2 month vaccination question

Specialties NP

Published

So I see that at the age of 2 months, there are 6 vaccinations that are due. Do we have to prescribe all 6 on the same day? I feel that it's too much vaccination for just one visit. Do they need to be separated by a few days?

Here is the immunization schedule: https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

You do realize they are combination vaccines on the market? Theycombine up to five different ones. For the two months vaccine most of the time it's like Pediarix so you're combining either HepB or Hib With polio & DtaP. and then Rotavirus is oral. No you don't want to have them come back another day they will be delayed will never be on time. You want to give the vaccines at every opportunity that you can you'll never have them up-to-date. Look up pediarix, kinrix, proquad, pentacel.

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Specializes in ICU + Infection Prevention.
I feel that it's too much vaccination for just one visit.

Is this emotion backed by evidence? How many antigens are they exposed to day to day?

If you look back to your immunology, you'll recall that if you don't administer a recommended combined/simultaneous vaccinations, you need to consider minimum intervals vs response/seroconversion rates. Otherwise you might have to redose!

4 weeks might be the interval depending:

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/genrec.pdf

This minimal interval is key in vaccinations that use multiple spaced doses of the same antigen, although there might be exceptions during accelerated (catch up) schedules and during outbreaks.

Remember the cost to the patient is much higher and compliance much lower if you space those vaccines out over 6 visits.

Good references:

Ask the Experts: Scheduling Vaccines

http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf

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Specializes in Med-Surg.

Babies are seen at 1 week, 1 month, 2 months, 4 months 6 months, 9 months, 1 year. At each of these visits several vaccines are giving. Most of which are series that need to be giving so far apart and on time.

Do you think that a parent is going to bring their baby in every couple of days or so at the two month mark to spread out shots and then again at 4 months and 6 months and so on. Its never going to happen. If you scare parents about getting shots based on the recommended schedule I would think they would be more likely to just refuse them all together. If the vaccines weren't safe to give together they wouldn't be scheduled together.

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No I didn't know. I am a recent Family Nurse Practitioner (FNP) grad and we only had 4 case studies for pediatrics. Thanks for telling me about this. I will look them up.

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You do realize they are combination vaccines on the market? Theycombine up to five different ones. For the two months vaccine most of the time it's like Pediarix so you're combining either HepB or Hib With polio & DtaP. and then Rotavirus is oral. No you don't want to have them come back another day they will be delayed will never be on time. You want to give the vaccines at every opportunity that you can you'll never have them up-to-date. Look up pediarix, kinrix, proquad, pentacel.

No I didn't know. I am a recent Family Nurse Practitioner (FNP) grad and we only had 4 case studies for pediatrics. Thanks for telling me about this. I will look them up.

Up Vote Up Vote ×
Is this emotion backed by evidence? How many antigens are they exposed to day to day?

If you look back to your immunology, you'll recall that if you don't administer a recommended combined/simultaneous vaccinations, you need to consider minimum intervals vs response/seroconversion rates. Otherwise you might have to redose!

4 weeks might be the interval depending:

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/genrec.pdf

This minimal interval is key in vaccinations that use multiple spaced doses of the same antigen, although there might be exceptions during accelerated (catch up) schedules and during outbreaks.

Remember the cost to the patient is much higher and compliance much lower if you space those vaccines out over 6 visits.

Good references:

Ask the Experts: Scheduling Vaccines

http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf

Lol no my emotions are not evidence-based! I just graduated from the Family Nurse Practitioner (FNP) program and am trying to figure things out. I will search for a helpful guideline on this.

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Babies are seen at 1 week, 1 month, 2 months, 4 months 6 months, 9 months, 1 year. At each of these visits several vaccines are giving. Most of which are series that need to be giving so far apart and on time.

Do you think that a parent is going to bring their baby in every couple of days or so at the two month mark to spread out shots and then again at 4 months and 6 months and so on. Its never going to happen. If you scare parents about getting shots based on the recommended schedule I would think they would be more likely to just refuse them all together. If the vaccines weren't safe to give together they wouldn't be scheduled together.

I completely agree with you. I haven't found a good source on the recommendation of vaccines except for the CDC vaccine chart. If you find a good guideline please let me know. I'm a new Family Nurse Practitioner (FNP) grad trying to figure things out.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
No I didn't know. I am a recent Family Nurse Practitioner (FNP) grad and we only had 4 case studies for pediatrics. Thanks for telling me about this. I will look them up.

What were your clinicals for your practicum for pediatrics consisting of? It's concerning that you're referencing only for case studies for pediatrics. Look at the ACIP (advisory committee on immunization practices) for more information.

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What were your clinicals for your practicum for pediatrics consisting of? It's concerning that you're referencing only for case studies for pediatrics. Look at the ACIP (advisory committee on immunization practices) for more information.

I did my rotations at a family practice center. But we did not have many pediatric patients. We had one a day on average. I do remember now that we did administer some combination vaccines.

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Specializes in NICU, Trauma, Oncology.

This is kinda scary. Stick with the evidence based schedule set forth by the CDC.

Also, even though it is 6 vaccines at 2 months. It's only 2 sticks (1 in each thigh) and an oral solution (rotavirus).

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Specializes in NICU, Trauma, Oncology.

Getting patients in the clinic once is hard enough. Trying to get them to come back several times is a great way to lose them to follow up and have them be left unvax'd.

The body is exposed to millions of new antigens everyday. 6 vaccines is proven safe and effective.

If the vaccines must be split for any reason. You do the inactive vax first then 2 weeks later the live vax. You must wait 4 weeks after giving any live vax or Ig to give another vax. This is what we learn in pharmacology 1 in nursing school. I am very concerned that you are an FNP that doesn't have this foundational knowledge.

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