Peds - Immunizations Flashcards
This vaccine is contraindicated for those with egg allergies.
Flu vaccine
What vaccine(s) are contraindicated in pregnant women and immunocompromised people?
MMR / Varicella (live vaccines)
This vaccine is contraindicated for people allergies or have hx of anaphylaxis to streptomycin.
Varicella / IPV
What general education would give your patient regarding what to expect after a vaccination administration?
1) Local muscle soreness
2) Low grade temperature
3) Local erythema and tenderness
If there is a break in the immunization schedule, how should you proceed?
Resume immunizations according to the child’s current age regardless of the vaccines previously missed.
Can you give Varicella and MMR at the same time?
No, separate administration of MMR from varicella by 1 month.
You have a 12 year old child in your office, what vaccines should he receive?
1) Meningococcal conjugate vaccine (MCV4 - Menactra / Menveo)
* Given as a series of 2, at ages 11 - 12 years, and booser at 16 years.
* No booster required if 1st administration occurs at or after 16 years.
2) HPV - quad (Gardasil); bivalent ( Cervarix)
* Series of 3 (11 - 12 years, then 1 month, then 6 months after 1st dose)
* Can no longer receive after 26 years old.
You’ve just given Johnny a Gardasil injection & ask him to sit for 15 minutes after administration, why do you do this?
Due to risk of labile syncope, postural hypotension, and vasovagal response.
Jimmy is 12 years old coming into the clinic today for a PPD in order to go to a new school. What vaccine is Jimmy also due for, and what are some special considerations to have in mind prior to administering either the PPD or the vaccine(s)?
He is also due for his final MMR, which can be given simultaneously with the PPD, however, prefer to postpone the PPD for 4-6 weeks after receiving the MMR to avoid possible suppressive response to the PPD (prevent a false (-)).
Kim is a 12 month old coming in for a well-child check, what vaccines do you anticipate administering?
1) Hib booster
2) PCV 13 booster
3) MMR (1st dose)
4) Varicella
5) Hep A
At what age can you first administer MMR?
12 months (1 year), next does at 12 years old (series of 2)
If your patient will be exposed to measles due to traveling to an endemic area, what is the earliest age at which you can administer MMR? What education must you give to your patient when MMR is administered early?
1) 6 months
2) Pt will still need to continue primary series at appropriate times (12 months and again at 12 years)
Jim is a 2 year old with leukemia. Jim’s mother requests FluMist rather than the IM version of the flu vaccine. What education must you provide?
FluMist is a live attenuated inactive virus (LAIV) and can only be used as an alternative to the trivalent inactivated virus (TIV) in healthy, non-immunocompromised persons aged 2 - 49 years.
Describe the administration schedule for IPV.
2, 4, 6 months, and 6 years old
What is the difference between IPV and OPV?
Oral polio virus is a live virus and is discouraged. IPV is inactivated.
When can OPV be administered?
OPV is only possible for doses #3 (6 months) and #4 (6 years)
Johnny is a 8 year old child coming in for his flu shot, what special instructions do you give Johnny’s guardian?
In children less than 9 years old, they must receive two doses 1 month apart. Instruct Johnny’s parent to RTC in 1 month for next dose.
At what age would administer a 0.25mL IM dose of the flu vaccine? And, at what age does the dose increase to 0.50mL?
1) from 6 to 35 months
2) children 3 years or older
Sammy is in for her 6 month well baby check, what vaccines do you administer?
1) Hep B (series of 3, 3rd dose)
2) DTaP (series of 3, 3rd dose)
3) Hib (series of 3, 3rd dose)
4) IPV (series of 4, 3rd dose)
5) PCV13 (Prevnar) (series of 3, 3rd dose)
6) Flu vaccine (annually therafter)
Anne is in for her 4 month well baby check, what vaccines do you administer?
1) DTaP (series of 3, 2nd dose)
2) Hib (series of 3, 2nd dose)
3) PCV13 (series of 3, 2nd dose)
4) IPV (series of 4, 2nd dose)
Jimmy is in for his 2 month well baby check, what vaccines do you administer?
1) Hep B (series of 3, 2nd dose)
2) DTaP (series of 3, 1st dose)
3) PCV13 (series of 3, 1st dose)
4) IPV (series of 4, 1st dose)
5) Hib (series of 3, 1st dose)
What is the administration schedule for hepatitis B?
Series of 3 (0 - 2- 6 months)
What is the administration schedule for rotavirus?
Series of 3 from 6 weeks to 32 weeks
What is the administration schedule for DTaP?
Series of 3 (2 - 4 - 6 months) and 2 boosters ( 15 months and 6 years)
At what age is DTaP no longer indicated?
7 years old
What is the administration schedule for Tdap?
Series of 1 at 11 or 12 years old, with boosters every 10 years, and should be administered to pregnant women at each pregnancy.
What is the administration schedule for the pneumococcal vaccine?
PCV13 (Prevnar) - series of 3 ( 2 - 4 - 6 months) and 1 booster at 12 months
When do you administer 23PS (Pneumovax)?
To children aged 24 to 59 months who completed the PCV13 series and are IMMUNE COMPROMISED.
What is the administration schedule for IPV?
Polio vaccine, series of 4 (2 - 4 - 6 months and 6 years)
At what age can you start give the flu vaccine?
At 6 months, children younger than 9 should get 2 doses, 1 month apart.
What is the administration schedule for MMR?
Series of 2, 1 year (12 months) and 12 years
What is the administration schedule for Varicella?
Series of 2, between 12 months 12 years, administer 2 doses 3 months apart.
What is the administration schedule for Hep A?
Series of 2, give 2 doses starting at 1 year and space the doses 6 months apart.
At what age should rotavirus vaccine no longer be given?
32 weeks ( 8 months) of age
What vaccine is given at time of birth?
Hep B
What vaccine can cause intussusception?
Rotavirus - can cause this 3 weeks after administration.
After the age of 5, what vaccines do you no longer give as they are no longer efficacious after this age?
1) Hib
2) Pneumococcal (Prevnar)
3) Rotavirus
If a caregiver for a child is immunocompromised should the child receive live vaccines?
No
Anne is born to a hepatitis B antigen (HBsAg) positive mother, how should you proceed?
1) Administer Hep B vaccine and Hep B immune globulin (HBIG) 0.50mL within 12 hours of birth.
2) Test for HBsAg and antibody to HBsAg after 3 or more doses of the Hep B series (at ages 9 to 18 months)
John is born to a mother with unknown HBsAg status, how should you proceed?
1) Determine mother’s status immediately following birth via a serology test.
2) Administer Hep B within 12 hours of birth.
3) If mother tests (+) then give HBIG no later than 1 week after birth.
