The first patient in the case study is a 3.5 kg (7 lbs, 7 oz.) newborn in the nursery with a normal exam; likewise, all maternal labs were norma... [Show More] l.
1. What vaccine(s) should she receive and why? This newborn should receive Hepatitis B at birth according to CDC immunizations schedules. If the mother is HBsAg(Hepatitis B surface Antigen)-negative; the infant should receive the 1st dose of monovalent Hepatitis B vaccine only within 24 hours as long as the infant is greater than or equal to 2000 grams and is medically stable (Birth-18 years Immunization Schedule, 2020).
2. If the mother is HBsAg-positive, the HepB vaccine and HepB immune globulin (HBIG) should be given within 12 hours of birth in separate limbs regardless of birth weight (Birth-18 years Immunization Schedule, 2020).
3. If the mother’s HBsAg status is unknown, the newborn should receive the Hep B vaccine with 12 hours with the caveat that if the child is greater than 2000 grams; they would also get the HBIG in a separate limb; also within 12 hours (Birth-18 years Immunization Schedule, 2020).
Your first patient in primary care clinic is a healthy 2-month-old. She received Hep B #1 in the nursery.
She is a term infant and parents have no concerns. Her exam is normal and there are no contraindications to giving her vaccines.
1. Which vaccines should the child receive at this visit? This child is ready to start receiving her vaccines in earnest. At this visit, she will be receiving second HepB, Rotovirus, DTaP, Haemophilus Influenza Type B (Hib), Pneumococcal conjugate valence 13 (PCV13), and Inactivated Polio virus (IPV). In situations where the child is “asplenic” or has sickle cell disease, HIV, persistent complement component deficiency, or if they use a complement inhibitor (ie. eculizumab, ravulizumab); the child should receive the first in the 4 part meningococcal series. This is not the case here (Birth-18 years Immunization Schedule, 2020).
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