Special CME Issue - West Virginia State Medical Association

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Table 1. Recommendations for Routine Immunization of Children 0-8 Years of Age Vaccine VIRUS VACCINES Code Number of Doses First Dose at Age Additional Doses at Ages Hepatitis B HepB 3 Birth 1-2m, 6-18m Notes Give HBIG within 12h of birth if Mother HbsAg positive Hepatitis A HepA 2 12-23 m 12-23m Two doses at least 6m apart Influenza, seasonal Flu 2 6m-8y At least 4w after first dose First year receiving vaccine 1 Over 8y Annually Administer one dose each Fall Measles, mumps, rubella MMR 2 12-15m 4-6y Can give second dose before 4y if at least 4 weeks between two doses Poliovirus, inactivated IPV 4 2 m 4m, 6-18m, 4-6y Final dose on or after 4y of age Rotavirus RV 3 2 m 4m, 6m Varicella Var 2 12-15m 4-6y BACTERIAL VACCINES Diphtheria, tetanus, pertussis DTap 5 2m 4m, 6m, 12- 18m, 4-6y Haemophilus influenza type b Hib 4 2m 4m, 6m, 12-15m No dose at 6m if Rotarix given at 2 and 4m Age 12m-12y need at least 3m between doses Need at least 6m between 2 nd and 3 rd doses No dose at 6m if PedVaxHIB or Comvax given at 2 and 4m Meningococcal MCV4 1 2-6y 2-6y High risk only Pneumococcal PCV13 4 2m 4m, 6m, 12-15m Complete PCV7 series with PCV13 Rotavirus What’s new: There are now two approved vaccines, RV5 and RV1, both live oral vaccines and about 74-87% effective at preventing the disease. Intussusception is not increased in recipients. Before vaccine, four of five children experienced rotavirus infection by age 5 and this illness accounted for 30-50% of hospitalizations among this age group. 4 RV5, a live oral vaccine, shows 98% effectiveness in preventing severe disease. RV1 appears to have similar rates of efficacy. RV1 has latex in the applicator and should not be administered to persons with latex allergy. RV5 is latex-free. Ethical issues about vaccines Parents who deny vaccines for their children, except for specific medical conditions confirmed by a physician, fail to act in the best interests of their children, religious beliefs notwithstanding. Physicians have an ethical responsibility to address their reasons for refusal and explain the risk and benefit. School districts in every state require routine immunizations of children before they start kindergarten, an important ethical prevention program. Some parents who refuse vaccines for their children, especially MMR, may worry that the vaccines cause autism. Unfortunately, that relationship was fostered by one group of researchers from the UK who published falsified data for personal gain. 13 Subsequently, several studies provided evidence that refuted autism as an adverse event of immunization with MMR vaccine. 14 26 West Virginia Medical Journal
Table 2. Recommendations for Routine Immunization of Adults Vaccine VIRUS VACCINES Code Number of Doses Age Range for Immunization Notes Hepatitis B HepB 3 All adults at high risk 19 years and older, especially health care persons Administer 2 nd dose 1 month later; 3rd dose at least 2 months after 2 nd Hepatitis A HepA 2 All adults at high risk19 years and older including travelers to countries with high endemicity Two doses at least 6m apart Influenza, seasonal Flu 1 All adults 19 years and older Annual immunization 1or 2 19-49 years if unvaccinated Persons who lack immunity Measles, mumps, rubella MMR 1 50 years and older if unvaccinated Persons who lack immunity Human papillomavirus HPV 3 Women 13-26 years, Men 9-26 years HPV4 Administer 2 nd dose 1-2 months later and 3 rd dose 6 months after 2 nd dose Zoster HZ 1 50 years and older Administer to persons who have or have not had shingles Varicella VZV 2 BACTERIAL VACCINES 19 years and older if unvaccinated or otherwise lack immunity Persons who lack immunity Diphtheria, tetanus, pertussis Td, Tdap 1 19 to 64 years 1 65 years and older 1-time dose of Tdap, Td vaccine every 10 y 1-time dose of Tdap Td vaccine every 10 y Meningococcal MCV4 1 or 2 55 years and younger 1 or 2 doses for pre-college students and booster every 5 years for high risk adults MPSV4 1 56 years and older Single dose Pneumococcal PPV23 1 or 2 1 dose before age 65 years for high risk adults; 1 dose for all adults over 65 years Second dose should be at least 5 years after first dose and after age 65 years THE ART, SCIENCE AND ETHICS OF PREVENTION | Vol. 108 27
Page 2 and 3: ServingOrtho:GKad 4/10/12 3:54 PM P
Page 5: contents Volume 108, No. 3 Special
Page 8 and 9: President’s Message Ethics and Ra
Page 10 and 11: Special Issue Commentary Losing the
Page 12 and 13: Special Issue Commentary A Tale of
Page 14 and 15: Commentary Article | Special Issue
Page 16 and 17: Falls and Dilemmas in Injury Preven
Page 18 and 19: Table 1. Demographics and Location
Page 20 and 21: Table 3. Injury Distributions Diagn
Page 22 and 23: 1993-2003 and 2001-2005. MMWR Morbi
Page 24 and 25: Immunizations for Adults and Childr
Page 26 and 27: Figure 1. Cumulative cases of selec
Page 30 and 31: Recently, the US Court of Federal C
Page 32 and 33: Screening Children for Hyperlipidem
Page 34 and 35: Figure 1. Proportion of “yes” r
Page 36 and 37: espect to specific patient populati
Page 38 and 39: Interdisciplinary Treatment of Adol
Page 40 and 41: can be prescribed at mealtime to su
Page 42 and 43: medicine and psychiatry, WVU psycho
Page 44 and 45: Possible Prevention and Treatment o
Page 46 and 47: vigorous activity could slow the pr
Page 48 and 49: substantially reduce cancer-related
Page 50 and 51: Using Health Information Technology
Page 52 and 53: Table 1. Meaningful Use Objectives
Page 54 and 55: platform on which more advanced dat
Page 56 and 57: small group practices, if the effor
Page 58 and 59: Extraskeletal Effects of Vitamin D:
Page 60 and 61: Cancer risk is decreased when level
Page 62 and 63: directly associated with insulin se
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Page 67 and 68: to psychiatrists or psychiatric nur
Page 69 and 70: to treatment, and facilitates a ref
Page 71 and 72: Ear, Nose and Throat Medical and Su
Page 73 and 74: Table 1. Meta-analysis of mammograp
Page 75 and 76: Table 3. Breast Self Exam and Clini
Page 77 and 78: lowered women’s stroke risk (RR 0
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What’s Good for Them Is Good for
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concern regarding the opinions of p
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captured, possibly underestimating
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Table 1. Summary of Medicare Covere
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homosexual men, and residents of in
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specifically discussed above and li
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Lifestyle modification is an often
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4. Varkey E, Cider A, Carlsson J, L
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seven randomized trials comparing s
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References 1. Alzheimer’s Associa
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found to occur in 80% of fatal ATV
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Table 3. Injury Patterns of Helmete
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can promote and contribute to these
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SPECIAL WESPAC SUPPLEMENT 2012 Supr
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West Virginia Medical Insurance Age
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Marshall University Joan C. Edwards
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West Virginia University Healthcare
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Please copy and fax both pages to C
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| Classified Ads Medical Oncologist
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WV Prevention Research Center Putti
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West Virginia Medical Journal P.O.
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Special CME Issue - West Virginia State Medical Association

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