Vaccines

Question 1

PPSV23 indication and timing

Answer 1

Indication: Hemoglobinopathies (SCD, asplenia, immunodeficiency, CHD, CLD, CSF leak, DM, CKD/nephrotic syndrome, cochlear implants). Timing: 1st dose after 2 years old AND >= 8 weeks after PCV13 (must complete all 4 PCV13), and 2nd dose 5 years later (2nd dose only for heme, asplenia, immunocomp)

Question 2

When to give newborn varicella-zoster IG?

Answer 2

If mom develops varicella from 5 days before to 2 days following delivery (at this time, mom has not had enough time to develop VZV-IgG and transfer it to baby transplacentally)

Question 3

Nasal live attentuated vaccine contraindication

Answer 3

Pregnancy, CHF, asthma in 2-4 year olds, hx of wheezing within 12 months, DM, chronic renal dz, immunosuppressive d/o, daily salicylate therapy, CSF leak, cochlear implant, hx severe allergy to vaccine component (NOT egg allergy)

Question 4

Catch up for Varicella vaccine

Answer 4

If absence of natural infection, requires 2 doses. For 2nd dose, if < 13 yo, give 3 months after 1st dose. If > 13 yo, give 1 month after 1st dose.

Question 5

Vaccine that requires storage in -15 to -50 degree C

Answer 5

Varicella

Question 6

1st dose of rotavirus must be given by?

Answer 6

15 weeks (or else can’t start)

Question 7

Encephalopathy within 7 days is an absolute contraindication for which vaccine?

Answer 7

DTaP

Question 8

Length to wait for PPD after MMR vaccine

Answer 8

4-6 weeks (1 month)

Question 9

Hip pain or arthralgia after vaccine?

Answer 9

Rubella

Question 10

What age do you not need to get Haemophilus influenza type B and PCV13 vaccine in healthy kids?

Answer 10

5 years or older

Question 11

Indication for tetanus IG

Answer 11

ONLY in dirty, puncture, burn wounds in people who have received < 3 doses of tetanus containing vaccine or unknown vaccination history

Question 12

Hep A post exposure prophylaxis

Answer 12

If within 14 days of exposure, can give IVIG or Hep A vaccine. If > 1 year old, give hep A vaccine. If < 1 year old, immunocompromised, or severe liver dz, give IVIG

Question 13

Premie hep B vaccine, mom HBsAg-negative

Answer 13

A preterm infant weighing < 2 kg at birth born to an HBsAg-negative mother should receive the 1st dose of HepB vaccine series starting at 1 month of chronological age—or at hospital discharge if prior to 1 month of chronological age.

If mom positive, needs to get hepB vaccine and ivig within 12 hours, but this vaccine doesn’t count to series