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Pediatric Nursing; Immunizations, Exams of Advanced Education

University of OxfordAdvanced Education

Pediatric Nursing; Immunizations

Typology: Exams

2025/2026

Available from 02/20/2026

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Pediatric Nursing; Immunizations
Different types of Immunity - correct answer - Monoprophylaxis - preventing
infectious disease with specific antibodies
- Active Prophylaxis (Vaccines)
- Immune Response to Vaccines
- Passive Prophylaxis
- Passive immunity
*96% reduction in U.S> vaccine-preventable diseases since the pre-vaccine era**
Three reasons Infants susceptible to infection - correct answer 1. The immune
systems are not fully developed at birth
2. Passively acquired maternal antibodies provide limited protection
3. Disease protection through immunization is incomplete ( timing of immunization
is tied to the responsiveness of the infant to specific vaccines and the waning
protection from maternal antibodies
active Immunity - correct answer immunizations introduces an antigen into the
body in the form of a vaccine causing the person to naturally produce antibodies
and develop active immunity without becoming sick with the disease
passive immunity - correct answer need to prevent the disease from occurring or to
reduce its severity- does not give lasting immunity
Types of Vaccinations (5 types) - correct answer 1. Killed Virus Vaccine
2. Toxoid
3. Live virus vaccine
4. Recombinant vaccine
5. Conjugate vaccine
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Pediatric Nursing; Immunizations

Different types of Immunity - correct answer - Monoprophylaxis - preventing infectious disease with specific antibodies

  • Active Prophylaxis (Vaccines)
  • Immune Response to Vaccines
  • Passive Prophylaxis
  • Passive immunity 96% reduction in U.S> vaccine-preventable diseases since the pre-vaccine era* Three reasons Infants susceptible to infection - correct answer 1. The immune systems are not fully developed at birth
  1. Passively acquired maternal antibodies provide limited protection
  2. Disease protection through immunization is incomplete ( timing of immunization is tied to the responsiveness of the infant to specific vaccines and the waning protection from maternal antibodies active Immunity - correct answer immunizations introduces an antigen into the body in the form of a vaccine causing the person to naturally produce antibodies and develop active immunity without becoming sick with the disease passive immunity - correct answer need to prevent the disease from occurring or to reduce its severity- does not give lasting immunity Types of Vaccinations (5 types) - correct answer 1. Killed Virus Vaccine
  3. Toxoid
  4. Live virus vaccine
  5. Recombinant vaccine
  6. Conjugate vaccine

Inactivated Virus vaccine (Killed virus vaccine) - correct answer A vaccine that contains a microorganism that has been killed but i still capable to inducing the human body to produce antibodies; whole or partial subunits of virus or bacteria

  • IPV (Inactivated poliovirus vaccine)
  • Hep A (Hepatitis A)
  • Hep B (Hepatitis B)
  • DTaP, DTP, Tdap (Diphtheria Vaccine, Pertussis Vaccine, Tetanus Toxoid)
  • Hib (Haemophilus Influenzae Type B)
  • TIV (inactivated influenza vaccine)
  • MCV4 (Meningococcal Vaccine)
  • PPSV23 (Pneumococcal Polysaccharide vaccine Toxoid - correct answer A toxin that has been treated (by heat or chemical, such as formaldehyde) to weaken its toxic effects but retain its antigenicity
    • Tetanus Toxoid Live Virus Vaccine - correct answer A vaccine that contains a microorganism in live but attenuated, or weakened, form; reduced virulence
  • OPV (Oral Polio Vaccine)
  • Var (Varicella Virus Vaccine)
  • MMR (Measles, Mumps, Rubella Vaccines)
  • LAIV (live attenuated for intranasal use Influenza vaccine
  • PRV, RV5 (Rotavirus Vaccine) Recombinant Vaccine - correct answer a vaccine in which an organism has been genetically altered for use in vaccines; Genetically altered
  • Hep B (Hepatitis B)

Public health laws relating to Vaccines - correct answer - laws in all 50 states require documentation that child has received immunization as condition of first entry into school

  • health care professionals must obtain informed consent
  • VAERS (Vaccine adverse event reporting system)
  • VFC (Vaccines for children program) VFC (Vaccines for children program) - correct answer Federal program that provides free vaccines for qualified children and adolescents less than 19 years of age and has resolved some of the economic factors associated with vaccine coverage VAERS (Vaccine Adverse Event Reporting System) and Vaccine Safety Datalink Project - correct answer The Vaccine Safety Datalink project, linking the CDC with eight managed care organizations, allows monitoring regarding the adverse effects of vaccines. This data system contains data from 9 million people who did and did not get a vaccine, and did or did not experience adverse events. This system makes it possible to identify rare adverse events to vaccines. The Vaccine Safety Datalink project supplements the Vaccine Adverse Event Reporting System, which enables notification of serious vaccine adverse events from all providers.
  • Both systems are important for monitoring vaccine safety Administering vaccinations; General info - correct answer - Know route and dose of vaccine; check insert
  • Each vaccine; separate syringe and needle, Separate site for each injection
  • Give record to parent
  • Viral vaccines are kept inside refrigerator not on door (viruses are sensitive to heat)
  • Do NOT delay immunization for mild illness Needle size for IM injections - correct answer Infant
  • 1 inch
  • 22-25 gauge needle

Toddler and older children

  • 1 to 1 1/4 inch
  • 22 - 25 gauge need Needle size for SQ or intradermal injections - correct answer - 5/8 to 3/4 inch
  • 25 gauge Recommended gauge and needle for IM injection; Newborns and Preterm Infants - correct answer Recommended Length of 22 -25 Gauge needles for IM immunizations and preferred injection site; Site: Anterolateral thigh IM needle size: 5/8 inch (16mm) Recommended gauge and needle for IM injection; Infants 1 to 12 months - correct answer Recommended Length of 22 -25 Gauge needles for IM immunizations and preferred injection site; Site: Anterolateral thigh IM needle size: 1 inch (25 mm) Recommended gauge and needle for IM injection; Toddlers 1 to 2 years - correct answer Recommended Length of 22 -25 Gauge needles for IM immunizations and preferred injection site; Site: Anterolateral thigh** preferred IM needle size: 1 to 1 1/4 inch (25-32 mm) Can also use: Site: Deltoid muscle of arm IM needle size: 5/8 to 1 inch (16 - 25mm)

Risks associated with Vaccination - correct answer - Allergy

  • Anaphylaxis
  • Guillain Barre Syndrome; peripheral neuropathy with an acute onset of rapidly developing symmetric motor weakness. Symptoms may initially present as pain, numbness, paresthesia, or weakness in all limbs. Weakness progresses bilaterally over days up to 4 weeks and can lead to respiratory distress and death if not diagnosed. Diphtheria, Tetanus, Pertussis (DTP, DTaP, Tdap); disease, type of vaccine, ages given, route - correct answer - Diphtheria; may lead to breathing problems, heart failure, paralysis
  • Tetanus; bacteria enters through wound - painful muscle spasms "lock-jaw"
  • Pertussis (Whopping cough) - coughing, choking for several weeks causing the infant to be unable to eat, drink, breathe Type: Inactivated Vaccine Route: IM Ages Given: 2m, 4m, 6m, 15-18m, 4-6 years Storage: refrigerate, irreversible loss of potency if frozen Diphtheria, Tetanus, Pertussis (DTP, DTap, Tdap); Contraindications, precautions, delay administration - correct answer Contraindications;
  • Precious encephalopathy within 7 days after DTaP
  • Progressive neurologic disorder (ex. epilepsy) Precautions;
  • Fever 40.5 C (105 F)or higher within 48 hours
  • COntinuous inconsolable crying lasing greater than 3 hours within 48 hours
  • Pale or limp episodes or collapse within 48 hours
  • Seizure within 3 days of dose Delay administration
  • Until moderate to severe febrile illness is resolved
  • Defer until a progressive neurologic problem is stable Diptheria Tetanus (DT) - correct answer Age: Given to children less than 7 years of age if child had serious prior reaction OR if parent refuses pertussis component of DTP Route: IM Type: Inactivated For persons greater than 7 years of age:
  • Boosters recommended for children 11-12 years of age (if 5 years have elapsed since last dose of DTaP/DT)
  • DT booster every 10 years Adacel - correct answer New recommendation - Adacel; Tdap-adolescent preparation
  • Tetanus
  • Acellular Pertussis
  • Diphtheria Persons who should receive this;
  • Over 11 - 64 years of age
  • health care professionals
  • Replace one dose of DT as booster Inactivated Polio Vaccine (IPV) - correct answer Type: Inactivated Route: SQ or IM (depending on brand) Ages Given: 2m, 4m, 6-18m, 4-6 years of age- may give initial dose as early as 6 weeks of age

Ages Given: 3 doses required- there is variability of vaccine schedule when administering Hep B

  • birth-2m, 1 month and 6 months after initial vaccination
  • If mother is Hep B+ (HBsAg+ or unknown), give neonate Hep B vaccine within 12 hours of life and give HBIG (Hepatitis B Immune Globulin) Measles, Mumps, Rubella (MMR) - correct answer Type: Live, attenuated vaccine Route: SQ Ages Give: 12-15 m, 4-6 years of age (two doses) MMR may be combined with the Varicella vaccine (MMRV)
  • must be given on or after 1st birthday Measles, Mumps, Rubella (MMR); Adverse effects - correct answer Adverse Effects: (due to measles component) Seen 7-10 days after vaccination
  • Fever and rash (common)
  • Seizure due to fever
  • Encephalopathy
  • Thrombocytopenia (due to measles and rubella component) Measles, Mumps, Rubella (MMR); Contraindications - correct answer Contraindications:
  • Anaphylactic reaction to prior dose or any vaccine component; eggs, neomycin, gelatin
  • Immunocompromised persons; HIV/AIDS, high dose or long term use to corticosteriods, and chemotherapy
  • If person received blood products within 3 - 11 months do not give MMR because possibility of no response
  • Can not be pregnant and must avoid becoming pregnant for 3 months Varicella Vaccine (Chicken pox) - correct answer Type: Live, attenuated vaccine Route: SQ

Ages Given: 12-18m, 4-6 yr (two doses) Contraindications

  • Allergic reaction to varicella vaccine, neomycin, gelatin
  • Serious illness, immunocompromised: HIV/AIDS, high dose or long term use of corticosteroids, chemotherapy
  • If received Blood products within 3 to 11 months Can not be pregnant and must avoid becoming pregnant for 3 months Pneumococcal Conjugate (PCV13) - correct answer Type: Conjugate vaccine Route: IM Ages Given: 2m, 4m, 6m, 12-15m; given at 24-59m if any dose is missing Pneumococcus; oval shaped encapsulated, non-spore forming gram positive organism that causes;
  • pneumonia
  • otitis media
  • meningitis Effective against Strep Pneumoniae; S. pneumoniae;
  • Pathogen that kills more than 1 million children world wide each year
  • Pneumococcal antibiotic response is increasing rapidly therefore it is better to prevent than treat Hepatitis A (Hep A) - correct answer Type: Inactivated Route: IM Ages given: 12-23 months or 2-18 years; first dose followed by second dose 6- 12months later
  • Vaccinate children older than 1 year

Influenza Vaccine; LAIV (Live, Attenuated Influenza Vaccine) - correct answer Type: Live attenuated for intranasal use Route: intranasal (patients 2 years and older)

  • Recommended for ages 5-49 years
  • Healthy patient Rotavirus Vaccine; PRV, RV5 - correct answer Type; Live Route: Oral Ages Given: 2m, 4m, 6m (3 doses)
  • do not start the series if the infant is 15 weeks of age or older Contraindications;
  • hypersensitivity/allergic reaction
  • Severe Combined Immunodeficiency Syndrome (SCID)
  • H/O intussusception Warnings:
  • no safety in immunocompromised patients; high doses corticosteroids, HIV/AIDS, blood products within 42 days Human papillomavirus Vaccine (HPV) - correct answer Gardasil, Cervarix Type: Recombinant Route: IM Ages Given: 11-26 years of age, female and male
  • three doses; administer the second dose 1 to 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose)