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Immunization Case Study

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IMMUNIZATION CASE STUDY 4

Immunization Case Study

NR602 Primary Care of the Childbearing and Childrearing Family Practicum

Immunization Case Study

Case #1

The CDC recommends all children get vaccinated against Hepatitis B. They should thus receive their first shot no later than 24 hours after birth (CDC, 2021). The initial vaccination is vital as it protects children from contracting Hep B from the mother or family members infected with the disease. Vaccine dose: Recombivax HB #1 5mcg/0.5mL dose IM GlaxoSmithKline.

In a case where the mother tests positive for Hep B, the baby should receive both the Hep B vaccine and hepatitis B immune globulin (HBIG). The shot should be administered no later than 12 hours after birth regardless of the weight and should be on separate limbs. Between 9 to 12 months after birth, infants born to Hep B positive mothers should get tested for Hepatitis B surface antigen (HBsAg). If the Hep B vaccination delays, the baby should get tested 1 to 2 months after the final dose (CDC, 2021).

On the other hand, where the Hepatitis B status of the mother is unknown, the baby should receive their first shot of Hep B within 12 hours after birth. In addition to the vaccine, they should receive HBIG within the first 12 hours. It is also necessary to determine the mother’s HBsAg status early enough to facilitate the vaccination process. If the mother is HBsAg-positive, the infant should receive HBIG no later than a week after birth (CDC, 2021).

Case #2

At two months of age, the child is ready for vaccination. Thus, at this visit, the child should receive his second dose of Hep B and the first dose of; Rotavirus (RV), Diphtheria, tetanus, and whooping cough (pertussis) (DTaP), Polio (IPV), Pneumococcal disease (PCV13), and Haemophilus influenza type b disease (Hib). RV #1 (Rotarix) 1-mL dose orally GlaxoSmithKline; DTaP #1 (Daptacel) 0.5-mL dose IM sanofi; IPV #1 (Ipol) 0.5-mL dose IM or subcutaneous sanofi; PCV13 #1 (Prevnar 13) 0.5-mL dose IM or subcutaneous Pfizer; Hib #1 (ActHIB) 0.5-mL dose IM sanofi (CDC, 2019).

The child should then return to the care clinic at four months of age. I would administer the second dose of RV, PCV13, DTaP, Hib, and IPV in this visit.

It sometimes becomes vital to combine vaccines to reduce the number of injections the baby receives. In such a case, at four months of age, DTaP, IPV, and HepB may be combined. Another combination may also be DTaP-IPV/Hib. However, one should be very keen when handling such procedures (CDC, 2021).

Case #3

Flu is dangerous for children. According to the CDC (2021), every child above six months of age requires to get a seasonal flu vaccine every year; by the end of October. Nonetheless, children can also get vaccinated as soon as the vaccines become available, regardless of the month. The 5-year-old, therefore, would require two doses of the Influenza vaccine; the first (Afluria #1 0.25-mL dose IM) to be administered immediately and the second after a month. Moreover, the child would need the 5th dose of DTaP (Daptacel #5 0.5-mL dose IM sanofi), 2nd doses of Varicella (Varivax #2 0.5-mL dose subcutaneous Merck), MMR (M-M-R II #2 0.5-mL dose subcutaneous Merck), and the 4th IPV (Ipol #4 0.5-mL dose IM or subcutaneous sanofi) (CDC, 2019).

According to CDC (2021), children receiving their first Flu vaccine at later stages should receive their initial two doses as soon as possible. They should then be vaccinated every year and maintain good health habits such as; avoiding people who are sick, regular washing of hands. They can also take flu antiviral drugs that would treat and also offer prevention against flu.

The vaccine doses administered at five years may, however, have some contraindications. For instance, they may present severe allergic reactions after a previous dosage or to other vaccine components.

Case #4

CDC recommends that at 11 years old, a child should continue receiving routinely recommended vaccines (CDC, 2021). Thus, in this case, I would suggest that the 11-year-old receive one dose of Menactra #1 0.5-mL IM from Sanofi vaccine to protect her against Meningococcal disease, one dose of the HPV (Gardasil 9 0.5-mL IM Merck) vaccine, one dose of TDaP (Boostrix#1 0.5-mL IM GlaxoSmithKline), and one dose of Influenza (Fluzone yearly 0.5-mL IM sanofi).

In this case, where the mother declines the child to get the recommended vaccinations and only receive what is required for school, the NP should provide the parent with important information and educate any misconceptions she has about the vaccines. It is important to explain information about the vaccines in a positive method, but also indicate the risks involved with Meningococcal disease, HPV, TDaP, and Flu.

After vaccination at 11 years, the child would require additional vaccination doses. The CDC recommends a COVID-19 vaccination at 12 years. Also, between 13 to 18 years, the child should get vaccinated against Flu, and receive her 2nd dose of Meningococcal conjugate and MenB (Serogroup B meningococcal) (CDC, 2021).

Reference

CDC. (2019, March 26). U.S. Vaccine Names. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/vaccines/terms/usvaccines.html.

CDC. (2021, February 12). Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

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