Highlight doc Day 3 - imm
#ir #peds
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| 2 | DTaP-IPV-Hib | Pneu-C-13 | Rot-1 | | 4 | DTaP-IPV-Hib | Pneu-C-13 | Rot-1 | | 6 | DTaP-IPV-Hib | | | | 12 | Men-C-C | Pneu-C-13 | MMR | | 15 | | | Var | | 18 | DTaP-IPV-Hib | | | | 4-6 | Tdap-IPV | | MMRV | | Gr 7 | Men-C-ACYW | HPV-4 | HB | | 14-16 | Tdap | | | | Yr | | | Infl | Live (MMR + V)àSC
Td q10y >24, Pneu q5y, shingles >65 |
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HEALTH SUPERVISION
- IMMUNIZATIONS (know Ontario immunization schedule)
- All IM excl MMR & V (SC) & Rota (oral)
- “Do vaccines cause ASD?” How do you advise the parents? Discuss
how you would calm mom's fear of autism in a child receiving MMR.
- Understand concern: worries, understanding of dz risks &
Vaccine benefits & risks, validate why may have belief
- if concerned re: ASD, discuss how original info was fraud &
no evidence to support link; give anecdotes of children
affected by vaccine-preventable dz’s
- stick to msg: vaccines are safe & effective & serious dz can
be prevented w/ imm
- vaccine benefits & risks, herd protection not 100% (tetanus from soil), ‘wait and see’ not good b/c many need mult doses & take time to protect
- vaccine safety system: held to higher safety standard than drugs, usually approved in Canada after use in other countries
- address pain assc w/ imm
- don’t dismiss from practice if parents refuse: majority of parents accept when concerns addressed
- Adverse reaction of MMR vaccine? (give 3)
- MMR: measles rash (7-14d), ITP, parotitis, febrile seizure
- Local: induration, tenderness, redness, swelling
- Allergic: urticaria, rhinitis, anaphylaxis
- Systemic: ↑T, rash, irritability, lymphadenopathy, arthr/myalgia, arthritis
- CIs: moderate/severe illness ± fever (not mild URTI), component allergy
- During a 6mo ♀ wellness visit, which diseases is the child being inoculated against (3 marks; there are five diseases, which opens up the possibility that I am wrong)? Name the AEs of such a vaccine (3 marks).
- Diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type B (Hib)
- AEs: serious s/e rare. Mild pain, swelling, redness x few days at site. Some get fever/rash/lose appetite/fussy/drowsy x1-2d after shot (acetaminophen to prevent pain & fever).
- Mother being counselled about HPV vaccine. Which of the following are correct?
- protects against genital warts T (not 100%)
- HPV causes cervical and anal cancer T (HPV 16,18)
- most of us will get the infection and clear it on our own F (10% incidence)
- injection at 0, 2, 6 months T (0, 1-2, 6)
- side effects are common F
- protects against four high-risk subtypes F (not HPV 6,11)
- doesn’t require yearly paps T (q3y)
- average time from acquiring high-risk genotype to cancer is 30-40 y F (15y)
- Which vaccination should an 11yo ♀ get before leaving for summer school?
- I answered DTaP booster. Hepatitis B, and meningococcal C
- 15mo well-baby visit: which vaccinations/route? Anticipatory guidance on safety (3 marks)
- Varicella SC
- Anticipatory guidance: 1) tantrums 2) nutrition 3) dentition 4) safety 5) language
- What are the immunizations necessary for a 7yo ♂ not from Canada?
- Depends on his immunization and country of origin/exposure Hx
DTap-IPV x 5, Hib x 4, Pneu-C-13 x 3, Men-C, MMR x 2, V x 2 - Just give everything he’s missed till now?
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