A 4-month-old baby has developed a fever of 40.2°C and become very irritable within 8 hours of receiving his second dose of routine immunization.
Which one of the following options would you consider for completing the immunization of this baby?
Correct Answer D:
Short-term, mild reactions to immunizations are common. Immunizations that may cause a fever include: Diphtheria, tetanus, acellular pertussis (DTaP) or diphtheria, pertussis, tetanus (DPT). Babies can have a fever of up to 40°C (104°F) within 2 to 3 hours of getting the DTaP or DPT shot. Children may be fussy and have other mild symptoms such as poor appetite, sleepiness, or redness and swelling at the shot site for a few days.
With Measles, mumps, and rubella (MMR), the shot site may become red, swollen, hard, and slightly warm within the first 24 to 48 hours. Fever also may occur 1 to 2 weeks after the shot. A mild rash may develop up to 3 weeks after the shot.
Fever is a common clinical complaint in adults and children and a frequently reported adverse event following immunization. It is a generally benign and common clinical sign.
A 14-month-old infant boy was brought in by his mother for required (routine and non routine) vaccination before they leave the country to go to Peru for Easter. The mother tells you that last week, he tried a small amount of scrambled eggs and developed hives, wheezing and swelling. He was treated in the emergency room. She has read some stories about possible immunization complications in children with egg allergy.
Which of the following contains the highest amount of egg protein and should not be given to persons hypersensitive to eggs?
Correct Answer D: Children with egg allergy present the biggest concern when receiving childhood vaccines. The following routine childhood immunizations may contain egg or egg-related proteins: influenza (flu) and measles-mumps-rubella (MMR) vaccines. In addition, the following non routine vaccines contain egg protein: yellow fever and typhoid vaccines. Yellow fever vaccine contains the highest amount of egg protein of all the egg-based vaccines. Live yellow fever vaccine is produced in chick embryos and should not be given to persons hypersensitive to eggs.
Diphtheria, tetanus, and pertussis, or DTaP, vaccine does not contain egg proteins (some contain bovine proteins).
A child born at 32 weeks gestation is brought to your office at 2 months of age for a routine check-up. The child has an upper respiratory tract infection but is afebrile.
What decision would you make regarding the child's today's vaccination?
Correct Answer C:
Acute illness is not a contraindication to immunization. At 2 months of age this child should receive the following shots:
In a 1-year-old pneumococcal 7-valent conjugate vaccine (Prevnar) is preferred rather than polyvalent pneumococcal vaccine (pneumovax) because of which one of the following advantages?
Correct Answer E:
Pneumococcal 7-valent vaccine produces a satisfactory immune response in a 1 year old, while polyvalent vaccine does not cause a good antibody response in children under the age of 2. Neither vaccine is available orally, and cost is not a factor. The 7-valent vaccine requires multiple doses. Neither vaccine can be combined with MMR.
Which one of the following patients should receive a second dose of varicella vaccine?
Two doses of varicella vaccine are now recommended for almost everyone. The first dose should be given at 12-15 months of age, and a second dose at 4-6 years of age. All unvaccinated people over 13 years of age without evidence of immunity should receive two doses of vaccine given 4-8 weeks apart. The vaccine is not recommended for pregnant women or immunocompromised patients.
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