2025 – PAGE 345 – VACCINES, IMMUNIZATIONS AND CONTRAINDICATIONS

2025 – Core Study Guide 17 – Vaccines, Immunizations and Contraindications 2025 – PAGE 345 – VACCINES, IMMUNIZATIONS AND CONTRAINDICATIONS

VACCINE SCHEDULE REMINDERS

The details of the vaccine schedule are complicated and you should not try to memorize all of them. Know some of the standard vaccines and when they are given. Do not worry about all the “ifs, ands, or buts.”

  • 2, 4, AND 6 MONTHS: Six vaccines are given: DTaP, IPV, Hepatitis B, Hib, Pneumococcus(PCV-13) and Rotavirus. Hep B is not required at 4 months if the newborn dose was given, but is allowed for simplification. Rotavirus is oral and live, while the others are all injected and not live. No more vaccines are required in the first year. COVID-19 vaccination is recommended for everyone 6 months and older. If unvaccinated, give age-appropriate primary series of updated vaccines with a schedule based on the vaccine manufacturer. Those with previous full vaccination need only 1 booster update when available, but no sooner than 8 weeks after previous vaccination.
  • BETWEEN 12 and 15 MONTHS: These do NOT need to be given all at the same time and there are different schedules and regimens available for working them into two well-child visits.
    • The 12-month vaccines include the live virus vaccines plus Hepatitis A. So, MMR #1, Varicella #1, and Hepatitis A #1.
    • The 15-month vaccines are similar to the 2-, 4-, and 6-month schedule. Give all those vaccines again except for Hepatitis B, IPV, and Rotavirus. So, DTaP #4, Hib #4, and Pneumococcus #4.
  • 18 MONTHS: Hepatitis A #2
  • KINDERGARTEN (4-5 YEARS): DTaP #5, IPV #4, MMR #2 and VZV #2. Remember that Hib and pneumococcusare not important threats for immune competent children older than 5 so no further vaccine doses are needed.
  • MIDDLE SCHOOL (11-12 YEARS): Tdap, HPV, and Meningococcus ACWY #1.
  • GRADUATION (16-18 YEARS): Meningococcus ACWY#2.

CATCH-UP IMMUNIZATION SCHEDULE PEARLS

The CDC’s catch-up immunization schedule does NOT include every pediatric vaccine. For example, PCV13 and Hib are NOT recommended for kids over 5 years old, and the first dose of rotavirus vaccine is NOT given to anyone 15 weeks or older. If a vaccine series was started but not completed, it is not necessary to restart the series. When scheduling appointments for catch up immunizations, use the minimum recommended interval between doses to get the child caught up as quickly as possible.

PEARL: You could be asked a question about how many doses of a given vaccine are required for the series.

    • MNEMONIC: SIX shots at SIX months of age and FOUR shots at FOUR years of age. For the 1-year shot, you could try to remember that SIX x 2 = 12. Therefore, there are TWO major immunization milestones at which time SIX shots are given (SIX months of age and 6 x 2 = 12 months of age).
    • MNEMONIC: 5-4-3-2-1—Use this to help you remember the number of times various vaccinations are administered.
      • 5 = Total of 5 DTaP doses (last one at 5 years of age)
      • 4 = P (and it kind of looks like an H) = Pneumococcal, IPV and Hib = 4eumococcal, I4V and 4 For 4neumococcal, there are a total of 4 doses with last dose given at 12-15 months of age. For I4V, there are a total of 4 doses with the last dose given at 4 years of age. For 4ib, there are a total of 3-4 doses (this depends on the manufacturer), with the last dose given at 12-15 months of age. Since there can be 3 OR 4 doses for Hib, the 4ib mnemonic is kind of a fib for Hib. Ha!
      • 3 = Total of 3 Hepatitis B doses (Minimum age for final dose is age 24 weeks)_
      • 2 = MMR, VZV, and Hepatitis A
      • 1 = Rhymes with NONE
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