Immunizations Flashcards
Hep B
how many?
timing?
Series of 3
0-2-6 months
What is management for newborn with HBsAg + mother?
Administer Hep B vaccine and HBIG within 12 hours of birth
When should baby born to Hep B + mother be tested for HBsAg and antibody?
After Hep B series is complete
age 9 to 18 months
If mother’s Hep B status is unknown at birth, what is the “deadline” for giving HBIG?
HBIG should be given by the end of first week of life
Final dose of Hep B should be given at or after what age?
6 months
Rotavirus
how many?
timing?
Series of 3
2-4-6
minimum age 6 weeks
maximum age for FIRST DOSE 14 weeks, 6 days
What is maximum age for giving Rotavirus vaccine?
32 weeks is the maximum age for giving Rotavirus
8 months
What is the risk of Rotavirus?
Increased (though still small) risk of intussuception 3 weeks after administration.
DTaP
how many?
timing?
5 total
2-4-6 months and two boosters – 15 months and 4 years
What is the maximum age for giving DTaP?
6 years of age is the maximum for DTaP
Does DTaP have more Diphtheria or Tetanus?
Diphtheria
Tdap has more Tetanus
When is Tdap recommended?
At age 11 - 12 years
and then every 10 years (Tetatus every 10)
Hib
how many?
timing?
total of 4
2-4-6 months + booster at 12 months
What are the major benefits of Hib?
Decrease in ear infections and pneumonia
What is the maximum age for giving Hib and Pneumovax (PS23)?
4 years
Pneumococcal
(PCV13 aka Prevnar)
how many?
timing?
total of 4
2-4-6 months + 12 months (booster)
Pneumococcal
(PS23 aka Pneumovax)
this is a supplemental dose - 23 vs 13 which is regular
who might need?
IMMUNO-COMPROMISED children should receive one additional dose at age 24 months.
What is the maximum age for giving Pneumovax (PS23)?
4 years is the maximum age for Pneumovax (PS23)
Examples of immuno-compromising conditions?
Sickle cell anemia HIV Renal failure Asthma Diabetes Splenic dysfunction
Polio vaccine (IPV)
how many?
timing?
Series of 4
2-4-6 months and 4 years
Is IPV injectable or oral?
Inactivated or live?
IPV is Injectable and Inactivated
Is OPV injectable or oral?
Inactivated or live?
OPV is Oral and Live
OPV is discouraged and only possible for doses 3 and 4
Influenza vaccine (TIV = trivalent inactivated vaccine)
how many?
timing?
One dose of influenza annually
Who needs two doses of influenza vaccine, 1 month apart?
Children younger than 9 years receiving influenza for the FIRST TIME get two doses, 1 month apart
Influenza
Who gets 0.25 mL dosing?
Children 6 months to 35 months get 0.25 mL
All others get 0.5 mL
What is FluMist?
Is it a live virus?
Flu vaccine by nasal spray
LAIV = LIVE attenuated inactive vaccine
Shed for 6 months
Who can get FluMist?
Healthy people aged 2 to 49 years
MMR
how many?
timing?
Series of 2
12-15 months and 4-6 years
**the two doses must be at least 28 DAYS apart
Can MMR be given simultaneously with PPD?
Yes, but prefer to separate by 4 - 6 weeks
This avoids suppressive response to PPD
Varicella
how many?
timing?
Series of 2
12 months and 4-6 years
**the two doses must be at least 3 months apart
Can varicella be given at the same time as MMR?
Prefer to separate by one month from MMR
If given together, titers are increased in both but may be too much and cause illness
Hepatitis A
how many?
timing?
Series of 2
Given age 1 - 2 years, doses 6 months apart
How is Hep A transmitted?
The oral-fecal route
Meningococcal vaccine (MCV4)
how many?
timing?
Series of 2
age 11 or 12 years and a booster at age 16
What is the reasoning for the timing of MCV4?
There is an increased rate of meningococcal disease between 16 and 21 years of age
Does an adolescent receiving first dose of MCV4 at age 16 or later need a booster dose?
No
HPV
how many?
timing?
Series of 3
age 11 or 12, then 1 month after first, 6 months after first
What are the oncologic strains of HPV?
types 16 and 18
What are the strains of HPV associated with genital warts?
types 6 and 11
Which HPV vaccine is quadrivalent?
Gardasil
“Quad-asil”
Which vaccines are LIVE?
MMR Varicella Rotavirus Flumist Shingles (herpes zoster) Smallpox
What is an advantage of LIVE vaccines?
The are good “teachers” often confer lifelong immunity in 1-2 doses.
Typical adverse reactions to immunizations?
Local erythema, tenderness, and muscle soreness
Low grade fever
Those with a history of anaphylaxis to
STREPTOMYCIN should not have which vaccinations?
IPV and varicella
Which vaccines are contraindicated in those who are pregnant or immunocompromised?
MMR and varicella
What ALLERGIES may be a contraindication to receiving the INFLUENZA vaccine?
Those with EGG or LATEX allergy may not be able to receive the flu vaccine.
What are reportable VAERS events?
Anaphylaxis
Encephalitis
Death
Which vaccines are given in a series of 2?
MMR
Varicella
Hep A
Meningococcal
