Immunizations

Question 1

Pneumovax

Answer 1

• all patients > 2 with chronic medical disease
  
  • asthma, DM, leukemia, CF, etc.
• all adults over age 65 if > 5 years since last dose

Question 2

Influenza Vaccine

Answer 2

• all >= 6 months
• if age 6 mo - 9 years and never had trivalent vaccine
  
  • give 2 doses 4 weeks apart
• contraindications
  
  • previous oculorespiratory syndrome with LRTI signs after flu shot
  • infants < 6 mo
  • previous Guillain-Barre within 8 weeks of flu shot
  • febrile illness at time of shot
  • previous allergic reaction to flu shot

Question 3

Zostavax

Answer 3

• adults > 50
• no need for 3 years post-HZV infection
• no pregnancy within 3 months of vaccine
• contraindications
  
  • immune-compromised, untreated TB, gelatin/neomycin allergy

Question 4

HPV Vaccines

Answer 4

• Gardasil
  
  • 6, 11, 16, 18
  • women 9-45, men 9-26
  • 3 dose series at 0, 60, 180
  • contraindicated in pregnancy or yeast allergy
• Cerverix
  
  • 16, 18
  • 3 dose series 0, 30, 180
  • perhaps more cervical cancer protection than Gardis

Question 5

Rotateq/Rotarix

Answer 5

• 2, 4 months
• contraindicated in immunocompromise, previous intussuception, IvIG in last 42 days
• live attenuated virus, may cause mild diarrhea

Question 6

Prevnar 13

Answer 6

• 6 weeks - 5 years
• adults > 50 (but not currently covered)