Immunization Schedule — Flashcards

Flashcard 1: Infants born to HbsAg-positive mothers should receive _____ immunization at birth

Answer: both active and passive (active/passive)

Flashcard 2: The measles rash starts on the _____ and moves down-wards

Answer: face

Flashcard 3: An infant born to a mother who is newly identified as HIV-positive within _____ weeks of delivery should be considered as high risk.

Answer: 4

Extra: According to **NACO 2021 guidelines**, an infant is considered **high risk** for HIV transmission if: - Mother received ART for **< 4 weeks** before delivery. - Mother has a viral load **> 1,000 copies/mL** in the last trimester (or no VL available). - Mother was newly diagnosed with HIV during the breastfeeding period. **Management of High-Risk Infants:** - Dual prophylaxis with **Zidovudine (AZT) + Nevirapine (NVP)** for 6 weeks. - Followed by **Nevirapine** for an additional 6 weeks (Total 12 weeks). *Note: In older guidelines, 6 weeks was sometimes mentioned in relation to the duration of prophylaxis, but the current threshold for maternal ART duration is 4 weeks.*

Flashcard 4: In children undergoing elective splenectomy, which pneumococcal vaccines are recommended to be administered at least 2 weeks prior?

Answer: PCV13 and PPSV23

Extra: Patients with anatomic or functional asplenia (e.g., splenectomy, sickle cell disease) require vaccination against encapsulated organisms: *S. pneumoniae*, *N. meningitidis*, and *H. influenzae* type b. **Pneumococcal vaccination protocol:** * **PCV13 (Conjugate):** Part of routine series; should be completed. * **PPSV23 (Polysaccharide):** Administered to high-risk patients ≥ 2 years of age, at least 8 weeks after the last PCV13 dose. * **Timing:** Ideally ≥ 2 weeks before elective splenectomy. If the surgery is emergent, vaccinate 2 weeks after surgery.

Flashcard 5: A **fully immunized** child is one who has received all vaccines due by the age of _____.

Answer: 1 year

Extra: A child is 'fully' immunized if they receive all vaccines due by 1 year of age. They are 'completely' immunized if they receive all vaccines due by 2 years of age.

Flashcard 6: HIV progression is _____ in infants and children

Answer: rapid

Flashcard 7: _____ is aka 100 days cough

Answer: Pertussis

Extra: Also known as whooping cough. caused by Bordetella pertussis.

Flashcard 8: Contraindications for pertussis-containing vaccines (DTwP/DTaP) include:

Answer: 1. Encephalopathy within 7 days of a previous dose 2. Progressive/unstable neurological disorder (e.g., uncontrolled epilepsy, infantile spasms)

Extra: For children with these contraindications, the pertussis component is omitted and the **DT** (Diphtheria and Tetanus) vaccine is administered instead of DTwP or DTaP. **Note on DTaP vs. DTwP:** In the Indian context (where DTwP is standard), DTaP is preferred over DTwP for: - History of severe local reaction, high fever, or persistent crying after a previous dose of DTwP. - Children with **stable** neurological conditions or a history of febrile seizures, to minimize the risk of post-vaccination fever. "Severe immunological deficits" (mentioned in the original card) is a contraindication for **live** vaccines (e.g., BCG, OPV, MMR), not for the pertussis vaccine (which is inactivated).

Flashcard 9: A rare, late complication of natural measles infection is _____

Answer: subacute sclerosing panencephalitis (SSPE)

Extra: The measles vaccine does not cause SSPE; it prevents it by protecting against natural (wild-type) measles infection. SSPE is caused by a persistent, mutated measles virus in the CNS.

Flashcard 10: 2c81993a56154e059965c33d86098fe2-ao-4

Answer: ART(anti retroviral therapy) protocol in children

Extra: