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Thera II > Immunizations > Flashcards

Immunizations Flashcards

1
Q

Hep B schedule

A

9-17 years
Usually grade 7
Months 0 + 4 months (recombivax) or 0, 6 (engerix)
2 dose is licensed for use in kids 11-15yo
If they didn’t receive their second dose prior to 16 birthday, a 3 dose series is required

Months 0, 1, 6 mo

Alternatively can be given with DTAP vaccine with first dose at 2 months, second dose at 4 months and 6 months and then a normal DTAP- IPV- HIB at 18 months (12-23mo)

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2
Q

DTAP schedule

A

DTAP- IPV- HIB

2, 4,6,18 mo (has 12-23 months to give)

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3
Q

Pneu C 13 schedule

A

2 mo, 4 mo , 1 year

Only to 6 weeks to 4 year olds

Remember 3= 3 doses in routine schedule

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4
Q

When should people receive TDAP and what is the schedule (TDAP-IPV) and TDAP and Td

A

> 6 years

TDAP- IPV = 4 years

TDAP = 14 years and 24 years

Td= Q10 years

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5
Q

IPV schedule

A

With DTAP

DTAP- IPV-HIB

2,4,6 and 18 mo and 4

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6
Q

HIB schedule // when is it no longer indicated

A

With DTAP 2,4,6,18 mo

No longer indicated if > 4 years

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7
Q

Rotavirus // when is it no longer required

A

2 mo, 4 mo

after 8 months of age

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8
Q

When should people get their tetanus shot

A

Routine tetanus vaccines

Adults previously not immunized

Post exposure / wound

Every pregnancy regardless of immunization status (need pertussis and flu vaccine)

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9
Q

Men-C-C schedule

A

1 year (12-48 mo)

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10
Q

Men C ACYW

A

Starts around 12 years (grade 7)
Single dose

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11
Q

MMR vaccines schedule

A

1 year (12-15mo) = only 1 dose

Second dose is in MMRV at 4 years old

At 15 months they get varicella dose

Can have second dose after 18 months no later than school time entry

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12
Q

MMRV schedule

A

Usually MMR-12 months
Varicella at 15 months
MMRV at 4 years

If 7-17 year old unvaccinated

Can do 2 doses of MMRV at least 3 months apart (if <12)

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13
Q

First dose varicella

A

at 15 months

Second dose is with MMRV at 4 years old
Can do after 18 months of age before school age

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14
Q

HPV vaccine (HPV9)

A

Grade 7 (9-14)
<15 year olds (male/ female)
2 dose series: @0, 6 mo

If > 15 -26 years females:
HPV9(gardasil) @ 0, 2, 6 mo

If > 9-26 males:
HPV9(gardasil) @0,2, 6 mo

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15
Q

Influenza vaccine

A

<9 years and never received influenza

X2 vaccines 4 weeks apart for the first one and then annually

> 9 years and never received influenza
X1 vaccine annually

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16
Q

Catch up schedule for 7-17 year
TDAP-IPV
HIB
ROT
PNEU C13
MEN-C-C
MEN-C-ACYW
MMR
Varicella
HB
HPV
Influenza

A

DTAP- stops at 6 years so not eligible

TDAP-IPV:
3 dose series / not 4 // it’s not DTAP (6weeks-6 years is for DTAP)
*** same schedule but 0,2, 12 months) instead of 2,4,6,18

HIB:
6weeks-4 years only
Not required

ROT- not eligible <8 months

PNEUC13 = not eligible 6 weeks -4 years

MEN-C-C if
If <13 years old:
Give one dose at first visit
If >13 year old:
Not eligible

** individuals born after Sept 1 2003 are eligible to receive a dose of Men-C-C. these individuals are also eligible to receive the Men-C-ACYW in grade 7. Or they received the MEN-ACYW, men C-C not required**

MEN-C-ACYW:
School immunization in grade 7-12
>4 weeks is required between Men-C and this one

MMR:
If <13 yo:
MMRV(4-12 year olds only) at first visit
2 doses: 0, 2 months

If >13 year:
MMR at first visit
2 doses: 0,2 months

Varicella
<13 =
Not required cause getting it in MMRV

> 13 = give at first visit
2 does at 0, 2 mo

HB
- school immunization grade 7-12
Usually grade 7
Months 0 + 4 months after first dose
2 dose is licensed for use in kids 11-15yo
If they didn’t receive their second dose prior to 16 birthday, a 3 dose series is required
Months 0, 1, 6 mo

HPV
-school immunizations grade 7-12

Grade 7 (9-14)
<15 year olds (male/ female)
2 dose series: @0, 6 mo

If > 15 -26 years females:
HPV9(gardasil) @ 0, 2, 6 mo

If > 9-26 males:
HPV9(gardasil) @0,2, 6 mo

Influenza
Every fall

17
Q

Catch up schedule for 1-6 year olds

A

TDAP-IPV:
- >7 year olds

DTAP-IPV- HiB
6 weeks to 6 years
First visit (0), 2mo, 4mo, and 6-12 after 3rd dose months after 3rd visit
If the child is 7 years on third dose then he gets TDAP-IPV instead with a booster 6-12 months after that one

HIB
6weeks-4 years only
(Although it is covered only for 4 years , they can give it 5-6 years in DTAP series

MEN-C-C:
If <13 years old:
Give one dose at first visit

MEN-C-ACYW:
School immunization in grade 7-12
>4 weeks is required between Men-C and this one

MMR:
If <4 years: MMR

If > 4 years: MMRV
MMRV(4-12 year olds only)

Both at first visit
2 doses: 0mo (MMR) <4 years
MMR= 2 doses at least 4 weeks apart
2 doses: 0, 3 mo after (MMRV)
MMRV= 2 doses at least 3 months apart

Varicella
Not required cause getting it in MMRV (>4 year olds)
If <4 years @ 0, 3 months apart
Varicella 2 doses at least 3 months apart

HB
- school immunization grade 7-12
Usually grade 7
Months 0 + 4 months after first dose
2 dose is licensed for use in kids 11-15yo
If they didn’t receive their second dose prior to 16 birthday, a 3 dose series is required
Months 0, 1, 6 mo

HPV
-school immunizations grade 7-12

Grade 7 (9-14)
<15 year olds (male/ female)
2 dose series: @0, 6 mo

If > 15 -26 years females:
HPV9(gardasil) @ 0, 2, 6 mo

If > 9-26 males:
HPV9(gardasil) @0,2, 6 mo

Influenza
Every fall

18
Q

Catch up for >17 yo

A

TDAP- IPV
1 dose of TDAP- IPV (>18)
The vaccines at 2, 6-12 mo and Q10 is Td only
0, 2 , 6-12 mo after
So at 0= TDAP-IPV
2, 6-12 mo(Td)

IPV is separate and follows the Td schedule at 2, 6-12 (stupid but it’s not together)

MMR = only good (MMRV is only for 4-12 year olds)

MMR at 0, 2 months
If born before 1970 presumed to be immune.

Varicella at 0 and 2 mo after (only if born after 2000) before presumed to be immune

Pneu C13 = not eligible (6w-4 years)
Pneu 23= only >65

Men C-C = 1986-1996 = 1 dose
Men C ACYW= 1997- younger = 1 dose

19
Q

Covid 19 who should be hospitalized ?

A

Cold, clammy, confusion
Decrease u/o, difficulty breathing, hemoptysis, non-blanching rash, SOB at rest, worsening respiratory symptoms

20
Q

Treatment for mild Covid

A

Supportive / Tylenol NSAIDs

21
Q

Treatment with mild illness at high risk for severe disease ?

A

Paxlovid (nirmatrelvir) BID x 5 days
- should be initiated within 5 days of symptom onset

Remdesivir IV - within 7 days of symptom onset

High risk:
CKD
Moderate or severe liver disease
DM
Obesity >30 bmi
Heart disease, HTN, CHF
Chronic respiratory disease like CF
CP
Intellectual disability
Sickle cell disease

Dex only recommended for hospital

22
Q

Antivirals for influenza / when to initiate for prevention

A

If LTC, antivirals should be given asap

Oseltamivir (Tamiflu) is first line agent during outbreaks 75 mg PO OD x 10 days (begin within 36 hours after exposure)

23
Q

Which influenza vaccine should be given for >65

A

IIV4 HD (high dose quadrivalent inactivated)

Standard dose is good too

24
Q

Which influenza vaccine for 6 months to 17 years

A

Quadrivalent inactivated influenza vaccine IIV4

25
Q

When is it CI for influenza ?

A

Anaphylaxis

Guillain bare syndrome within 6 weeks of subsequent influenza vaccines

Safe to use if egg allergy

26
Q

Treatment for influenza (mild)

A

Tylenol/ ibuprofen
** children should not use ASA due to risk of Reye’s syndrome

Antivirals not recommended for healthy adults and children

27
Q

Treatment for influenza

A

1 treatment is Tylenol (do not use ibuprofen after 20 Weeks)

1-64 who have chronic conditions or are immunocompromiaed or >65 strongly suspected or confirmed based on symptoms

** treatment best initiated within 48 hours of onset of symptoms **

High risk for complications:
Cardiac/respiratory disorders, DM, cancer, metabolic disorder, renal disease / CKD, anemia, hemoglinipathy, neurological development mental conditions, morbid obesity >40, LTC residents, pregnancy, indigenous

Tamiflu (oseltamivir) 75mg BID x 5 days

Pregnancy
#1 prevention with influenza vaccines

Or oseltamivir (safe)

28
Q

Vaccines during Pregnancy

A

Influenza

TDAP 27-36 weeks GA

Avoid all live vaccines

Rubella non immune mothers should wait till delivery for immunization

Those with negative varicella serology should undergo serology and if not immune avoid anyone who is sick

29
Q

MMRV is good for which population only?

A

4-12 year olds

30
Q

DTAP is good for which population only until you move on to TDAP

A

6 weeks to 6 years

31
Q

HIB schedule / when is it no longer required

A

6 weeks to 4 years

Schedule is with DTAP-IPV-Hib at 2,4,6,18 months

32
Q

Men-C-C eligible for who?

A

Those born after September 1 2003

Or between 1986-1996

33
Q

Men C ACYW eligible for who?

A

Those born 1997 and up

Thera II (12 decks)

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