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Flashcards in Immunization Deck (14):
0

Hepatitis B vaccine

minimum age
routine schedule of immunization

minimum age: at birth
routine: ideally 0, 1 mo, 6 mos
in some cases,
birth (monovalent), [6 wks, 10 wks, 14 wks] (part of combination vaccine DTwP/HepB/Hib 5-in-1) --- 4 doses if the 3rd dose is given before 24 wks or if px is preterm and 1st dose was given at birth


primary series is given in 3 doses
1st dose - within 12 hrs, subsequent doses given at least 4 wks apart, 3rd dose preferably given not earlier than 24 wks (6mos)

1

Hepatitis B

For infants born to hepatitis B surface antigen (HBsAg)–positive mothers, what should be given?

HepB vaccine and 0.5 mL of HBIG within 12 hours of birth

test for HBsAg and anti-HBs 1 to 2 months after completion of the HepB series, at age 9 through 18 months (preferably at the next well-child visit)

2

Hepatitis B

If mother's HBsAg status is unknown, what should be done

regardless of weight, give HBV first within 12 hrs then confirm HBsAg status, if +, give HBIG within 7 days

3

Hepatitis B

Minimum interval between doses

The primary 3-dose series should be at least 4 weeks apart, with the 3rd dose preferably given not earlier than 24 wks (6mos)

A fourth dose is needed if the third dose was given before 24 wks (eg as part of combination vaccines, with a schedule of 6-10-14 wks DTP-HepB-Hib)

4

Hepatitis B

How many doses should be given if HepB was administered as part of combination vaccine after the birth dose?

4 doses

5

Hepatitis B

If patient was previously unvaccinated, what should be the routine catch-up schedule?

follow a 3-dose schedule:
0, 1-2 mos, 6 mos

6

Hepatitis B

For previously unvaccinated children between 7-18 yrs old, what is the catchup sched?

Follow 3-dose series: 0-1-6 mos (PPS)

7

BCG should be given at the earliest possible age within first 2 mos of life. For healthy infants and children >2 mos who are NOT given BCG at birth, PPD is NOT necessary, except in which conditions?

If any of the following are present:
- suspected congenital TB
- hx of close contact to known or suspected infectious cases of TB
- clinical findings suggestive of TB and/or CXR suggestive of TB

* in any of these conditions, induration of >5 mm is (+)

8

HiB

route of administration
minimum age
minimum interval
number of primary doses
routine schedule
booster age

route: IM
minimum age: 6 wks
minimum interval: 4 wks
no of primary doses: 3
routine schedule: 6-10-14 wks
booster age: 12-15 mos, 6 mos after 3rd dose

9

HiB

for unimmunized children aged 5 yrs and older, what are the conditions that warrant HiB vaccination?

sickle cell disease
leukemia
HIV
post-splenectomy pxs

10

Enumerate the live attenuated vaccines

MMRV, OPV, RV (viral), BCG (bacterial)

- derived from "wild" virus or bacteria
- attenuated
- must replicate to be effective
- immune response similar to natural infection
- potential for reversal to pathogenic form
- interference from circulating antibody
- unstable

11

What are the whole cell inactivated vaccines?

viral: influenza, polio, rabies, hepatitis A
bacterial: pertussis, typhoid

12

What are the types of fractional inactivated vaccines?

Protein-based
- subunit: hepB, influenza, acellular pertussis, typhoid Vi
- toxoid: diphtheria, tetanus

Polysaccharide based
- pure: pneumococcal, meningococcal, Hib (PRP)
- conjugate: Hib (PRP-T, PRP-OMC), pneumococcal

13

What is the minimum interval between 2 live injected vaccines?

4 weeks

- there is no contraindication to simultaneous administration of any vaccine
- injected live vaccines (MMRV) are not believed to have an effect on live vaccines given orally (OPV, rotavirus, oral typhoid)
- live oral vaccines may be given at any time before or after live injected vaccines