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EXPRESS
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Stay current! Every week, IAC Express is delivered directly to your email box. It features important immunization developments, such as the latest vaccine recommendations and licensures, important journal articles, practical vaccination resources, conference announcements, and more.
READ CURRENT ISSUE: IAC Express Special Edition
Ask the Experts: CDC Experts Answer Your Questions
Issue 1321: August 17, 2017
The following questions and answers have all been published previously as a Question of the Week in 2017 issues of IAC Express.
IAC extends thanks to our experts: Andrew T. Kroger, MD, MPH; Candice L. Robinson, MD, MPH; Raymond A. Strikas, MD, MPH, FACP, FIDSA; Donna L. Weaver, RN, MN; and Jessie Wing, MD, MPH, all from the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC).
Dtap/Tdap/Td Vaccines
Q: Is there any contraindication to administering Tdap vaccine and Rhogam at the same time to a pregnant woman?
Q: Mom comes in with her 19-month-old. She reports that her (the mother's) sibling has a history of a severe reaction to pertussis vaccine in the mid-1990s. Now mom is reluctant to give her child pertussis vaccine although the child received Pediarix (DTaP-HepB-IPV, GlaxoSmithKline) 2 months ago without incident. Should we be concerned about the mother's family history of a severe reaction to pertussis vaccine?
Q: A dose of Kinrix (DTaP-IPV; GSK) should have been administered to a 4-year-old, but Pentacel (DTaP-IPV/Hib; Sanofi Pasteur) was administered instead. Does the dose of DTaP count?
Q: Are there recommendations for administering Tdap when Td is not available?
Q: If a person received a Tdap vaccine and then had a positive pertussis PCR two weeks later, could it be a false positive from the vaccine or should we consider this a case of pertussis? The patient had a cough, nausea, and vomiting for 2–3 days prior to PCR testing.
Q:  A 7-year-old has a history of 3 doses of DTaP, appropriately spaced, between 4 years and 6 years of age. Is her DTaP series complete?
Q: Tenivac Td (Sanofi Pasteur) for adults is expected to be unavailable until the second half of 2017. Another Td vaccine produced by MassBiologics is available at our wholesaler, but it looks like the components are slightly different from Tenivac. Are the two products interchangeable during the shortage?
Q: My 11-year-old patient received a dose of Tdap when he was 7 years old. He also received a dose of Td 6 months later in order to finish a primary series of tetanus-toxoid. Can I give him a dose of Tdap now?
Q: A 16-year-old refugee's record indicates 2 doses of Td separated by 1 month and 1 dose of Tdap given 4 months after the second Td. The first Td was given at age 16 years. Is he up to date?
Pneumococcal Vaccines
Q: Is systemic lupus erythematosus (SLE, lupus) a risk-based indication for pneumococcal vaccines?
Q: We have a 45-year-old patient taking Mesalamine for ulcerative colitis. Should he receive PCV13 and/or PPSV23?
Rabies Vaccines
Q: A patient recently exposed to a bat received the rabies vaccine series. One of the doses was given in the gluteus. Does this dose count?
Varicella Vaccine
Q: I have a patient who is 62 years old and is immigrating to the U.S. She received a dose of zoster vaccine 2 months ago. The immigration requirements state she should receive 2 doses of varicella vaccine. Does she need additional varicella vaccine?
Zoster Vaccine
Q: For our "Mother's Day Out" program, one of the teachers has shingles. The program serves moms of 2-month-olds to 4-year-olds. All children are up to date with their vaccinations, but some are too young to have received varicella vaccine. Is it safe for the teacher to work?
Q: My healthy 29-year-old son recently had a mild episode of herpes zoster. He has no underlying medical problems. He was treated with famcyclovir. Should he now get zoster vaccine?
Precautions and Contraindications
Q: I had an 18-year-old in the clinic today for varicella vaccination. He reports having antiphospholipid syndrome being treated with rituximab (a drug that affects the function of B lymphocytes). The next dose of rituximab will be in 2 weeks. He has also had 12 immune globulin (IG) injections in the last year. Should he get the varicella vaccine at all with this condition, and if so, what time frame do we need to be concerned with in relation to the rituximab treatment and/or IG?
Scheduling Vaccines
Q: If a child falls behind on immunizations, is it recommended to use only minimum intervals to get the child caught up? Or should we use a minimum interval for the same vaccine only once?
Vaccine Safety
Q: Why are zoster, pneumococcal polysaccharide (PPSV23) and meningococcal serogroup B (MenB) vaccines not covered by the National Vaccine Injury Compensation Program?
 
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