Immunizations

Question 1

Hepatitis B (HBV)

Answer 1

Series of 3
First at birth (only vaccine given at birth)

Contraindications:
life-threatening allergy to yeast

Question 2

Diphtheria, Tetanus, acellular Pertussis (DTaP)

Answer 2

Series of 5
first at 2 months

Contraindications:
Encephalopathy within 7 days after dose
Deferred in individuals with progressive neurologic disorders

*Anyone coming into contact with infant needs a Tdap booster
Need one for every pregnancy
Booster at 11-12yo

Question 3

Haeomophilus influenzae type B (Hib)

Answer 3

2 or 3 dose series and a booster
first at 2 months

Contraindications:
less than 6 weeks old
severe allergic rxn to dry natural rubber latex (pick another brand)
hypersensitivity to yeast

*Prior to vaccine, Hib was leading cause of bacterial meningitis in children

Question 4

Inactivated poliovirus (IPV)

Answer 4

Series of 4
first at 2 months

Contraindications:
Anaphylactic rxn to neomycin/streptomycin/polymyxin B

Question 5

Pneumococcal conjugate (PCV13)

Answer 5

Series of 4
first at 2 months

*Good for immature immune system of those high risk

Question 6

Rotavirus

Answer 6

Series of 2 (Rotarix) or 3 (RotaTeq)
first at 2 months

Oral, live-attenuated

Most common cause of diarrhea and vomiting in infants

Contraindications:
severe combined immunodeficiency (SCID)
severe latex allergy (Rotarix)
hx of intussusception (telescoping of intestines)
acute moderate - severe gastroenteritis
altered immunocompetence

Question 7

Hepatitis A (HAV)

Answer 7

Series of 2
first 12-23 months
separate doses by 6-18 months

Contraindications:
severe latex allergy

*AZ at higher risk
Low SES and poor hygiene = high risk

Question 8

Measles, Mumps, Rubella (MMR)

Answer 8

Series of 2
first at 12-15 months
live vaccine

Contraindications:
anaphylactic rxn to meomycin or gelatin
*pregnancy
immunosuppression

Question 9

Varicella (chickenpox)

Answer 9

Series of 2
first at 12-15 months
live vaccine

Contraindications:
anaphylactic rxn to meomycin or gelatin
*pregnancy
altered immunity

Question 10

MMRV (measles, mumps, rubella and varicella)

Answer 10

Series of 2
first as 12-15 months

Contraindications:
severe allergic run after previous dose (MMRV, MMR or Varicella) or to a vaccine component (neomycin or gelatin)
altered immunity
*pregnancy

Question 11

Meningococcal (Menactra, etc.)

Answer 11

Series of 2
first at 11-12yo (booster at 16yo)

• High risk: 2mo-10yo
  ex. asplenia, complement deficiency, community outbreak, travel

*first-year college students

Question 12

Serogroup B Meningococcal (MenB)

Answer 12

Series of 2 or 3
>10yo who are at increased risk for this disease
ex. complement deficiencies, disease outbreak, asplenia

Recently approved and recommended for high risk (covers an additional serotype)

Contraindications:
hx severe allergic rxn to diphtheria or tetanus toxoid
latex allergy
pregnancy?

Question 13

Human Papillomavirus (HPV)

Answer 13

Series of 3
routine at 11-12yo, then 2 months later, then 4 months later

Gardasil (9 serotypes) or Cervarix (2 serotypes)

recombinant vaccine

Question 14

Inactivated Influenza Vaccine (IIV) aka flu shot

Answer 14

Annual change in strains
ANNUALLY for everyone 6+months
children 6mo-8yo require 2 doses during first season of vaccination
*particularly important for pregnant moms, chronic disease, immunosuppression

Contraindications:
allergy to vaccine component
egg allergy (only hives = okay)
Guillain-Barre Syndrome

Question 15

Live, Intranasal Influenza Vaccine (FluMist)

Answer 15

ages 2-49
healthy children 2-8yo can receive either live or inactivated vaccine
recombinant vaccine

Contraindications:
egg allergy
pregnant
immunosuppressed
2-17yo on aspirin
*PRECAUTION - asthma pts