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So here we go to the heart of the matter, and this is the routine vaccination schedule for children in this country. And this is from the MMWR published by the CDC and this is approved by the American Academy of Pediatrics, the American Academy of Family Practice, and this is really just the general immunization schedule, that if you know this, you will know almost everything there is to know about immunization and for the next hour. So that’s all you have to memorize is this. For hepatitis B, in general, the shots – and we’ll talk about some of the recent changes in that. DTaP vaccine, five dose series; H. flu type B vaccine is three or four doses; for polio that has been a little bit changed but in general it’s four doses, and the first two are ITV. Rotavirus we will skip. MMR vaccine a two dose series; and varicella, one dose of varicella vaccine in general on the routine schedule. So this is all pretty straightforward and everything is pretty easy, right?
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So the other part of this table is that there are just a few little footnotes and so this does tend to get a little bit complicated and that’s in regards to the individual vaccines. So we are going to talk about those coming up, the individual vaccines. But first I just want to remind you that some kids will come to you and they won’t be up to date on their immunizations. This is a table that’s in the syllabus and shows the catch-up immunization schedule. It just shows some general intervals. These are derived from the routine schedule and you can pretty much figure them out. This is something that you wouldn’t need to memorize but you do need to know when kids are under-immunized, which vaccines are indicated and figure out a schedule for them to get up to date on their immunizations.
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Adolescent immunizations; there’s been a recent push to make the 11-12 year old visit a routine visit in the office for a variety of reasons, and including immunizations, to make sure that adolescents are caught up and up to date with some of the vaccines that may be different from when they were younger, such as make sure they get varicella vaccine. Make sure that they have two doses of MMR vaccine and that they are up to date on the hepatitis B vaccine series. Also you can give them a booster dose of tetanus at that time, and give other vaccines if indicated in special circumstances, such as hepatitis A vaccine, flu vaccine or pneumococcal vaccine.
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We are going to talk briefly about passive immunization. I’ll talk about it more with hepatitis A. But in general, passive immunization is the administration of pre-formed antibody is effective preventing hepatitis A. Gamma globulin, you give that, and you can prevent that if given within 14 days of exposure. And measles within six days of exposure. Intravenous immune globulin, IV IG in general, also contains a wide variety of antibodies and you can use that in the same situation if somebody is getting that for another reason. This will also provide protection just like the IM version.