Vaccines

Question 1

Live Vaccines

Answer 1

MMR
Intranasal Influenza
Cholera
Rotavirus
Oral Typhoid
Varicella
Yellow Fever

Others:
Tuberculosis
Dengue
Smallpox
Ebola

*Multiple life vaccines can be given on the same day or spaced 4 weeks apart, except oral rotavirus and typhoid vaccines

Question 2

Live vaccines and TB skin test

Answer 2

• Give life vaccines on the same day as the TST
• Wait for 4 weeks after a life vaccine to perform the TST
• Administer the TST first, wait ≥ 24hrs, then give the life vaccine

Question 3

Live vaccines and antibodies

Answer 3

• Vaccine - 2 weeks - antibody product
• Antibody product - ≥ 3months - vaccine
• Simultaneous adm. of vaccine and antibody is recommended for post-exposure prophylaxis of certain diseases (Hep A, B, rabies, tetanus)

Question 4

Vaccines for infants/ children

Answer 4

• 3 dose Hep B started at birth
• RSV monoclonal antibody if mother was not vaccinated during pregnancy
• Other vaccines start at age 2 months: PCV15 or PCV20, DTaP, Hib, polio, rotavirus
• Live vaccine series generally start at age ≥12 months: MMR, varicella
• No polysaccharide vaccines before age 2 years

Question 5

Vaccines for adolescents/ young adults

Answer 5

• Meningococcal quadrivalent vaccine
  2 doses (at age 11-12 years and at 16 years)
  1 dose for 1st year college students in residential housing (if not previously vaccinated)
• HPV
  recommended at age 11-12 years
• Tdap
  at age 11-12 years

Question 6

Vaccines for pregnancy

Answer 6

• Live vaccines C/I
• Inactivated influenza vaccine, in any trimester
• RSV if at week 32-36 during RSV season
• Tdap x 1 with each pregnancy at week 27-36

Question 7

Vaccines for older adults

Answer 7

• Shingrix, age ≥50 years, 2 doses 2-6 months apart
• Pneumococcal vaccine ≥50 years, 2 doses ≥12 months later

Question 8

Vaccines for sickle cell disease & other causes of asplenia

Answer 8

• Hib
• Pneumococcal vaccine
• Meningococcal vaccine

Question 9

Immunodeficiency

Answer 9

• Live vaccines are C/I
• Pneumococcal vaccine 19-50 years (2 doses, 1x then ≥8 weeks later)
• Shingrix ≥19 years (2 doses, 2-6 months apart)
• Additional vaccines for HIV pts (Meningococcal quadrivalent vaccine, Hep A, Hep B)

Question 10

Vaccines adm

Answer 10

• SC only: yellow fever, dengue, smallpox and monkeypox
• IM or SC: MMR II, MMRV, varicella, PPSV23, IPV
• Intranasal: FluMist Quadrivalent
• PO: Thypoid (Vivotif) capsules
• Oral solutions: cholera and rotavirus