FNP (Pediatrics Part 1 - Immunization) QUESTIONS WITH 100% Accurate solutions +Rationales

Hepatitis A

Universally recommended for all children at age 1 year (12-23 months)

The 2 doses should be administered at least 6 months apart

Delay vaccine if moderately or severely ill

**Hepatitis B**

3 dose series: 0, 1-2 months, 6 months after the first

Delay blood donation for 28 days (screening test could mistake vaccine for Hep B infection)

DTaP < 7 years of age

5 dose series:

#1 at 2 months

#2 at 4 months

#3 at 6 months

#4 at 15-18 months (6 months from dose #3)

#5 at age 4-6 years (final dose at age >/= 4 yrs.)

Minimum age for initial dose is 6 weeks

Hib (Haemophilus Influenza Type B)

#1 age 2 months

#2 age 4 months

#3 age 6 months

#4 age 12-15 months

For unvaccinated children ages 15 months or older, administer only one dose

treat pertussis with

macrolide

Pneumococcal conjugate vaccine PCV

PCV13: 4 dose series (give to infants)

#1 age 2 months

#2 age 4 months

#3 age 6 months

#4 12-15 months

See immunization schedule for special populations (PCV 23)

Polio (IPV only)

(Can give to all pt's due to it being a "dead" vaccine)

#1 age 2 months

#2 age 4 months

#3 age 6-18 months

#4 age 4-6 years

(Contraindicated for allergies to neomycin, streptomycin, or ploymixin B)

Immunity with Live Attenuated Vaccines

Live attenuated vaccines must replicate in order to produce immunity

Fever, rash after live or attenuated immunization represent a reaction to viral replication, not the vaccine

MMR and Varicella are examples

MMR or MMRV

2 dose series:

#1 age 12-15 months

#2 age 4-6 years

The second dose of MMR may be given at anytime, provided at least 1 month has elapsed since the first dose, and both doses are given at or after age 12 months.

Contraindicated if allergic to neomycin or gelatin

Varicella

Given at age 12-18 months; booster at 4-6 years OR age 11-12 years if child lacks a reliable history of chickenpox infection

If given at age 13 years or later, 2 doses are required, given at least 1 month apart

Contraindicated if allergic to neomycin or gelatin

Influenza Vaccine

Recommended annually ages >/= 6 months

Cautious use in patients who experience hives with exposure to eggs, but may with additional safety precautions

Children

When enough members of the US are immunized against influenza it provides protection for those who have not been immunized. This is known as:

Herd immunity

**Meningococcal Conjugate Vaccine (MCV4)**

Administer to all children age 11-12 years

Or 13-18 years if not previously vaccinated; Booster at age 16

Consider other adolescents, college freshmen living in dorms

If administered at age 16, no booster needed

HPV (human papilloma virus)

2 dose: boys, girls initiating schedule 9-14 years (0, 6-12 mos)

3 dose series: 0, 1-2, and 6 months

Avoid in pregnant women

Ok if breastfeeding to receive vaccine

A common reaction with HPV, MCV4, and Tdap vaccines is syncope. This is an example of a(n)

Systemic reactions

Adverse Reactions

Adverse reactions can be: local (redness), systemic (fever), or allergic

Most common reactions among adolescents are to: HPV, MCV4, and Tdap (Syncope)

Spacing Vaccines

A vaccine given 4 days prior to the scheduled time to receive is considered a valid dose

A vaccine given 5 day prior to the scheduled time to receive is considered an INVALID dose and should be repeated.

A 4 year old is schedule to receive a varicella immunization today. What is a contraindication to receiving this immunization today?

1. Receiving allergy shots

2. Currently on Tamiflu for flu prophylaxis

3. She is taking amoxicillin

4. She had ear tubes placed 4 weeks ago.

What is CDC's recommendation for length of time to monitor a child after receiving an immunization?

15 minutes

A 55 year old grandmother will be the primary care giver for her 4 month old grand baby for about 40 hours weekly. What does the CDC recommend for the grandmother? Select all that apply.

1. There are no specific recommendations

2. She should get a flu shot in October

3. She should receive a Tdap if she has not had one recently

4. She should receive a Rotavirus vaccine

5. She should get a Td vaccine

A mother reports that her 1 year old has an allergy to eggs that produces a non-pruritic rash. Which immunizations are contraindicated?

1. None

2. Influenza only

3. MMR only

4. MMR and influenza

NOTE: IgE for allergic reaction

A 12 month old received the MMR immunization 3 weeks ago. When can the varicella immunization be given?

In 1 week

**NOTE: Live attenuated vaccines must be 4 weeks apart or at the same time**