Immunizations Flashcards
Which are live virus vaccines?
MMR
Varicella
Rotavirus
Schedule for HepB
birth, 1 and 6 months
Schedule for DTaP
2, 4, 6, 12-18mo, 4-6yrs
Schedule for polio
2, 4, 6-18mo , 4-6yrs
Schedule for Hib/pneumococcal
2, 4, 6, 12-15mo
Schedule for MMR and varicella
12-15mo, 4-6yrs
Which routine vaccines for adolescents?
TdaP, MCV4, HPV, influenze
What are 6 contraindications for DTaP?
anaphylaxis encephalopathy within 7 days seizure within 3 days persistent crying within 2 days for >3hrs collapse or sick state within 2 days day Fever >405 within 2 days
When would you defer DTaP and to what age?
if severe neuro issues or seizures, defer to 1 yr
ContraI for MMR/V
Pregnancy
HIV CD4<15%
Avoidance of aspirin for 6wks for post-vaccination
Which vaccine will give you febrile seizures after 1st dose?
MMRV
ContraIndication for rotavirus
SCID, h/o intussusception
ContraIn for LAIVA - intranasal
severe egg allergy, asthma, chronic aspirin therapy risk of Reye
If you have a cut and <3 shots of tetanus then what?
vaccinate and TIG if dirty wound
If you have a cut and >3 shots of tetanus then what?
if wound is dirty –> vaccinate, if >5yrs since last dose
if wound is clean –> vaccinate, i 10yrs since last dose
If mother is + HBsAg then what
Give baby HBiG within 12 hrs, vaccinate 12hrs, 1-2mo, 6mo
What if premature baby is born to HGsAg+ mother
Give HBIg and vaccinate, but can’t count first dose, so need to give real first dose at 2kg/30days
What is f/u for treated infant of HBsAg+ mom
anti HBs and HBsAg at 9-18months, if neg, give 3 more doses
If mother’s HepB status is unknown, then what
vaccinate first, if baby is premature, give HBIG then screen mom
If previously unknown mom is found to be HbsAg+ then what?
HBIG ASAP (up to 1 week) complete vaccination
What do you give VariZIG?
within 10 days of exposure and pt is susceptible to chicken pox
+ significant exposure
+ risk of complications
Who must you give an extra dose of PPV13 to?
anatomic or functionally asplenic patient, SCD, HIV, cochlear implant or CSF leak
Who should you give PPSV23 to?
asplenic, SCD, HIV, cochlear implant or CSF leak, chornic disease
When should you give PPSV23?
> 8 wks after last PCV13 dose, revaccinate high-risk children once after 5 years
Besides teenagers, who should you give MCV4 to?
HIV pts, 2 dose 11-12 yers, booster at 16 yrs, 2 mo interval
Also - pts who are complement component deficient, functional or anatomic asplenia, travel to hyperendemic or epidemic area (can vaccinate as early as 2 months of age)
When do you use TDaP?
Routine for kids who need it at 11-12yrs
If catch-up needed 13-18yrs
Undervaccinated children 7-10yrs
Maternal vaccination during each preg or immediately postpartum
Difference in administration of RV5 vs RV1
Pentavalent 3 doses, monovalent 2 doses
What is the difference in PCV13 and PPSV23?
PPSV23 less immunogenic - indicated for high risk children >2yrs of age
Does diptheria vaccine prevent disease or colonization?
prevents disease
Polio is what kind of vaccine
killed virus
Within how many days of HepA should Ig be given?
14 days
Within how many days of measles exposure should Ig be given
6 days
Max age for giving rotavirus
8 months
ContraI h/o intussusception
Rotavirus
ContraIndicated if IVIg recently given
MMR
PPD can be performed on day of or 1 month later
MMR
ContraI if prior dose caused seizure within 3 days
DTaP
What is catchup schedule for HepB
3 doses time 0, 1 and 6 months later
2 doses time 0 and 4 to 6 months later
What type of vaccine is HepA
inactivated virus
Pt is 1yr and traveling and might have been exposed to HepA
administer vaccine within 2wks of exposure
PPx against HepA dose - duration of protection
- 02ml/kg >3 months
0. 06ml/kg >5 months
High risk strain of HPV for cancer
16, 18
High risk strain of HPV for genital warts
6, 11
What age should routine HPV vaccines be given?
11-12yrs of age.
What is age of female and male when catch-up HPV can still be done
female <26yrs, males <21yrs
In what circumstance is person at high risk for rabies?
When biten by bats or in the same room as bats, feral cats, dogs, ferrets, wild-life
What to do for bites with high risk for rabies?
RIG - infiltrate wound, rabies vaccine 4 dose series
If pt came in with bite wounds, what should you do?
check tetanus routine immunization and assess for risk of HepB and GIV
What to do if escaped dog or cat bites you?
consult public health officials
Which are low risk bites?
livestock, rodents, lagomorphs
What antibiotics for PPX if dog, cat, or human bites?
Amox or cefpodoxime, TMP-SMX+clindamycin, or parenteral ampicillin-sulbactam
Can following be given to household contacts of immunocompromised person?
1) flu
2) varicella
3) MMR
4) Rota
Can give MMR or rotavirus
In immunocompromised child - you can routinely administer non-live vaccines but live vaccines shouldn’t be given except wen?
HIV-infected child has CD4>15%
What should be given or premature baby with chronic respiratory disease?
RSV ppx
For HIV+ kids, what additional vaccines should you give
PCV13, PPSV23, MCV4 (2 dose primary series)
What additional vaccines should be given to asplenic children?
PCV - PCV13, PPSV23, MCV (administer earlier, 2 dose primary series, booster every 5 years)
