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Re: Adult Vaccinations From: Anna Meenan, MD (annam@uic.edu) Tue Dec 13 07:43:30 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ainsron: "Re: Interesting weekend part 2" Previous message: Rita Kucmierz: "Re: Adult Vaccinations" In reply to: Charlie Chambers: "Adult Vaccinations" You might want to download one of my absolute favorite PDA applications called Shots 2005 (soon to be updated to Shots 2006, I'm sure). It's freeware and can be found at http://www.immunizationed.org. Brought to you by the friendly folks at the Society of Teachers of Family Medicine. Comes with pretty colored charts of when to give immunizations, and when you tap on the name of the actual immunization, you can pull up indications, contraindications, dosing schedule, catch-up schedule, etc. It has a chart for adult imms also. According to the chart, adults born after 1957 need one dose of MMR, with a second one a month later if they are a college student, a healthcare worker, planning on travelling internationally, or are exposed to measles. You can get her started on her tetanus series anytime, but since she's never been immunized, you should probably give her the new Tdap, which contains acellular pertussis vaccine that is now approved and recommended for older children and adults, due to the waning immunity from childhood imms, and the fact that adults are now becoming a reservoir for pertussis, endangering newborns who are too young to have received the whole series yet. The recommendation is to give a single dose of Tdap, followed by a Td booster one month later, and a second Td booster 6 months after that. Tdap is OK to give after the first trimester. (Tdap info not in Shots 2005 yet. I assume it will be in Shots 2006.) Don't forget Varivax when you give the MMR after delivery, unless she has a known history of having had chicken pox. You can also start her Hep B series anytime. Initial dose, one month later, and 6 months later. In any vaccine series, the recommended intervals are minimum intervals. If someone is late for a dose, even if by a matter of years, the series should be continued where left off, never restarted. -- Anna Meenan, MD P.S. Has anyone noticed the new feature on the web archive of the List? Certain words (such as "pregnant" in Charlie's post), are underlined ad colored green, and when you click on them, you get a link to a commercial site (in this case "pilates for pregnancy" at E-Bay). Amazing. At Mon, 12 Dec 2005, Charlie Chambers wrote: > >Came across something that stumped me today. I have a pregnant >patient who had no vaccinations as a child. Obviously, after delivery >she'll need a postpartum rubella. We had figured we'd go ahead and >give her a MMR. The question becomes does she need to have series? >And if so, what's the timing? > >Thanks > >************************************************************************ >* > >-- >************************************************************************ >Charlie Chambers >Hood River, OR >cchamber@alumni.rice.edu > >"No matter where you go... > there you are." >Dr. Buckaroo Banzai >************************************************************************ > >************************************************************************ > Next message: ainsron: "Re: Interesting weekend part 2" Previous message: Rita Kucmierz: "Re: Adult Vaccinations" In reply to: Charlie Chambers: "Adult Vaccinations"

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