CMS III Final: Peds - Immunization schedule

Live Vaccines

MMR, OPV (Oral Polio Vaccine), Varicella, Yellow Fever, Rotavirus (Oral), Nasal Flu (Flumist), Smallpox, BCG, oral typhoid

DTaP (Diphtheria, tetanus, acellular Pertusis)

- 5 doses: 2, 4, 6, 15-18 mo, 4-6 yo

- DTaP and DT for <7 yo

Tdap

- 11-12 yo, if 5 years since previous vaccination

- Every 10 years thereafter

- Pregnant women 27-36 weeks (not dependent on previous Tdap)

Influenza: LAIV (Flumist)

- Healthy children 2-8 yo

- First time dose must be a series of 2, then booster 1 month after

- If LAIV and MMR given at the same time, do not give Varicella or yellow fever on same day, MUST space them 28 days apart

MMR - Measles, mumps, rubella

- 2 doses: 12-15 months, 4-6 yo

- MMR given prior to 12 months age is invalid

- If MMR and Varicella given at the same time, do not give LAIV and/or yellow fever on same day. MUST WAIT AT LEAST 28 days

- DO NOT GIVE MMR AND VARICELLA IN THE SAME SITE

Varicella

- 12-15 months, 4-6 yo

- May be administered simultaneously with MMR

- If MMR and Varicella given at the same time, do not give LAIV and/or yellow fever on same day. MUST WAIT AT LEAST 28 days

Meningococcal:

Anti-Neisseria meningitidis (ACY-W135)

- Indications: Complement deficiency, Asplenia

- If vaccinated at 13-15 yo, give booster dose between 16-18 yo

- Menactra and PCV13 must be separated by 4 weeks

Meningococcal:

MenB Vaccine

- Indications: 10+ yo at increased risk

- Bexsero - 2 doses, 1 month apart

- Trumenba - 2 doses, 6 months apart

(He said won't test schedule for different brands)

HPV Vaccine:

Gardasil 9 (only HPV vaccine available in US)

- 9-45 yo

- If first vaccine prior to age 15, 2 doses:

0 and 6-12 months apart

- If first vaccine after 15th bday, 3 doses:

0, 2 and 6 months apart

Pregnant pts

No live vacc, no HPV vacc

Tdap recommended at 27-36 wks

Immunocompromised pts

No live vacc

Pt living with immunosuppressed person

MMR, Varicella, annual influenza vaccine

Acute Illness pts

Severe illness - delay vaccine until better otherwise it's fine