Vaccines Flashcards
What’s Prevnar?
PCV13
What’s Pentacel?
DTaP-IPV-Hib combined
What’s in Pediarix IM?
DTaP, HepB, and IPV
Shots at birth?
Hep B #1
Shots at 2mo visit?
Hep B #2 (can be at 1-2 mo), Rota #1, DTap #1, Hib #1, PCV #1, IPV #1 (Pentacel, Prevnar, Heb B and PO Rotarix)
Shots at 4mo visit?
Rota #2 (Last dose if Rotarix, 2/3 if RotaTeq), DTaP #2, Hib #2 (Done if Pentacel, others 2/3 for others), PCV #2, IPV #2 (Pentacel, Prevnar and PO Rotarix)
Shots at 6mo visit?
Rota #3 (if RotaTeq, already done if had 2 Rotarix), Heb B #3 (can be 6-9mo range), DTaP #3, Hib #3 (if certain types, done), PCV #3, IPV #3, IM Flu (Pediarix, Prevnar and Flu)
Shots at 12mo visit?
Hep B #3, Hib #3/4, PCV #4, IPV #3, MMR #1, Var #1, Hep A #1, IM Flu PRN
Shots at 15-18mo?
DTaP #4, Hep A #2 (2 doses between 12 and 23 mo), IM flu PRN, MCV if high risk
How many childhood doses do we give of DTaP and when are they given?
5 @ 2mo, 4mo, 6mo, 15-18mo and 4-6yo (n.b. Dose 5 is not necessary if dose 4 was administered at age 4 years or older and at least 6 months after dose 3)
How many childhood doses do we give of IPV and when are they given?
4 doses @2mo, 4mo, 6-18mo and 4-6yo; administer the final dose at or after age 4 years and at least 6 months after the previous dose (even if they’ve had 4+ doses prior d/t combo usage)
How many childhood doses do we give of Hib and when are they given?
3 or 4 doses (depends on brand); usual 4-dose Pentacel/ActHIB/Hiberix schedule is at 2, 4, 6, 12–15 months (n.b. Unvacc’d at 15–59 mo: 1 dose; Previously unvacc’d children > 60 m/o who are not high risk do not require vaccination)
How many childhood doses do we give of MMR and when are they given?
2-dose series at 12–15 months, 4–6 years
Dose #2 may be administered as early as 4 weeks after dose 1.
How many childhood doses do we give of PCV13 and when are they given?
4-dose series at 2, 4, 6, 12–15 months
How many childhood doses do we give of Varicella and when are they given?
2-dose series at 12–15 months, 4–6 years
Dose 2 may be administered as early as 3 months after dose 1 (a dose administered after a 4-week interval may be counted).
How many childhood doses do we give of Rotavirus and when are they given?
2 or 3 (depends on brand):
- Rotarix: 2-dose series at 2 and 4 months
- RotaTeq: 3-dose series at 2, 4, and 6 months
- *If any dose in the series is either RotaTeq or unknown, default to 3-dose series.
How many childhood doses do we give of HepA and when are they given?
2-dose series (minimum interval: 6 months) beginning at age of 12 months
How many childhood doses do we give of HepB and when are they given??
3-dose series at 0, 1–2, 6–18 months (use monovalent HepB vaccine for doses administered before age 6 weeks)
Infants who did not receive a birth dose should begin the series as soon as feasible
Hep B vaccination at birth if mother is HBsAg (+) or unknown?
HBsAg-positive
given vaccine + HBIG) (in separate limbs) w/in 12 hrs of birth, regardless of BW.
- For infants <2,000 g, administer 3 add’l doses of vaccine (total of 4) starting @ 1 mo.
Test for HBsAg and anti-HBs at age 9–12 months. If HepB series is delayed, test 1–2 months after final dose.
HBsAg unknown
give vaccine w/in 12 hrs of birth, regardless of BW.
- For infants <2,000 g, also give HBIG (in separate limb) w/in 12 hrs of birth, given 3 add’l doses of vaccine (total of 4 doses) beginning @ age 1 mo.
- Determine mother’s HBsAg status ASAP. If mother is HBsAg-positive, administer HBIG to infants ≥2,000 g ASAP, but no later than 7 days old.
How many doses of HPV9 are given? When?
9-14 y/o at initial vaccination: 2-dose series at 0, 6–12 months (min interval: 5 mos)
15+ y/o at initial vaccination: 3-dose series at 0, 1–2 months, 6 months (minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to dose 3: 12 weeks / dose 1 to dose 3: 5 months)
N.B. If completed valid vaccination series with any HPV vaccine, no add’l doses needed
Influenza vaccine schedule, contraindications
2 doses 4 wks apart for children age 6 months 8 years who have received fewer than 2 lifetime doses; 9+ y/o just 1 regardless
Contraindications for LAIV?
h/o severe allergic rxn to a previous dose of any influenza vaccine or to any vaccine component (excluding egg, see details above)
Receiving aspirin or salicylate-containing medications
Age 2–4 years with history of asthma or wheezing
Immunocompromised due to any cause (incl meds and HIV)
Anatomic/functional asplenia
Cochlear implant
CSF-oropharyngeal communication
Close contacts or caregivers of severely immunosuppressed persons
Pregnancy
Received influenza antiviral within past 48 hrs
MCV4 (serogroups A,C,W,Y)
2-dose series at 11–12 years, 16 years [Menactra or Menveo]; earlier if: traveling to endemic area, including African meningitis belt and Hajj, sickle cell or other asplenic condition, HIV, complement deficiency, complement inhibitor use (e.g. eculizumab, ravulizumab)
Men B
- Shared Clinical Decision-Making: Adolescents not at increased risk age 16–23 years (preferred age 16–18 years) based on shared clinical decision-making:
Bexsero: 2-dose series at least 1 month apart
Trumenba: 2-dose series at least 6 months apart; if dose 2 is administered earlier than 6 months, administer a 3rd dose at least 4 months after dose 2. - Special situations
Anatomic or functional asplenia (including sickle cell), persistent complement component deficiency, complement inhibitor (e.g., eculizumab, ravulizumab) use:
Bexsero: 2-dose series at least 1 month apart
Trumenba: 3-dose series at 0, 1–2, 6 months
Bexsero and Trumenba are not interchangeable; the same product should be used for all doses in a series.
pneumococcal vaccination recs for chronic heart disease (particularly cyanotic congenital heart dz and cardiac failure), CLD (including asthma on high-dose, oral steroids), diabetes
Age 2–5 years
Any incomplete* series with:
3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior PCV13 dose)
Less than 3 PCV13 doses: 2 doses PCV13 (8 weeks after the most recent dose and administered 8 weeks apart)
No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after any prior PCV13 dose)
Age 6–18 years
No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after any prior PCV13 dose)
pneumococcal vaccination recs for CSF Leak or cochlear implant
Age 2–5 years
Any incomplete* series with:
3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior PCV13 dose)
Less than 3 PCV13 doses: 2 doses PCV13 (8 weeks after the most recent dose and administered 8 weeks apart)
No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after any prior PCV13 dose)
pneumococcal vaccination recs for Sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiency; HIV infection; chronic renal failure; nephrotic syndrome; malignant neoplasms, leukemias, lymphomas, Hodgkin disease, and other diseases associated with treatment with immunosuppressive drugs or radiation therapy; solid organ transplantation; multiple myeloma:
Age 2–5 years
Any incomplete* series with:
3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior PCV13 dose)
Less than 3 PCV13 doses: 2 doses PCV13 (8 weeks after the most recent dose and administered 8 weeks apart)
No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after any prior PCV13 dose) and a 2nd dose of PPSV23 5 years later
Age 6–18 years
No history of either PCV13 or PPSV23: 1 dose PCV13, 2 doses PPSV23 (dose 1 of PPSV23 administered 8 weeks after PCV13 and dose 2 of PPSV23 administered at least 5 years after dose 1 of PPSV23)
Any PCV13 but no PPSV23: 2 doses PPSV23 (dose 1 of PPSV23 administered 8 weeks after the most recent dose of PCV13 and dose 2 of PPSV23 administered at least 5 years after dose 1 of PPSV23)
PPSV23 but no PCV13: 1 dose PCV13 at least 8 weeks after the most recent PPSV23 dose and a 2nd dose of PPSV23 administered 5 years after dose 1 of PPSV23 and at least 8 weeks after a dose of PCV13
pneumococcal vaccination recs for
Age 6–18 years
No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after any prior PCV13 dose)
When is Tdap given?
Adolescents age 11–12 years: 1 dose Tdap
Pregnancy: 1 dose Tdap during each pregnancy, preferably in early part of gestational weeks 27–36
Tdap may be administered regardless of the interval since the last tetanus- and diphtheria-toxoid-containing vaccine.
