The Shots
Is it appropriate to give a vaccine to a child with a 101.0F fever?
YES!
4-year-old presents to clinic. She has not been seen since she was 6 months of age. On a previous visit, she received DTaP, PCV13, IPV, and Hep B. She missed her final Hib, 4th PCV13, and 4th DTaP doses typically administered at 12-15mo visits. Should she restart the series given time elapsed between doses?
NO
Which vaccine is absolutely contraindicated if history of encephalopathy within 7 days of dosing?
DTaP
You are seeing siblings for their well child checks: a 13-year-old male and 15-year-old female. Parents are interested in vaccinating both kids against HPV. What is the difference in dosing between the siblings?
13 yo = 2 doses
15 yo = 3 doses
A 5-year-old presents for tuberculin skin testing due to possible exposure. MMR was given 1 week ago. Is it appropriate to place PPD today? If not, how long must you wait?
NO, wait 4-6 weeks before placing PPD
A pregnant woman presents for prenatal visit. This is her second pregnancy, and she is recalls receiving a vaccine to protect against pertussis at some point during previous pregnancy. What vaccine is she referring to and when should she receive vaccine?
Tdap should be administered for EVERY pregnancy between 27-36 weeks
A patient is treated with Neomycin for E. coli diarrhea and has an anaphylactic reaction to the antibiotic. Which is vaccine is contraindicated in this patient?
MMR
Which vaccine is associated with high fever and increased risk of febrile seizures 5-12 days after administration?
MMRV in 12-23 months of age
Name the 4 lives vaccines.
MMR
Varicella
Rotavirus
Intra-nasal Influenza
A 10-year-old presents to ED after stepping on a rusty nail. He completed 5 doses of DTaP series; the last dose was given at 4-year-old well child check. Should he receive a tetanus vaccine?
YES, >5 years since previous vaccine administered
What are 2 absolute contraindications to the rotavirus vaccine?
Intussusception & SCID
An 18-month-old presents with her parents to the Acute Care Clinic. The mother was recently diagnosed with Hepatitis A after traveling to China. What can be administered to the child to prevent Hepatitis A infection?
Hep A vaccine or IVIG if given within 14 days of exposure
Which vaccines must be stored in the FREEZER? (< 5F or –15C)
MMRV
Varicella
12-month-old patient presents for well child check. When discussing vaccinations, patients decided to administer MMR, but wish to delay Varicella vaccination. When can this patient receive the Varicella vaccine?
>1 month after MMR
A 17-year-old patient presents to your clinic asking about the HPV vaccine. She has not been previously vaccinated for HPV but discloses a history of HPV infection. Can she receive the HPV vaccine?
YES
A 7-year-old patient presents to your clinic as a new patient. She has not received any vaccinations since birth. What vaccines can no longer be administered?
HiB & Rotavirus
Can a child with HIV and CD4 count > 15% normal for age receive MMRV?
NO
A preterm infant is born to a HBsAg+ mother and receives both HepB and HBIG within 12 hours of birth. She also receives HepB vaccinations at 1 month of age and 2 months of age. She is now presenting for her 6-month-old WCC. Should you administer the HepB vaccine?
YES
You are seeing the following patients in clinic this afternoon. Who should NOT receive the PCV13 vaccine?
2-month-old with congenital heart defect
6-month-old with sickle cell disease
15-month-old with cochlear implant
NONE
A patient is admitted to the hospital and treated with IVIG for Kawaski Disease. How long must MMR vaccine be delayed after administration of IVIG?
11 months