Immunizations Flashcards
Normal term newborn whose mother is HBs antigen positive. Protocol for child?
HBV vaccine and Hep B immunoglobulin within 12 hrs of birth, second dose of Hep B vaccine at 1~2mo, and third dose of Hep B vaccine at 6mo
Benefit from Hib vaccine?
95-100% effective in preventing invasive Hib disease. Disease can result in meningitis, hearing loss, or mental retardation. Adverse reactions are very rare, and no serious reactions have been directly linked to the vaccine.
24yo US-born M healthcare worker does not remember having chicken pox. No contraindications. What will happen w/ vaccination?
After vaccine, may develop varicella infection, but it will not be contagious.
Can receive vaccination even if wife is pregnant. (but still a live vaccine)
Pt started work at drug treatment hospital, requires Hep B vaccine. Pt is anti-HBs positive. Next step?
No vaccination necessary
23yo homosexual M, received typical childhood vaccinations (tetanus, diphtheria, pertussis, polio, Hep B, MMR, Hib). What does he need?
Hep A
Indicated in men who have sex with men, IVDA, or lab workers dealing with primates
Medical indications: chronic liver disease, pts receiving clotting factor concentrates
People at risk for varicella
Immunocompromised
- children w/ leukemia
- pts on meds
- pts w/ immuno def.
Newborns of mothers who have varicella 5 days before and 2 days after delivery
Premature babies
Pregnant women who do not have evidence of immunity
Meningitis vaccination indications
Functional asplenia
Travelers to endemic areas
College students, military recruits
Pneumococcal vaccination indications
Chronic disease and functional asplenia
Residents of long-term care facilities
24yo pregnant F not immune to rubella. When should she receive vaccine?
Early postpartum period
Do not vaccinate during pregnancy, but vaccination does not indicate therapeutic abortion
32yo F last tetanus booster 11yrs ago. What does she need?
Tdap
recommended for adults age 19-64 to replace next booster dose of tentaus
18mo never immunized, needs influenza
Two doses of TIV (trivalent inactivated influenza vaccine)
Minimum age for TIV is 6mo
- two doses between ages 6mo and 8yo who are receiving for first time
2.5yo M never received PCV-7.
Vaccinated with a modified schedule for immunization
All healthy children age 24-59 months who have not completed their primary immunization for PCV7 be given one dose of PCV7.
If child received less than three doses of the PCV7 during his/her primary immunization series, two doses should be given at least 8 weeks apart.
The usual schedule for the series is one vaccination 2, 4, 6, and 12 to 15 months.
30yo F w/ abnormal Pap 2 yrs ago w/ colpo, bx, and cryotherapy. Divorced and currently monogamous. Subsequent Pap have been normal.
Vaccination is not recommended for 30yo women
HPV recommended for all adults younger than 26yrs. H/o genital warts is not contraindication to vaccination. People who have sex w/ multiple partners should receive immunization if they meet criteria.
What patient should receive quadrivalent HPV vaccinations?
Safe and effective in females age 11-26 (11-21 in males).
It can be given when pt has abnormal uterine bleeding or when she is breastfeeding.
Can also be given to immunocompromised.
IT IS NOT RECOMMENDED DURING PREGNANCY
67yo F longtime smoker quit 5 yrs ago, h/o emphysema, rarely needs inhaler, received PPV at 63yo, and Td shot at 63yo. Takes care of her infant granddaughter at home. What vaccines does she need?
Tdap - should be given to pts >65yo who have close contact w/ infant age <12mo.
People born before 1957 are considered immune and do not need MMR.
People born before 1980 are considered immune and do not need varicella.
PPV one-time revaccination is 5yrs after initial.
Intranasal influenza should only be used in healthy adults younger than 50yo.
