# Immunization Station

<div align="left" dir="ltr" id="bkmrk-age-immunization-2-m"><table border="1" style="border-collapse: collapse; width: 100%; height: 326px;"><thead><tr style="height: 29px;"><td style="width: 17.916738%; height: 29px;">**Age**

</td><td style="width: 82.202452%; height: 29px;">**Immunization**

</td></tr></thead><tbody><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**2 months**

</td><td style="width: 82.202452%; height: 35px;">**[Vaxelis (DTaP-IPV/HepB/Hib)](#bkmrk-vaxelis-%28dtap-ipv%2Fhe), [Vaxneuvance (PCV15)](#bkmrk-vaxneuvance-%28pcv15%29), [RotaTeq (RV5)](#bkmrk-rotateq-%28rv5%29)**

</td></tr><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**4 months**

</td><td style="width: 82.202452%; height: 35px;">**[Vaxelis (DTaP-IPV/HepB/Hib)](#bkmrk-vaxelis-%28dtap-ipv%2Fhe), [Vaxneuvance (PCV15)](#bkmrk-vaxneuvance-%28pcv15%29), [RotaTeq (RV5)](#bkmrk-rotateq-%28rv5%29)**

</td></tr><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**6 months**

</td><td style="width: 82.202452%; height: 35px;">**[Vaxelis (DTaP-IPV/HepB/Hib)](#bkmrk-vaxelis-%28dtap-ipv%2Fhe), [Vaxneuvance (PCV15)](#bkmrk-vaxneuvance-%28pcv15%29), [RotaTeq (RV5)](#bkmrk-rotateq-%28rv5%29), [flu (eligible)](#bkmrk-flu-vaccine)**

</td></tr><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**12 months**

</td><td style="width: 82.202452%; height: 35px;">**[M-M-R II](#bkmrk-m-m-r-ii-%28measles%2C-m), [Varivax (Varicella)](#bkmrk-varivax-%28varicella%29), [Vaqta (Hep A)](#bkmrk-vaqta-%28hep-a%29)**

</td></tr><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**15 months**

</td><td style="width: 82.202452%; height: 35px;">**[Vaxneuvance (PCV15)](#bkmrk-vaxneuvance-%28pcv15%29), [Pentacel (DTaP-IPV/Hib)](#bkmrk-pentacel-%28dtap-ipv%2Fh)**

</td></tr><tr style="height: 35px;"><td style="width: 17.916738%; height: 35px;">**18 months**

</td><td style="width: 82.202452%; height: 35px;">**[Vaqta (Hep A)](#bkmrk-vaqta-%28hep-a%29)**

</td></tr><tr style="height: 29px;"><td style="width: 17.916738%; height: 29px;">**4 years**

</td><td style="width: 82.202452%; height: 29px;">**[ProQuad (MMR &amp; Varicella)](#bkmrk-proquad-%28mmr-%26-varic), [Quadracel (DTaP-IPV)](#bkmrk-quadracel-%28dtap-ipv%29)**

</td></tr><tr style="height: 29px;"><td style="width: 17.916738%; height: 29px;">**11 years**

</td><td style="width: 82.202452%; height: 29px;">**[Adacel (Tdap)](#bkmrk-adacel-%28tdap%29), [Menquadfi (ACWY)](#bkmrk-menquadfi-%28meningoco), [Gardasil (HPV) ](#bkmrk-gardasil-%28hpv%29)**

</td></tr><tr style="height: 29px;"><td style="width: 17.916738%; height: 29px;">**16 years**

</td><td style="width: 82.202452%; height: 29px;">**[Menquadfi (ACWY)](#bkmrk-menquadfi-%28meningoco), [Trumenba (Meningococcal B)](#bkmrk-trumenba-%28meningococ)**

</td></tr></tbody></table>

</div>---

## **Adacel (Tdap)**

- **Number of doses:** 1 dose (booster) at 11–12 years old, then every 10 years.
- **Spacing:**
    - Administer at least 5 years after the last tetanus-containing vaccine.
- **Major teaching:**
    - Protects against tetanus, diphtheria, and pertussis.
    - Critical for adolescents and adults to prevent pertussis transmission to infants.
    - May cause mild pain or swelling at the injection site.

---

## **Gardasil (HPV)**

- **Number of doses:**
    - 2 doses (6–12 months apart) for individuals starting at age 11–12 and under 15 years.
    - 3 doses (0, 1–2, and 6 months) for individuals ≥15 years or immunocompromised.
- **Spacing:**
    - Ensure a minimum interval of 5 months between the first and last doses.
- **Major teaching:**
    - Protects against HPV-related cancers and genital warts.
    - Most effective when given before exposure to HPV.
    - May cause fainting; observe adolescents for 15 minutes post-vaccination.

---

## **M-M-R II (Measles, Mumps, Rubella)**

- **Number of doses:** 2 doses (at 12–15 months and 4–6 years).
- **Spacing:**
    - Minimum interval: 4 weeks between doses.
- **Major teaching:**
    - Live vaccine; avoid in immunocompromised individuals or during pregnancy.
    - May cause mild fever or rash 1–2 weeks after vaccination.
    - Critical for preventing measles outbreaks.

---

## **Menquadfi (Meningococcal ACWY)**

- **Number of doses:** 2 doses (at 11–12 years and 16 years).
- **Spacing:**
    - At least 8 weeks between doses if additional doses are required for high-risk individuals.
- **Major teaching:**
    - Protects against meningococcal disease (ACWY serogroups).
    - Recommended for college students living in dormitories.
    - May cause mild soreness at the injection site.

---

## **Pentacel (DTaP-IPV/Hib)**

- **Number of doses:** 4 doses (at 2, 4, 6, and 15–18 months).
- **Spacing:**
    
    
    - Minimum interval of 4 weeks between doses in the primary series (2, 4, and 6 months).
    - Booster dose at 15–18 months, spaced at least 6 months after the third dose.
- **Major teaching:**
    
    
    - Combines protection against 5 diseases: diphtheria, tetanus, pertussis, polio, and *Haemophilus influenzae* type b (Hib).
    - Reduces the number of injections needed at each visit.
    - Common side effects include mild fever, irritability, and injection site redness/swelling.
    - Ensure parents are aware of the importance of completing the series for full protection against these diseases.

---

## **ProQuad (MMR &amp; Varicella)**

- **Number of doses:** 2 doses (at 4–6 years and earlier if needed).
- **Spacing:**
    - Minimum interval of 3 months between doses.
- **Major teaching:**
    - Combines MMR and Varicella for convenience.
    - Live vaccine; avoid in pregnancy or severe immunosuppression.
    - Mild rash or fever may occur.

---

## **Quadracel (DTaP-IPV)**

- **Number of doses:** 1 dose at 4–6 years.
- **Spacing:**
    - Must be spaced at least 6 months after the previous DTaP-IPV dose.
- **Major teaching:**
    - Protects against diphtheria, tetanus, pertussis, and polio.
    - Booster dose completes the series before entering school.

---

## **RotaTeq (RV5)**

- **Number of doses:** 3 doses (at 2, 4, and 6 months).
- **Spacing:**
    - Minimum interval of 4 weeks between doses.
    - Final dose must be administered before 8 months of age.
- **Major teaching:**
    - Protects against severe rotavirus gastroenteritis.
    - Oral vaccine; no injection required.
    - Common side effects include mild diarrhea or fussiness.

---

## **Trumenba (Meningococcal B)**

- **Number of doses:** 2 doses (0 and 6 months apart).
- **Spacing:**
    - A 3-dose schedule (0, 1–2, and 6 months) may be recommended for certain high-risk groups.
- **Major teaching:**
    - Protects against meningococcal B disease, which can cause rapid and severe infections.
    - Recommended for individuals 16–23 years old, especially those in high-risk settings (e.g., college campuses).

---

## **Vaqta (Hep A)**

- **Number of doses:** 2 doses (at 12 months and 18 months).
- **Spacing:**
    - At least 6 months between doses.
- **Major teaching:**
    - Protects against hepatitis A, a liver infection spread by contaminated food/water.
    - Common side effects include mild injection site soreness.

---

## **Varivax (Varicella)**

- **Number of doses:** 2 doses (at 12–15 months and 4–6 years).
- **Spacing:**
    - Minimum interval of 3 months between doses.
- **Major teaching:**
    - Live vaccine; avoid in pregnancy or severe immunosuppression.
    - Mild rash or fever may occur 1–2 weeks after vaccination.

---

## **Vaxelis (DTaP-IPV/HepB/Hib)**

- **Number of doses:** 3 doses (at 2, 4, and 6 months).
- **Spacing:**
    - Minimum interval of 4 weeks between doses.
- **Major teaching:**
    - Protects against six diseases (diphtheria, tetanus, pertussis, polio, hepatitis B, and Haemophilus influenzae type b).
    - May cause mild fever, soreness, or swelling at the injection site.

---

## **Vaxneuvance (PCV15)**

- **Number of doses:** 4 doses (at 2, 4, 6, and 15 months).
- **Spacing:**
    - Minimum interval of 4 weeks between primary doses.
    - Booster dose recommended at least 8 weeks after the 3rd dose.
- **Major teaching:**
    - Protects against 15 serotypes of *Streptococcus pneumoniae*, which can cause pneumonia, meningitis, and bacteremia.
    - May cause mild fever or irritability post-vaccination.

---

## **Flu Vaccine**

### **FluMist (Live Attenuated Influenza Vaccine - LAIV4)**

- **Type:** Live attenuated vaccine administered intranasally.
- **Age indications:** Approved for healthy individuals aged 2–49 years.
- **Effectiveness:** Comparable to the flu shot in most years but may vary depending on the season and strains.
- **Contraindications:**
    - Children &lt;2 years or adults ≥50 years.
    - Pregnant individuals.
    - Immunocompromised individuals or close contacts of severely immunocompromised individuals (e.g., bone marrow transplant patients in protective isolation).
    - Children 2–4 years with asthma or wheezing in the past 12 months.
    - Severe allergy to any FluMist component.
- **Major teaching:**
    - Avoid in individuals taking aspirin or salicylate-containing medications due to the risk of Reye's syndrome.
    - Mild side effects include runny nose, sore throat, or headache.

### **Flu Shot (Inactivated Influenza Vaccine - IIV4)**

- **Type:** Inactivated vaccine administered via intramuscular injection.
- **Age indications:** Approved for individuals 6 months and older, including pregnant individuals and those with chronic health conditions.
- **Effectiveness:** Provides broad protection against circulating influenza strains; updated yearly to match predicted strains.
- **Contraindications:**
    - Severe allergy to any flu shot component, including egg protein (though egg-free formulations are available).
- **Major teaching:**
    - Common side effects include mild soreness or swelling at the injection site, low-grade fever, or fatigue.
    - Safe for individuals with chronic medical conditions or weakened immune systems.
    - For children &lt;9 years receiving the flu vaccine for the first time, 2 doses are required at least 4 weeks apart.

**Key Differences:**

<table id="bkmrk-aspect-flumist-%28nasa"><thead><tr><th>Aspect</th><th>**FluMist (Nasal Spray)**</th><th>**Flu Shot (Injection)**</th></tr></thead><tbody><tr><td>**Type of Vaccine**</td><td>Live attenuated</td><td>Inactivated</td></tr><tr><td>**Route of Administration**</td><td>Nasal spray</td><td>Intramuscular injection</td></tr><tr><td>**Age Range**</td><td>2–49 years</td><td>6 months and older</td></tr><tr><td>**Pregnancy Safe?**</td><td>No</td><td>Yes</td></tr><tr><td>**Immunocompromised Use?**</td><td>No</td><td>Yes</td></tr><tr><td>**Common Side Effects**</td><td>Runny nose, sore throat, headache</td><td>Soreness, redness, low-grade fever</td></tr></tbody></table>