Boards- APEA Peds Exam || 2025 (Actual Exam)
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- Routine immunization schedule for children at
Hep A Vaccine minimum age 1 yr
- 2 doses at least 6m apart
- 3 dose series
- #1: 0m
Hep B Vaccine
- #2: 1-2m
- #3: 6-18m after #1
- <7 yrs of age
- 5 dose series:
#1: 2m (minimum age 6 wks)
DTaP Vaccine #2: 4m
#3: 6m
#4: 15-18m (6m after #3)
#5: 4-6y (final dose >4y)
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- >7 yrs
- 11-12 yrs: Tdap booster- contains tetanus, diphtheria,
and acellular pertussis
- Tdap can be administered regardless of last interval
Tdap
since the last tetanus- and diptheria-toxoid-
containing vaccine
- After Tdap, pts should receive Td booster 10y
(routine)
1 dose Tdap during each pregnancy, preferably in
Pregnancy and Tdap
early part of gestational weeks 27-36
- #1: 2m
- #2: 4m
Hib (Haemophilus
- #3: 6m
influenzae Type B)
- #4: 12-15m
- Unvaccinated at 15-59m: 1 dose
- 4 dose series
Pneumococcal conjugate
- given at 2, 4, 6, and 12-15 mo
vaccine (PCV)
- minimum age 6 wks (PCV13), 2 yrs (PPSV23)
- Rotarix: 2-dose series at 2, 4mo
- RotaTeq: 3-dose series at 2, 4, 6 mo
Rotavirus Vaccination
- Do NOT start series on or after age 15 wks, 0 days
- Do NOT continue series after 8mo, 0 days
- 4-dose series at ages 2, 4, 6-18mo, 4-6 yrs
- administer final dose on or after 4th bday and at
least 6m after previous dose
Polio (IPV only)
- IPV is not routinely recommended for US residents
18 yrs and older
- Oral polio no longer given in US
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- 2 dose series
- #1: 12-15m
#2: 4-6 yrs
MMR or MMRV - second dose of MMR may be given at any time,
provided at least 1mo has elapsed since 1st dose and
both doses are given at age 12m or older
- Contraindicated if allergic to neomycin or gelatin
- Live attenuated vaccines must replicate to produce
immunity
- Fever, rash after live or attenuated immunizations
Immunity with Live
represent a reaction to viral replication, not the
Attenuated Vaccines
vaccine
- MMR and varicella are examples
- Give them on the same day or at least 4 wks apart
- Never give to children < 1 yr, pregnant women, or
Live Attenuated Vaccines
immunocompromised pts
- Given at age 12-18m, booster 4-6yrs OR age 11-12yrs
if child lacks a reliable hx of chickenpox infection
Varicella vaccine
- If given at age 13 yrs or later, 2 doses are required, at
least 1mo apart
- Recommended annually ages >6m
- Children <8 yrs receiving vaccine for first time need
Influenza Vaccine
2 doses separated by 4 wks
- 1 dose annually for all people 9yrs and older
- Egg allergy, hives: administer any flu vaccine
appropriate for age and health
Flu Vaccine Allergic - Egg allergy, angioedema, resp distress: administer
Reactions any flu vaccine appropriate for age and health under
supervision of HCP who can mange severe allergic
conditions
- Administer to all children 11-12yrs, and ate age 16 yrs
Meningococcal Conjugate - Or 13-15 yrs if not previously vaccinated; booster
Vaccine (MenACWY) age 16-18 yrs
- If administered at age 16-18 yrs: 1 dose
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- 2- or 3- dose series depending on age at initial
HPV (Human vaccination
Papillomavirus) Vaccine - age 9-14 yrs: 0, 6-12 mo later
- age >15 yrs (to 26 yrs): 0, 1-2mo, 6mo
- Localized (redness/swelling of site), systemic (fever),
or allergic (hives, anaphylaxis)
Adverse Vaccine
- Most common runs among adolescents are to: HPV,
Reactions
Men ACWY, and Tdap (syncope)
- Allergic rxns occur within 1h (usually 15 min)
- A vaccine given 4 days prior to the scheduled time
to receive it is considered a valid dose
Spacing of Vaccines - A vaccine given 5 days prior to the scheduled time
to receive it is considered an invalid dose and should
be repeated
- Otitis media
- Pneumonia
- Bronchiolitis
- Viral gastroenteritis
- UTI
Common conditions in
- Viral exanthems
peds
- Most childhood infections are viral and self-limited
- Children often have nonspecific s/s w/ infectious
illnesses:
fussiness/irritability, stomach upset, poor appetite,
lower-than-normal energy, maculopapular rashes
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