Clerkship Ready: Pediatrics

Before You Counsel on Vaccines

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Providing vaccines is one of the most important health promotion activities that we do. However, it involves much more than just putting in the orders for the various vaccines. In this podcast episode, we will briefly review how vaccines work, the types of vaccines, what you need to do before the visit, what you should review with families before ordering the vaccines (including precautions and contraindications), and anticipatory guidance about vaccines. We will also talk a little bit about how to handle vaccine hesitancy.

  1. List of pediatric vaccines
  2. How vaccines work
    1. Harmless piece of the pathogen that is enough to create immune response
    2. Explaining how vaccines work to parents
      1. Emphasis on protecting the community, not just one person
      2. Analogy of vaccine being like a software update
      3. Analogy of vaccine being like a flame retardant that stops a fire from spreading
      4. Analogy of vaccine being like an insecticide that stops bugs from spreading
      5. Types of vaccines
        1. Live, attenuated vaccines – cannot be given to patients with immunocompromise
        2. Vaccines without live, attenuated pathogen – includes mRNA vaccines
        3. RSV vaccines
          1. Vaccine for older adults and pregnant adults
          2. Monoclonal antibody for infants
          3. What you need to do before the visit
            1. Review the vaccine record
            2. Review the medical record for vaccine contraindications
            3. What you should review with families before ordering the vaccines (including precautions and contraindications)
              1. Current or recent illness
              2. Allergies
              3. Problems with vaccines in the past
              4. Chronic disease
              5. History of intussusception, seizures, neurological problems
              6. History of blood transfusion, immunoglobulin or antiviral medications
              7. Pregnancy
              8. Anticipatory guidance about vaccines
                1. Shared decision making
                2. Common side effects are a sign that vaccines are working
                3. Treatment of fever
                4. How to handle vaccine hesitancy
                  1. Recommend the vaccines
                  2. Ask if they have questions that you can answer
                  3. Provide reputable resources
                  4. Helping older children with their anxiety about being vaccinated

                    5.  

                    REFERENCES/LINKS:

                    www.cdc.gov/vaccines

                    AAP Child and Adolescent Immunization Schedule by Age: https://publications.aap.org/redbook/pages/Immunization-Schedules?autologincheck=redirected

                    O’Shea P, John J, et al. Reframing the Conversation about Child and Adolescent Vaccines, January 2023, Frameworks Institute. https://www.frameworksinstitute.org/wp-content/uploads/2023/01/reframing-the-conversation-about-child-and-adolescent-vaccinations_Jan272023.pdf

                     

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                    Clerkship Ready: PediatricsBy MedReady
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