Immunizations Flashcards
vaccines given at BIRTH
hepatitis B
vaccines given at the 2-month visit
- 2nd dose of hepatitis B (if not yet given @ 1 month visit)
- rotavirus (oral)
- DTaP (diphtheria, tetanus, and acellular pertussis)
- Hib (haemophilus influenzae type b)
- PCV13 (pneumococcal)
- IPV (inactivated poliovirus)
vaccines given at the 4-month visit
dose 2 of the following:
- rotavirus (oral)
- DTaP (diphtheria, tetanus, and acellular pertussis)
- Hib (haemophilus influenzae type b)
- PCV13 (pneumococcal)
- IPV (inactivated poliovirus)
vaccines given at the 6-month visit
dose 3 of
- hepatitis B
- rotavirus (oral) if 3-dose series is given (as opposed to Rotarix, which is a 2-dose series)
- DTaP
- Hib
- PCV13 (pneumococcal)
- IPV (inactivated poliovirus)
**now eligible for influenza (if flu season)
how early in a child’s life can the annual influenza vaccine be given?
6 months
how early in a child’s life can the 1st dose of the MMR vaccine be given?
12 months
how early in a child’s life can the 1st dose of the Varicella vaccine be given?
12 months
hepatitis A vaccination series…
- how many doses?
- how far apart?
- when is the 1st dose?
- 2-dose series
- 6 months apart
- 1st dose at 12 months
At what age is HPV vaccination begun?
- routinely recommended at ages 11-12
- can begin as early as age 9
HPV vaccinations…
- how many doses?
2-3 dose series depending on age of vaccination initiation
Who gets Tdap? DTaP?
- DTaP for children < age 7
- Tdap for ages 7+
DTaP…
- How many doses in series?
- When are they given?
5-dose series at the following times:
- 2 months
- 4 months
- 6 months
- 15-18 months
- 4-6 years
Live Virus vaccines
- MMR: measles, mumps, rubella
- MMRV: measles, mumps, rubella, varicella
- Varicella
- Rotavirus (Rotariq & Rotateq)
- BCG
- Smallpox
- Influenza (one formulation)
Rotavirus vaccine carries an increased risk of _____ within 7 days of the ____ dose
- Intussusception
- 1st or 2nd
If the MMRV is given as the first immunization dose for measles, there is an increased risk of ______ (as opposed to the first measles immunization being given as MMR)
Febrile seizures
How do we induce passive immunity?
Administration of immunoglobulins
Adverse reactions of immunoglobulin administration
- Localized injection site pain
- Flushing
- Headache
- Chills
- Sweating
- Shock
What immunoglobulin is used to treat infants at high risk for adverse outcomes from RSV?
Palivisumab (Synagis)
What is the name of the book (and who is it from) that contains recommendations for vaccinations for children?
AAP Red Book
What happens if a live vaccine is given during IVIG therapy?
Patient will not post an immune response; vaccine won’t work; don’t give during IVIG therapy
Major symptom for mumps
Enlarged parotid gland (cheek)
Only oral vaccine that infants get
Rotavirus
Who gets the meningococcal B vaccine?
College age, dorm living
- How many doses are in the MMR series?
- When are the doses given?
- 2 doses
- 1st dose 12-15 months
- 2nd dose 4-6 years
- How many doses are in the polio vaccine series?
- When are they given?
- 4 doses
- 2 months old
- 4 months old
- 6-18 months
- 4-6 years
- How many doses are in the Hib vaccine series?
- When are they given?
3-4 doses, depending on manufacturer
- 2-dose series = PedvaxHIB
- 3-dose series = ActHIB, Hiberix, Pentacel, or Vaxelis
- 2 months
- 4 months
- 6 months for some formulations
- booster at 12-15 months
- How many doses in hepatitis B?
- dosing schedule
- 2-3-dose series
- w/in 12-24h of birth
- 1 month after dose 1
- 6 months after dose 1
How soon after birth is the hepatitis B vaccine given?
- negative hepatitis B status: w/in 24hr
- unknown or positive hepatitis B: w/in 12 hours
- How many doses in the varicella vaccine?
- When are they given?
- 2 doses
- 12-15 months
- 4-6 years
- How many doses in the pneumococcal vaccine series?
- When are they given?
- 4 doses
- 2 months
- 4 months
- 6 months
- 12-15 months
- How many doses in the rotavirus vaccine series?
- When are they given?
- 2-3 doses
- 2 months
- 4 months
- 6 months (if needed based on formulation; RotaTeq)
Rotarix vs. Rotateq
- both are rotavirus vaccines
- not interchangeable
- Rotarix = LIVE, given in 2 doses (2 and 4 months)
- Rotateq = LIVE, given in 3 doses (2, 4, and 6 months)
- last doses need to be given before 8 months of age
What does rotavirus cause?
severe gastroenteritis
Describe the connection between a rotavirus vaccine and intussusception.
- Rotashield (live virus) withdrawn from market (1999) for causing intussusception
- Rotavirus vaccine schedule is the way it is due to the risk of naturally-occurring intussusception being low
- Over 80% of intussusception cases associated w/ rotavirus vaccine were in children who received 1st dose after 3 months of age
- Peak of naturally-occurring intussusception is around 6 months
- Final doses should be given before 8 months minimize overlap w/ naturally-occurring intussception
- Australia: https://www.nps.org.au/radar/articles/rotavirus-vaccines-rotarix-and-rota-teq-for-prevention-of-rotavirus-gastroenteritis
Name the CDC’s book on vaccines
Pinkbook
All vaccines except which one are 0.5mL?
What is the EXCEPTION with DTaP?
only given until age 7; after that Tdap is given
What is the difference between DTaP and Tdap?
- DTaP contains more diptheria and pertussis than Tdap
- DTaP given until age 7; Tdap given after age 7
What to do for an infant traveling to an area endemic for measles?
- only demonstrated to be effective when 1st vaccine at 1 year
- no MMR in breastmilk
- give 1st vaccine before travel
- vaccinate again at 1 year
EXCEPTION for rotavirus vaccine
not given after 8 months of age
(intussusception affected kiddos after 8 months of age)
What happens if the mom is hepatitis B positive or her hepatitis B titer status is unknown?
give hepatits B vaccine w/in 12 hours of birth
AND
give immuneglobulin to baby
What is the minimum # of weeks between vaccines and why? (particularly important when trying to catch up vaccines)
- > 4 weeks between subsequent doses of the same vaccine
- need time for body to mount an immune response (T Lymphocytes)
Who gets Tdap?
- patients who need a booster
- pregnant patients
- healthcare workers
EXCEPTION for HIB
Not given after age 5
Who gets PCV-23 (Pneumovax)?
patients who have issues with their spleen (splenectomy or a spleen that isn’t 100% effective)
When is PPSV-23 given? How many doses are given?
- around age 2
- only need 1 dose
Can we given the polio vaccine on a sugar cube?
no longer available in the U.S.
EXCEPTIONS for FLU VACCINE
- not given until 6 months of age
- if under age 9: 1st time child is vaccinated, needs 1 dose and 2nd dose 1 month later
- vaccinated yearly
- under age 3: 0.25mL given
- > 3: 0.5mL given
Varicella dosing
- 1st @ 1 year
- need to be 3 months apart
How is hepatitis A transmitted?
oral-fecal
When is the 1st hepatits A vaccine given?
age 1 year
Meningococcal vaccine: dosing and spacing
- age 12
- age 16
What happens if pt does not present for meningococcal vaccine until age 16?
- give 1 dose
- no booster needed
If a child needs catch-up vaccines, how should you think about it?
- focus on the age of the child currently, and what vaccines can be given at that age
- What is their age now?
- How many vaccine doses they need
What allergy contraindicates administration of IPV?
anaphylaxis to streptomycin
(HOWEVER, there is an IPV not grown on streptomycin)
What kind of egg issue keeps a patient from getting the flu vaccine?
anaphylactic reaction to eggs
- Who should receive 2 HPV doses?
- Who should receive 3?
Minimum interval between HPV doses
5 months
Which Meningitis serotypes cause 90% of meningococcal disease in the U.S.?
B, C, Y, and W135
Which meningitis serotype has a recommended vaccination for college-age patients?
Meningitis B
What is the limit of PPSV23 doses prior to age 65?
2 doses
What to tell parents when a child is given the MMR vaccine?
- transient rashes adn fever of 103 can occur 5-12 days after vaccination
- fever typically resolves in 1-2 days, sometimes takes 5 days
Contraindications to measles vaccine
- pregnancy or planning pregnancy w/in 28 days
- anaphylactic reaction to gelatin, egg, neomycin or prior MMR vaccine
- febrile illness
How soon after measles exposure should the vaccine be given to provide protection?
w/in 72 hours
Who in the U.S. is eligible for the BCG vaccine?
infants and children with:
- negative TB skin test who:
- life w/ persons w/ infectious pulmonary TB (not effectively treated) & child cannot be removed
- live w/ persons w/ drug resistant TB (to isoniazid and rifampin) & cannot be separated from those persons
True or False?
(And why?)
A child can experience recurrent RSV infection–even if they received palivizumab
True
Because more than one strain of RSV can be circulating in a community
Which children are eligible for palivizumab (Synagis)?
- infants born prior to 29W (until they are 12 months old)
- children born prior to 32W w/ chronic lung disease (until they are 2 years old)
- infants w/ cyanotic or complicated CHD (up to 12 months of age)
- infants w/ neuromuscular disorders or congenital anomalies that compromize clearing of respiratory secretions (up to 12 months of age)
