Childhood Immunizations Flashcards
What is the schedule of immunizations based on?
Optimize individual immune response, as well as promote community immunity
What is the basis of the discussion regarding vaccination?
Risks vs benefits
What is the problem with the “attack by antigens” idea?
We fight way more antigens daily than giving in vaccine
Who is the jerk who falsely linked vaccination to autism? How many people were involved in this study?
Dr. Wakefield
12 patients total
What is the first vaccine given? When?
Hep B
at birth and 1 and 2 months
What are the three risks of the Hep B vaccine?
Soreness
Temperature (99.9F)
How many doses are given for the Hep B vaccine?
3-4 doses
What are the vaccines that are given at 2 months? (5)
Hep B TDaP HiB PCV IPV
What are the disadvantages of giving less shots and spreading out?
Prolongs times between shots, increases risk for infectious disease
What is the best way to minimize the shots given?
Give more combination vaccines
Do you have to discuss every vaccine given, or can you give them a sheet with info, and document that they read it?
Give them the document
What is the IRIS?
Immunization registry information system–computerized record of vaccination that is available to providers
Should you delay immunization for mild illnesses (e.g. mild temp, cold, rhinorrhea, diarrhea etc)?
No
Should you immunize for other diseases if the child has a more than mild illness (e.g. fever more than 101, flu, etc)?
No
What chronic diseases should not receive vaccinations? (3)
- Immunosuppressed
- CA
- Severe allergic reaction to previous shots
What is the VIS?
Form for the IRIS system
When should flu shots be given?
6 months onward
What are the new vaccines that are given at the 12 month period? (3)
MMR
Varicella
Hep A
When should DTaP shot be given?
15 and 18 months
What are the risks of getting the varicella vaccine? (2 + rare)
- Mild rash
- Fever/pain/swelling
- Very rare–Pneumonia +szs
What are the risks of NOT getting the varicella vaccine?
- Encephalitis
- Death
- Necrotizing fasciitis 2/2/ MRSA
When is the HPV vaccine given?
11 yo
What is the appropriate response to giving the HPV vaccine?
I am not suggesting they’re having sex, but I need to give it now before they even have a chance to get it
How many serotypes does the HPV vaccine protect against?
9 serotypes
What are the risks of the HPV vaccine?
- Pain/erythema
- HA maybe
- Swelling
What is the risk of NOT getting the HPV vaccine?
Increased risk for cervical and anal cancers
Do you still give the HPV vaccine if a 16 yo kid has already had sex?
Yes
How do you approach the vaccine refusers? (3)
- Listen to concerns
- Discuss benefits/risks
- Discuss at subsequent visits
Should aspiration be used for IM injections?
No
What, generally, is the last vaccine given in a round of shots?
Most painful last
How do you improve pain control prior to 2 yo?
Breast or formula feed them during
How do you improve pain control 0-3 yo?
Hold child
What position should patients be in when given vaccine and they’re greater than 3 years old?
Upright
Is restraining children appropriate to give vaccine?
No
What age should topical pain analgesics be used prior to immunizations?
Before 12 years
Under what age should parents always be present during vaccination?
Under 10 years
