Age: 7 years and older Tetanus Diphtheria Acellular Pertussis - correct answer Trade Name: Boostrix, Adacel Abbreviation: TDAP Type: Inactivated Bacterial Route: IM Schedule: Single Dose Dose: 0.5mL Booster: Single Dose Only (Td used as booster) Licensing Age: Boostrix:10yrs and older. Adacel: 10-64yrs old

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Twinrix - correct answer Trade Name: Combination vaccine containing Hep A and Hep B Abbreviation: Hep A-Hep B Type: Inactivated Viral Route: IM Schedule: Day 0, 30, 180 Dose: 1.0mL Booster: N/A Licensing Age: 18yrs and older Typhoid (Injectable) - correct answer Trade Name: Typhim Vi Abbreviation: None Type: Inactivated Bacterial Route: IM Schedule: Single dose Dose: 0.5mL Booster: 2 years Licensing Age: 2 years and older Typhoid (Oral) - correct answer Trade Name: Vivotif Berna

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Abbreviation: Ty Type: Live Attenuated Bacterial Route: PO Schedule: 4 capsules: 1 cap every other day until finished. Finish capsule 1 week before travel Dose: 4 capsules Booster: 5 years Licensing Age: 6 years and older Varicella - correct answer Trade Name: Varivax Abbreviation: VAR Type: Live Attenuated Viral Route: SubQ Schedule: Day 0 and 28 Dose: 0.5mL Booster: N/A Licensing Age: 12 months and older Yellow Fever - correct answer Trade Name: YF-Vax Abbreviation: YF Type: Live Attenuated Viral

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Route: SubQ Schedule: Single Dose Dose: 0.5mL Booster: 10 years Licensing Age: 9 months and older COMVAX - correct answer Trade Name: COMVAX Abbreviation: Hib-Hep B Type: Inactivated Bacteria Route: IM Schedule: Age 2 months, 4 months and 12-15 months Dose: 0.5mL Booster: N/A Licensing Age: 6 weeks to 15 months Diphtheria Tetanus - correct answer Trade Name: Generic Abbreviation: DT Type: Inactivated Bacteria Route: IM Schedule: 2m, 4m, 6m, 15-18m, 4-6yrs

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Dose: 0.5mL Booster: N/A Licensing Age: 6 weeks-6yrs Diphtheria, Tetanus, Acelluar Pertussis - correct answer Trade Name: Daptacel, Infarix, Tripedia Abbreviation: DTaP Type: Inactivated Bacteria Route: IM Schedule: 2m, 4m, 6m, 15-18m, 4-6yrs Dose: 0.5mL Booster: None Licensing Age: 6weeks-6yrs KINRIX - correct answer Trade Name: Kinrix Abbreviation: DTap-IPV Type: Inactivated Bacteria and Virus Route: IM Schedule: Used for 5th dose in DTap and 4th dose in IPV series for children 4-6yrs old Dose: 0.5mL Booster: N/A

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Licensing Age: 4-6yrs old PENTACEL - correct answer Trade Name: Pentacel Abbreviation: DTaP-IPV/Hib Type: Inactivated Bacteria and Virus Route: IM Schedule: 2, 4, 6, and 15-18 months of age Dose: 0.5mL Booster: N/A Licensing Age: 6 weeks-<5yrs of age Haemophilus Influenzae Type B - correct answer Trade Name: PedvaxHIB, ActHIB, Hiberix Abbreviation: Hib Type: Inactivated Bacteria Route: IM Schedule: PedvaxHIB: 2, 4, 12-15months, ActHIB:2, 4, 6, 12-15months, Hiberix: single dose at 15-18months Dose: 0.5mL Booster: N/A Licensing Age: PedvaxHIB: 6 weeks-71 months, ActHIB:

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Meningococcal Groups C and Y & Haemophilus b Tetanus Toxoid Conjugate - correct answer Trade Name: MenHibrix Abbreviation: Hib-MenCY Type: Inactivated Route: IM Schedule: 2, 4, 6, and 12 through 15 months of age Dose: 0.5mL Booster: N/A Licensing Age: 6 weeks of age through 18 months of age Diptheria-Hepatitis B-Inactivated Polio - correct answer Trade Name: Pediarix Abbreviation: DTaP-Hep B-IPV Type: Inactivated Bacteria and Virus Route: IM Schedule: 2, 4, and 6 months Dose: 0.5mL Booster: IM Licensing Age: 6 weeks through 6 months Rotavirus - correct answer Trade Name: Rota Teq, Rotarix

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Abbreviation: Rota Teq-RV5, Rotarix-RV1 Type: Live Attenuated Virus Route: PO Schedule: Rota Teq-2, 4 and 6 months, Rotarix- 2 and 4 months Dose: Rota Teq- 2.0mL, Rotarix-1.0mL Booster: N/A Licensing Age: Rota Teq-6-32 weeks of age, Rotarix Diptheria, Tetanus, (Acellular)Pertussis, and HibVaccine - correct answer Trade Name: TriHibit Abbreviation: DTaP-Hib Type: Inactivated Bacteria Route: IM Schedule: Used for fourth dose of Hib and DTaP only Dose: 0.5mL Booster: N/A Licensing Age: 15-18months Tuberculosis Transmission - correct answer Transmitted through aerosolized droplets

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PPD Dosage - correct answer 0.1mL of 5TU Strength Types of Exemptions - correct answer Medical: A. Underlying health condition(immune competence, pharmacologic or radiation therapy, pregnancy, prior response to immunization. B. Evidence of immunity based on serologic tests. Administrative: A. Separation or Retirement within 180 days may be exempt from deployment (mobility immunizations. B. Less than 30 days of service remaining. C. Religious Noncompliance with Immunizations - correct answer Military members who refuse vaccinations are subject to administrative actions under the UCMJ