Vaccines/Screening

Question 1

Hep B

Answer 1

Born tor mother HBsAg+ - Mandatory within 12 hrs birth (or if status is unknown) -preterm baby dose not counted - HBIG given -tested after primary series for response if neg give 3 dose series again -2nd dose min 1 month after 1st dose - 3rd dose min 4 months after 1st dose, 2 months after 2nd dose & after 6 months old

Question 2

Hep A

Answer 2

• Unvaccinated & exposed–>Hep A PLUS IM IVIG within 14 days

Question 3

DTaP

Answer 3

-do not give pt >7yo give Tdap

Question 4

Hib

Answer 4

• Dont give pt >5yo lower risk serious sequela & have had natural dz EXCEPT pt w/ functional/anatomical asplenia

Question 5

Varicella

Answer 5

-3-5% will develop localized rash or a generalized rash within up to 1 month -pt needs to avoid contact immunocompromised pt

Question 6

Meningococcal

Answer 6

-2-10 yo w/ terminal complement deficiency, functional/anatomical asplenia & other high risk pt -vaccinated >=7yo need revaccinated in 5 yrs - vaccinated 2-6yo need revaccinated in 3yrs - AFTER, revaccinated 5yr intervals

Question 7

Pneumococcal

Answer 7

• -<24 mo –> 7-valent
• -24mo- 5yo:
  
  • mod risk (daycare, indians, alaska, African americans)–> 7 valent -
  • high risk (SCD,asplenia,HIV,chronic card/pulm, DM, cochlear implacnt)– > 7-valent then 23-valent (repeat dose 5yrs after)
• 6-18 yo
  
  • high risk–> should ALSO receive single dose PCV 13

Question 8

Rotavirus

Answer 8

• >15 mo don’t give initial dose - >8mo don’t give final dose

Question 9

MMR

Answer 9

• Adverse effects:
  
  • fever 103
  • rash 6-12 days after,
  • joint pain (adolescents- 2nd rubella components) 7-12 days after

Question 10

Live Vaccines

Answer 10

-MMR, Varicella, Rotavirus, OPV - can be given to HIV+ - can be given pt living with immunocompromised or pregnant person (NOT OPV) -MMR/Vari- post exposure (within 72hrs) prophylaxis w/vaccine

Question 11

Immunodeficiency

Answer 11

• NO MMR (except HIV+), varicella (except HIV, hypogamma or dysgamma), OPV, Rotavirus

Question 12

Pregnancy

Answer 12

NO- MMR, Varicella, Intranasal flu, IPV, OPV

Question 13

SubQ vaccines

Answer 13

MMR, Varicella, MMRV, IPV

Question 14

PKU

Answer 14

• after 24hr before 7 days
• if done less 24 hr repeat 1-2 weeks

Question 15

Vision

Answer 15

• Toddler-Unliateral cover test for ocular misalignment
• 3-5yr- Random-dot-E tet for refractory errors

Question 16

Hearing

Answer 16

• by age 3 month
• 3,4,5 then every 2-3 yrs until adolescent