Recommendations, Immunizations Flashcards
When give fluoride and iron fortified foods?
Fluoride - after 6 mo
Iron - 4-6 mo
Vit D supplement
Formula:
Only if formula has no vit D
Baby low birth weight
Poor milk intake
Breastfeeding:
Inadequate Vit D intake in mom’s diet, no sun exposure
Introduce solids at
4-6 mo age
Risk of atopy before this
How long avoid honey for?
1st year life
Live attenuated vaccines
Viral
- MMR
- varicella
- yellow fever
Bacteria
- BCG
- oral typhoid
Inactivated vaccines
Virus
- polio
- rabies
- hepatitis A
Protein based/toxoid
- hep B
- influenza
- pertussis
- diptheria
- tetanus
Polysaccharide based
- pneumococcal
- HIb
- meningococcal
Simultaneous admin of vaccines
OK for inactivated vaccines at separate sites except:
- cholera
- typhoid
- plague
Live viruses should be administered 1 month apart
Pneumococcal and whole virus flu can be given together at diff sites
Vaccine hypersensitivities 2/2 to..
Egg
Neomycin
Streptomycin
When are you permanently contraindicated to vaccines?
Severe allergy to prior admin
Encephalopathy after pertussis vaccine
OK to immunize preterm infants at chronologic age?
Yes!
And don’t reduce dosage
General rules for catch up
For lapsed vaccines
- resume schedule as if usual interval has elapsed - don’t repeat doses
- 2nd dose HiB only if 1st dose > 15 mo old
- 2nd dose PCV7 only if child < 2 yo
When is Hib 2 dosing needed and when is it not?
If had HiB disease < 2 yo - no immunity conferred
Don’t need 2 dose if give vaccine > 15 mo age
If mom is Hep B +, what do you do for neonate?
Begin prevention within 12 h birth
HBV and HBIG at DIFFERENT sites
Vaccinations at birth
Hep B #1
Vaccinations at 2 months
6 vaccines
(Pentacel)
DTaP #1
Polio #1
Hib #1
Pneumococcal #1 (Prevnar)
Rota #1
Hep B #2
Vaccinations at 4 months
5 vaccines
(Pentacel)
DTaP #2
Polio #2
Hib #2
Pneumococcal #2
(Prevnar)
Rota #2
Vaccinations at 6 months
6 vaccines
(Pentacel)
DTaP #3
Polio #3
Hib #3
Pneumococcal #3 (Prevnar)
Rota #3
Hep B #3
Vaccinations at 9 months
No vaccines, catch up on missed doses
Vaccinations at 12 months
3 vaccines
MMR #1
Varicella #1
Hep A #1
Vaccinations at 15 months
DTaP #4
Pneumococcal #4
(Prevnar)
Hib #4
Vaccinations at 18 months
Hep A #2
Vaccinations at 4-6 years
DTaP #5
Polio #4
MMR #2
Varicella #2
Vaccinations at 11-17 years
Tdap (only for kids s> 7 yo)
Meningococcal
Vaccinations at 9-17 years
HPV
- minimum 9 yo
- dose at 0, 2, 6 months
Dtap vs Tdap
DTap only for kids < 7 yo
Tdap only for kids > 7 yo
Screening labs at 12 months
CBC
lead
1 contraindication for intranasal flu vaccine
Asthma
Tdap vs DTap
Tdap for adults > 7
DTap for kids < 7
Contraindications vs precautions for diptheria/tetanus vaccine
Contraindication
- anaphylaxis
Precautions
- mod - severe acute illness
- Guillain-Barre within 6 wks of vaccine
- arthus-type hypersensitviity rxn
Contraindications vs precautions for pertussis vaccine
Contraindications
- anaphylaxis
- progressive neuro d/o (uncontrolled epilepsy, infantile spasms)
- Encaephaloathy w/in 1 week of prev vaccine dose
Precautions
- mod - severe acute illness
- seizure w/in 3 days
- temp > 105 within 2 days
- hypotonic-hyporesponsive episode within 2 days
- inconsolable, persistent crying within 2 days
DTaP is only available combo usuall. When do you give just the diptheria and tetanus toxoids wthout pertussis?
Encephalopathy within 1 week., progressive neuro d/o
Anaphylaxis to DTaP in past is a contraindication to avoid all components!
Contraindications to rotavirus vaccine
Anaphylaxis to ingredients
Hx of intussusception
Hx uncorrected congenital malformation of GI tract (eg Meckel)
SCID
