vaccines & contraindications Flashcards
name the 7 live vaccines
rota
mmr
var
opv
adenovirus
yellow fever
IN flu
what steroid dose if given should make you avoid vaccinating a patient for at least 1 month
20mg/day or >2mg/kg/day lasting at least 14 days
when should a premie baby get Hep B if their mom is Hep B negative
can delay for 1 month
what vaccine should not be given to a premie in hospital becuase it is shed in the stool and infect others
rotavirus
how long should you wait to give another live vaccine if the patient recieved 1 today
at least 1 month
can you vaccinate a healthy HIV patient with live vaccines
yes, if they are well and disease is under control
are live vaccines like mmr and var contraindicated in the family members of an immunocompromised person
no, give them
what are the rules for PPD administration and MMr vaccine
they can be done on the same day but if MMR is given prior to PPD you have to wait at least 4 weeks prior to testing PPD
1st rota dose should not be given before ___ or after ___?
6 weeks
15 weeks
can you give rota to a child who has an immunocompromised family member in the home
yes
can you give a baby presenting for vaccines for the first time at 4 months rota
no becuase they are 16 weeks (>15 weeks) old
what vaccine should not be given to an asthmatic
IN flu
which children require two vaccines for flu if it is their first time
ages 6 mo -8 years
last dose of hep b should not be given before what age
6 months
ideal regimen for Hep B vaccine is
0 , 1 mo and 6 mo
if mom is hep b status unkown what should baby get
hep b vaccine within 12 hours of birth
if om is hep b positive when baby is born what do you give
hep B and HBIG no later than day 7 of life
if your patient has an intimate contact who has meningitis what do you do
ppx rifampin or rocephin even if they are vaccinated
what two vaccines are recommended during pregnancy
tdap and flu
what UDE is associated with rifampin
reddish orange tears and urine
what is given for H flu ppx
rifampin
when to give H flu ppx to a patient
if there are TWO documented cases around them
what ppx for pertussis should be given and to who
all householld contacts and all exposed should get a macrolide ( give azithromycin to children 6 weeks or less as erythromycin can cause PS)
Hep B needle stick in an uncertain immune status patient
check for antibody, if negative then give HBIG and START full vaccine series
if positive do nothing
a child ( < 6 months) exposed to measles 3 days or less ago should get
IFIM or IVIG
a child 6-11 months exposed to measles 3 days or less ago should get
MMR
a child 6-11 mo who is exposed to measles 4-6 days ago should get
IVIG or IGIM
if a child of any age was exposed to measles more than 6 days ago, what ppx do they get
none its to late to prevent the disease
can a child go back to daycare if they were exposed 72 hours ago and gets MMR vaccine
yes
for tetanus exposure, what vaccine is given for a child < 7, 7-11 and > 11
DT
Td
Tdap
if tetanus exposure in someone who had a shot > 5 years ago and its dirty
give booster
patients with severe gelatin allergy shouldnt get what shots
yellow fever
if a patient has encephalopathy or prlonged seizure within 1 week of getting DTAP what to do in he future
give DT (likley the reaction was the pertusis componenet)
what vaccines have gelatin in them
MMR, varicella, flu and yellow fever
which vaccine have traces of neomycin and streptomysin in them
polio, mmr and var
how long to wait after 20mg/d o >2mg/kg/day sterid course to vaccinate
one month
how long to wait after IVIG to give live vacine
1 month
what is the only live vaccine you CANNOT give to a child who lives with an immuno compromised family member
OPV
can pregnant mothers let one of their children recieve a live vaccine
yes
what does CD4 count have to be in HIV kid to get live vaccine
> 15%
what sxs are different in kawasaki and adeno from measles
- conjunctivits that is lymbic sparing
- exudative pharyngitis
what symptoms proceeds the diarrhea of rota
vomiting
what age should rota virus vaccination should not be continued in
> 8 months
children on what therapy really need flu vaccine and why
salicylate therapy becuase of the risk for reye syndrome if they get flu
what is a dx that is contraindicated in giving the flu vaccine
GBS
if a mother has an unknown Hep B status and she has a baby <2000g what to give
Hep B and HIBG
chidlren with Hep B positive moms should have anti-Hbs and HbsAg checked when
beween 9-12mo, if neg AB then restart 3 dose series
what is the most contagious pertussis phase
cattahral stage
what are the three pertusis stages
- cattarahl
- paroxysmal
- convalescent
what is a contraindication to giving pertusis or DTAP vaccine
encephalopathy or severe anaphylaxis within 7 days of prior dtap vaccine
why do we have to give so many pertusis containing shots
becuase of waning vaccine immunity
pertusis cough is associated with what lab
leukocytosis with lymphpcytosis (90%)
chlamydia cough is associted with what two findings
stacatto cough
eosinophilia
what tetanus containing vaccine should be given to a child who is > 7 but is not completed vaccinated against tetanus
TDAP
if a patient has a hx of anaphylaxisis to a shot, what test should be done
skin prick testing
when should Pcv23 be given
in children older than 2 who are HR (give 8 weeks after last PCV 13 and again 5 years later)
patients with spinal bifida usually have what allergy ans should avoid what shot
latex allergy
rotavirus shot has latex in bottle
patients with terminal complement deficiency and properdin deficiency are at high risk for what dx
meningococcal
