Flashcards in Immunization Deck (14):
Hepatitis B vaccine
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)
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)
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
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)
How many doses should be given if HepB was administered as part of combination vaccine after the birth dose?
If patient was previously unvaccinated, what should be the routine catch-up schedule?
follow a 3-dose schedule:
0, 1-2 mos, 6 mos
For previously unvaccinated children between 7-18 yrs old, what is the catchup sched?
Follow 3-dose series: 0-1-6 mos (PPS)
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 (+)
route of administration
number of primary doses
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
for unimmunized children aged 5 yrs and older, what are the conditions that warrant HiB vaccination?
sickle cell disease
Enumerate the live attenuated vaccines
MMRV, OPV, RV (viral), BCG (bacterial)
- derived from "wild" virus or bacteria
- must replicate to be effective
- immune response similar to natural infection
- potential for reversal to pathogenic form
- interference from circulating antibody
What are the whole cell inactivated vaccines?
viral: influenza, polio, rabies, hepatitis A
bacterial: pertussis, typhoid
What are the types of fractional inactivated vaccines?
- subunit: hepB, influenza, acellular pertussis, typhoid Vi
- toxoid: diphtheria, tetanus
- pure: pneumococcal, meningococcal, Hib (PRP)
- conjugate: Hib (PRP-T, PRP-OMC), pneumococcal