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A 1-year-old child is brought to the clinic for a routine child health examination. His parents have been very compliant and have not missed any of his other health maintenance visits. He is a healthy child with no significant past medical history. Thus far, he has received the following vaccines (at the appropriate times): inactivated polio (IPV) 3 times, diphtheria/tetanus/acellular pertussis (DTaP) 3 times, hepatitis B (hep B) 3 times, haemophilus influenza type B (Hib) 3 times, and Pneumococcal conjugate (PCV) 3 times. At this time you should administer
A. DTaP, Hib, MMR, varicella
B. DTaP, IPV, varicella, PCV
C. DTaP, MMR, varicella, PCV
D. Hib, MMR, varicella, PCV
E. IPV, Hib, MMR, PCV
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Posts: 3,675,934
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Posts: 3,675,934
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Joined: Sep 2021
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Posts: 3,675,934
Threads: 734,342
Joined: Sep 2021
Reputation:
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Posts: 3,675,934
Threads: 734,342
Joined: Sep 2021
Reputation:
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Posts: 3,675,934
Threads: 734,342
Joined: Sep 2021
Reputation:
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Posts: 3,675,934
Threads: 734,342
Joined: Sep 2021
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The correct answer is D. Thus far this patient is up to date on his vaccines. The two live vaccines, MMR and the varicella vaccine, are not recommended for use before the first birthday, but should be given the first time the child sees the doctor after 12 months of age. The MMR then requires a booster dose between the ages of 4 and 6. If the varicella vaccine is given at less than 13 years of age, no booster is needed. PCV is a newer vaccine that is now recommended for all children between the ages of 2 and 23 months. If started at 2 months, the series consists of 3 primary vaccines, at 2, 4, and 6 months with a booster dose between 12 and 15 months of age. The primary series of Hib consists of 3 shots at 2, 4, and 6 months of age with a booster at 12-15 months. Although some formulations of the Hib vaccine require only 2 shots in the primary series (at 2 and 4 months of age), no matter what formulation is used, the booster dose must be given no earlier than 12 months of age, a minimum of 2 months after the previous dose.
DTaP, Hib, MMR, varicella (choice A) is not correct because this child is not due for DTaP at this time. The primary series for DTaP consists of 3 shots; 2 mo, 4 mo, and 6 mo. The first booster is given at 15 months of age and a minimum of 6 months must have elapsed between the third and fourth. Another booster is given at 4-6 years of age. After that time, the child should receive Td booster starting at 11-12 years of age and every 10 years thereafter.
DTaP, IPV, varicella, PCV (choice B) is not correct because he is not due for DTaP or IPV at this time.
DTaP, MMR, varicella, PCV (choice C) is incorrect because he is not due for DTaP at this time.
IPV, Hib, MMR, PCV (choice E) is incorrect because this child has already received 3 doses of IPV. IPV is given at 2 months, 4 months, and between 6 and 18 months. Another booster is not required until the child is between 4 and 6 years of age.
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