Reference no: EM133988798

Immunizations

Patient 1: Two five-year-old girls are on your schedule for a kindergarten physical. The foster parent of one of the children indicates she received all her immunization from birth to one year of age, but after that the child has not had any further vaccines. The second child appears to have been vaccinated per the CDC schedule.

• Is there a difference in the immunization plan you will initiate today for these two patients? Why or why not?
• What immunizations will you be ordering for each of these two patients today?

Patient 2: Today you have two patients on your schedule for the HPV vaccine. One is a 27-year-old female. In taking her health history, you find that she is sexually active and that she had a splenectomy when she was 17. The second patient is an eleven-year-old female whose mother is concerned and wants to discuss the vaccine further before consenting. She feels that by giving the child the vaccine she is giving her permission to be sexually active.

• What type of immunizations will you recommend and why for each of these patients?
• What type of counseling will you provide in each of these scenarios related to their immunization needs?

Patient 3: The following two patients present for their yearly physicals before going to spend the holidays with their grandchildren, who are two months, 18 months, and seven years of age. The 72-year-old male states he "doesn't want a flu shot" because he's afraid he will just get sick like his neighbor who got her shot last week; however, his 67-year-old wife, who you are also seeing for a follow-up related to shingles she had a month ago, states, "I want the flu vaccine, but I don't need the shingles vaccine now since I've already had it."

• How will you counsel these individuals? Are there risks related to the children from either party?
• What adult immunizations should be recommended for these patients?

Patient 4: Your final patient of the day is a three-month-old baby. The nurse states that the mom is refusing vaccinations today even though though the baby's records show she is up to date on her immunizations. Mom explains that she feels like her baby is getting "too many" shots and since everyone else is being vaccinated then they can skip a few of the vaccines and her baby will be just fine.

• What is herd immunity and how can this help protect individuals who are not vaccinated? What are the rates for your state related to immunizations, and how could this affect herd immunity?
• What immunizations should this patient receive today, and is there any leeway in the schedule to help alleviate some of the mom's concerns?