Ask the Experts is one of our most popular destinations for healthcare professionals. Our experts provide clear, easy-to-understand answers to commonly asked questions about vaccines and their use.
In the RotaTeq clinical trials in the first week after any dose vaccine recipients had a small but statistically significant increased rate of diarrhea (18.1% in the RotaTeq group, 15.3% in the placebo group) and vomiting (11.6% in the RotaTeq group, 9.9% in the placebo group). During the 42-day period following any dose, statistically significantly greater rates of diarrhea, vomiting, otitis media, nasopharyngitis and bronchospasm occurred in RotaTeq recipients compared with placebo recipients.
In the Rotarix clinical trials, in the first week after vaccination, Grade 3 (i.e., those that prevented normal everyday activities) cough or runny nose occurred at a slightly but statistically higher rate in the Rotarix group (3.6 %) compared with placebo group (3.2%). During the 31-day period after vaccination, these unsolicited adverse events occurred at a statistically higher incidence among vaccine recipients: irritability (11.4% in Rotarix group, 8.7% in placebo group) and flatulence (2.2% in Rotarix group, 1.3% in placebo group).
In clinical trials of both vaccines the occurrence of intussusception was studied very carefully; see the separate question and answer on this topic.
Yes. Allergy to bee venom is not a contraindication for any vaccine.
There is currently no information on the effect of varicella vaccine on reactivity to a tuberculin skin test (TST). Until information is available, it is prudent to apply the same rules to varicella vaccine as are applied to MMR: a TST (i.e., PPD) may be applied before (preferably) or simultaneously with varicella vaccine. If vaccine has been given, delay the TST for at least 4 weeks.
No. Self-reported doses and history of vaccination provided by a parent or other caregiver are not considered to be valid. You should only accept a written, dated record as evidence of vaccination.
Either Trumenba (MenB-FHbp) or the Bexsero MenB vaccine brand (MenB-4C) may be used for people with HIV infection. People with HIV infection do not appear to be at higher risk for meningococcal serogroup B disease, and ACIP does not specify use of the 3-dose schedule for people with HIV. Booster doses of MenB are not recommended for people with HIV in the absence of another indication for MenB vaccination.
Penbraya (MenABCWY, Pfizer) is an option for people age 10 years and older only when both MenACWY and MenB (Trumenba) vaccines are due at the same visit and at least 6 months have elapsed since the most recent dose of Penbraya. An adolescent with HIV should receive a 2-dose primary MenACWY series (with the doses given 8 weeks apart), followed by MenACWY booster doses every 5 years. If this teen needs the MenACWY primary series vaccination and also chooses to receive Trumenba, Penbraya may only be used for one of the doses because dose 2 in the MenACWY primary series is due 8 weeks after dose 1 and the minimum interval between Penbraya doses is 6 months.
First, injectable influenza vaccines cannot cause influenza because they contain only parts of the virus. The live attenuated nasal spray vaccine is modified so that it cannot cause influenza because it cannot replicate at human body temperature. Fewer than 1% of vaccinated people might develop flu-like symptoms, such as mild fever and muscle aches, after vaccination. These vaccine side effects are not the same as having influenza, but people may confuse the side effects with illness.
Other reasons a person might have had influenza illness or an illness that they thought might be “the flu” after vaccination include:
Vaccine effectiveness (VE) varies by age and by season, depending upon the circulating viruses. In most recent seasons, influenza vaccination has reduced the risk of illness by between roughly 40% and 60% in the vaccinated population (including all ages) during seasons when most circulating influenza viruses are well-matched to the vaccine. VE is generally lower for adults age 65 years and older. Influenza vaccination has also been shown to reduce influenza disease severity even if someone does get sick after vaccination, and vaccination reduces the risk of influenza hospitalization and deaths in children and adults. Influenza vaccination also reduces the risk of stroke and acute cardiac events, like heart attack and heart failure, among people with heart disease.
For more information on this topic, go to: www.cdc.gov/flu-vaccines-work/index.html.
Many pregnant people will have a choice about whether to get Abrysvo during pregnancy or to immunize their infant with an RSV preventive antibody product after birth. Those who are previously unvaccinated and between 32 and 36 weeks 6 days’ gestation between September and January, may be vaccinated with Abrysvo or have their infant receive an RSV preventive antibody product soon after birth (preferably within the first week of life if born during a month when RSV preventive antibody product administration is recommended).
It is important to note that both Abrysvo RSV vaccine and RSV preventive antibody products may not be available or an option for all people in all settings. In some facilities or circumstances, only one option might be available: those offered Abrysvo during pregnancy may not wish to defer that option unless they are confident that an RSV preventive antibody product will be available for their infant. Conversely, if the pregnant person received RSV vaccine before the current pregnancy, only an RSV preventive antibody product administered after birth is recommended for RSV prevention. All infants up to 8 months 0 days of age whose mothers were not vaccinated may be given an RSV preventive antibody product when feasible, before or during their first RSV season.
The minimum interval between the two doses of Heplisav-B is 4 weeks. For the 3-dose series vaccines, Engerix-B, PreHevbrio (no longer available), and Recombivax HB, the minimum interval between the first and second doses is 4 weeks. The final dose of vaccine must be administered at least 8 weeks after the second dose and should follow the first dose by at least 16 weeks. Vaccine doses administered 4 or fewer days before the minimum interval or age are considered valid. Doses received 5 or more days before the minimum interval or age should be repeated using the correct schedule. Because of the unique accelerated schedule for Twinrix, the 4-day “grace period” does not apply to the first three doses of this vaccine when administered on a 0-, 7-, 21–30-day, and 12-month schedule.
CDC has a product-specific webpage for each COVID-19 vaccine (www.cdc.gov/vaccines/covid-19/info-by-product/index.html); however, at this writing the page has not been updated for the 2025–2026 Formula COVID-19 vaccines. You may access the package inserts for all four licensed 2025–26 COVID-19 vaccines on the Immunize.org COVID-19 main page: www.immunize.org/vaccines/a-z/covid-19/.
No. No additional doses of pneumococcal vaccine are recommended.
Do not restart the series or give additional doses. The previously administered doses of PCV13 are valid. Complete the pneumococcal conjugate vaccination series with either PCV15 or PCV20 in accordance with the routine schedule.
ACIP recommends meningococcal vaccination only for high-risk children younger than 11 years. ACIP defines high-risk children age 2 months and older as (1) those with persistent complement component deficiency (an immune system disorder) or who take a complement inhibitor (examples include eculizumab [Soliris], ravulizumab [Ultomiris], and sutimlimab [Enjaymo]), (2) those with functional or anatomic asplenia, (3) those with HIV infection, (4) those traveling to or residing in an area of the world where meningococcal disease is hyperendemic or epidemic or (5) those identified by public health officials as being at risk during a community outbreak attributable to a vaccine serogroup.
Menveo (MenACWY-CRM), in its two-vial formulation requiring reconstitution, is approved for children age 2 months and older; the one-vial formulation that does not require reconstitution may be administered to children age 10 years or older. MenQuadfi (MenACWY-TT) is approved for children age 2 years and older. Children at increased risk for meningococcal disease should receive booster doses as long as they remain at increased risk.
Use of either brand of MenB in persons younger than age 10 years is off-label in the U.S. There is no ACIP recommendation for use of this vaccine for this age group.
Bexsero (MenB-4C) has been studied among infants and is approved for infants by the European Medicines Agency (the European version of the U.S. Food and Drug Administration). It is routinely recommended for infants in the United Kingdom (see www.nhs.uk/vaccinations/menb-vaccine/ for details). A clinician may choose to use a vaccine off-label if, in their opinion, the benefit of the vaccine exceeds the risk from the vaccine.
ACIP does not specifically recommend eye protection when administering vaccines to prevent exposure to blood spatter.
In 2020, in response to the COVID-19 pandemic, CDC temporarily recommended the use of protective eyewear in areas where SARS-CoV-2 was circulating widely to reduce the risk of infection with SARS-CoV-2. In the current setting of widely available and effective COVID-19 vaccines and treatments, CDC has resumed recommending standard pre-pandemic infection control practices during vaccination.
What you do depends on when the error is identified. If the error is discovered while the person is still in the office, you can administer the other “half” of the Engerix-B dose. If the error is discovered later, the dose should not be counted. The person should be recalled to the office and given a full age-appropriate 1.0 mL repeat dose. The same recommendation would apply if the error was with Recombivax HB.
If administered vaccine is found to be stored at an inappropriate temperature, whether too cold or too warm, the provider should contact the state health department to determine whether the vaccine dose is invalid. If the vaccine dose is determined to be invalid, another dose should be given. This applies to both inactivated and live vaccines. If the damaged vaccine was a live virus vaccine (e.g., MMR, MMRV, VAR), you should wait at least 4 weeks after the previous (damaged) dose was given before repeating it. If the damaged vaccine was an inactivated vaccine, you can give the repeat dose on the same day you gave the damaged dose or at any other time, with one exception. The exception is Shingrix (herpes zoster vaccine), which should be repeated at least 28 days later due to the potential for increased side effects due to the chemical adjuvant it contains to enhance its effectiveness. If you prefer, you can perform serologic testing to check for immunity for certain vaccinations (e.g., measles, rubella, hepatitis A, diphtheria, varicella, and tetanus).
The Advisory Committee on Immunization Practice (ACIP) does not recommend zoster vaccination for immunocompetent people younger than age 50 years regardless of their history of shingles.
Yes. Vaccinated women still need to see their healthcare provider for periodic cervical cancer screening. The vaccine does not provide protection against all types of HPV that cause cervical cancer, so even vaccinated women will still be at a small risk for some cancers from HPV.
CDC began adding barcodes to VISs in 2012. The barcode is intended to save time and prevent documentation errors by allowing immunization providers to scan the name and edition date of the VIS, information required to be documented in the permanent record of immunization, into an electronic medical record, immunization information system, or other electronic database. Scanning the barcode instead of manually recording the information is optional but can be helpful.
Using 2D barcodes requires a 2D barcode scanner and software that is programmed to accept and process data contained in the VIS barcodes. Providers may continue to use any VISs without barcodes as long as the VIS content is otherwise the same. For more information about using barcodes, visit www.cdc.gov/vaccines/hcp/about-vis/barcodes-faq.html.
Yes. In this situation, a second dose of Tdap should be administered at the recommended age of 11 or 12 years.
Yes, unless the person is allergic to any of the vaccine components. HepA vaccination is safe and effective and is recommended for any person who wishes to obtain immunity.
Large pre-licensure clinical trials of both RotaTeq and Rotarix did not find an increased risk for intussusception among vaccine recipients. A large post-licensure study of more than 1.2 million rotavirus vaccine recipients found a very small increased risk of intussusception (1 to 1.5 additional cases of intussusception per 100,000 vaccinated infants) in the 7 to 21 days following the first dose. No increased risk of intussusception was found after the second or third doses. CDC and the Food and Drug Administration (FDA) continue to believe that the benefits of rotavirus vaccination outweigh the risks associated with vaccination and that routine vaccination of infants should continue.
A study conducted by the CDC Vaccine Safety Datalink (VSD) between May 2006 to February 2010 found no increased risk of intussusception following vaccination with RotaTeq. However, the study indicated an increased risk of intussusception following dose 1 and dose 2 of Rotarix. CDC estimates that there is a small increased risk of intussusception, usually within the first week after dose 1 or dose 2 of rotavirus vaccine, resulting in one additional case for every 20,000 to 100,000 U.S. infants who receive the vaccine.
In 2008, FDA licensed Kinrix, a combination DTaP and IPV vaccine. It is approved for use as the fifth dose of DTaP and the fourth dose of IPV in children ages 4 through 6 years who received DTaP (Infanrix) and/or DTaP-HepB-IPV (Pediarix) as the first three doses and DTaP (Infanrix) as the fourth dose. It should not be given to children younger than age 4 years.
Latex is a product of the rubber tree. It is processed and used in various products, including some that come in contact with vaccines. Latex may be present in syringe plungers, vial stoppers, or in the tip caps on prefilled syringes. Some people develop sensitivity to latex, particularly if they have had significant cumulative latex exposure, such as from repeated surgeries early in life or employment in the healthcare industry.
The most common type of latex sensitivity is contact-type allergy; however, on rare occasions, severe (anaphylactic) allergy occurs. People with a history of anaphylactic reactions to latex should generally not be given vaccines that have been in contact with natural rubber or latex, either in the vial or in the syringe, unless the benefit of vaccination outweighs the risk of a potential allergic reaction. People with latex allergies that are not anaphylactic in nature may be vaccinated as usual.
Adults without evidence of immunity and no contraindications to MMR vaccine can be vaccinated without testing. Only adults without evidence of immunity might be considered for testing for measles-specific IgG antibody, but testing is not needed prior to vaccination.
CDC does not recommend measles antibody testing after MMR vaccination to verify the patient’s immune response to vaccination.
Two documented doses of MMR vaccine given on or after the first birthday and separated by at least 28 days is considered proof of measles immunity, according to ACIP. Documentation of appropriate vaccination supersedes the results of serologic testing for measles, mumps, rubella, and varicella.
ACIP has made a series of changes in its recommendations for pneumococcal vaccination of adults since 2022 in response to the licensure of new pneumococcal conjugate vaccines (PCVs). In January 2022, CDC published recommendations for PCV15 (Vaxneuvance, Merck) and PCV20 (Prevnar 20, Pfizer) as pneumococcal vaccination options for all adults age 65 and older and for adults age 19 through 64 with certain medical conditions or other risk factors for pneumococcal disease. ACIP stopped recommending PCV13 (Prevnar 13, Pfizer) for adults; however, CDC clinical guidance allows for its use in rare circumstances if only PCV13 is accessible and the patient would otherwise be unvaccinated. When PCV15 is used routinely, it should be used in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23, Pneumovax, Merck) given one year later.
In June 2024, ACIP recommended PCV21 (Capvaxive, Merck) as an option in all situations where PCV is recommended for adults. As with PCV20, PPSV23 is not recommended following PCV21.
In October 2024, ACIP recommended that routine immunization of all adults with a PCV begin at age 50 years, rather than age 65 years. This change was made to address the substantial amount of preventable invasive pneumococcal disease (IPD) among adults age 50 through 64.
Adults 19 through 49 years eligible for pneumococcal vaccination as a result of a high-risk condition who have no or unknown history of PCV should receive one dose of PCV20 or PCV21 alone, or a dose of PCV15 followed by a dose of PPSV23 one year later (with a minimum interval option of 8 weeks for people with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak).
The current CDC guidance for the use of pneumococcal vaccines in adults are outlined in this job aid from CDC: www.cdc.gov/pneumococcal/downloads/Vaccine-Timing-Adults-JobAid.pdf.
Immunize.org has standing orders for pneumococcal vaccination of adults for all PCV options and PPSV23 (if indicated) at: www.immunize.org/catg.d/p3075.pdf.
Giving patients an influenza Vaccine Information Statement (VIS) is mandatory under the National Childhood Vaccine Injury Act of 1986. The VIS must be given to all adults as well as to parents or guardians of children prior to vaccination. Two VISs are available, one for live attenuated influenza vaccine (LAIV) and one for inactivated influenza vaccine (IIV) and recombinant vaccine (RIV). The IIV and RIV VIS and all of its translations are available here: www.immunize.org/vaccines/vis/influenza-inactivated/. The LAIV VIS and all of its translations are available here: www.immunize.org/vaccines/vis/influenza-live/. Current influenza vaccine VISs are dated August 6, 2021.
Immunize.org also offers a printable PDF document with QR codes for easy access to all of the IIV and RIV influenza vaccine VIS translations: www.immunize.org/wp-content/uploads/catg.d/p2092.pdf. Healthcare providers or recipients can scan the codes to access a digital copy of the translation on their mobile device.
Yes. VFC-eligible pregnant adolescents younger than age 19 may receive VFC-funded Abrysvo (Pfizer) RSV vaccine during pregnancy, if indicated, in VFC-participating facilities. Contact your state or territorial immunization program with questions about VFC and Abrysvo.
No, the dose should not be repeated. The Clinical Implications of Nonstandard Vaccination Practices subsection of the Vaccine Administration section of CDC’s General Best Practices for Immunization explains that the immune response to vaccines recommended to be administered by the subcutaneous route is unlikely to be affected if the vaccines are inadvertently administered by the intramuscular route. For this reason, repeating doses of vaccine administered by the intramuscular route when recommended by the subcutaneous route is not necessary. See this subsection here: www.cdc.gov/vaccines/hcp/imz-best-practices/vaccine-administration.html#cdc_report_pub_study_section_6-clinical-implications-of-nonstandard-vaccination-practices.
The third dose of Vaxelis (DTaP-IPV-Hib-HepB, MSP Company) administered at age 5 months (less than 24 weeks of age) is not considered a valid dose of the HepB component, because the last dose of HepB vaccine should be given at 24 weeks of age or older. The child will need an additional dose of HepB vaccine at age 24 weeks or older, and at least 4 weeks after the inadvertent dose of Vaxelis. The DTaP, IPV, and Hib components of the Vaxelis dose erroneously administered at age 5 months are considered valid doses and do not need to be repeated, as long as there was a minimum 4-week interval between the second and third doses of these three components.
CDC and ACIP recommend vaccination of all people age 6 months through 64 years based on individual decision-making (also known as shared clinical decision-making), with an emphasis that the risk-benefit of vaccination is most favorable for individuals who are at an increased risk for severe COVID-19 disease and lowest for individuals who are not at an increased risk, according to the CDC list of COVID-19 risk factors. Refer to CDC’s interim clinical considerations for COVID-19 vaccination for the specific dosing schedule: www.cdc.gov/covid/hcp/vaccine-considerations/routine-guidance.html#cdc_clinical_guidance_recomm_key-table-1-2025–2026-covid-19-vaccination-schedule-november-4-2025.
The American Academy of Pediatrics (AAP) has issued separate COVID-19 vaccination recommendations for children during the 2025–26 season. Refer to the full statement for details of their recommendations: https://doi.org/10.1542/peds.2025-073924. In summary, AAP recommends age-appropriate COVID-19 vaccination of the following groups of children:
Lowering the age for routine PCV use in adults from 65 to 50 years was intended to address the substantial burden of preventable invasive pneumococcal disease (IPD) and pneumococcal pneumonia in people age 50 through 64 years. Despite long-standing risk-based recommendations for pneumococcal vaccination of adults age 19 through 64 at increased risk of IPD, by 2022, just 23% of this target group had received at least one adult pneumococcal vaccination, according to CDC’s National Health Interview Survey. In addition, according to CDC surveillance data, by age 50, the rate of IPD among Black adults is higher than the rate in the general population of the United States by age 65. Finally, the newer PCV products protect against a substantially larger proportion of pneumococcal serotypes responsible for IPD in adults, compared to PCV13. ACIP members expressed their hope that expanding the simple age-based recommendation to give PCV at age 50 would increase access to and administration of PCV, especially among unvaccinated people at increased risk of IPD.
It is likely. Effectiveness of pneumococcal polysaccharide vaccine (PPSV23) begins waning significantly after about 5 years. While current pneumococcal conjugate vaccines (PCVs) are expected to remain effective longer than that, for at least several years, a future PCV dose may be needed by those vaccinated at younger ages to boost protection later in life. When ACIP voted to lower the routine PCV vaccination age to 50, the committee took into consideration that an additional dose, perhaps 10 or 15 (or more) years later, may be needed. In coming years, ACIP will periodically review any evidence of waning protection, evaluate future pneumococcal vaccine products, and make recommendations for revaccination of older adults when needed.
Quadracel (Sanofi) is a combination DTaP and IPV vaccine. It was approved by the FDA in 2015 for use in children 4 through 6 years of age as the fifth dose in the DTaP series, and as the fourth or fifth dose in the IPV series in children who have received 4 doses of Pentacel (DTaP-IPV-Hib, Sanofi) and/or Daptacel (DTaP, Sanofi) vaccine. It should not be given to children younger than age 4 years. CDC published a short MMWR article about Quadracel on September 4, 2015 (www.cdc.gov/mmwr/pdf/wk/mm6434.pdf, pages 948–9).
Even with appropriate equipment and temperature monitoring practices in place, power disruption can result in destruction of the entire vaccine supply. Precautions should always be taken to protect the storage unit’s power supply. CDC recommends the following best practices.
Include this information as well as what to do if a vaccine storage temperature excursion occurs in your facility’s emergency Standing Operating Procedures.
All people age 19 through 49 with the following medical conditions who have no history of pneumococcal vaccination or an unknown pneumococcal vaccination history should receive either a single dose of PCV20 or PCV21 alone or a dose of PCV15 followed by a dose of PPSV23 at least 1 year later. If using the PCV15 + PPSV23 series, clinicians can consider giving the dose of PPSV23 a minimum of 8 weeks later for more rapid protection against the serotypes unique to PPSV23 to people with immunocompromising condition, cochlear implant, or cerebrospinal fluid (CSF) leak. The conditions are:
For details of vaccination following hematopoietic stem cell transplantation, see www.cdc.gov/vaccines/hcp/imz-best-practices/altered-immunocompetence.html
Public health authorities working with Alaska Natives and American Indians may provide additional guidance for individuals in those communities where the overall risk of invasive pneumococcal disease is increased.
CDC publishes VISs in English only; all translations have been developed by others. To access all currently available VISs in dozens of languages, go to Immunize.org’s website at www.immunize.org/translations/.
Not all stoppers in vaccine vials contain latex. Some manufacturers have switched to synthetic rubber-like materials that do not contain rubber latex or dry natural rubber. The best approach is to check the package insert, which will indicate if the packaging contains latex. Also, remember that prefilled syringes could contain natural rubber in the plunger, in the needle cover, or in the tip cap. This information is also supplied in the package insert.
Yes, unless they have a contraindication to vaccination.
Any temperature reading outside the recommended range for vaccine storage is a temperature excursion. However, it is generally the total amount of time, or cumulative time, out of range that affects the viability of vaccine. Any time appropriate vaccine storage temperatures are in question, stop giving vaccinations and contact your state immunization program and/or the vaccine manufacturer for further guidance about whether or not a vaccine may be used. The CDC Storage and Handling Toolkit contains detailed guidance on the management of a temperature excursion. See www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf, pages 12–15. Additional information for COVID-19 and mpox vaccine temperature excursions is available in the addendum at the end of the toolkit.
Yes. HPV vaccine is recommended for all people through age 26 years, regardless of sexual orientation or gender identity.
Yes. The updated ACIP recommendations for the use of Tdap vaccine state that Tdap or Td may be used in any situation where Td only was previously recommended. The updated guidelines are available at www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6903a5-H.pdf.
All children should receive 2 doses of HepA vaccine beginning at age 1 year (i.e., 12–23 months). The 2 doses in the series should be administered at least 6 months apart. Any child age 2 through 18 years not previously vaccinated should be vaccinated. For a copy of the ACIP recommendations on hepatitis A, go to www.cdc.gov/mmwr/volumes/69/rr/pdfs/rr6905a1-H.pdf.
Both vaccines should be stored at refrigerator temperature and protected from light. Do not administer the vaccine if it has been frozen or exposed to freezing temperatures.
Yes, Dengvaxia may be given at the same visit with any live or non-live vaccines that are also indicated for the patient.
If Dengvaxia is not administered on the same day as another live vaccine, the two vaccines should be separated by at least 4 weeks to minimize the potential risk of interference.
Yes. Although it is preferable to use the same manufacturer’s DTaP vaccine for all of the doses in the series, you can give either Kinrix or Quadracel as the fifth dose of DTaP and fourth dose of IPV at age 4 through 6 years if the previous brand is unknown or if Kinrix or Quadracel is the only product stocked.
Live varicella vaccine should not be given to anyone known to be pregnant. If a person who is planning to become pregnant in the future comes in for a visit or an annual exam, the varicella history should be obtained and if indicated, 2 doses of vaccine should be given, spaced 4 to 8 weeks apart. Vaccine recipients capable of becoming pregnant should be counseled to avoid pregnancy for one month following each dose of varicella vaccine. A person who is inadvertently vaccinated while pregnant or becomes pregnant within a month of vaccination should be counseled about the theoretical risk to the fetus; however, it should not be considered a reason to terminate a pregnancy. Pregnant people should be assessed for evidence of varicella immunity and if non-immune, should receive the first dose of varicella vaccine following completion of the pregnancy and prior to hospital discharge. A second dose should be given 4 to 8 weeks later.
A history of having had measles is not sufficient evidence of measles immunity. A positive serologic test for measles-specific IgG will confirm that the person is immune and is not at risk of infection regardless of the multiple myeloma. Multiple myeloma is a hematologic cancer and is considered immunosuppressive so MMR vaccine is contraindicated in this person.
ACIP recommends that microbiologists who work with meningococcal isolates in a laboratory receive both MenB and MenACWY vaccines. MenB can be given at the same time as any other vaccine. For accelerated protection, you can administer a 3-dose series of Bexsero (MenB-4C) or Trumenba (MenB-FHbp) on a 0-, 1–2-, and 6-month schedule. If dose 2 is delayed and administered 6 months or longer after dose 1, the primary series is complete.
Because protective antibody levels begin to wane within 1–2 years after completing the primary series, ACIP recommends a booster dose of MenB one year after completing the primary series, followed by a booster dose every 2–3 years thereafter, as long as risk remains. MenB vaccine brands work differently and are not interchangeable. All doses, including booster doses, should be of the same type (either MenB-FHbp or MenB-4C). If the primary series type is not known or is not available, restart the primary series with the available brand.
Microbiologists may receive a dose of MenABCWY (Penbraya, Pfizer) as an alternative to separate administration of MenACWY and MenB (MenB-FHbp, Trumenba) when both vaccines would be given on the same clinic day and at least 6 months have elapsed since most recent Penbraya dose.
The most important factor in preventing outbreaks is annual vaccination of all residents and staff who work at facilities such as nursing homes, assisted living facilities, and other group living situations. Groups that should be targeted include physicians, nurses, and other personnel working or volunteering in hospitals and outpatient settings who have contact with high-risk patients in all age groups, and providers of home care to high-risk people (for example, visiting nurses, therapists, and volunteers).
Hib vaccination is contraindicated for individuals known to have experienced a severe allergic reaction (anaphylaxis) to a vaccine component or following a prior dose. Hib-containing vaccines are contraindicated for children younger than 6 weeks of age because of the potential for development of immunologic tolerance. The PedvaxHIB vial stopper contains dry natural rubber which could produce an allergic reaction in children with severe allergy to latex.
Vaccination should be delayed for children with moderate or severe acute illnesses. Minor illnesses, such as a mild upper respiratory infection are not a reason to delay vaccination.
Contraindications and precautions for the use of Pentacel (DTaP-IPV/Hib) and Vaxelis (DTaP-IPV-Hib-HepB) are the same as those for their individual component vaccines.
An Emergency Use Authorization (EUA) fact sheet for vaccine recipients and caregivers is provided to a vaccine recipient (or caregiver) when FDA allows the use of an unapproved vaccine during a public health emergency. For information about EUAs for vaccines, see www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained. The manufacturer prepares an EUA fact sheet for healthcare providers (in place of the package insert found in licensed and approved vaccines), and an EUA fact sheet for recipients and caregivers that informs the recipient, to the extent possible, of the potential benefits and risks of the vaccine, that the recipient has the option to refuse or accept the vaccine, and any available alternatives to the vaccine. An EUA fact sheet should be provided to the recipient before administration and documented in the shot record, as is done with a VIS, when a vaccine is administered under EUA conditions.
Yes. Menveo (MenACWY-CRM) or MenQuadfi (MenACWY-TT) may be given simultaneously with PCV or at any interval before or after receipt of PCV.
You can locate information on latex in vaccine packaging in the package insert for the vaccine. All package inserts for vaccines licensed in the United States are available from FDA at: www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states.
Disposable syringes are meant for administration of vaccines, not for storage. CDC recommends that vaccines that have been drawn into syringes by the provider be discarded at the end of the clinic day if unused. Manufacturer-filled syringes that have not been activated (i.e., have not had the needle guard removed or a needle attached) may be kept and used until their expiration date. A manufacturer-filled syringe does not contain a preservative to help prevent the growth of microorganisms. Once the sterile seal has been broken, the vaccine should be used or discarded by the end of the workday.
ACIP recommends that patients needing prophylaxis against tetanus always be given either Td or Tdap rather than TT, as long as there is no contraindication to the other vaccine components. If it’s already been given and the person had not yet received Tdap as an adolescent or adult, you should make certain that he gets Tdap as soon as feasible. If he had received Tdap previously, he can wait until the next scheduled booster dose is due to get his routine Td or Tdap booster.
No. You do not need to expel the air pocket. The air will be absorbed. This is not true for syringes that you fill yourself; you should expel air bubbles from these syringes prior to vaccination to the extent that you can do so.
People with a reliable history of varicella can be considered to be immune. A reliable history for healthcare personnel consists of (1) a healthcare provider’s diagnosis of varicella or verification of history of varicella disease; (2) a healthcare provider’s diagnosis of herpes zoster or verification of a history of herpes zoster; or (3) laboratory evidence of immunity or laboratory confirmation of disease. Immunity following disease or vaccination is probably life-long. More than one primary infection with varicella is unusual.
No. The minimum interval between dose #1 and #2 of HepA vaccine is 6 calendar months, not 24 weeks.
You should continue where the patient left off and complete the series. You never have to restart the series.
Studies indicate that immunologic memory remains intact for at least 30 years and confers protection against clinical illness and chronic HBV infection, even though anti-HBs levels that once measured adequate might become low or decline below detectable levels. If exposed to HBV, people whose immune systems are competent will mount an anamnestic response and develop protective anti-HBs. Studies are on-going to assess whether booster doses of HepB will be needed in the future.
