Preventative Pediatrics/Vaccines Flashcards
When can you give live vaccines after a recent course of steroids?
If course of steroids given lasted less than a total of 14 days, regardless of dose, any vaccine allowed
When do you need to delay live vaccines after a recent course of steroids? When do you give vaccines in this case?
If steroid course lasted 2 weeks or more AND EITHER:
(1) >2mg/kg/day steroids OR
(2) >20mg/day
Have to wait one month after the course is over.
Think twice about giving which vaccines to a premature baby?
Hep B (would give at DOL 30 or at hospital discharge, whichever comes first if <2kg)– would count toward series as long as MOP is HepB negative.
Rotavirus–risk of transmission of rotavirus while in the hospital, do NOT give while hospitalized
Live vaccines?
MMR Varicella Rotavirus Oral Polio (but USA uses IPV-inactive), Yellow Fever Influenza (inhaled only)
What criteria do you have to meet to receive the inhaled influenza vaccine?
At least 2 years old and healthy
No history of asthma
No hx of immunocompromise
Not pregnant
True or False. You can give live vaccines to a pregnant teenager.
FALSE.
True or False. You can give live vaccines to an HIV patient as long as they are otherwise healthy.
TRUE. Only if HIV+ AND have a low CD4 count (<200) would not give.
Can you give MMR and Varicella vaccines to household members of a pregnant or immunocompromised person?
Yes
Can you give Rotavirus vaccine to household members of an immunocompromised patient?
Yes, just warn about viral shedding in the stools
In what age window can the rotavirus vaccine be initiated?
6 weeks to 15 weeks (so if they come for the first time to clinic at 4 months old–would not give rotavirus)
Between what ages do you need to give 2 doses of flu vaccine for the first year they receive it?
6 months to 8 years, two vaccines six months apart.
After 8 years can just get one vaccine a year
Hepatitis A vaccine?
Two doses
First dose at 12 months, then 2nd dose at min 6 months after
Hep B vaccine–normal circumstances?
Birth
Between doses 1 and 2: one month (~2 mo WCC for simplicity)
Between doses 1 and 3: four months (~4mo WCC) AND not before 24 weeks of age
Need to have at least two months between doses 2 and 3.
Which, if any, of the following HepB vaccination schedule is NOT allowed?
0, 2, 6 months 0, 1, 6 months 2, 4, 6 months 0, 2, 4, 6 months 0, 2, 4 months
All except the last one is allowed.
Okay to have an extra HepB because of combination vaccines (one is wasted as part of a combination vaccine-but that’s okay per CDC)
Last one– cannot give last dose earlier than 24 weeks
HepB immunization if MOP’s HepBsAg is + and baby is term AGA?
Give HepB vaccine and HBIG within first 12 hours of life on separate extremities.
HepB immunization if MOP’s HepBsAg is unknown?
Give HepB vaccine at birth (or within 12 hours) and then send MOP’s HepBsAg– if positive, give baby HBIG within the first 7 days of life.
HepB immunization if MOP’s HepBsAg is + AND baby is premature?
Give HepB vaccine and HBIG within first 12 hours of life on separate extremities.
If baby is preemie AND BW <2000g, WOULD NOT count birth dose as part of vaccination series–so would need three additional doses.
HepB immunization if MOP’s HepBsAg is neg AND baby is premature?
If premature but >2kg, can give HepB immunization at birth and would count.
If preemie but <2 kg, give HepB vaccine at DOL 30 or at discharge, whichever comes first (this would count).
HPV vaccine? When would you need to get three doses?
HPV if started before age 15 years, 2 doses 6 mos apart.
If >15 years of age, 3 vaccines on a 0/1-2/6 month type schedule
Men(ACWY)– simple
1st dose: 11yrs
2nd dose: 16 years, otherwise about 3 years after first dose
Men(ACWY) if presenting as a unimmunized college freshman
Just one dose of Men(ACWY)
Men(B)
Recommended; given at 16 years, with booster dosing dependent on series used (between 1-6 months apart)
High risk population that should receive Men(B)?
Complement deficiency, spleen damage or removal, immunocompromised