Vaccine
Indication/Recommendations
Schedule
Contraindications/Precautions
Dosing/Administration
MMR-‐II
Contraindications:
Pts
b orn
i n
1 957
o r
l ater
( especially
i f
b orn
o utside
Give
1
o r
2
d oses
d epending
o n
LIVE
V ACCINE
•
•
•
the
U S)
s hould
r eceive
a t
l east
1
d ose
o f
M MR
i f
indication
Previous
a naphylactic
r eaction
t o
t his
0.5
m L
S UB-‐Q
•
•
Measles,
there
i s
n o
l ab
e vidence
o f
i mmunity
o r
vaccine
o r
t o
a ny
o f
i ts
c omponents
Store
i n
F REEZER
•
st
Mumps,
documentation
o f
a
d ose
g iven
o n
o r
a fter
t he
1
If
g iving
2
d oses,
s hould
s eparate
including
g elatin
o r
n eomycin
•
Rubella
birthday
by
a t
l east
4
w eeks
Pregnancy
o r
t he
p ossibility
o f
To
R econstitute:
•
HIGH
R ISK
P ATIENTS-‐
s hould
r eceive
2
d oses
pregnancy
w ithin
4
w eeks
6.
Withdraw
t he
e ntire
•
Healthcare
p ersonnel
( Paid,
U npaid,
Within
7 2
h rs
o f
m easles
e xposure,
Severe
i mmunodeficiency
volume
o f
d iluent
i nto
o
•
•
Volunteer)
give
1
d ose
a s
p ostexposure
Hematologic
a nd
s olid
a
s yringe
o
Students
e ntering
c ollege
a nd
o ther
p ost-‐
prophylaxis
t o
s usceptible
a dults
tumors
7.
Inject
a ll
o f
t he
o
high
s chool
e ducational
i nstitutions
Receiving
C hemo
diluent
i n
t he
s yringe
o
International
t ravelers
If
2
o r
m ore
l ive
v accine
a re
t o
b e
g iven
Congenital
into
t he
v ial
o f
o
o
Pts
b orn
b efore
1 957
a re
u sually
c onsidered
(FluMist,
M MR,
V aricella,
Z oster,
Immunodeficiency
lyophilized
v accine
•
immune,
b ut
e vidence
o f
i mmunity
( serology
o r
and/or
Y ellow
F ever)
t hey
s hould
b e
Long-‐term
8.
Gently
a gitate
t o
m ix
o
documented
h istory
o f
2
d oses
o f
M MR)
s hould
b e
given
o n
t he
s ame
d ay
O R
s paced
a part
immunosuppressive
t herapy
thoroughly
–
p roduct
considered
f or
h ealthcare
p ersonnel
by
a t
l east
2 8
d ays
Severely
s ymptomatic
H IV
should
b e
c lear
y ellow
o
in
c olor
Women
o f
c hildbearing
a ge
w ho
d o
n ot
h ave
•
Note:
R outine
p ost-‐vaccination
NOTE:
H IV
i nfection
i s
N OT
a
9.
Withdraw
t he
e ntire
acceptable
e vidence
o f
r ubella
i mmunity
o r
serologic
t esting
i s
n ot
r ecommended.
contraindication
t o
M MR
f or
t hose
w ho
contents
i nto
a
n ew
vaccination
s hould
r eceive
v accine
are
n ot
s everely
i mmunocompromised
( i.e.
syringe
IF
p regnant
w oman
i s
f ound
t o
b e
r ubella
•
CD4
≥
2 00)
10. Inject
t he
t otal
susceptible,
g ive
1
d ose
o f
M MR
p ostpartum
volume
( about
0 .5
Precautions:
mL)
s ub-‐q
i nto
o uter
aspect
o f
u pper
a rm
Moderate
o r
s evere
a cute
i llness
•
(preferred
s ite)
If
b lood,
p lasma,
a nd/or
i mmune
•
globulin
w ere
g iven
i n
t he
p ast
1 1
months,
s ee
a dditional
A CIP
If
n ot
u sed
i mmediately,
guidelines
may
s tore
v accine
v ial
i n
History
o f
t hrombocytopenia
o r
•
dark
p lace
3 6
–
4 6
°
F
f or
thrombocytopenic
p urpura
up
t o
m ax
o f
8
h ours
Note:
I f
T B
t est
a nd
M MR
a re
b oth
n eeded
but
n ot
g iven
o n
t he
s ame
d ay,
d elay
T B
test
f or
4
t o
6
w eeks
a fter
M MR
Gardasil
Contraindications:
All
p reviously
u nvaccinated
w omen
t hrough
a ge
2 6
3
d oses
a t
0 ,
2 ,
a nd
6
m onths
0.5
m L
I M
•
•
•
Previous
a naphylactic
r eaction
t o
t his
Consider
g iving
H PV4
t o
m en
t hrough
a ge
2 6
t o
Must
b e
a t
l east
4
w eeks
b etween
•
•
•
HPV
reduce
t heir
l ikelihood
o f
a cquiring
g enital
w arts
dose
1
a nd
2
vaccine
o r
t o
a ny
o f
i ts
c omponents
If
p ossible
u se
t he
s ame
including
y east,
a morphous
a luminum
product
f or
a ll
3
d oses
Must
b e
a t
l east
1 2
w eeks
•
hydroxyphosphate
s ulfate,
o r
between
d ose
2
a nd
3
polysorbate
8 0
Overall,
m ust
b e
a t
l east
2 4
w eeks
•
between
d ose
1
a nd
3
Precautions:
Moderate
o r
s evere
a cute
i llness
•
Pregnancy-‐
d ata
i s
l imited
s o
d elay
•
until
a fter
c ompletion
o f
t he
pregnancy
References:
A ll
i nformation
i s
f rom
e ither
t he
C DC
w ebsite
o r
t he
i ndividual
p roduct
p ackage
i nserts.