Peds E2- Vaccines (copy)

Which vaccinations are LIVE?

MMR, OPV, Varicella, Yellow fever, Rotavirus, Nasal flu, Small pox, BCG, oral typhoid

Which type of vaccine is more likely to cause a severe reaction (Live/Inactivated)

Live

Live vaccines can interfere with each other if they are given less than ______ apart

28 days

What is an exception to the 28 day rule for live vaccines?

Yellow fever must be given on the same day or wait 30 days from other live vaccines

Which vaccines are inactivated?

Whole cell (IPV), Fractional subunit (Hep B, DTaP), Fractional polysaccharide (Hib, Prevnar), Toxoid (Td), mRNA (Pfizer or Moderna COVID-19)

Are there contraindications to simultaneous administration of routine vaccines?

nope

Why may immunization programs and/or school entry requirements not accept all doses of a vaccine?

it was given earlier than the minimum age or interval

All clinically significant postvaccination reactions should be reported to:

Vaccine Adverse Event Reporting System (VAERS)

What are contraindications for live vaccines?

Allergic response, encephalopathy, pregnancy, immunosuppression

What are contraindications for inactivated vaccines?

Allergy, encephalopathy

What are invalid contraindications to vaccines?

mild illness, live w/ pregnant or immunosuppressed individual, breastfeeding, preterm birth, FMH of rxn, multiple vaccines, etc

In patients who are born preterm, vaccines are given according to (chronological/gestational) age

Chronological

What kind of vaccines cannot be given to pregnant women or severely immunosuppressed pts?

Live vaccines

Can the HPV vaccine be given during pregnancy?

No

When should pregnant women get the Tdap vaccine?

between 27-36 weeks

*not dependent on previous Tdap

Which vaccines should people living with immunosuppressed persons get?

MMR, Varicella, & annual flu

DTaP and DT is used for children of what age?

<7 yo

DTaP schedule

5 doses: 2 months, 4 months, 6 months, 15-18 months, 4-6 years

If DTaP is given to patients ≥7 yo, is the dose valid?

Yes

If Tdap is given to patients <7 yo in place of DTaP doses 1, 2, or 3, is the dose valid?

NO- give DTaP dose!

If Tdap is given to patients <7 yo in place of DTaP doses 4 or 5, is the dose valid?

Yes

Tday and Td are not meant for children <____

7 yo

Tdap/Td schedule

Age 11-12 yo (if 5 years since previous vaccination), every 10 years therafter

If pt is unvaccinated and >7 yo, how many doses should they receive of Tdap? How far apart between each dose?

3 doses- 1 month between #1 and #2, and 6-12 months between #2 and #3

What are the minimum ages for Tdap?

Boostrix: 10-65+ yo

If pt has a history of ________ reaction following a prior dose of tetanus/diphtheria toxoid containing vaccine, defer Tdap/Td until 10 years has elapsed since reaction

Arthrus

MMR schedule

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

MMR given prior to _______ is invalid

12 months

Is MMR safe to give to a patient with egg allergies?

Yes

Is the MMR vaccine recommended for asymptomatic HIV patients?

yes, but not those with severe immunosuppression

Can MMR & Varicella vaccines be given in the same site?

NOOOOO

If MMR and varicella, LAIV and/or yellow fever are NOT given on the same day, how many days do they have to be spaced out?

28 days

Hib is not recommended for children over what age?

59 months (5 years)

Hib dose #1 should NOT be given earlier than _________

6 weeks

When would an additional dose of Hib be given after 5 yo?

child has anatomic or functional asplenia (sickle cell), HIV+, not received primary series after age 14 months

What is the PPSV23 vaccine?

purified pneumococcal polysaccharide 23 stereotypes

What is the PCV13 vaccine?

pneumococcal conjugate

Who is the PPSV23 vaccine for?

adults > 64, HIV+, high risk children > 2 yo

When should Prevnar (a PCV13 vaccine) be given?

*for children < 60 months

2, 4, 6, 12-15 months

How should the PPSV23/PCV13 vaccines be given?

PCV13 prior w/ single revaccination w/ PPSV23 5 yrs later

When should you restart the Hep B vaccines series?

do not need to restart NO MATTER how long since previous dose

Who is recommend to get post Hep B vaccine testing to determine immunity?

hemodialysis pt, immunodeficient persons, infants born to HBsAg+ mom, sex partners of persons w/ chronic HBV, healthcare personnel

Who is the Hep A vaccine recommended for?

international travelers, MSM, illegal drug use, occupational risk, chronic liver disease pts

Which polio vaccine does the U.S. exclusively use?

IPV

What constitutes a complete polio vaccine series?

any combo of 4 doses of OPV and IPV by 5 yo

Varicella schedule

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

Varicella vaccination may be administered simultaneously with _____, but NOT in the same site

MMR

What are contraindications to the Varicella vaccine?

allergy, pregnancy, immunosuppression

Who should you NOT begin the Rotavirus series in?

infants older than 14 weeks + 6 days

If a pt is allergic to latex, which Rotavirus vaccine should they get?

RV5 (RotaTeq)

Which Rotavirus vaccine should you be cautious using in pts w/ Spina Bifida or bladder exstrophy?

RV1 (Rotrix) only

Who is the MenB vaccine recommended for?

any pt 16-23; pts 10+ yo at inc risk

Can you mix & match the MenB vaccines?

NO, must receive same vaccine for both doses

Who should receive the flu shot?

All children/teens over 6 months

Hepatitis B schedule

3 doses: Birth, 1-2 months, 6-18 months

Rotavirus schedule (RV1 vs RV5)

RV1 = 2 doses: 2 months, 4 months

RV5 = 3 doses: 2 months, 4 months, 6 months

Hib schedule for ActHIB

2 months, 4 months, 6 months, 12-15 months*

* = booster

Hib schedule for PedvaxHIB or COMVAX

2 months, 4 months, 12-15 months*

* = booster

Hepatitis A schedule

2 doses that are 6-18 months apart for patients ≥1 yo

What is the only HPV vaccine available in the US?

Gardisil 9

What is the Gardisil vaccine schedule if given prior to age 15?

2 doses: 0 and 6-12 months apart

What is the Gardisil vaccine schedule if given after age 15?

3 doses: 0, 2, 6 months apart

Pediarix is a combo of what vaccines?

DTaP-HepB-IPV

Pediarix schedule

3 doses: 2, 4, 6 months

*NOT approved for booster doses

Twinrix is a combo of what vaccines?

Hep A & Hep B

How old must pts be to receive Twinrix?

18+ yo

Twinrix schedule

standard: 3 doses: 0, 1, 6 months apart

accelerated: 4 doses: day 0, 7, 21-30 days + booster @ 12 months

Memorize the Vaccination schedule

:)