vaccines Flashcards
HBV Routine immunization of infants– 3 doses ?
Birth, 1 month, 6 months
HBV Routine immunization for adolescents ?
3 doses of pediatric or
2 doses of adult
Pediatric HBV ?
Recombivax or Engerix 0.5 ml IM
Adult HBV ?
Recombivax 1 ml IM
RV5 ?
Rotateq
RV5 doses ?
latex-free, no reconstitution needed, 3 dose series
RV1 ?
Rotarix
RV1 doses ?
has latex, must be reconstituted with diluent, possible increase risk of intussusception, 2 dose series
RV1 months ?
oral
2 and 4
RV5 months ?
oral
2 4 6
Rotavirus, dont start if ?
Do not start if 15 weeks or older
If infant spits it up, do not repeat dose
DTaP marketed as ?
Daptacel, Infanrix, Tripedia
DTaP amount ?
0.5 mL IM
DTaP months ?
2, 4, 6 and 15-18 months, and 4-6 years (5 doses)
5 doses
3 months – not adequately immunized
DT ?
when pertussis is contraindicated
Td ?
tetanus toxoid and reduced amount of diphtheria, typically for adults requiring tetanus
DtaP-Hib ?
(TriHIBit),
DTaP-IPV-HepB ?
(Pedarix),
DTaP-IPV-Hib ?
(Pentacel),
DTaP-IPV ?
(Kinrix)
DTaP contraindications ?
Anaphylactic-type reaction to previous dose
Encephalopathy within 7 days of previous dose (not attributable to another cause)
Progressive neurologic d/o
DTaP precautions ?
High fever (40.5C)
Persistent, inconsolable crying within 48⁰ of previous dose
Seizures within 3 days of previous dose
DTaP AR ?
Local reaction, especially with increasing number of doses
Fever
PedvaxHIB months ?
2, 4, and 12-15 mos
H. flu only
ActHIB months ?
2, 4, 6 and 12-15 mos
H. fu only
Pneumococcal conjugate vaccine (PCV13) recommendation ?
all children younger than 5 years old, all adults 65 years or older, and people 6 years or older withcertain risk factors.
Pneumococcal polysaccharide vaccine (PPSV23) recommendation ?
all adults 65 years or older. People 2 through 64 years old who are athigh risk of pneumococcal diseaseshould also receive PPSV23.
PCV13: Age at 1st dose (months): 2-6 months ?
3 doses
1 dose at 12-15 mos booster
PCV13: Age at 1st dose (months) 7-11 months ?
2 doses
1 dose at 12-15 mos booster
PCV13: Age at 1st dose (months) 12-23 months ?
2 doses
no booster
PCV13: Age at 1st dose (months) 24-59 months in healthy children ?
1 dose
no booster
PCV13: Age at 1st dose (months) 24-71 months in children at risk* ?
2 doses
no booster
IPV route and months
Subcut
2, 4, and 6-18 mos and 4-6 years.
ALL need a dose at 4-6 years
LAIV marketed as ?
Fluzone, Fluvirin, Fluarix, Afluria
Annual vaccination for ALL people 6 mos old and up, in the fall
Each year a new formulation is made, based on surveillance in Asia
?
LAIV
LAIV Children 6-35 months dosing ?
0.25 mL IM, older children 0.5 mL
MMR given in two doses – months ?
12-15 mos and 4-6 yrs
MMRV higher rate of ?
seizures
Reconstitute with diluent, inject sub cut ?
MMR
Rule out pregnancy first and advise no conception for __ mos after injection for MMR
3
MMR contrindications ?
Pregnant, immunocompromised, egg allergy, high-dose steroids
MMR AR ?
Few develop fever 6-12 days later
5% get a rash
Rare – encephalitis, Guillain-
Barre (1 in 3 million)
Febrile seizure, esp if MMRV
VAR marketed as ?
Varivax
VAR store in ?
freezer
VAR need to be reconstituted , T or F ?
T
VAR dosing schedule ?
12-15 mos and 4-6 years
May do MMRV for 2nd dose
VAR contraindications ?
Severe allergic reaction to previous dose
Immunodeficient
Pregnant women
VAR precaution ?
Personal or family hx of febrile seizures
VAR AR ?
20% get minor injection site reactions
Rash
HepA for ?
children
travelers to countries with high rates of Hep A
children with Hep B or Hep C infection
children with clotting disorders
adolescent/adult males who have sex with men
occupational exposure
illegal drug users
close contact with international adoptee
2-18 yo if previously unimmunized
HepA marketed as ?
Havrix or Vaqta
HepA doses and route ?
2 dose IM
HepA 1-18 years ?
0.5 mL, 6-18 mos apart
HepA 19+ years ?
1.0 mL, 6-18 mos apart
HepA contrindications ?
Allergic reaction to previous dose
HepA precautions ?
Pregnant
Moderate/severe illness
HepA AR ?
Uncommon and mild – injection site pain, HA, loss of appetite
Meningococcal Vaccine serogroups ?
A, B, C, W-135 and Y
Meningococcal Vaccine serogroups that predominate in the US ?
B C Y
No vaccine for serogroup __ ?
B
Two MCV4 vaccines available – ?
Menactra and Menveo
MCV4 for who ?
For all people 11-12 years, booster dose at age 16 years
Earlier and more frequent doses for those at risk
MCV4 dosing ?
0.5
Neisseria meningitidis who is at risk ?
College freshmen living in dorms
Military recruits
People who travel to or live in countries with high rates of meningococcal disease
People with complement deficiency
People with functional or anatomic asplenia
Immunocompromised people
so give them the MCV4 vaccine
MCV 4 contrindications ?
Allergic reaction to vaccine or diphtheria toxoid
MCV4 precautions ?
Okay to give to immunosuppressed patients
MCV4 AR ?
Injection site pain
4.3% get more systemic reactions – fever, HA, fatigue, malaise, arthralgias, vomiting, diarrhea, rash, seizures
Meningitis Exposure ?
Post-exposure prophylaxis for close contacts
Within 24 hours
Rifampin, ceftriaxone, maybe cipro
Tdap – marketed as ?
Boostrix, Adacel
Tdap 11-18 yo doses ?
0.5 mL IM
INSTEAD OF the Td booster
Tdap 19-64 y.o. dosing ?
single dose of Tdap
Tdap 65+ yo. dosing ?
single dose of Tdap if not previously dosed and if will have contact with an infant
Tdap contrindications ?
allergy
Tdap precautions ?
Guillain-Barre within 6 wks of previous tetanus vaccine
Tdap AR ?
local pain, HA, fatigue
Most common STI in US ?
HPV
HPV: Types 16 and 18 cause 70% of ?
cervical cancers
HPV: Types 6 and 11 cause 90% of ?
genital warts
HPV dosing and months ?
3 doses, 0.5 mL IM
0, 2 and 6 months
HPV they can start when ?
Can start as early as 9
2 doses for 9-14 yo (6 months apart)
HPV recommendation ?
all 11- 12 yrs and through 26 yo if not previously immunized
3 doses
Other Vaccines ?
Rabies Vaccine Typhoid Fever Vaccine Japanese Encephalitis Vaccine Tuberculosis Vaccine Yellow Fever Vaccine
