Vaccines: the memorization of when and what and when not to if the patient has certain conditions. Imagine questions that are simple but complicated. For example, perhaps an age is given and you need to know what vaccinations were due by that age or if the child had never had vaccines what could be given as catch-up? It is really not complicated and again if you are a parent this may be an easier topic if you are of the pro-vax crowd (as I am).
Below see the schedule from the CDC that is also approved by the American Pediatric Association along with the recommended schedule for catching up on vaccines if missed.
Special Population Considerations
1. Preterm infants
- Immunize on the basis of chronologic age.
- Do not reduce vaccine doses.
- If birth weight is less than 2 kg, delay HepB vaccine because of reduced immune response until the patient is 30 days old or at hospital discharge if it occurs before 30 days of age (unless the mother is positive for HepB surface antigen).
2. Children who are immunocompromised
- No live vaccines
- Inactivated vaccines and immune globulins are appropriate
- Household contacts should not receive oral polio vaccine
- MMR, influenza, varicella, and rotavirus vaccines are recommended
3. Patients receiving corticosteroids
a. Live vaccines may be administered to patients receiving the following:
- Topical corticosteroids
- Physiologic maintenance doses
- Low or moderate doses (less than 2 mg/kg/day of prednisone equivalent)
b. Live vaccines may be given immediately after discontinuation of high doses (2 mg/kg/day or more
of prednisone equivalent) of systemic steroids given for less than 14 days.
c. Live vaccines should be delayed at least 1 month after discontinuing high doses (2 mg/kg/day or more
of prednisone equivalent) of systemic steroids given for more than 14 days.
4. HIV Positive Patients
a. MMR should be administered unless patient is severely immunocompromised.
b. Varicella should be considered for asymptomatic or mildly symptomatic patients.
c. Inactivated vaccines should be administered routinely.
Hi Blonde One, For what it is worth, I waited until my son was two before vaccinating him. My reasoning was simply to let him grow naturally, without injecting him aluminum products, which we now see has detrimental affects on the brain (THROW OUT YOUR ALUMINUM POTS!), and also be sure he didn’t have autism already. There’s enough controversy there to talk all day and never resolve the debate, however, with autism affecting more boys this decade than ever before, why take a chance? Yes, I’m a pharmacist. I even realize that some of the autism correlation data was forged. Perhaps these problems are due to the cellular waves in the air, or the genetically modified foods the mother and baby eat.
Before I had children, I believed the government and the FDA wholeheartedly. Now, I look things over carefully before believing the data as truth. Often, studies are done with very few subjects, then the findings are released on main-stream media. Makes me wonder if someone needs to sell more vitamin “xyz” this week, so they’ll publish the study that vitamin “xyz” now improves “abc” condition in 9 out 10 adults… That is the 9 out of the 10 adults that were studied. What kind of p value is THAT not-so-well-study going to have? Seriously, I’ve seen customers in retail pharmacy as me if some particular product will really work on its promise. I look at their magazine, and then point out things such as there’s a “correlation” or this study was done at the University of some state… perhaps some 23 year old grad students who are paying $5 to other students to partake in their study. It could also be legit. But, Ma’am, this isn’t where to get your advice.
Anyway, enjoying your blog. I’ve got to start looking into board cert oncology. That’s my first choice, we really need it at work!
Simple things like garlic pills and cranberry pills. C’mon, just eat the food. It even tastes better than the pill! Well. I highly recommend the Vaccine Book, by Dr. Sears. He takes a conservative approach while also keeping in mind that vaccines have saved thousands of lives, and won the battles over many diseases and plagues.
Ultimately, my son is now up to date on ALL his vaccines. While he was building his own immune system at home, he was not in daycare, did not travel abroad, and we did not have visitors from far away, or by people not already vaccinated. He was in contact with church, family, and friends. We began the vaccinations with one per month. To spread it out felt much safer.
Alternative vaccination schedules can sicken your kid. In his popular 2007 tome, The Vaccine Book: Making the Right Decision for Your Child, pediatrician Robert “Dr. Bob” Sears (son of the best-selling author Dr. William Sears) encourages parents who are skittish about shots to reconsider the vaccination schedule recommended by the Centers for Disease Control and Prevention to decrease the likelihood of a bad reaction. Parents should consider getting “fewer shots at each infant checkup and spreading the shots out over more time,” he suggests on AskDrSears.com, the online arm of his family’s pediatric advice franchise. Online parent forums are full of posts touting pediatricians amenable to the Sears vaccine schedule. But Dr. Mary Fallat, chair of the American Academy of Pediatrics’ bioethics committee, says doctors have an ethical duty to warn parents that delaying vaccines will leave kids exposed to disease. If enough of them adopt the Sears schedule, it could weaken our herd immunity to catastrophic diseases like whooping cough. The kicker? A 2010 study in Pediatrics showed that adopting an alternative schedule doesn’t affect children’s long-term outcomes.
Ok all that to say I did delay with my first child, a NICU baby boy. I did not with my second. I am more concerned about things in our food than aluminum.
Oncology… That would be a great one to do. Would you do the general pharmacotherapy one first or just go straight to oncology?