Immunizations Flashcards
Hep B schedule
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)
DTAP schedule
DTAP- IPV- HIB
2, 4,6,18 mo (has 12-23 months to give)
Pneu C 13 schedule
2 mo, 4 mo , 1 year
Only to 6 weeks to 4 year olds
Remember 3= 3 doses in routine schedule
When should people receive TDAP and what is the schedule (TDAP-IPV) and TDAP and Td
> 6 years
TDAP- IPV = 4 years
TDAP = 14 years and 24 years
Td= Q10 years
IPV schedule
With DTAP
DTAP- IPV-HIB
2,4,6 and 18 mo and 4
HIB schedule // when is it no longer indicated
With DTAP 2,4,6,18 mo
No longer indicated if > 4 years
Rotavirus // when is it no longer required
2 mo, 4 mo
after 8 months of age
When should people get their tetanus shot
Routine tetanus vaccines
Adults previously not immunized
Post exposure / wound
Every pregnancy regardless of immunization status (need pertussis and flu vaccine)
Men-C-C schedule
1 year (12-48 mo)
Men C ACYW
Starts around 12 years (grade 7)
Single dose
MMR vaccines schedule
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
MMRV schedule
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)
First dose varicella
at 15 months
Second dose is with MMRV at 4 years old
Can do after 18 months of age before school age
HPV vaccine (HPV9)
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 vaccine
<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
Catch up schedule for 7-17 year
TDAP-IPV
HIB
ROT
PNEU C13
MEN-C-C
MEN-C-ACYW
MMR
Varicella
HB
HPV
Influenza
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
Catch up schedule for 1-6 year olds
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
Catch up for >17 yo
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
Covid 19 who should be hospitalized ?
Cold, clammy, confusion
Decrease u/o, difficulty breathing, hemoptysis, non-blanching rash, SOB at rest, worsening respiratory symptoms
Treatment for mild Covid
Supportive / Tylenol NSAIDs
Treatment with mild illness at high risk for severe disease ?
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
Antivirals for influenza / when to initiate for prevention
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)
Which influenza vaccine should be given for >65
IIV4 HD (high dose quadrivalent inactivated)
Standard dose is good too
Which influenza vaccine for 6 months to 17 years
Quadrivalent inactivated influenza vaccine IIV4
