I. Hepatitis B Vaccine
II. Diphteria and Tetanus Vaccine
a. Td: at 7 yrs, 11-12 yrs booster, then every 10 yrs:
i. Contaminated wound and more than 5 yrs since booster: give anther booster.
ii. If unimmunized, also give TIg
iii. Pertussis:
iii. Pertussis:
a. Used to be whole-cell, now acellular.
b. Different combinations available:
i. DTap
ii. TriHIBIT (DTap+Hib)
iii. Pediatrix (DTap+ Hep B + IPV)
IV. Poliovirus Vaccine:
a. Now use inactivated IPV (no longer the oral type to prevent the few cases of poliomyelitis).
V. MMR (measles, mumps, rubella):
a. Mumps: childhood viral illness – orchitis, myocarditis, encephalitis.
b. Measles: respiratory and neurologic
c. Rubella: congential anomalies, ophthalmologic, cardiac, neurologic, mental retardation.
d. The vaccine (MMR):
i. Live attenuated
ii. don’t give to:
1. pregnant or
2. immunocompromised
3. children with egg allergies
4. not within 3 months of being given blood products or immunoglobulin
iii. the vaccine can suppress tuberculin skin test
VI. Varicella vaccine (Varivax):
a. Who to give it to: children 12 months and older (just 1 dose for those under 12 years), adults with no history of chickenpox.
b. If 12 years or older: give 2 doses at least 1 month apart.
VII. Pneumococcal Vaccine:
a. S. pneumoniae: respiratory infection, bacteremia, community-acquired pneumonia and meningitis, sinusitis, otitis media.
b. Prevnar (PCV7) — Pneumococcal conjugate vaccine
i. Reduces risk of invasive disease by 90% from 7 serotypes
ii. Don’t give to adults. Given to children up to 2 years of age.
c. PPV — (Pneumococcal polysaccharide vaccine)
i. For older children and adults
ii. Should give before splenectomy
VIII. Influenza Vaccine:
a. Recommended for:
i. children 6 to 23 months
ii. adults over 50 years
iii. those with chronic metabolic diseases, women who will be in the 2nd or third trimester during flu season, health care workers
iv. avoid in ppl with egg allergies
b. nasal version available but should be avoided by health care workers, those in close immunocompromised (virus can be shed for 7 days after administration).
IX. Hepatitis A vaccine:
a. Individuals traveling to areas where it is endemic
b. Children attending daycare
X. Meningococcal vaccine:
a. Meningitis: very high morbidity and mortality
b. Menactra (a polysaccharide-conjugate vaccine)
i. 11-12 yrs of age, high school entry, college freshmen in dormitories
ii. high risk groups (asplenia)