Page 554 - Saunders Comprehensive Review For NCLEX-RN

an anaphylactic reaction to a previously administered
vaccine or a component in the vaccine.
2. Live virus vaccines generally are not administered to
individuals with severely deficient immune systems,
individuals with a severe sensitivity to gelatin, or
pregnant women.
3. A vaccine is administered with caution to an
individual with a moderate or severe acute illness,
with or without fever.
4. See Section IX, Recommended Childhood and
Adolescent Immunizations, for specific information
for each type of vaccine.
C. Guidelines for administration (Box 18-4)

Children born preterm should receive the full dose of each vaccine at the

appropriate chronological age.
IX. Recommended Childhood and Adolescent Immunizations (Box 18-5)
A. For the most up-to-date information, refer to Centers for Disease
Control and Prevention (CDC) Web site:
http://www.cdc.gov/vaccines/schedules/index.html.
B. Hepatitis B vaccine (HepB)
1. Administered by the intramuscular route
2. Contraindications: Severe allergic reaction to previous
dose or vaccine component (components include
aluminum hydroxide, yeast protein)
3. Precautions: An infant weighing less than 2000 g or an
infant with moderate or severe acute illness with or
without fever
4. HBsAg (hepatitis B surface antigen)-positive mothers
a. Infant should receive HepB vaccine and
hepatitis B immunoglobulin (HBIG)
within 12 hours of birth.
b. Infant should be tested for HBsAg and
antibody to HBsAg after completion of
HepB series (9 to 18 months of age).
5. Mother whose HBsAg status is unknown
a. Infant should receive the first dose of
hepatitis vaccine series within 12 hours
of birth.
b. Maternal blood should be drawn as
soon as possible to determine the
mother’s HBsAg status.
c. If the mother’s HBsAg test result is
positive, the infant should receive
HBIG as soon as possible (no later than
1 week of age).

554