Immunizations Flashcards
Hepatitis B - # Doses, Ages, SE
- 3 doses (first dose monovalent, other combos) for everyone
- @ Birth - 2 - 6 months
- Last dose cannot be given before 6 months
- Normal SE (fever, HA, site soreness)
Hepatitis B - Special situations
- Mother positive for Heb B: give HBIG immunoglobulin <12hrs of birth and first dose of vaccine
- Mother’s status unknown? Give Hep B vaccine <12hrs of birth, and HBIG IF <2000g
*If >2000g, need HBIG < 1 week
DTaP - # Doses, Ages, SE
- 5 doses
- @ 2, 4, 6, 15 -18 months, 4-6 years
- Irritability, anorexia, tiredness, vomiting + normal SE for 1-3 days
Catch up schedule dependent on child’s age at first dose
Start Tdap at 11 -12
Precaution recommended if hx of Guillen Barre within 6 weeks of prior T/Dtap dose
DTaP /Tdap- Special situations (wound)
Wound management with hx of 3 doses:
<7 yrs give dose if > 5 years since last dose (unless clean/minor wound)
> 7 yrs, if clean/minor wound, yes if > 10 years since last dose
For other wounds, give if >5 years since last dose
Tdap # Doses, Ages, SE
1 dose @ 11-12 years, then Q 10 years
Same SE as Dtap, minus irritability
1 dose early in every pregnancy (for pertussis)
IPV - Doses, Ages, SE
4 - dose series
@ 2, 4, 6 - 18 months, and 4-6 years
*Final dose must be administered >on/after 4th birthday but > 6 months from prior dose
*If schedule started with OPV, should finish with IPV
SE are site swelling, pain, redness
Rotavirus - Doses, Ages, SE, Special situations
Rotarix = 2 doses @ 2, 4 months
RotaT (THREE)eq = 3 doses @ 2, 4, 6, months
If type unknown, always default to 3 dose
Risk factor of intussusception, thus cannot give 8 months
Cannot starts series after 15 weeks
PCV13 - Doses, Ages, SE, Special situations
4 dose series
@ 2, 4, 6 months and 12 - 15 months
Use separate injection site
If series incomplete, and ages 2- 4.9 years (59 months) give one dose if healthy
SE are site symptoms, HA, drowsiness, anorexia
PPSV23 - Doses, Ages, SE
Can give @ 2 years - 18 years if:
- Hemoglobinopathies
- Spleen problems
- HIV
-Kidney problems (nephrotic syndrome, failure) - Chronic pulmonary/cardiac disease
- Diabetes or congenital immunodeficiencies
Hib - Doses, Ages, SE
4 doses
@ 2, 4, 6, 12-15 months
If >5 years, no doses are recommended
SE are site swelling/redness/fever
Influenza - Doses, Ages, SE
-IIV: >6 months
-LAIV4 > 2 years
RIV ONLY for > 18 years
If first dose ever and < 8years, give two doses 4 weeks apart
Common SE
Influenza - special situations for LAIV4
- contains 4 viruses
- cannot give in pregnancy, or with those with immunosuppression?
-Nasal spray version may cause runny nose
MMR - Doses, Ages, SE
2 doses
@ 12 months, 4-6 years (technically, 2nd dose can be give >4 weeks after dose)
Mild rash, temporary pain and muscle stiffness mostly in women not immune to rubella component
MMR - Special situations
Contraindicated in:
- mod/severe illness, pregnancy, immunosuppression
Precaution for recent blood product, family history of any seizures (MMRV only)
May be given with TB testing, but precaution recommended however best practice to delay PPD for 4-6 weeks to avoid a suppressive response (cause a false negative TB result)
Early vaccination recommended at 6 to 11 months for children during a measles outbreak
Early vaccination is also recommended if an infant 6 to 11 months old is to travel outside of the United States
Varicella - Doses, Ages, SE
2 doses
@ 12 months, 4-6 years
For catch up doses, wait 3 months between if < 13, or 4 weeks if > 13yrs
MMRV can be given at either if parents express preference, but max age is 12 years
SE are generalized rash, maculopapular, sometimes mild shingles, but not all cases caused by vaccine
Varicella - Special situations
Contraindicated in mod/severe illness, pregnancy, immunosuppression
Precautions in recent blood product, acyclovir or aspirin
For MMRV family or personal hx of seizure
For catch up, wait 3 months between doses if <13, if >13 minimum of 4 weeks
Hepatitis A - Doses, Ages, SE
2 doses
12 months, 18 months
Can give through age 18
Can’t give in moderate/severe illness
systemic reactions uncommon
HPV - Doses, Ages, SE
2 doses if started before < 15 years, 2nd dose given 6-12 months later
3 doses if >15 years, or immunocompromised
SE can include muscle, joint pain, FAINTING, counsel to lie down and be observed for 15 minutes post admin
Meningococcal sero group ACYW- Doses, Ages, SE
2 doses
@ 11-12 years, and 16 years
SE can be localized reaction, fever > 100, HA, malaise, fatigue
approved in infants as young as 2 months old, who are at an increased risk of meningococcal disease. Since asplenia poses a high risk of contracting meningococcal infection, the child should receive the meningococcal conjugate vaccine now, and continue to be revaccinated every 5 years for lasting protection.
Give meningococcal vaccine to child with sickle cell early (2 months), number of doses in series depends on age 4-2 doses (2 @ 7 months or older)
Men B (sero group B) - Doses, Ages, SE
Not routine
2 doses, 2nd dose 6 months after first
3 doses starting at age 10 if sickle cell or asplenic (2nd dose in 1-2 months, 3rd dose at 6 months)
Can give starting @v 16 years - 23
Bexsero and trumenba not interchangeable
Live vaccine pearls
- Live vaccines if not given on same day, must wait 4 weeks
- Ideal to give antibody products 2 weeks prior, or wait 3-11 months
- Delay live virus vaccines >3 months post chemo therapy
