Author Question: A 4 -year-old child who has been receiving high-dose systemic glucocorticoids for several months ... (Read 89 times)

jCorn1234 · **on:** Jul 23, 2018

A 4 -year-old child who has been receiving high-dose systemic glucocorticoids for several months comes to a clinic for school immunizations, which usually include the DTaP vaccine;

varicella virus vaccine (Varivax); the measles, mumps, and rubella virus (MMR) vaccine; and the inactivated poliovirus vaccine (IPV). The clinic nurse will expect to administer which vaccines to this child?
a. All four school immunizations
b. DTaP and IPV only
c. DTaP, OPV, and Varivax only
d. DTaP and IPV, along with immunoglobulins

Question 2

The parents of an infant who will be attending day care tell the nurse that they do not want their child vaccinated against rotavirus because an older cousin developed intussusception after receiving this vaccine.

Which response by the nurse is correct?
a. Intussusception is much less serious than getting the disease.
b. It was probably just a coincidental reaction to the vaccine.
c. The newer vaccines for rotavirus are not associated with intussusception.
d. Your child will have herd immunity and won't need the vaccine.

CourtneyCNorton · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Children who are immunocompromised should not receive live virus vaccines, including the MMR vaccine and Varivax. Children taking high-dose systemic glucocorticoids are immunocompromised and should not receive the vaccine until therapy is stopped and normal glucocorticoid production returns. The oral polio vaccine (OPV) contains live virus and is contraindicated. Immunoglobulins are not indicated unless children are exposed to the diseases themselves.

Answer to Question 2

ANS: C
The rotavirus vaccine product RotaShield was withdrawn because of the high rate of intussusception associated with it. The two products currently on the marketRotaTeq and Rotarixdo not carry a risk for intussusception. Intussusception can be life threatening, so telling parents it is less serious than the disease is incorrect. Intussusception was not merely a coincidental reaction. Herd immunity is not guaranteed.