Preventative Peds

Question 1

When do you stop giving HiB with catch up vaccines?

Answer 1

In children without immune compromise, do not need to start series after 5 years of age

Question 2

Catch up planning for TDaP/TD?

Answer 2

If <7 - complete DTaP series, if > 7, first dose should be TDaP, then complete catch up with TD

Question 3

Minimum interval between catch up varicella dosing

Answer 3

if < 13 years of age, min interval is 3 months, if > 13 years of age, min interval is 28 days

Question 4

Minimum interval between catch up MMR, PCV13 and HiB vaccines

Answer 4

4 weeks

Question 5

What vaccines suppress TST reactivity if given prior t placement of PPD?

Answer 5

MMR, varicella and live attenuated flu

Question 6

What is considered the vaccination cut off as severe immunosuppression in children with HIV?

Answer 6

T lymphocyte percentage less than 15% then don’t give live attenuated vaccines

Question 7

Polio vaccine recommendations when traveling to an endemic area

Answer 7

If traveling to an area with circulating wild type polio for more than 4 weeks - should receive polio booster prior to travel even if have completed initial series

Question 8

Pneumococcal vaccination recommendations in immuncompromised or asplenic pateitns

Answer 8

Complete initial PCV 13 series (2, 4, 6 and 12 months). Complete PPSV23 series at 2 and 5 years of age (first vaccine >8 weeks since last PCV13)

Question 9

Tooth eruption in children

Answer 9

Mandiublar central incisors then maxillary central incisors then erupt laterally. 7+4 rule (first erupt at 7 months, have 4 teeth by 11 months, etc. adding 4)

Question 10

Dosing of live attenuated vaccines around IVIG administration

Answer 10

Must wait 3-11 months post IVIG (exact duration pending indiation for IVIG and vaccine) to give live attenuated vaccines and have immune response. If IVIG given wihtin 2 weeks of live vaccine, vaccine needs regiven

Question 11

IM injection sites

Answer 11

anterolateral thigh, deltoid if old enough

Question 12

HiB catch up rules

Answer 12

Only one dose needed if child between 15-59 months and immunocompetent. If <11 months - should receive routine series with last dose >15 months (and 8 weeks since 2nd dose). If 12-14 months - should receive 2 dose series with last dose >15 months and 8 weeks since 1st dose

Question 13

PCV13 catch up rules

Answer 13

<12 months - should receive 4 dose series. 12-24 months should receive 2 dose with 2nd dose 8 weeks after first. If >24 months only need 1 dose