preventive Flashcards
oldest you can be to get DTaP
6 yo
adolescents and Tdap
one dose, ideally 11-12yo
DTaP schedule
2, 4, 6, 15-18mo, 4yo, adolescence
catch up dipth, tet, pertussis
Tdap substituted for one of the Td boosters
contraindication for pertussis vaccine
encephalopathy within 7 days of receiving pertussis vaccine, evolving neurologic condition
can you give Tdap to pregnant woman
yes
can you give Tdap to immuncompromised people
yes
should you give pertussis vaccine to someone who had pertussis
yes
when do you give tetanus immunoglobulin
if dirty wound AND not fully immunized
when do you give Td after wound
if >5 years since last booster and dirty wound
if >10 years since last booster and clean wound
Hib schedule
2, 4, 6 mos
or 2, 4, 6, 12-15 mos
combination vaccines - who can get them?
primary series, age 6 weeks - 6 years
HBV vaccine schedule
birth, 2 mos, 6-18mos
contraindication to HBV vaccine
severe allergic reaction to prior dose
OK in pregnancy
can preemies get HBV vaccine?
yes, even if < 2kg
within 30 DOL or prior to discharge
if <2kg, still need full series
hep B PEP in infants/unvaccinated
HBIG and HBV series
hep B PEP if full series and antibody positive
nothing
hep B PEP if full series and antibody negative
HBIG and HBV series
hep B PEP if HBV vaccine status unknown
test for antibody
hep A vaccine - when given
1 year
hep A vaccine contraindications
allergic reaction to aluminum hydroxide or phenoxyethanol
children traveling to hep A endemic areas
< 1yr: get immune globulin
> 1yr: get vaccine, at least 2-4 wks prior to departure
MCV4 - strains covered?
A, C, Y, W135
MCV4 schedule
11-12yrs, 16yrs
prior to college if not vaccinated before
MCV4 if immunocompromised
yes!
HPV vaccine age
9 is youngest, rec 11-12
catch up for F 13-26
MMR schedule
12-15mos, 4-6yrs
vaccines at <1yr don’t count towards series
MMR and other live vaccines?
either given together or >4wks apart
SEs of MMR vaccine
high fever within 12 days of vaccination, lasts 1-2 days
rash
REASSURE
MMR contraindications
severe allergic reaction to vaccine, neomycin, gelatin
pregnancy
severe immunocompromised
MMRV problem
higher rate of febrile seizures in 12-23 mos
contraindicated in HIV
PPDs and MMR?
can place before or with MMR
should not be placed after MMR for 4-6 weeks
HIV+ and vaccines
measles if not severely immunocompromised, NO MMRV
varicella if CD4 counts OK
inactivated flu only
varicella schedule
12-15mos, 4-6 yrs
if older, unvaccinated, and has not had chickenpox
contraindications to varicella vaccine
pregnancy
allergic reaction
serious immunocompromise
who gets varicella IG as PEP
immunocompromised w/o previous vaccine/infection
non-immune pregnant women
preemie < 28 wks GA
preemie > 28 wks GA in hospital with non immune mom
newborn if mom contracted 5 days before to 2 days after birth
who gets varicella vaccine as PEP
all who get IG plus:
12 mos and older within 72 (or 120) hrs from exposure
how long after chemo OK to give inactivated and live vaccines?
inactivated - fine during chemo if not induction or consolidation
live - minimum 3-6 months after chemo is over
EXCEPTION: varicella given to children with ALL in remission
PCV schedule
2, 4, 6, 12-15mos
catch up for all children < 6 yos
if 6 or older, when to get PCV?
if immunocompromised or asplenic
if CSF leaks and cochlear implants
if chronic heart, lung, renal disease, diabetes
who gets PPSV23
if immunocompromised or asplenic (these get total 2 doses)
if CSF leaks and cochlear implants
if chronic heart, lung, renal disease, diabetes
IPV schedule
2, 4, 6 mos, 4 yrs
rota schedule
2, 4, 6 mos (if RV5)
2, 4 mos (if RV1)
how old is too old for rota vaccine
15 weeks for first dose (but still do the rest of the series even if you miss it)
8 months for last dose
rota contraindications
severe allergic reaction
SCID
intussusception
underlying GI disease on immunosuppressive treatment
do you readmin rota if they spit it up
no
vaccine timing with solid organ transplant
live vaccines - min 1 month prior
inactivated vaccines - min 2 weeks prior
who can get LAIV
2 years or older
which vaccines do we worry about with egg allergy
yellow fever vaccine - see allergist prior
influenza IF anaphylaxis to egg
when to screen for cholesterol
5-9 if risk factores
9-11 for everyone
what does UVA do
all day risk
drug induced photosensitivity
what does UVB do
10A-5P highest risk
skin aging
sunburn
skin cancer
where do infants <2y or <20lbs sit in car
infant/rear facing car seat at 45 degree angle
where do toddlers > 2yr or >20lbs sit in car
convertible car seat with harness, forward facing
where do school age children <4’9” sit in car
booster seat
how old to sit in front seat
13yr
bicycle deaths most common age grp
<15yrs
75% deaths due to head injuries
what % children wear bike helmets
<10%
bicycle helmets reduce serious injury by __
85%
water heater temp
120
more than ___% of suicide attempts with gun are fatal
90
infants most likely to drown in
bathtub
children <5 most likely to drown in
residential pool
adolescents most likely to drown in
fresh water
above ground pools more vs less likely to cause drowning
less
drowning higher in which groups
AfAm males, males (75% of all drownings)
how do you secure home pool
4 sided fence around pool, self-locking and self-latching gate
maternal cigarette use during pregnancy –>
preterm birth, IUGR
SIDS
asthma
behavior and attention problems
are school based education programs useful for smoking prevention
yes if focus on role playing refusal skills and give info on health impact
when to use nicotine replacement therapy in adolescents
if confident it will be used appropriately and quitting not likely otherwise
