TOC   

Immunization       See also KP Immunization Site  | http://www.texmed.org/has/prs/iin/default.asp (Immunization Information)

Immunization 2006  

MMWR February 8, 2002 CDC General Recommendations on Immunization      
Recommendations of the Advisory Committee on Immunization Practices (ACIP) and The American Academy of Family Physicians (AAFP)  
 http://www.aegis.com/pubs/mmwr/2002/MM51rr02.html                  
 Recommendations of the ACIP on CDC site       
 See the Immunization Schedule in Acrobat pdf file format  
                              

Influenza Vaccine 0.5 mL IM yearly   |  Standing Order  
- for age >65 or those with chronic illness or health care workers.
- they are inactivated split- or whole- virus vaccines. They are highly purified & contain only noninfectious viruses, therefore cannot cause influenza.

Pneumococcal Vaccine  (Pneumovax or Pnu-Imune) 0.5 mL IM or SC  |  Standing Order

• once or 5 yr later for booster - for age >65 or those with chronic illness.
• they are composed of 23 purified capsular polysaccharide antigens of S.pneumoniae.

Hepatitis A vaccine (Havrix) 1 mL IM, repeat once in 6-12 months (2 doses)  |  Standing Order

• travelers, chronic liver disease, drug use, homosexual, clotting disorders.
• the vaccines are killed, formalin-inactivated vaccines prepared from whole virus.
• persons traveling to highly endemic areas should receive the first dose of vaccine at least 2 weeks before departure.
• If <2 weeks, then give both vaccine and immunoglobulin, at different sites.

Hepatitis B vaccine (Engerix-B or Recombivax HB) 1 mL, repeat at 1 & 6 months later (3 doses)  |  Standing Order
- for household/sexual contact with carrier, drug user, hemodialysis, health workers, prison inmantes, etc.
- they are recombinant nDNA HBV vaccines.

Tetanus Td 0.5 mL IM, repeated every 10 years after completion of primary 3 doses.  Standing Order
- the tetanus toxoid is an inactivated toxoid vaccine.

Guide to Tetanus Prophylaxis in routine wound management:

• Hx of 3 doses Td ---> no Td or tetanus immunoglobulin Rx needed, but  
  If > 10 yrs, give Td for minor clean wounds, & if >5 yrs, give Td for all other wounds.
• Unknown or <3 doses of Td ---> Td but no TIG for clean minor wounds; both Td & TIG for all other wounds.

MMR 0.5 mL SC
with repeat dose may be given after 2 months.

Varicella vaccine (Varivax) 0.5 mL SC with 2nd dose 4-8 wk later.  |  Standing Order
- it is a live, attenuated viral vaccine.
- It should not be given to pregnant women , cancer or immunosuppressed persons, or those with active untread tuberculosis.
- adults with a reliable history of varicella are considred immune.  Anti-varicella-zoster virus antibodies test is available.

HPV vaccines  (10-2006)
Gardasil vaccine is given as three 0.5 mL IM injections at 0, 2, and 6 months, and may be given at the same time as hepatitis B vaccine,  for girls and women 9 -26 years old.
Cervarix vaccine is coming also.

Immunization Links

• Immunization Organization Home Page  
  (Good Resource on Immunization)
• Summary of recommendations for baby immunization - Aug. 1999  
• CDC  Immunization Recommendation
• Recommended Childhood Immunization ScheduleUnited States, 2002  MMWR. 2002;51:31-33
• Recommended Childhood Immunization Schedule—United States, 2000 (CDC)  
• Revised! Summary of Rules for Childhood Immunization (10/27/98)      
• Revised! Summary of recommendations for adult immunization - Aug. 1999
• Guidelines for Vaccinating Pregnant Women - Oct. 1998
• Revised! Dosage schedule of hepatitis A and B vaccines 1998
• Vaccinations for adults with hepatitis C virus infection
• CDC Travel Info
• Travel Vaccination

Immunization files that can be downloaded from     
         the CDC website. |  Immunization

• Chicken Pox Vaccine  (2/1/96 Interim )
• Diphtheria, Tetanus, and Pertussis Vaccines - What you need to know  (8/15/97 )
• Haemophilus Influenzae Type b Vaccine (HIB)    (5/1/96)
• Hepatitis A Vaccine - What you need to know    (8/25/98)
• Hepatitis B Vaccine and Hepatitis B Immune Globulin   (5/1/96 )
• Influenza Vaccine - What you need to know   (7/1/98 )
• Measles, Mumps, and Rubella Vaccine (MMR)   (6/10/94)
• Pneumococcal Polysaccharide Vaccine - What you need to know   (7/29/97 )
• Polio Vaccines - What you need to know   (2/6/97 )
• Tetanus and Diphtheria Vaccine (Td)   (6/10/94 )
• Typhoid Vaccine  1994

2006