Vaccinations Flashcards
Which vaccinations are give subcutaneously?
Which vaccinations are live vaccinations?
Subcutaneous vaccines: MMR, varicella, IPV
Rotavirus, MMR, varicella are live vaccines
All vaccine given before 1 year are either killed or recombinant except for the rotavirus vaccine
Can live vaccinations be adminstered to HIV patients?
Yes.
MMR and varicella vaccines can be adminstered to an asymptomatic HIV infected patient
HIV patients should receive MMR and varicella vaccine at 12 months of age
Which vaccines can not be given to a pregnant adolescent?
Do not give MMR, varicella, intranasal influenza, HPV to pregnant adolescent
How many MMR vaccinations should a child at age 12 receive?
When should Tdap be adminstered?
When should meningococcal vaccination be adminstered?
Give 2 MMR vaccines by 12 years of age
Tdap is due at 11-12 years old, then Td every 10 years after
MCV4 given at 11-12 years with follow up boosters at 16 year
When is it not appropriate to adminster live vaccines?
Do not give live vaccines such as BCG, oral poliovirus, MMR, varicella vaccine to children with congenital defects of their immune function, children receiving immunosuppressive therapy, or children undergoing a bone marrow transplant
Do not give live virus or bacterial vaccines to a child receiving 2mg/kg or more of prednisone for longer than 14 days, children should be off high dose steroids for at least 3 months
Facts about the MMR vaccine
Measles vaccine may suppress tuberculin activity
If MMR and PPD are not given on the same day, will need to wait 6 weeks before giving the PPD
Varicella and MMR are given on the same day, or will need to wait 4 weeks apart
If a child has received any type of immunoglobulin, wait 3 months before giving the MMR or varicella vaccine
If the child has received a transfusion of packed RBC, must wait 5 months before giving MMR or varicella vaccine (6 months if given whole blood, 7 months if given plasma or platelets, 8 months if given IVIG for ITP, and 11 months if given IVIG for Kawasaki disease)
Post exposure within 72 hours prophylaxis with varicella or MMR vaccine is recommended to prevent disease
If MMR is given between 6 - 12 months as post exposure prophylaxis, the patient will still need to receive MMR series at 12 months and 4 years, prior to 6 months post exposure prophylaxis is immune globulins
Pneumococcal Vaccine
Give to high risk groups:
- cochlear implants
- cardiac or pulmonary disease
- immunocompromised
- long term steroid use
If patient is between 24 and 59 months who is not completely vaccinated for their age, just give one dose
If patient completed all series of PCV7 and are between 14 and 59 months old, then give one dose of PCV13
If the patient is at high risk, completed all series of PCV7 and is between 60 and 71 months old, then give 1 dose of PCV13
PCV 13 should be at least 8 weeks after the previous dose of PCV7
Meningococcal Vaccine
Vaccinate at 11-12 years old, then booster at 16 years old
For high risk patients such as complement deficiency or asplenia, give 2 doses at least 8 weeks apart, then 1 dose every 5 years after
Varicella
Two doses, first dose is 12-15 months, second dose is 4-6 years
Recommended minimum interval for those less than 13 years is 3 months
If older than 13 years, then wait 4 weeks between each dose
Make sure you vaccine children on low dose steroids, children with asthma, inhaled steroids, children of pregnant women
Do no vaccinate: in children with high dose steroids, greater than 2 mg/kg/day or pregnant adolescents
DTap/Tdap
Do not give children older than 7 years old DTap, give Tdap instead followed by Td for the remaining catch up doses and every 10 years
One Tdap once in your life, then get Td every 10 years
Hib
Vaccine is not effective against the nontypeable forms of Haemophilus that frequently cause otitis media and upper respiratory infections
Minimum age is 6 weeks
Hib is not recommended for those over 5 years except
- high risk patients with sickle cell
- leukemia
- HIV
- splenectomy
Hepatits A
Give to adolescent men who have sex with men
Adolescents who abuse IV drugs
Recommended for all children
Given at 1 year of age in 2 doses, 6 months apart
If hepatitis A exposure in household, give Hepatitis A vaccine as post exposure prophylaxis if over 1 years old, if less than 1 years old, give immunoglobulin
Rotavirus Vaccine
Minimum age of first dose is 6 weeks
Minimum interval between shots, 4 weeks
Prior to introduction of vaccine, most children were infected by age 5 years
Most common cause of gastroenteritis in infants and young children
If the child was not given an initial rotavirus vaccine by 15 weeks of age, then do not give it at all.
Do not administer the final dose of rotavirus if the child is greater than 8 months.
Do not give rotavirus to any children with a history of intussusception
Influenza Vaccine
Two types of influenza vaccine: inactivated and live attenuated vaccine
Live attenuated flu vaccine only in children greater than 2 years old and healthy
Can not use in pregnant adolescents and in girls 2-4 years old if they have been wheezing in the last 12 months
All children over than 6 months may get the flu vaccine
Children ages 6-23 months have increase risk of complications from flu
For children under 9 years old who have never been vaccinated with the Flu before, give at least 4 weeks apart x 2 for the first season
Intranasal flu vaccine can be given to healthy children greater than 2 years old, not for children with diabetes, asthma, or HIV
Do not vaccinate with the influenza vaccine if there was
- severe reaction to previous vaccination
- severe allergies to eggs
- Guillain Barre syndrome within 6 weeks of getting flu vaccine
HPV
Covers types 6, 11, 16 and 18 boys and girls 9 to 26 years old
Give at 0, 2, and 6 month intervals
Can increase risk of syncope after vaccination. Recommended to observe patients for 15 mins after vaccination
