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Ask the Experts

December 02, 2015
We see many patients with multiple co-morbidities (COPD, heart disease, diabetes, dialysis, etc.). Which influenza vaccine should we give to this patient population?

 

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November 25, 2015

It has just come to my attention that the plumbers working for our plumbing contractor receive hepatitis A vaccine because of their exposure to sewage. Is this a CDC recommendation?   

 

 

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September 01, 2015

I was taught that gloves should be worn when giving vaccines. Other nurses say that this is not necessary. Which is correct?

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August 25, 2015

Should international travelers receive both meningococcal conjugate vaccine and meningococcal serogroup B vaccine? 

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August 19, 2015

Can teens receive Vaccines For Children (VFC) vaccines without a parent being present? 

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August 04, 2015

An adult patient had a bone marrow transplant and had previously received a Tdap vaccine. The oncologist recommended another dose of Tdap. Is this acceptable in this situation? 

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July 28, 2015

A healthy child received only one dose of pneumococcal conjugate vaccine (PCV) at age 10 months. She is now 6 years old. Our state requires one dose of PCV13 after the first birthday for school attendance. Her physician says because she is older than 59 months, she does not need another dose of PCV. What should we do in this situation?

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July 21, 2015

A physician ordered a 40-µg dose of hepatitis B vaccine for a hemodialysis patient. The clinic does not stock the Recombivax HB (40 µg/dose) formulation and would like to give 2 adult doses of Engerix B (20 µg/dose) for each dose in the series. Is this acceptable?

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July 14, 2015

We have a child who received the second dose of hepatitis A vaccine 3 months after the first dose. A repeat dose (dose #3) was given 4 months after the (invalid) second dose. Both dose #2 and dose #3 appear to be invalid because the intervals were less than 6 months. Should this child receive a fourth dose of hepatitis A vaccine? 

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July 07, 2015

If a patient began the human papillomavirus (HPV) vaccine series with 4-valent HPV vaccine (4vHPV, Gardasil, Merck), can the series be completed with 9-valent HPV vaccine (9vHPV; Gardasil 9)? Should a booster dose of 9vHPV be given to persons who have already completed the 4vHPV series? 

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June 30, 2015

Does a patient living in the U.S. who has documentation of having had meningococcal vaccine at age 2 and 5 years in Saudi Arabia still need to have doses at ages 11–12 years and age 16 years or are the previous doses sufficient?  

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June 23, 2015

Is it necessary for us to record the actual date that the Vaccine Information Statement (VIS) was provided or can it be assumed that the VIS was provided on the day the shot was given?

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June 18, 2015

An 8-year-old child received three doses of oral polio vaccine before his first birthday. Should he receive an additional dose of inactivated poliovirus vaccine (IPV)? 

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June 09, 2015

Should a male postpone receiving the MMR vaccine if he and his spouse are trying to conceive? 

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June 02, 2015

An infant is going to be traveling internationally before turning one year of age, but is not scheduled to travel for a few months. Do we need to wait to vaccinate with MMR vaccine until some point closer to departure? 

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May 26, 2015

Can MMR, varicella, and hepatitis A vaccines be given to a child whose mother is hepatitis C positive?  

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May 20, 2015

For an adult who experienced probable thrombocytopenic purpura after one dose of MMR as a child, it is my understanding that they should not receive MMR vaccine. Is this correct? This person has a positive serology for mumps and rubella but not measles. 

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May 12, 2015

How effective are the current pertussis vaccines and do they provide any protection against parapertussis? 

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May 05, 2015

A 60-year-old patient will be starting corticosteroid therapy. He will start at 20 mg per day for 4 days, and then taper to 15 mg for 3 weeks. He will continue therapy for a year, but the dosing will change depending on his response. Should I administer zoster vaccine now or wait until he is taking a lower dose of corticosteroids? And if the patient should wait, what dose of corticosteroids would be safe for administration of the shingles vaccine? 

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April 28, 2015

If MMR vaccine is given at 9 months of age, it will not count as the first dose. Is this because immunity at this age may not develop?

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April 21, 2015

I have heard concerns from individuals who are undergoing chemotherapy about being exposed to a child who recently received MMR vaccine. Is there a risk for the vaccinated child to transmit vaccine virus to the chemotherapy patient? 
 

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April 14, 2015

In regard to the current measles outbreak, some people are saying that children who have not had the vaccine should pose no threat to vaccinated people. It is my understanding that during an outbreak, vaccinated people can still contract it. Am I correct?  

 

 

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April 07, 2015

If an infant got a dose of the adult formulation of hepatitis B vaccine in error, should the dose be counted? When should the next dose be scheduled for this infant? Do we need to be concerned about a possible adverse event?

 

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March 31, 2015
I have a female patient who has a history of immune thrombocytopenia and had a splenectomy as treatment. This patient responded to the treatment. She is not currently on medication for this condition. How long after a splenectomy should a person wait before they get an MMR vaccination? 
 

 

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March 25, 2015

I need information about the administration of vaccines to 3-month-old conjoined twins (joined at the buttocks). The mother states that a hepatitis B vaccine was given at birth but there is no record of this. For their routine immunization, do we provide one set of vaccinations or two, given that they are conjoined at the buttock but share no major organs?

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March 17, 2015

Can varicella vaccine be used as postexposure prophylaxis for a 9-month-old who was exposed to herpes zoster?

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March 13, 2015

We have a 63-year-old patient who states she had tetanus as a child. She does not know whether she ever had any tetanus-containing vaccines in her lifetime. Should Tdap be given to this patient, and is it safe? 

 

 

 

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March 03, 2015
A patient born in 1970 has a history of measles disease and is also immunosuppressed due to multiple myeloma. The patient wants to travel to California, but is concerned about the measles outbreak. Should the patient receive the MMR vaccine? 
 

 

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February 24, 2015
We received a call from a healthcare provider who inadvertently administered MMR vaccine to a woman who was 2 months pregnant. Please advise as to appropriate action steps. 

 

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February 17, 2015

How does being born before 1957 confer immunity to Measles?​

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February 09, 2015

A pediatric surgeon's 12-month-old child received the varicella vaccine and two days later developed a varicella-like rash. The surgeon had chickenpox as a child and had a positive varicella titer several years ago. Is it okay for the surgeon to continue to see patients? Also, is the varicella virus in the rash that develops following vaccination as virulent as the wild-type virus?

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