immunizations Flashcards
hep B
how many doses, when to give?
3 dose
birth
1-2 months
6-18months
hep B
how many doses, when to give?
3 dose
birth
1-2 months
6-18months
hep B + mothers
when to vaccine newborn
12 hours (hep B and HBIG), follow up 1-2 months
hep B catch up for older children
2 dose (4 months apart) of Recombivax HB is ok for children 11-15 yo.
rotavirus (rotateq vs rotarix)
3 dose for Rotateq
2, 4, 6, months (rotateq)
2 dose for Rotarix
2, 4 months
dtap
hep B + mothers
when to vaccine newborn
12 hours (hep B and HBIG), follow up 1-2 months
hep B catch up for older children
2 dose (4 months apart) of Recombivax HB is ok for children 11-15 yo.
rotavirus (rotateq vs rotarix)
3 dose for Rotateq
2, 4, 6, months (rotateq)
2 dose for Rotarix
2, 4 months
IPV
4 dose
2 months
4 months
6-18 months
4-6 yo
tdap
1 dose to ALL adolesents 11-12 year old
(regardless of last td injection)
then td booster every 10 years
Hib (haemophilus influenzae type B)
4 dose
2, 4, 6, months
12-15 months
pneumococcal PCV 13
Prevnar
4 dose
2, 4, 6, months
12-15 momths
pneumovax
> 65 yo one time dose
or
IPV
4 dose 2 months 4 months 6-18 months 4-6 y
mmr
live virus
2 dose
12-15months
4-6 yo
varicella
live virus
2 dose
12-15 months
4-6 yo
hep A
2 dose
12-23 months
4-6 yo
hpv
3 dose
11-12 yo hpv4 (gardisil) or hpv2 (cervarix) for femals ONly hpv4 (Gardisil) for boys
0, 1-2 months, 6 months
meningococcal
2 dose
11-12 yo
booster at 16 yo
varicella
evidence of immunity
2 dose (4-8 wks apart) unless evidence of immunity
born before 1980, except healthcare worker or pregnant
hx of varicella
hx of zoster
laboratory of evidence of immunity
zoster
everyone age 60 years or older
single dose
MMR adults immune if born before
if born before 1957
when to give hpv vaccine series
how many in series?
9-26 yo
3 dose
reduce likelihood of general warts
gardasil protects agains which types
cancer PLUS warts
type 6, 11, 16, 18
ceravix is which types?
16, 18
cancer only
who requires 2 doses of influenza vaccine, and how far apart?
6months - 8 years, >1 month apart during their first season of vaccination
FIRST TIMERS
live virus
mmr
varicella
flu mist
zoster
rotavirus protocol
give within 6 months of age
oral form only to infants
harmless shed through stool, standard care
what ages is LAIV flu mist recommended
2-8 yo
who should NOT receive LAIV
49 yo
2-17 yo receiving aspirin therapy
pregnant, immunocompromised, ashtma
what to give to someone who experienced only HIVES from eggs
give IIV (egg or cell culture based) or RIV3 trivalent recombinant influenza vaccine.
** MUST wait 30 minutes after to observe patient
when to give at 12-15 months
(9) *hep a hep B (prn) hib- 4th dose ipv (prn) influenza (IIV only, no live until 2 yo)
pvc13 (prevnar)- 4th dose
dtap (15-18 months)
*mmr
*varicella
when to start TDAP
> 7 yo
dtap
2, 4, 6 months immunizations
H H D Rip (6)
hep B h, influenza b dtap rotavirus IPV Pcv13 (prevnar)
when to give at 12-15 months
(9)
hep B (prn) hib ipv (prn) influenza (IIV only, no live until 2 yo) dtap (15-18 months) *mmr *varicella hep a
4-6 yo
IDMV
IPV
Dtap
MMR
Varicella
prevnar (PVC13)
4 dose
2, 4, 6, months
12-18 months
when is rotavirus contraindicated
infants with severe combined immunodeficiency (SCID)
doses administered ____days before minimum interval considered valid
4 days
pneumoccal
ALL adults age 65 yo older ONE TIME
pneumococcal for immunocompromised
19-64 yo
2 dose
pcv 13, pps23 8 weeks apart
when to revaccinate with pneumococcal
ONE TIME revaccinations 5 years aftr ppsv 23 if 19-64 yo with chronic renal failture, asplenia (sickle cell/splencetomy) or immunocompromised
OR
if last dose was >5 years ago and was given
MMR for young adults who have not be immunized
2 doses 1 month apart
pneumococcal for HIV
HVC 13, PPSV23 8 wks later, 2nd PPSV23 in 5 years, and another at 65 (if was younger than 65 yo at time of dsg)v
who is pneumococcal PPSV23 indicated for?
> 65
No additional dose of PPSV23 is indicated for adults vaccinated with PPSV23 at or after age 65 years.
50-65 american indians, alaska natives asthma, DM, liver disease cigarette smokers age 19 years or older cochlear imlants serebrospinal fluid leaks nursing homes
PPSV23 not used for children under ____ yo
2
pneumococcal protects against what?
meningitis and septicemia associated with S. pneumonia
pneumococcal for HIV
HVC 13, then PPSV23 8 wks later
who is pneumococcal PPSV23 indicated for?
> 65
No additional dose of PPSV23 is indicated for adults vaccinated with PPSV23 at or after age 65 years.
50-65 american indians, alaska natives asthma, DM, liver disease cigarette smokers age 19 years or older cochlear imlants serebrospinal fluid leaks nursing homes
Adults aged 65 years or older who
have not received PCV13 or PPSV23:
Administer PCV13 followed by PPSV23 in 6 to 12 months.
Have not received PCV13 but have received a dose of PPSV23 at age 65 years or older
Administer PCV13 at least 1 year after the dose of PPSV23 received at age 65 years or older.
Have not received PCV13 but have received 1 or more doses of PPSV23 BEFORE age 65
Administer PCV13 at least 1 year after the most recent dose of PPSV23
administer a dose of PPSV23 6 to 12 months after PCV13, or as soon as possible if this time window has passed, and at least 5 years after the most recent dose of PPSV23.
Adults aged 19 through 64 years with immunocompromising conditions or anatomical or functional asplenia who have not received pneumococcal
1 dose pcv13, 8 weeks after ppsv23, 2nd dose 5 years after ppsv23
Administer PCV13 followed by PPSV23 at least 8 weeks after PCV13
administer a SECOND dose of PPSV23 at least 5 years after the first dose of PPSV23.
who is candidate for revaccination 5 years after ppsv23
ONE TIME revaccination 19-64 yo chronic renal failure, asplenia (sickle cell or splenecomty), immunocompromised
if they had ppsv23 BEFORE 65 years old if 5 years have passed.
who should receive hep b booster
pts on dialysis or pts ( HIV/stem cell transplant) anti-HB levels decline
post exposure prophylaxis hep b
give a single vaccine booster prn if has complete series
if has NOT had series, provide series PLUS hbig
hep b vaccine contraindication ( allergy)
baker’s yeast (bread)
small pox
serious contagious disease caused by the variola virus. lesions are ALL the same stage during eruptive stage (varicella is different stages). Small pox vaccine contains LIVE vaccinia virus. Until scab comes off, recipient can shed the vaccinia virus ( not small pox) but can cause illness.
s/s: red spots on the tongue that spread into the mouth and throat. Very contagious at the time. Rash appears on the skin, spreads to all body parts within 24 hours.
evidence of immunity to varicella
born before 1980 in the US
documentation of vxv vaccine
lab evidence of immunity or confirmation of disease
dsg or verification of varicella disease or herpes zoster
hep A schedule adults
2 dose (11-12 yo)
havrix: 0, 6-12 months
vaqta: 0, 6-18months
twinrix (hep A and B): 3 doses 0, 1, 6 months
or 4 dose at 0, 7, 21-30 days, booster at 12moths)
varicella vaccine for adults
2 doses, 4-8 wks apart ( with NO hx of varicella infection of immunization)
post exposure varicella
give within 3 days if possible
VZIG is a pooled blood product6
tdap adults, never had immunization
needs 3 doses
For unvaccinated adults, administer the first 2 doses at least 4 weeks apart and the third dose 6 to 12 months after the second.
tdap > 7 yo
hep A schedule adults
3 dose (11-12 yo)
hep A when traveling
4-6 wks before travel.
hep A post exposure
give within 2 weeks
immune globulin or HAV vaccine
tx: supportive measures
poliovirus is spread by
fecal-oral route
medications to stop smoking
nicotine replacement
buproprion (Wellbutrin, zyban)
varenicline (Chantix)
what to monitor on varenicline (Chantix)
mood changes (suicide risk)
