EXAM #2: CHILDHOOD IMMUNIZATIONS Flashcards

1
Q

What is the schedule of periodicity?

A

CDC published schedule of vaccine that is intended to:

1) Optimize the individual immune response
2) Ensure strong community immunity

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2
Q

What is the first vaccine given the kids?

A

Hepatitis B

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3
Q

When is the Hep B vaccine given?

A

At birth

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4
Q

What are the risks of the Hep B vaccine?

A

1) Soreness
2) Fever

Severe problems are EXTREMELY RARE

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5
Q

What are the benefits of the Hep B vaccine?

A

1) Annually, nearly 40,000 infected

2) Hep B leads to death of 2,000 - 4,000 patients annually from cirrhosis or liver cancer

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6
Q

How many doses of Hep B vaccine are given?

A

3-4

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7
Q

How can the 2 month vaccine load be lessened?

A

1) Spread the vaccines out over time
- Less antigens per visit
- Increases the time of greatest risk
2) Administer combination vaccines*

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8
Q

Before giving immunizations to a child, what should be given to the parents?

A

VIS, Vaccine Immunization Sheet

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9
Q

What is the IRIS system?

A

Iowa’s Immunization Registry Information System

*Keeps track of vaccines

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10
Q

If a child has a mild illness–low grade fever, cold, runny nose, cough, ear infection, mild diarrhea–do you need to wait till the next office visit to vaccinate the child?

A

NO–unless the child has a severe illness, you can immunize today

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11
Q

List some examples of severe illness that would prevent vaccination.

A

1) Immunosuppression
2) Severe allergic reaction to previous dose of the vaccine
3) Chronic health condition e.g. cancer

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12
Q

What immunizations are given at 9 months?

A

None

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13
Q

What are the risks of the varicella vaccine?

A

1) Mild rash
2) Fever, pain, swelling
3) Possible pneumonia and seizure (very rare)

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14
Q

What are the benefits of the varicella vaccine?

A

1) 12,000 hospitalized annually with:
- Pneumonia
- Encephalitis
- Flesh-eating superimposed bacterial infection
2) 100 people died annually from disease

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15
Q

At 11 y/o, you recommend the HPV vaccine. Parents react negatively; how do you react?

A

“I’m not accusing your child of having sex now; I want them vaccinated before they’re sexually active.”

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16
Q

What are the risks of the HPV vaccine?

A

1) Pain
2) Redness or swelling
3) Fever
4) Headache

17
Q

What are the risks of not getting the HPV vaccine?

A

1) Cervical cancer

2) Head/neck/anal cancers

18
Q

What is the AAP approach to vaccine refusers?

A

1) Ask why
2) Listen
3) Discuss specific vaccines separately
4) Discuss strategies to limit pain
5) Use ongoing relationship to discuss immunizations at subsequent visits

Don’t fire your patients

19
Q

How can you control pain with vaccines?

A

1) Don’t aspirate
2) Give most painful LAST
3) Given 0-2 sugar solutions before injection
4) Hold kids during injection (upright is best)
5) Topical analgesics
6) Keep parents in the room