pediatric vaccines.txt

  1. Skin test prior to administration of this/these vaccines in egg allergic patients.
    • yellow fever
    • influenza (only if mild reaction to eggs. If severe anaphylactic reaction to eggs, vaccine is contraindicated and skin testing should not be done. Chemoprophylaxis indicated.)
  2. What do you do/not do in an egg allergic patient who needs the MMR vaccine?
    • Do NOT skin test (not enough egg antigen to make test reliable)
    • Do NOT withhold vaccine

    • Do give vaccine
    • consider monitoring for 90 minutes after administration
  3. Which childhood vaccines are subQ

    Which are oral
    SubQ: MMR, varicella, IPV

    Oral: rotavirus
  4. Which vaccines are live
    • MMR
    • Varicella
    • Rotavirus
    • nasal flu
    • oral typhoid
    • yellow fever
  5. This vaccine is contraindicated in immunocompromised children and those with immunocompromised people at home
    oral polio vaccine (OPV)
  6. caution with this/these vaccine/s in patients allergic to eggs
    • influenza (both kinds)
    • yellow fever
  7. caution with this/these vaccine/s in patients allergic to stretomycin, neomycin, polymixin B
    • IPV
    • OPV
  8. caution with this/these vaccine/s in patients allergic to neomycin
    • MMR
    • varicella
  9. caution with this/these vaccine/s in patients allergic to gelatin
    • MMR
    • varicella
    • yellow fever
  10. avoid these vaccines in pregnant patients
    • MMR
    • Varicella
    • intranasal flu
    • IPV
    • OPV
  11. avoid these vaccines in patients who are breastfeeding
    none ;-)
  12. absolute contraindications to DTaP
    • encephalopathy within 7 days of previous dosing
    • anaphylaxis with previous dose
  13. Relative contraindications to DTaP
    • temp >40.5 w/in 48hrs of previous dose with no other cause
    • collapse/shock like state w/in 48hrs of previous dose
    • seizures w/in 3 days of previous dose
    • persistent inconsolable crying within last 48 hours
  14. absolute contraindications to MMR
    • anaphylaxis to neomycin or gelatin
    • pregnancy (no cases of vaccine induced congenital rubella syndrome; no need to teminate pregnancy if MMR given to pregnant woman)
    • immunodeficiency (except most HIV infected children can receive MMR)
  15. Relative contraindications to MMR
    • recent IgG (give 2 weeks before or 3-12 months after IgG)
    • thrombocytopenia with first dose
    • high dose (2mg/kg/day or >20mg/day) oral corticosteroids for 14 days or more (wait 1 month from steroid discontinuation)
  16. Why is OPV no longer recommended
    vaccine associated paralysis

    IPV does not cause this
  17. Other than normal vaccination when shoule Hib be given or not given
    • do not give to normal child after age 5
    • give to child <24 months with invasive H. influenzae infection as natural immunity may not develop
    • give to all with functional/anatomic asplenia (sickle cell, other hemoglobiopathy, AIDS)
  18. What do you give to a newborn with a HBsAg+ mother
    HepB vaccine within 12 hours of delivery

    HepB immunoglobulin within 12 hours of delivery at a different site
  19. What do you give to a newborn whose mother's HBsAg status is unknown?
    HepB vaccine within 12 hours of delivery

    If testing shows mom is positive, give immunoglobulin to child within 1 week from delivery but preferrably ASAP
  20. side effects of varicella vaccine
    • 3-5% develop localized varicella-like rash w/in 1 month
    • 3-5% develop generalized varicella-like rash w/in 1 month
    • if rash develops, keep children away from immunocompromised individuals
  21. contraindications (and non-contraindications) for varicella vaccine
    • avoid immunocompromised patients (but HIV, hypogammaglobulinemia, dysgammaglobulinemia, oral steroids <2mg/kg/day and <20mg/day are ok)
    • Do not vaccinate pregnant women (but ok to give to child if mom is pregnant)
  22. types and timing of pneumococcal vaccines
    • 7-valent (PCV) at 2,4,6,12-15 months
    • give series to 24-59 unvaccinated month olds if high risk or moderate risk

    • high risk: SSD, asplenia, HIV, chronic cardio-pulm dz (not asthma), diabetes
    • moderate risk: daycare, native americans/alaskans, african americans

    • 23 valent (PPSV) for children with immunodeficieny, asplenia, chronic disease
    • now give after PCV series completed, ideally at ages 2 and 5.
  23. Who get meningococcal vaccine
    • universal recommendation for 11-12 year olds
    • 2-10 year olds with terminal complement deficiency, asplenia, other high risk groups
    • those going into crowded living environments (college dorms, military barracks)
  24. when do you give rotavirus vaccine
    • must start by 15 weeks
    • must complete before 8 months
    • RotaTeq 2,4,6 months
    • Rotarix 2,4 months

    Remeber intussusception with old vaccine, not with new ones
  25. What HPV serotypes does HPV vaccine prevent
    • 6,11 cause >90% of genital warts
    • 16,18 cause ~70% of cervical CA
  26. Who get HPV vaccine and when
    females age 9-26 (recently approved in males of same ages)

    • most start at 11-12 years
    • give a 0,2,6 months

    Still give if history of HPV infection
  27. vaccine at birth
  28. vaccine at 1 month
    Hep B
  29. vaccines at 2 months
    • HepB (if not at 1 month)
    • DTaP
    • Hib
    • IPV
    • PCV
    • Rota
  30. vaccines at 4 months
    • DTaP
    • Hib
    • IPV
    • PCV
    • Rota
    • Maybe HepB
  31. vaccines at 6 months
    • DTaP
    • Hib
    • IPV
    • PCV
    • Rota
    • Maybe HepB
    • Maybe Influenza
  32. vaccines at 12-15 months
    • MMR
    • Varicella
    • HepA (with 2nd dose 6-12 months later)
    • Hib
    • PCV
    • DTaP (15 months)
    • Maybe HepB
    • Maybe influenza
  33. vaccines at 4-6 years
    • DTaP (not after age 7, switch to Tdap)
    • IPV
    • MMR (2nd dose can be given 1mo after first)
    • Varicella (2nd dose can be given 3mo after first)
  34. Vaccines at 11-12 years
    • Tdap (then Td boosters q10yr or with injury)
    • HPV
    • MCV4
    • remeber to catch up on MMR, varicella, HepB
  35. When is HepB vaccine given
    • 1st dose as early as birth, at least by 2mo
    • 2nd dose at least 1mo after 1st
    • 3rd dose at least 4mo after 1st and 2mo after 2nd, not before 6mo of age
  36. When is DTaP given
    • 2,4,6,12-15,4-6yrs
    • switch to Tdap after 7 years
  37. When is Hib given
    • 2,4,6,12-15mo
    • some formulations do not require 6 mo dose
  38. When is PCV given
  39. when is IPV given
    • 2,4,6mo
    • 4-6yr
Card Set
pediatric vaccines.txt
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