Snapshot A 54-year-old man presents to her primary care physician for a worsening productive cough. His cough began approximately 2 months ago, and over the past week, he has been producing more yellow sputum. Medical history is significant for chronic obstructive pulmonary disease. He drinks occasionally and smokes 1-pack per day for the past 35 years. The patient is started on broad-spectrum antibiotics and receives 23-valent pneumococcal polysaccharide vaccine (PPSV23) due to his current cigarette use and chronic lung disease. Introduction Definition login to view 1 more bullet Terminology login to view 8 more bullets Vaccinations in Children (0-6 Years of Age) Vaccinations in Children Vaccine Age Comments Hepatitis B First dose within the first 24 hours of life Second dose at 1-2 months of age Third dose at 6-18 months of age Subunit vaccine In HBsAg-positive mothers, the infant should receive the hepatitis B vaccine and hepatitis B immune globulin Rotavirus First dose at 2 months Second dose at 4 months Third dose at 6 months Live-attenuated vaccine Can increase risk for intussusception Diphtheria, tetanus, and/or pertussis First dose at 2 months Second dose at 4 months Third dose at 6 months Fourth dose at 15-18 months Fifth dose at 4-6 years of age Booster doses are given starting at 11 years of age Inactivated vaccine H. influenzae type b conjugate First dose at 2 months Second dose at 4 months Third dose at 12-15 months Inactivated vaccine Pneumococcal conjugate (PCV 13) First dose at 2 months Second dose at 4 months Third dose at 6 months Fourth dose at 12-15 months Inactivated vaccine Poliovirus First dose at 2 months Second dose at 4 months Third dose at 6-18 months Fourth dose at 4-6 years Inactivated vaccine Influenza Annually ≥ 6 months of age Intramuscular vaccine is an inactivated vaccine Intranasal vaccine is a live-attenuated vaccine Measles, mumps, and rubella First dose at 12-15 months Second dose at 4-6 years of age Live-attenuated vaccine Varicella First dose at 12-15 months Second dose at 4-6 years of age Live-attenuated vaccine Hepatitis A First dose at 12-24 months Second dose given at least 6 months after the first dose Inactivated vaccine Vaccinations in Adolescents (7-18 Years of Age) Vaccinations In Adolescents Vaccine Age Comments Tetanus, diphtheria, acellular pertussis (Tdap) 11-12 years of age Inactivated vaccine Human papillomavirus Two doses at 9-14 years of age in patients between the ages of 9-14, the 2 dose are administered 6-12 months after the first dose Three doses at ≥ 15 years of age given at 0, 1-2, and 6 months Subunit vaccine Three doses of this vaccine are also recommended in immunocompromised adolescent patients Meningococcal First dose at 11-12 years of age Second dose at 16 years of age Inactivated vaccine Influenza First dose given at 7-10 years of age and then annually Intramuscular vaccine is an inactivated vaccine Intranasal vaccine is a live-attenuated vaccine Vaccinations in Adults (> 18 Years of Age) Vaccinations in Adults Vaccine Age Comments Influenza One dose annually Inactivated vaccine In HBsAg-positive mothers, the infant should receive the hepatitis B vaccine and hepatitis B immune globulin Tetanus, diphtheria, acellular pertussis (Tdap) or tetanus and diphtheria (Td) One dose Tdap and then a Td booster every 10 years In pregnant women, 1 dose of Tdap should be given during each pregnancy between 27-36 weeks gestation Varicella Two doses 4-8 weeks apart if the patient is without immunity to varicella Zoster Two doses given 2-6 months apart at ≥ 50 years of age Pneumococcal (PPSV23) Given at least 1 year after PCV13 administration in adults ≥ 65 years of age PPSV23 is indicated in - patients 19-64 years of age with the following chronic heart disease (excluding hypertension) chronic liver disease chronic lung disease diabetes mellitus cigarette smoking - patients ≥ 19 with immunodeficiency disorders HIV anatomical or functional asplenia chronic renal failure or nephrotic syndrome cerebral spinal fluid leak cochlear implant PPSV23 is given after PCV13 PPSV23 is not conjugated and does not stimulate a helper T-cell response Special Circumstances Splenectomy login to view 11 more bullets HIV login to view 2 more bullets Patients with an egg allergy login to view 2 more bullets Pregnancy login to view 7 more bullets Prematurity login to view 2 more bullets