Immunizations

Question 1

vaccines in pregnancy

Answer 1

influenza
Tdap x1 each pregnancy weeks 27-36
live vaccines contraindicated

Question 2

asplenia

Answer 2

HiB
PCV13 (Prevnar) and PPSV23 (Pneumovax)
meningococcal

Question 3

DTaP

Answer 3

children get 5 doses - 2,4,6,12-18 months & 4-6 yrs

given to children <7yrs

Question 4

HiB

Answer 4

children

adults after splenectomy

Question 5

Hep A

Answer 5

children: 2 doses @ age 1 year
adults: drug users, MSM, liver disease

Question 6

Hep B

Answer 6

children: 3 doses - birth, 1 month, 6 months
adults: healthcare workers, ESRD, liver disease, drug users, MSM

Question 7

HPV

Answer 7

males & females age 9-26, immunocompromised, MSM

2 doses if under age 15, 3 doses if 15+

Question 8

Influenza

Answer 8

annual for everyone 6 months or older
age 6 mo - 8 yrs get 2 doses 4 wks apart
if egg allergy, get inactive form (trivalent inact., IIV3)
get during pregnancy
age 65+ get Fluzone high-dose, Fluad
quadrivalent live attenuated (LAIV4) not rec for ‘17-‘18

Question 9

meningococcal

Answer 9

MCV4 - 1 dose age 11-12 yrs, boster @ age 16
Menactra, Menveo
Men B - Bexsero, Trumenba

Question 10

Pneumococcal

Answer 10

children, adults 65+, immunocompromised
PCV13 (Prevnar) - only 1 dose if given age 6+
children <2 get PCV13 b/c they don’t respond to polysaccharide viruses (PPSV23/Pneumovax)
adults 65+ w/o previous vaccine get PCV13 and PPSV23 12 months apart
PCV - 1 dose before age 65, 2 before age 65 if immunocompromised, everyone 65+ gets 1 dose
immunocompromised age 6-64 = 1 dose PCV13 + 2 doses PPSV23
give Prevnar 13 x1 then 8 wks later PPSV23 x2 - PPSV23 doses given 5+ years apart

Question 11

Rotavirus

Answer 11

Rotarix, RotaTeq

given to all infants under 15 wks

Question 12

Tetanus/Diptheria

Answer 12

DT - infants/children <7 yrs
Td (Tenivac) - booster every 10 yrs age 7+
Tdap (Adacel,Boostrix) - x1 age 11+ w/o prior vaccine, during prenancy, to those close to infants, healthcare workers
DTap - children <7. 7+ unvaccinated get Tdap instead
wound prophy - deep, dirty wounds give Td booster if >5 yrs since last Td booster

Question 13

Varicella

Answer 13

varivax (chickenpox) - 2 doses age 12-15 months and 4-6 years, anyone w/o immunity gets 2 doses, c/i if allergy to gelatin or neomycin
zostavax (shingles) - live vaccine. c/i in pregnancy, immunocompromised

Question 14

IM injections

Answer 14

in deltoid muscle
use 1” needle
insert @ 90 degrees

Question 15

SC injections

Answer 15

in fatty tissue over tricep
use 5/8” needle
insert @ 45 degrees