Schedule
Name the vaccines for a healthy child at 2 months
Pediarix (Dtap, IPV, HepB), Hib, PCV13, Rotavirus
Why do we give MMR and Varicella instead of MMRV at 12 months?
Higher risk of febrile seizure with the first dose of MMRV then MMR + Varicella.
Dtap, IPV, HBV
What is the contraindication to all vaccines?
Life threatening allergic reaction to vaccine.
"Won't all those vaccines overload their little body?"
- validate concern: many parents worry about this
- Share: 14 vaccines used today have 160 viral and bacterial proteins and carbohydrates that stimulate the immune system, in 1908 3000+. Newborns manage 100 trillion bacteria in their nose, intestine, and skin with huge quantities of antibodies made daily for protection
- recommend: I recommend she get these vaccines today
What is the youngest age you can get the 2 month vaccines?
6 weeks
Why do we give HPV at 11? (any one reason)
1. body more immunogenic at 11-12
2. works better before sexarche
3. we already see kids for other shots at that age
What is in Twinrix?
HAV and HBV
Can we give the rotavirus vaccine to infants in the NICU?
no
"Vaccines have thimerasol and I heard that's bad."
Validate: I hear that from a lot of parents, and I have personally done research on this topic because I care about keeping my patients safe.
Ask permission: Can I share with you what I know about this?
Share: Thimerasol is not in vaccines for < 6, except multi-dose flu. Theorectical concern for neurotoxicity (methyl mercury causes this at high levels, but thimerasol is ethyl mercury - and no studies have found harm).
Recommend: I recommend your child receive all the scheduled vaccines today.
What vaccines does a healthy 4 year old get?
MMR-V (Measles, Mumps, Rubella - Varicella)
Dtap
IPV
Why do children need to avoid aspirin after the varicella vaccine?
People should avoid using salicylates for 6 weeks after getting varicella vaccine. This is because of the association between aspirin use and Reye syndrome following varicella, and also the potential risk of Reye syndrome if a person is given aspirin after varicella vaccination.
What is in Kinrix?
Dtap and IPV
What is the most worrisome adverse reaction to the rotavirus vaccine?
Increased risk of intussusception, most within first week post vaccination, estimated to range from about 1 in 20,000 to 1 in 100,000 US infants who get rotavirus vaccine. Benefits far outweigh risk of intussusception.
"I heard vaccines contain formaldehyde."
Validate: Many parents ask me about this, and I appreciate your concern for your child.
Ask for Permission: Can I share with you what I know about this topic?
Share: Small amounts of fermaldehyde are in vaccines (they keep the vaccines safe from contamination over time), but they are far less than what is in the body naturally, and then levels that cause cancer. The most an infant would be exposed to in vaccines is 0.2 mg which is considered safe. Given that we have it in our blood, the average infant has 1.1 mg, which is a value higher then any amount in vaccines. 600x this has been safely given to animals.
Recommend: I recommend you receive these vaccines.
What vaccines do you get at 11 years old?
HPV, Tdap, Meningitis
True/False
State level policies around non-medical exemptions to vaccines make a difference in vaccination rates.
True - CO recently passed HB 163, strengthening process to obtain non-medical exemptions, which is a proven public health strategy to improve vaccination rates.
What is in Pentacel?
Dtap, IPV, Hib
Can you get chicken pox from the varicella vaccine?
No - but, you can get a vaccine varicella-like rash without vesicles in 3-5% of recipients usually 5-26 days after immunization
"Vaccines have toxins."
Validate, Ask Permission.
Give information: the additives in vaccines help the body create a better response. They are all naturally occurring and non-toxic.
Recommend: I recommend your child get the scheduled vaccines today.
Adjuvants are substances that are added to allow vaccines to work better and enhance the immune response and may decrease the quantity of vaccine needed or decrease the number of doses required. Adjuvants include- aluminum salts (Within the first 6 months of life infants will get 4.4 mg of aluminum from vaccines, if breastfed they will get 7 mg, formula fed will get 38 mg and soy formula will get 117 mg - 3rd most abundant element), monophosphoryl Lipid A (A low toxicity derivative of LPS a component of bacterial cell walls that has useful immune-stimulatory properties), squalene (naturally found in plants, animals and human), CpG (two nucleic acids (cytosine and guanine)).
What is the are the age parameters for Rotavirus (latest you can give first dose and last dose)?
15 weeks and 8 months
True/False
Standing orders for vaccines improve vaccination rates.
While we want all kids to come in for their WCC, we realize that eliminating any barriers to vaccines, helps our overall vaccination rates.
What percentage of Kindergarteners should be vaccinated to provide community protection against a measles outbreak?
95%
A 4 yo with RA has been on 2 mg/kg of prednisone for 15 days. What vaccine(s) are contraindicated?
MMRV
"I want an alternative schedule."
Explore: Could I ask why you make this request?
Ask permission
Share information: The CDC, AAP, AAFP all recommend the current schedule. Each vaccine has been matched with the age that it works the best and protects children for the longest possible.
Share concern: I worry that if we don't vaccinate your child on schedule, they could get sick.
Recommend: I recommend your child get vaccines on schedule today.