Childhood Immunizations

Question 1

What is the schedule of immunizations based on?

Answer 1

Optimize individual immune response, as well as promote community immunity

Question 2

What is the basis of the discussion regarding vaccination?

Answer 2

Risks vs benefits

Question 3

What is the problem with the “attack by antigens” idea?

Answer 3

We fight way more antigens daily than giving in vaccine

Question 4

Who is the jerk who falsely linked vaccination to autism? How many people were involved in this study?

Answer 4

Dr. Wakefield

12 patients total

Question 5

What is the first vaccine given? When?

Answer 5

Hep B

at birth and 1 and 2 months

Question 6

What are the three risks of the Hep B vaccine?

Answer 6

Soreness

Temperature (99.9F)

Question 7

How many doses are given for the Hep B vaccine?

Answer 7

3-4 doses

Question 8

What are the vaccines that are given at 2 months? (5)

Answer 8

Hep B
TDaP
HiB
PCV
IPV

Question 9

What are the disadvantages of giving less shots and spreading out?

Answer 9

Prolongs times between shots, increases risk for infectious disease

Question 10

What is the best way to minimize the shots given?

Answer 10

Give more combination vaccines

Question 11

Do you have to discuss every vaccine given, or can you give them a sheet with info, and document that they read it?

Answer 11

Give them the document

Question 12

What is the IRIS?

Answer 12

Immunization registry information system–computerized record of vaccination that is available to providers

Question 13

Should you delay immunization for mild illnesses (e.g. mild temp, cold, rhinorrhea, diarrhea etc)?

Answer 13

No

Question 14

Should you immunize for other diseases if the child has a more than mild illness (e.g. fever more than 101, flu, etc)?

Answer 14

No

Question 15

What chronic diseases should not receive vaccinations? (3)

Answer 15

• Immunosuppressed
• CA
• Severe allergic reaction to previous shots

Question 16

What is the VIS?

Answer 16

Form for the IRIS system

Question 17

When should flu shots be given?

Answer 17

6 months onward

Question 18

What are the new vaccines that are given at the 12 month period? (3)

Answer 18

MMR
Varicella
Hep A

Question 19

When should DTaP shot be given?

Answer 19

15 and 18 months

Question 20

What are the risks of getting the varicella vaccine? (2 + rare)

Answer 20

• Mild rash
• Fever/pain/swelling
• Very rare–Pneumonia +szs

Question 21

What are the risks of NOT getting the varicella vaccine?

Answer 21

• Encephalitis
• Death
• Necrotizing fasciitis 2/2/ MRSA

Question 22

When is the HPV vaccine given?

Answer 22

11 yo

Question 23

What is the appropriate response to giving the HPV vaccine?

Answer 23

I am not suggesting they’re having sex, but I need to give it now before they even have a chance to get it

Question 24

How many serotypes does the HPV vaccine protect against?

Answer 24

9 serotypes

Question 25

What are the risks of the HPV vaccine?

Answer 25

- Pain/erythema - HA maybe - Swelling

Question 26

What is the risk of NOT getting the HPV vaccine?

Answer 26

Increased risk for cervical and anal cancers

Question 27

Do you still give the HPV vaccine if a 16 yo kid has already had sex?

Answer 27

Yes

Question 28

How do you approach the vaccine refusers? (3)

Answer 28

- Listen to concerns - Discuss benefits/risks - Discuss at subsequent visits

Question 29

Should aspiration be used for IM injections?

Answer 29

No

Question 30

What, generally, is the last vaccine given in a round of shots?

Answer 30

Most painful last

Question 31

How do you improve pain control prior to 2 yo?

Answer 31

Breast or formula feed them during

Question 32

How do you improve pain control 0-3 yo?

Answer 32

Hold child

Question 33

What position should patients be in when given vaccine and they're greater than 3 years old?

Answer 33

Upright

Question 34

Is restraining children appropriate to give vaccine?

Answer 34

No

Question 35

What age should topical pain analgesics be used prior to immunizations?

Answer 35

Before 12 years

Question 36

Under what age should parents always be present during vaccination?

Answer 36

Under 10 years