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| As appeared in the June 2010 of Vaccinate Adults |
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Click here for PDF version |
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| Q: |
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Instead of giving
tetanus/diphtheria toxoid and acellular pertussis (Tdap) vaccine
to a father-to-be who needed protection against pertussis, we
mistakenly gave him tetanus/diphtheria (Td) toxoid. How soon after
the Td dose can we give him the dose of Tdap he needs? |
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| A: |
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As long as they are younger than
age 65 years and at least age 10 years, parents, grandparents,
healthcare workers, and all others who have not already received
Tdap, and who are close contacts of infants younger than age 12
months, should receive a single dose of this vaccine as soon as
possible to protect infants from pertussis. When giving Tdap to
protect infants, one does not need to observe a "minimum interval"
between giving Td and Tdap. For example, if you had immediately
realized that you had mistakenly given the father-to-be Td instead
of Tdap, you could have given him the needed Tdap dose at the same
visit at which you gave him the erroneous Td dose. |
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| Q: |
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CDC recommendations
state that the minimum intervals for human papillomavirus (HPV)
vaccination are at least 4 weeks between doses #1 and #2, and at
least 12 weeks between doses #2 and #3. This adds up to a total of
16 weeks between doses #1 and #3. But the recommendations also say
that there must be a minimum of 24 weeks between doses #1 and #3.
This doesn't make sense to me. |
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| A: |
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When administering HPV vaccine,
you must meet ALL the minimum intervals. For example, if you give
dose #2 at the minimum interval of 4 weeks after dose #1, you must
wait 20 weeks to give dose #3 in order to meet the 24-week minimum
interval between #1 and #3. Determination of these minimum
intervals was based on extensive discussion with the manufacturers
and on data from the HPV clinical trials. |
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| Q: |
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We mistakenly gave
a patient the diluent for Menveo meningococcal conjugate vaccine
(MCV4; Novartis) without adding it to the powdered vaccine. Since
vaccine is present in the diluent as well as in the powder, what
should we do now? |
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| A: |
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Menveo's liquid vaccine component
(i.e., diluent) contains the C, Y, and W-135 serogroups, and the
lyophilized vaccine component (i.e., freeze-dried powder) contains
serogroup A. Because the patient received only the diluent, he or
she is not protected against invasive meningococcal disease caused
by Neisseria meningitidis serogroup A.
Invasive disease with N.
meningitidis serogroup A is very rare in the United States; it is
more common in some other countries, particularly the African
meningitis belt. If the patient who received only the C-Y-W135
diluent does not plan to travel outside the United States, the
dose does not need to be repeated. However, if the patient plans
to travel outside the United States, the dose should be repeated
with either correctly reconstituted Menveo, or with a dose of
Menactra brand (sanofi pasteur) MCV4. There is no minimum interval
between the incorrect dose and the repeat dose. |
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We now have two
meningococcal conjugate vaccines (MCV4) to chose from—Menactra
(sanofi pasteur) and Menveo (Novartis). It
would be useful to know if they are interchangeable when repeat
doses of MCV4 are needed. |
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| A: |
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Although both vaccines are
licensed for single-dose use, you can use either vaccine to
revaccinate people ages 11 through 55
years who are at prolonged increased risk for meningococcal
disease. Only Menactra is licensed for vaccinating children ages
2 through 10 years. Use only meningococcal polysaccharide vaccine
(MPSV4; Menomune; sanofi pasteur) when vaccinating or
revaccinating people age 56 years and older.
To access updated recommendations for revaccinating people at
prolonged increased risk for meningococcal disease, go to:
www.cdc.gov/mmwr/PDF/wk/mm5837.pdf, and see pages 1042–43. |
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| Q: |
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If an adult or
child has not had documented chickenpox but has had shingles, is
varicella vaccination recommended? |
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| A: |
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No. Shingles is caused by
varicella zoster, the same virus that causes chickenpox. A history
of shingles based on a
healthcare provider diagnosis is evidence of immunity to
chickenpox. Therefore, a person who has had shingles does not need
to be vaccinated against varicella. He/she should still receive
zoster vaccine, however, if it is not contraindicated and
he/she is age 60 or older. |
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Click here for PDF version |
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Immunization Action Coalition • 1573 Selby Ave • St. Paul, MN 55104 |
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tel 651-647-9009 • fax 651-647-9131 |
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 5U38IP000290) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC. |
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