Immunization Answer Sheet - 1/03
Revised June 2011, Larry B. Mellick, MD, Professor of Pediatrics and Emergency Medicine, Medical College of Georgia
American College of Emergency Physicians Section of Pediatric Emergency Medicine
- The most current immunization schedules can be obtained from the Centers for Disease Control and Prevention at http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm.
- C. Answers A through E are the vaccination schedule for DTaP in chronologic order.
- D. The last childhood vaccine is given at age 4-6 years. Boosters are needed every 10 years for non-tetanus-prone wounds and every 5 years for tetanus-prone wounds (i.e., soil contamination, bite wounds with crush injury). Many teens will remember getting a vaccine around 11 or 12 yrs and insist it was tetanus. In most cases, it was probably their Hepatitis B series or MMR booster, since 11 years old would be an odd time to give a tetanus booster, but the recommended time to give Hepatitis B vaccination to someone not immunized in infancy.
- 6 weeks: It is recommended that the first dose be given at age 6 through 14 weeks (maximum age: 14 weeks 6 days). It is recommended that vaccination not be initiated for infants aged 15 weeks 0 days or older because there is insufficient safety data for dose #1 after this age. The maximum age for the final dose of the series is 8 months 0 days.
- 5-12 days post vaccination: Up to 15% of recipients can be expected to become febrile 5-12 days post vaccination due to either the measles or rubella component of the vaccine.
- A. Approximately 15% of adolescent and adult women can experience arthritis or arthalgias after the vaccination, which is generally given as a booster at age 11-12 years. Rashes can occur, but generally not vesicular. The MMR is a subcutaneous vaccine, making muscle hematomas unlikely.
- Over 6 months: A minimum age of 6 months for trivalent inactivated influenza vaccine [TIV]. The vaccine is administered in 2 doses separated by at least 4 weeks to children aged 6 months through 8 years who are receiving seasonal influenza vaccine for the first time. So if you happen to vaccinate these kids in your ED, send them to their PMD for the second half in a month.
- Yes: Approximately 15-20% of 1-dose vaccinated persons may develop varicella if exposed to VZV. Breakthrough varicella is defined as infection with wild-type varicella that occurs greater than 42 days after vaccination. The disease is usually milder in clinical presentation.
- Usually low or no fever
- Develop < 50 lesions
Copyright 2004 American College of Emergency Physicians. Pediatric Emergency Medicine Section quizzes may be reproduced for educational purposes only. To obtain permission to reprint for any other purpose, please submit your written request to: Deputy Executive Director, American College of Emergency Physicians, PO Box 619911, Dallas, TX 75261.