HY lecture notes:
There are some 2020 updates to mention for the vaccine schedule (HY for FM and peds shelves, as well as 2CK in general).
I’ll write out the schedule in timeline form first, followed by when to administer per organism (depending on whichever you find easier to digest).
Bear in mind persons with special circumstances (i.e., immunodeficiency, asplenia, living in endemic area, etc.) will receive a modified schedule, but the below is the normal vaccine schedule assessed on USMLE and shelves.
Normal vaccine schedule by timeline
At birth:
- Hepatitis B
At 2, 4, 6 months (3 doses total):
- Hepatitis B (new 2020 guidelines: skip at 4 months; so give at birth, 2 months, and 6 months)
- Strep pneumo PCV13
- Rotavirus (oral; live-attenuated)
- Polio (Salk; IM killed)
- TDaP (tetanus, diphtheria, pertussis)
- Haemophilus influenzae type B
At 1 year:
- Strep pneumo (4th dose)
- Haemophilus influenzae type B (4th dose)
- MMRV (mumps, measles, rubella, varicella; 1st dose)
- Hepatitis A (1st dose)
At 18 months:
- Hepatitis A (2nd dose)
- TDaP (4th dose)
At 4-6 years:
- TDaP (5th dose)
- Polio (4th dose)
- MMRV (2nd dose)
Age 9-45:
- HPV (2 doses if first given age 9-14; 3 doses if first given age 15+)
School age 11-13:
- TDaP (6th dose)
- Meningococcal (1st dose)
School age 16:
- Meningococcal (2nd dose)
Vaccines by organism
HepB: birth, 2 + 6 months (3 doses)
Rotavirus (oral; live-attenuated): 2, 4, 6 months (3 doses)
Polio (Salk; IM killed): 2, 4, 6 months; 4-6 years (4 doses)
Strep pneumoniae PCV13: 2, 4, 6 months; 1 year (4 doses)
Haemophilus influenzae type B: 2, 4, 6 months; 1 year (4 doses)
Tetanus, diphtheria, pertussis (TDaP): 2, 4, 6 months; 18 months; 4-6 years; 11-13 years (6 doses)
Hepatitis A: 1 year; 18 months (2 doses)
Mumps, measles, rubella, varicella (MMRV): 1 year; 4-6 years (2 doses)
HPV: 9-45 years (2 doses if first given age 9-14; 3 doses if first given age 15+)
Meningococcal: 11-13 years; 16 years (2 doses)
Special notes
Influenza
- Two options: either killed (IM) or live-attenuated (intranasal)
- Only give in fall or winter (if they say, e.g., April, the answer is don’t give)
- Give IM killed starting at age 6 months, then every year (annually)
- Live-attenuated may be given annually in the fall or winter only to non-pregnant, non-immunocompromised persons age 2-49
Strep pneumoniae (additional administrations)
- Give one dose of PCV13 to all persons age 65, then PPSV23 6-12 months later.
- To patients with asplenia, sickle cell, and cochlear implants, give PPSV23 6-12 months after last dose of PCV13.
Shingles (herpes zoster; VZV)
- Give at age 60.
