immunizations

Question 1

when does the advisory committee on immunization practices publish updated immunization schedules

Answer 1

annually in January

Question 2

Administration on all vaccines given except influenza

Answer 2

0.5 mL IM or SQ depending on vaccine

Question 3

What type of vaccine MUST be given as first dose

Answer 3

monovalent

Question 4

Hep B Vaccine

Answer 4

-All Newborns: 1st dose before hospital discharge
-Second Dose: 1-2 months of age: monovalent or combo vaccine containing Hep B

-infants born to hepB antigen + mothers:
- admin hep B vax within 12 hr of birth
- Test for HBsAG and Antibody after 3 or more doses of Hep B series at 9-18 months

Question 5

Rotovirus

Answer 5

-Series of 3 from 6-32 wks
-admin 1st dose 6-14 wks and each subsequent at 4 wk intervals
-must complete series before 32 wks
- do not admin a dose after age of 32 weeks

Question 6

DTaP

Answer 6

-series of 3 primart (2-4-6) and boosters (15 m & 6 yr)
-DTaP not indicated for children 7 or older

Question 7

Tdap

Answer 7

-Series of 1 at 11 or 12 with subsequent every 10 years

Question 8

HIB Conjugate

Answer 8

Series of 3 primary(2-4-6) and 1 booster (12 m)

Question 9

Pneumococcal Vaccine (PCV13 and PPSV23)

Answer 9

PCV13
-Series of 3 primary (2-4-6) and 1 booster (12m)

PPSV23
-Children 24-59 m if they have the following: hemoglobinopathies; aslenia; splenic dysfunction;HIV; congenital immunodeficiencies; renal failure; nephrotic syndrome; chronic cardiac disease; COPD; diabetes; consider in this age group if Native AMerican, AA or alaskan descent or attending daycare

Question 10

Polio

Answer 10

-Series of 2 (2,4,6 and 6 yr)
-IPV (Inactivated vaccine) for all

Question 11

Flu

Answer 11

-One dose annually
- beginning at 6 m
-0.25 mL IM 6-35 months
-0.50 mL IM 3 yr and up
-9 and under receive 2 doses 1 month apart

Question 12

MMR

Answer 12

-Series of 2 (1yr by 12 yrs)
-if exposed can give at 6 m
- may be given with TB testing with PPD
-prefer to postpone PPD for 4-6 wks to avoid suppressive response to PPD

Question 13

Varicella

Answer 13

-Series of 2 b/t 12 m & 12 yrs, min. 3 mo apart
- Prefer seperation of MMR by 1 month

Question 14

Hep A

Answer 14

-series of 2 (1 - 2 yrs) 6 m apart

Question 15

Meningococcal

Answer 15

-Series of 2 (11-12 and booster at 16)
-increased rate of meningococcal disease between 16 & 21
- adolescents receiving 1st does at or after 16, no booster necessary

Question 16

HPV

Answer 16

-series of 2 as early as 9 but recommended at 11-12; second dose given 6-12 m after 1st
-Series of 3(15 or older; second dose given 1-2 months and third at 6 months
-Gardasil 9 is only prep available; covers cervical, vulvar, vaginal and anal cancers caused by HPV(7 types); precancerous or dysplastic lesions (9HPV types); and genital warts (2 HPV types)

Question 17

how to resumes if break in recommend schedule

Answer 17

resume immunizations according to chlild’s current age regardless of vaccines previously missed

Question 18

Vaccine adverse reactions

Answer 18

-local muscle soreness
-low grade temp
-local erythema and tenderness

Question 19

Vax Contraindications

Answer 19

IPV: in pts with hx of anaphylaxis to streptomycin

MMR: contra in pregnancy or immunosuppressed

Varicella: contra in pregnancy, immunosuppressed and streptomycin allergy

Flu: contra in anaphylaxis to eggs

Question 20

VAX reportable events

Answer 20

Vaccine Adverse Events Reporting System

• Anaphylaxis
  -Encephalitis
  -Death