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Vaccines Flashcards

1
Q

At what ages is the Hepatitis B Virus (HBV) vaccine administered?

A

1st dose: birth
2nd dose: 1mo - 2mo
3rd dose: 6mo - 18mo

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2
Q

At what ages is the Rotavirus (RV) vaccine administered and what are the rules on timing?

A 
Rotarix (RV1)
 - 1st dose:  2mo
 - 2nd dose:  4mo
RotaTeq (RV5)
 - 1st dose:  2mo
 - 2nd dose:  4mo
 - 3rd dose:  6mo

***Either can be given as early as 6wk

4wk b/t each dose:

  • 1st can’t be given after 15wk old
  • Series needed to be completed by 8mo

***If latex allergy, must do 3-dose RV5 formulation

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3
Q

At what ages is the DTaP vaccine administered? What is the minimum time frame between each?

A 
1st dose:  2mo
2nd dose:  4mo
3rd dose:  6mo
4th dose:  15mo - 18mo
5th dose:  4yo - 6yo

—4wk—4wk—6mo—6mo—>Tdap

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4
Q

At what ages is the Haemophilus influenzae type b (Hib) vaccine administered?

A

1st dose: 2mo
2nd dose: 4mo
3rd dose: 6mo
4th dose: 12mo - 15mo (at least 8 wks after last dose)

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5
Q

At what ages is the Pneumococcal conjugate (PCV13) vaccine administered?

A

1st dose: 2mo
2nd dose: 4mo
3rd dose: 6mo
4th dose: 12mo - 15mo (8wk after 3rd dose)

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6
Q

At what ages is the Inactivated Polio (IPV) vaccine administered and what is the minimum time period b/t doses?

A

1st dose: 2mo
2nd dose: 4mo
3rd dose: 6mo - 18mo
4th dose: 4yo - 6yo

—4wk—4wk—6mo

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7
Q

At what ages is the Influenza vaccine administered?

A

Annual dose starting at 6 months of age

- Receive x2 doses the 1st year received if <9yo

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8
Q

At what ages is the MMR vaccine administered? What is the minimum time interval between the doses

A

1st dose: 12mo - 15mo
2nd dose: 4yo - 6yo

28d

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9
Q

At what ages is the Varicella vaccine administered and what is the minimum time interval between doses?

A

1st dose: 12mo - 15mo
2nd dose: 4yo - 6yo

If <13yo, at least 3 mo b/t doses
If > than or = to 13yo, at least 1mo b/t doses

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10
Q

At what ages is the Hepatitis A Virus vaccine administered?

A

1st dose and 2nd dose: 12mon - 24mo; doses must be separated by 6 months

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11
Q

At what ages is the Meningococcal vaccine administered?

A

1st dose: 11yo - 12yo
2nd dose: 16yo

If receive 1st dose at 16yo, don’t need a booster

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12
Q

At what ages is the Tdap vaccine administered? And if Tdap is 1st version given based on age, how many more doses are needed and when?

A

Booster doses:

  • 11yo - 12yo (up until 18 yo)
  • Pregnancy (27wk - 36wk)
  • if child is 7 yrs old or older & has not received any vaccines, Tdap is first vaccine given
  • –8wks—>Td—6mo—>Td (3 total)
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13
Q

At what ages is the HPV vaccine administered and what is the minimum interval between doses?

A

1st dose: 11yo - 12yo, but can start at 9yo

—1-2mo—3mo

If <15yo at time of 1st dose, only need 2 doses total separated by 6mo

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14
Q

When is the Meningococcal B vaccine administered?

A

2 doses b/t 10yo - 25yo for the following populations:

  • Persistent complement component deficiencies (including inherited or chronic deficiencies in C3, C5-9), properidin, factor D, factor H, or taking Eculizumab
  • Anatomic or functional asplenia (including Sickle Cell Disease)
  • Microbiologists exposed to Neisseria meningitides
  • If increased risk to be near an outbreak
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15
Q

When is the Pneumococcal Polysaccharide (PPSV23) vaccine administered?

A

Ages 2yo - 64yo if any of the following apply:

  • Cigarette smokers age 19 years and older
  • Chronic cardiovascular disease (e.g., congestive heart failure, cardiomyopathies; excluding hypertension)
  • Chronic pulmonary disease (including COPD and emphysema, and for adults ages 19 years and older, asthma)
  • DM
  • Alcoholism
  • Chronic liver disease, cirrhosis
  • Candidate for or recipient of cochlear implant
  • Cerebrospinal fluid (CSF) leak or cochlear implant
  • Functional or anatomic asplenia (e.g., sickle cell disease, splenectomy)
  • Immunocompromising conditions (e.g., HIV infection, leukemia, congenital immunodeficiency, Hodgkin’s disease, lymphoma, multiple myeloma, generalized malignancy) or on immunosuppressive therapy
  • Solid organ transplantation; for bone marrow transplantation, see www.cdc.gov/vaccines/pubs/hemato-cell-transplts.htm.
  • Chronic renal failure or nephrotic syndrome
  • **Start at 2yo & at least 8wk after 4th PCV13
  • If never received PCV13 vaccine series, just give x1 dose of PCV13; then, give PPSV23 8wk later, & 2nd PPSV23 5yr later
  • No more than 2 doses of PPSV23 per child
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16
Q

What vaccine is administered at birth?

A

HBV

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17
Q

What vaccines are administered at 2mo?

A 
HBV (2nd dose, or 1mo)
Rotavirus
DTaP
Hib
PCV13
IPV
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18
Q

What vaccines are administered at 4mo?

A 
Rotavirus (2nd dose)
DTaP (2nd dose)
Hib (2nd dose)
PCV13 (2nd dose)
IPV (2nd dose)
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19
Q

What vaccines are administered at 6mo?

A 
HBV (3rd dose, or 6mo - 18mo)
DTaP (3rd dose)
PCV13 (3rd dose)
IPV (3rd dose, or 6mo - 18mo)
Influenza (can start annually at 6mo)
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20
Q

What vaccines are administered at 12mo?

A 
Hib (3rd or 4th)
PCV13 (4th dose)
MMR 
Varicella
HAV (2 dose series, b/t 12mo - 24mo)
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21
Q

What vaccines are administered at 15mo?

A

DTAP (4th dose, 15mo - 18mo)

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22
Q

What vaccines are administered at 4yo - 6yo?

A

DTaP (5th dose)
IPV (4th dose)
MMR (2nd dose)
Varicella (2nd dose)

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23
Q

What vaccines are administered at 11yo - 12yo?

A

Meningococcal
Tdap
HPV

24
Q

What vaccines are administered at 16yo?

A

Meningococcal (2nd dose)

25
Q

What are the contraindications and precautions for the DTaP/Tdap vaccine?

A

Contraindications:

  • Serious allergic reaction –> refer to allergist for confirmation & possible desensitization
  • Encephalopathy w/in 7d of receiving pertussis-containing vaccine (NOT a cx for Td*)
  • Infantile spasms, poorly-controlled sz, or progressive encephalopathy w/in 7d of “”

Precautions:

  • Guillain Barre Syndrome w/in 6wk after previous dose
  • Evolving neuro d/o
  • Moderate or severe acute illness w/ or w/o fever
26
Q

What are the side effects of the DTaP/Tdap vaccine?

A

Rare = irritability, sz w/in 3d, hypotonic-hyporesponsive episode, temp >104.8F, & limb swelling

27
Q

After a human bite, which viral tests should be done?

A

HBV & HIV

28
Q

Who is at increased risk for invasive Hib infections?

A

AAs, Native Alaskans, Native Americans, immunodeficient individuals, malignancies, Hb-opathies, & asplenia

29
Q

If didn’t receive a full Hib vaccination series, but received a dose at 15 mo, how many further doses are needed?

A

None

30
Q

If don’t start Hib vaccination series until b/t 7-11mo OR 12-14mo, when and how often should child be vaccinated? What if not starting until 5yo or older?

A

7-11mo: x2 doses 4 wks apart –> then, booster at 12-15mo
***If last dose of Hib is at 15mo, doesn’t matter how many total doses were received; does not need any additional doses

12-14mo: x1 dose –> then, booster 8 wks later

5yo or older: NONE!
- Exceptions: splenectomy >5yo; repeat dose 3 mo after immunosuppression/HSCT w/ initial given 2wk prior; >5yo who is HIV+; & complement deficiency

31
Q

What is the contraindication to the HBV vaccine?

A

Severe allergic reaction (to Baker’s yeast)

32
Q

What should be done if an infant is born to a mom who is HBsAg+ or unknown status? What follow-up should be done?

A

Give HBV IG w/in 1st 12hrs PLUS vaccine (even if <2 kg); can be given as late as 7d if known maternal status

Check at 9-18mo to ensure infant is HBsAb+ & HBsAg-
- If low, need 3 additional doses separated by 2mo each

33
Q

When should preemies be given the HBV vaccine?

A

If < 2 kg –> give w/in 30DOL or before discharge (whichever is 1st)
- This 1st dose will not count if <2 kg –> will need 3 more doses at 1mo, 2-3mo, & 6mo (4 doses total)

If > or = to 2 kg –> need only 3 doses (birth—4wk—>1mo—8wks—>6mo)

34
Q

What is the minimum time frame between Hep A vaccine doses?

A

6mo

35
Q

What are the contraindications to the Hep A vaccine?

A

Hypersensitivity or allergic reaction to vaccine components - aluminum hydroxide & phenoxyethanol

36
Q

What are the side effects of the meningococcal vaccine?

A

Pain, erythema, & swelling at site; headache; fatigue; irritability; syncope; & Guillain Barre Syndrome

37
Q

What is the meningococcal vaccine schedule for complement-deficient patients, HIV+, asplenic patients, military recruits, or patients tx’d w/ Eculizumab (binds C5 inhibitor) patients?

A

Menveo:

  • Give @ 2mo, 4mo, 6mo, & 12mo
  • If start @ 7-23mo, give 2 doses: 2nd dose b/t 1-2yo & > than or = to 3 mo after 1st dose
  • If start @ > than or = to 24mo, give 2 doses 8-12wk apart

Menactra: DO NOT use before 24mo (can interfere w/ PCV13)
- Give 2 doses 8-12wk apart w/ 1st dose given 4wk after last PCV13

If either primary series is completed before 7yo, give booster in 3yrs & then Q5yr going forward; if > or = to 7yo when primary series is completed, give booster Q5yr

Bexsero (B):
- Give @ > or = to 10yo –> get 2 doses separated by 1mo

Trumenba (B):
- Give @ 0mo, 1-2mo, & 6mo

38
Q

What is a side effect of HPV vaccine?

A

Vasovagal syncope

39
Q

What are the rules about MMR or VZV vaccine and IVIG administration?

A

DO NOT give IVIG until 2 wks after administration of MMR/VZV vaccine; if given w/in time frame, MMR/VZV will have to be readministered 11 mo later

Can’t give MMR/VZV vaccine until 11mo after IVIG administration

40
Q

What are the side effects of the MMR vaccine?

A

High fever (>103F) +/- rash w/in 12d, thrombocytopenia

41
Q

What are the contraindications to the MMR vaccine?

A

Severe allergic reaction to neomycin or gelatin

Pregnancy

Severely immunocompromised: HIV+ w/ CD4 <15%, high-dose steroids (> or = to 2mg/kg/d or >20mg/d for > or = to 2wk), chemotherapy
- Must wait 4 wks for issues to resolve before giving vaccine

42
Q

When are the general rules for combined MMRV vaccine administration and when is it contraindicated?

A

Doses must be separated by 3mo

Due to its association w/ higher rate of febrile sz 5-12d after administration in 12-23mo children, must be given separately when <24mo

Contraindicated in HIV+ pt’s

43
Q

What are the rules about administering a PPD test and vaccines?

A

MMR, VZV, and other live vaccines:

  • PPD can be placed at same time as vaccine
  • PPD should NOT be placed w/in 4-6wk period AFTER MMR/VZV has been given
44
Q

What are the contraindications to the VZV vaccine?

A

Prior allergic reaction to neomycin or gelatin

Pregnancy

Severely immunocompromised: HIV+ w/ CD4 <15%, high-dose steroids (> or = to 2mg/kg/d or >20mg/d for > or = to 2wk), chemotherapy
- Must wait 4 wks for issues to resolve before giving vaccine

  • **Should wait to get pregnant until 1mo after receiving vaccine
  • **Avoid using ASA 6 wks after vaccination due to risk of Reye’s Syndrome
45
Q

What are the vaccine contraindications for children receiving chemotherapy?

A

Can receive inactivated vaccines as long as they are not currently in induction or consolidation, but live vaccines can’t be given until 3-6mo after chemo has ended

46
Q

What are the catch-up vaccine recommendations for PCV?

A

If immunocompetent and > or equal to 5yo, do not need to start vaccine series

If start @ 7-11mo, only need x2 doses 8wk apart, w/ booster at 12-15mo

If start @ 12-24mo, only need x1 dose 8wk after 1st

47
Q

What is the only contraindication to either pneumococcal vaccine?

A

Serious allergic reaction

48
Q

Which vaccine can be transmitted to immunocompromised household members?

A

IPV (polio) & LAIV

***Can also give an extra IPV dose if going to endemic area

49
Q

What are the contraindications to the polio (IPV) vaccine?

A

Anaphylaxis after previous IPV

Streptomycin, Polymyxin B, or Neomycin allergy

50
Q

Which type of rotavirus vaccine should be given if patient has a latex allergy?

A

RotaTeq (RV5)

51
Q

What are the contraindications to the rotavirus vaccine?

A

Severe hypersensitivity reaction

Allergic reaction to previous dose

SCID

H/o intussusception

52
Q

What are the special considerations when giving the rotavirus vaccine?

A

Infants who have rotavirus GE –> still need to complete vaccine series; can wait until improvement occurs if moderate-to-severe disease

Infants who have underlying GI disease but NOT on immunosuppression –> receive vaccine series
- Rarely causes hepatitis and meningoencephalitis

Premature infants who are at least 6wk of age & discharged can receive vaccine

53
Q

How is the vaccine schedule adjusted for those patients receiving solid organ transplantation?

A

Inactivated vaccines –> give at least 2wk before transplant
- Restart series 6mo after transplantation

Live vaccines –> give at least 4wk before transplant

54
Q

When is LAIV contraindicated?

A

RAD, pregnancy, chronic heart disease, DM, CKD, ASA tx, or immunocompromised

55
Q

What is a side effect of the influenza vaccine?

A

Guillain Barre Syndrome (rare)

56
Q

What is the only vaccine with enough egg protein to cause a reaction?

A

Yellow Fever

However, if anaphylactic reaction to eggs, all influenza vaccines are contraindicated; should instead receive chemoprophylaxis

Gen Peds (2 decks)

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