Screening and Assessing
Steps to take before you immunize
In this section: critical steps for appropriately assessing your patient’s
immunization needs and the tools to complete those steps!
Overview of this section:
Assessing the need
for immunizations
assures no
Best Practices Checklist: Screening and Assessing
Five Steps to Take Before You Immunize
yy Step 1: Get an immunization history
yy Step 2: Determine vaccines needed
opportunity is
missed to give all
vaccines that are
due.
yy Step 3: Screen for contraindications and precautions
yy Step 4: Provide vaccine risk-benefit education
yy Step 5: Assess future immunization needs
Key Resources for Screening and Assessing
Who to Call
Centers for Disease
Control and Prevention
800-232-4636
Minnesota Immunization
Program
For Minnesota specific issues
(e.g. Minnesota school law)
800-657-3970
651-201-5503
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
53
Best Practices Checklist: Screening and Assessing
The information in this checklist will be covered in more detail throughout this section.
clinician (e.g., in the waiting room or exam room).
Get an immunization history
ˆˆ In advance of patient visits, we review
immunization records and flag charts of patients
who are due or overdue.
ˆˆ We’ve trained our immunization staff to know how
to determine valid and invalid contraindications to
vaccinations.
ˆˆ When providing reminder calls we ask patients
or parents to bring their immunization records.
ˆˆ We use MIIC to help identify vaccination needs.
ˆˆ We follow true contraindications and dispel
common misconceptions among staff and
patients.
ˆˆ Each time a patient comes in, we routinely ask
to see their immunization record to determine if
they received vaccinations elsewhere.
ˆˆ We use all patient encounters (including acutecare and follow-up visits) to assess and provide
vaccinations.
ˆˆ If we can't locate any records of previous
vaccinations, we treat the patient as
unvaccinated and give vaccinations that are
recommended or required for school, child care,
or work.
Provide vaccine risk-benefit education
ˆˆ We have the patient/parent sign a release of
records to obtain immunization records from
other clinics.
ˆˆ We give patients/parents Vaccine Information
Statements (VISs) to read and offer a copy
to take home for each vaccine. If they need a
VIS in another language, we provide it, if it is
available.
Determine vaccines needed
ˆˆ We post and refer to the current immunization
schedule for children, adolescents, and/or adults
in order to provide all recommended vaccines.
ˆˆ We use the “catch-up” schedule to bring children
up to date on their vaccinations when they have
fallen behind.
ˆˆ We’ve trained our staff (e.g., receptionist,
scheduler) to know how to determine the
minimum ages and/or intervals permissible
between vaccinations. This helps ensure that we
miss no opportunity to vaccinate.
ˆˆ We are familiar with special vaccination
recommendations for high-risk patients (e.g.,
special groups who need hepatitis A, hepatitis B,
pneumococcal, and meningococcal vaccines).
ˆˆ We take the time to answer patients’ questions
on vaccines and provide resources to those
who have questions, concerns, or want more
information.
Assess future vaccination needs
ˆˆ We inform the patient/parent when the next
appointment for vaccinations is due.
ˆˆ We set up the next immunization appointment
and give the patient an appointment card before
they leave the clinic.
ˆˆ If we are unable to schedule an appointment we
put the information in an electronic recall system
or manual tickler system.
ˆˆ When scheduling appointments, we remind
patients/parents to bring along their (or their
child’s) personal immunization record. We also
confirm the address and phone number in case
we need to contact them.
Screen for contraindications and precautions
ˆˆ We ask patients/parents to complete a screening
questionnaire for contraindications and precautions
to determine if the vaccinations they need can
be given safely on the day of their visit. To save
time, we have them complete it prior to seeing the
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Minnesota Department of Health, July 2011
Step 1: Get an immunization history
Review the patient's immunization record at every visit.
Whether you use paper or electronic records, make sure you have a system for
viewing, reviewing, and flagging patient records for immunizations that are due or
overdue.
yy Paper medical records
○○ Place the immunization record in the front inside cover of the patient’s
medical chart so it can be checked at every visit.
○○ Flag the record if the patient is behind on recommended immunizations.
○○ Make a note of which immunizations are due or overdue.
yy Minnesota Immunization Information Connection (MIIC)
○○ View online or print a copy of the patient’s immunization record prior to the
visit or when the patient checks in.
Five Steps to
Take Before
You Immunize
Don't miss an
opportunity!
Check the
immunization history of
ALL patients at every
visit.
○○ Review MIIC's predictions to see which immunizations are due or overdue.
yy Electronic medical records (EHR)
○○ View online or print a copy of the patient’s immunization record prior to the
visit or when the patient checks in.
○○ Review the EHR's alert system to see which immunizations are due or
overdue.
Can't find an immunization record?
Don’t just take your patient’s word for what shots he or she has had. You need
a written record of which vaccines the patient has received and when (including
the month, year, and preferably the day). Getting an immunization history helps
assure that patients receive needed vaccines at the right minimum intervals and
are not over-vaccinated.
Where to look for patient immunization records
yy An immunization registry, such as the Minnesota Immunization Information
Connection (MIIC). Immunization registries have been growing since the
1990s and may have at least partial immunization records - especially for
patients born since 1995.
yy Clinics. Check with all health care providers where shots may have been
given, including neighborhood clinics and local public health departments.
yy Family records. Family or personal records such as baby books may contain
immunization records (e.g., the Minnesota "Gold Card").
yy Schools or child care providers. Child care providers and schools must verify
immunizations for attendees and may be able to look up records.
yy Military records. Military records may be a source of immunization information
for those who have served in the military.
yy U.S. Citizenship and Immigration Services (USCIS) health records.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
55
Five Steps to Take Before
You Immunize: Step 1
Whose records aren't in MIIC?
MIIC only began in 2000, so unless clinics/providers have entered past
immunization records, most likely MIIC won't have immunization records for
persons:
yy Who received their shots in another state
yy Who Were born before 1995
yy Whose clinic/provider doesn't participate in MIIC
yy Who haven't received any shots
Tell patients to call the MIIC Help Desk at 651-201-5503 or 800-657-3970 to
find out if their immunization records exist in MIIC.
TAKE ACTION
If you can’t find a patient’s record anywhere:
1. Consider the patient unvaccinated.
2. Administer shots today that are required for school, child care, or work.
3. Schedule a follow-up appointment and continue to look for records before
the patient’s next clinic visit.
4. Obtain a signed release of information form from the patient or parent/
guardian if you need to request immunization records from another state's
clinic or immunization registry.
5. Once you have received an immunization history, update the clinic record
and MIIC and follow up with the patient or parent/guardian.
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Minnesota Department of Health, July 2011
Five Steps to Take Before
You Immunize: Step 2
Step 2: Determine vaccines needed
Use the following resources and guidelines to assess for needed vaccines. Don't
assume your patient only needs routine vaccines recommended for his or her
age. Check vaccine needs based on risk factors such as occupation, medical
condition, or social behavior, and give all the vaccines the patient needs. Patients
may need vaccines more frequently, sooner, or in a different dosage than routinely
recommended.
AGE


Infants, children, and adolescents
○ Recommended Immunization Schedule for Children and Adolescents,
Minnesota, MDH (pages 73-75)
○
Summary of Recommendations for Child/Teen Immunization, IAC (pages
81-84)
○
Perinatal Hepatitis B Prevention Pocket Guide, MDH (page 89)
Adults
○ Do I Need Any Vaccinations Today? IAC (pages 71-72)
○ Recommended Adult Immunization Schedule, Minnesota, MDH (pages
77-79)
○ Summary of Recommendations for Adult Immunization, IAC (pages 85-88)
○

Is your patient
behind on their
immunizations?
Make sure to
follow the catchup schedule and
minimum intervals
for their age.
Pneumococcal Vaccination Pocket Guide, MDH (page 90)
All ages
ACIP’s General Recommendations on Immunization:
○ Table 1. Recommended and minimum ages and intervals between vaccine
doses (pages 94-95)
○
○
○
Table 3. Guidelines for spacing of live and inactivated antigens (page 96)
Table 4. Guidelines for administering antibody-containing products and
vaccines (page 96)
Table 5. Recommended intervals between administration of antibodycontaining products and measles- or varicella-containing vaccine, by
product and indication for vaccination (page 97)
FOREIGN-BORN
Immunization recommendations for foreign-born persons living in Minnesota are
the same as for anyone born in the United States. Follow these general rules:





Vaccines administered outside of the U.S., including products not used in
the U.S., are considered valid if they meet the minimum age and interval
requirements.
If no written documentation exists, consider the patient unvaccinated.
Vaccinate/revaccinate by giving age-appropriate vaccinations the same as for
anyone born in the U.S.
Use the catch-up schedule to get patients up to date.
Serologic testing is not routinely recommended; however it can help determine
which vaccinations are needed in some situations. Serologic testing isn't
available for all vaccines and isn't a guarantee of protection against infection;
see page 58 for resources.
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
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57
Five Steps to Take Before
You Immunize: Step 2
How many times have
you looked at a new
patient’s immunization
record and said, "I
have no idea what this
means?"


Some patients'
immunization records
may have foreign vaccine
terms listed on them.
See pages 111-130 for
resources to help you
translate foreign vaccine
terms.
Children adopted internationally may have unreliable immunization records
and revaccination may be necessary. Alternatively, serologic testing may be
used to determine vaccines needed.
For more on vaccine recommendations and serologic testing for foreign-born
persons, see:
○ ACIP’s General Recommendations on Immunization: Table 14.
Approaches to evaluation and vaccination of persons vaccinated outside
the United States who have no (or questionable) vaccination records (page
99)
○
○
○

ACIP’s General Recommendations on Immunization: Table 1. Recommended
and minimum ages and intervals between vaccine doses (pages 94-95)
Recommended Immunization Schedule for Children and Adolescents,
Minnesota, MDH (pages 73-75)
Recommended Adult Immunization Schedule, Minnesota, MDH (pages
77-79)
For translation of foreign vaccine terms and vaccine products, see:
○ Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages,
IAC (pages 111-112)
○
Disease, Vaccine and Related Terms, CDC (pages 113-118)
○
Trade Names, CDC (pages 119-129)
IMMUNIZATION LAWS
Immunization laws protect everyone, because high immunization levels prevent
disease outbreaks. Minnesota has various laws requiring immunizations for children
and adults enrolled in child care, school, and college settings. Legal exemptions are
allowed - both for medical reasons and conscientiously held beliefs.

Provider's Quick Reference on Minnesota's Immunization Laws, MDH (pages
133-134)
MEDICAL CONDITION
It may be helpful to review all of the vaccines that may be indicated,
recommended, or contraindicated because of the patient's medical condition. The
following resources included in this guide can help.

Immunocompromised
○ ACIP’s General Recommendations on Immunization: Table 13. Vaccination
of persons with primary and secondary immunodeficiencies (page 98)
○
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Summary of ACIP Recommendations on Use of Immune Globulins, MDH
(page 104)
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Five Steps to Take Before
You Immunize: Step 2

Medical and other indications
○ Do I Need Any Vaccinations Today? IAC (pages 71-72)
○ Recommended Adult Immunization Schedule, Minnesota, MDH (pages
77-79)
○ Vaccines Indicated for Infants, Children, and Adolescents Based on
Medical and Other Indications, MDH (pages 105-107)

Pregnant women
○ Pregnancy and Vaccination pocket guide, MDH (page 91)

○
Recommended Adult Immunization Schedule, Minnesota, MDH (pages
77-79)
○
Guidelines for Vaccinating Pregnant Women, CDC
Not included in this guide but available on the web at www.cdc.gov/
vaccines/pubs/preg-guide.htm
Premature infants
Immunize premature infants according to the child's chronologic age. Hepatitis
B is an exception in some cases.
○ Recommended Immunization Schedule for Children and Adolescents,
Minnesota, MDH (pages 73-75)
○
Perinatal Hepatitis B Prevention Pocket Guide, MDH (page 89)
○
Vaccines Indicated for Infants, Children, and Adolescents Based on
Medical and Other Indications, MDH (pages 107-103)
OCCUPATION
Some occupations require certain immunizations. To help determine what
immunizations might be needed, review the following references.

Health care workers
○ Recommended Adult Immunization Schedule, Minnesota, MDH (pages
77-79)
○
Healthcare Personnel Vaccination Recommendations, IAC (page 109)

Other occupations that may place patients at risk
○ Vaccines Indicated by Occupation, MDH (pages 105-107)

ACIP recommendations
Not included in this guide but available on the web at www.cdc.gov/vaccines/
pubs/ACIP-list.htm:
○ Immunization of Health-Care Workers: Recommendations of the Advisory
Committee on Immunization Practices (ACIP) and the Hospital Infection
Control Practices Advisory Committee (HICPAC), MMWR, December 26,
1997 / 46(RR-18);1-42.
○
Influenza Vaccination of Health-Care Personnel: Recommendations of
the Healthcare Infection Control Practices Advisory Committee (HICPAC)
and the Advisory Committee on Immunization Practices (ACIP), MMWR,
February 24, 2006 / 55(RR02);1-16.
July 2011, Minnesota Department of Health
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59
Five Steps to Take Before
You Immunize: Step 2
TRAVEL
If your patient is traveling out of the country they may need immunizations specific
to their destination. For a comprehensive review of immunizations needed as
well as disease prevention strategies, refer patients to an international travel
health clinic. These clinics provide a variety of pre- and post-travel services and
are authorized by the Minnesota Department of Health to administer yellow fever
vaccine.
 International travelers
○ Vaccines for the International Traveler: Plan Ahead for Your Travel Shots,
MDH; includes a list of international travel clinics in Minnesota (pages 130132)
○
Health Information for International Travel (Yellow Book), CDC
Not included in this guide but available on the web at www.cdc.gov/travel/
index.htm
SOCIAL BEHAVIOR
Additional immunizations may be recommended based on your patients' social
behavior (e.g., sexual activity, sexual orientation, recreational drug use).
○
○

Do I Need Any Vaccinations Today? IAC (pages 71-72)
Recommended Adult Immunization Schedule footnotes, Minnesota, MDH
(page 78)
ACIP recommendations
Not included in this guide but available on the web at www.cdc.gov/vaccines/
pubs/ACIP-list.htm:
○ Prevention of Hepatitis A Through Active or Passive Immunization
○
A Comprehensive Immunization Strategy to Eliminate Transmission of
Hepatitis B Virus Infection in the United States
-
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Part I: Immunization of Infants, Children, and Adolescents
Part II: Immunization of Adults
○
Bivalent Human Papillomavirus Vaccine (HPV2, Cervarix) for Use in
Females and Updated HPV Vaccination Recommendations from the ACIP
○
Quadrivalent Human Papillomavirus Vaccine (HPV4, Gardasil) for Use in
Males and Guidance from the ACIP
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Five Steps to Take Before
You Immunize: Step 3
Step 3: Screen for contraindications and precautions
Don't miss opportunities to vaccinate because of misconceptions about a
contraindication or precaution.


Be aware of all possible contraindications or precautions for health
conditions that might preclude giving a particular vaccine. See the Guide to
Contraindications and Precautions to Commonly Used Vaccines on pages 135138.
Remember to screen patients each time you vaccinate because responses to
the questions may change. See the Immunization Action Coalition's Screening
Checklist for Contraindications to Vaccines for Children and Teens and
Screening Checklist for Contraindications to Vaccines for Adults on pages
139-142.
What is a contraindication?
A contraindication to a vaccine is a condition in a patient that greatly increases the
chance of a serious adverse reaction. Generally, vaccines should not be given if
someone has a contraindication.
What is a precaution?
A precaution is a condition in a patient that may either increase the chance of a
serious adverse reaction to a vaccine or compromise the ability of the vaccine to
produce immunity. Generally, when a precaution exists, vaccines should be deferred.
When to give a vaccine despite a precaution:
In general, when a permanent or temporary precaution exists, vaccine should
be deferred. However, there may be situations when the benefit of vaccination
outweighs the risk, and the provider may choose to give the vaccine. For example,
prolonged crying or a high fever after a dose of pertussis-containing vaccine is
considered a precaution to giving subsequent doses of pertussis vaccine to a
child. But, if the child is at high risk of pertussis infection (e.g., during a pertussis
outbreak in the community), a provider may choose to vaccinate the child and
treat the adverse reaction if it occurs.
Screening for
contraindications and
precautions prevents
unnecessary adverse
events.
Local allergic reaction:
 Itching or swelling localized
to the vaccination site
 Usually not a
contraindication to
vaccination
A severe allergic reaction
(e.g., anaphylaxis) is
the sudden or gradual
onset of:
 Generalized itching,
redness, or hives
 Swelling of the lips, face,
or throat
 Bronchospasms
(wheezing)
 Shortness of breath
 Shock
 Cardiovascular collapse
These are NOT contraindications or precautions for administering any
vaccines. Give vaccines.
 Mild acute illness with or without fever
 Mild to moderate local reaction (swelling, redness, soreness); fever less
than 105°F or 40.5°C after prior dose
 Lack of prior physical examination in well-appearing person
 On antibiotics
 Convalescent phase of illness
 Premature birth (hepatitis B vaccine is an exception in certain circumstances;
see Perinatal Hepatitis B Prevention Pocket Guide, page 89)
 Recent exposure to an infectious disease
 Allergy to substances not in the vaccine
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
61
Five Steps to Take Before
You Immunize: Step 4
Step 4: Provide vaccine risk-benefit education
Risk-benefit education comes in two main forms: giving patients/parents the
legally required Vaccine Information Statements (VISs) and talking with them
about any concerns they may have.
Reminder
All patients, including
adults, must be given
VISs before they get
their shots. Use the
VIS as an opportunity
to talk about vaccine
safety issues.
Give Vaccine Information Statements (VISs)
Federal law (National Childhood Vaccine Injury Act of 1986,42 U.S.C. §300aa-26)
requires that VISs be provided to the vaccine recipient (including adult vaccinees)
each time vaccinations are administered. This applies to each dose in a multidose series. VISs are required for all recommended childhood and adult vaccines.
Additional VISs are available for vaccines not routinely recommended. For more
information on VISs see the table Give Vaccine Information Statements (VISs) on
page 63 and Instructions for the Use of Vaccine Information Statements on page
143.
Encourage patients/parents to carefully read the VISs you give them before
receiving the vaccination. The VIS answers questions like:
 What shots is my child getting today?
 What diseases are the shots preventing?
 What are the possible side effects?
 Is there any reason not to give the shot today?
 What do I do if a side effect occurs?
 When do I bring my child back for more shots?
In addition to VISs, be sure to have other resources on hand to address patients'
concerns; see Reliable Sources on Immunization Information on pages 145-146.
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Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Five Steps to Take Before
You Immunize: Step 4
Give Vaccine Information Statements (VISs)
What is a VIS?
A vaccine information statement (VIS) is an information
sheet, produced by CDC, informing vaccine recipients, or
their parents or legal guardians, of the benefits and risks
of a vaccine.
When must a VIS be
given?
Federal law requires VISs to be given before
administering each dose of all recommended vaccines.
Note: A Multi-Vaccine VIS is as an optional alternative
when two or more routine childhood vaccines (i.e., DTaP,
hepatitis B, Hib, pneumococcal, polio, or rotavirus) are
administered at the same visit.
To whom must a VIS
be given?
yy The parent or legal guardian of any child to whom the
provider intends to administer the vaccine, or
yy The adult to whom the provider intends to administer
vaccine.
How must a VIS be
provided?
yy Offer a copy to read during the immunization visit and
before administering vaccine:
○○Patients may read the VISs as a paper copy, on an
office computer, or as a permanent laminated copy.
yy Offer a copy to take home with them (however they
aren't required to take it with them):
○○Patients may take a paper copy, or if they prefer to
download the VIS onto a mobile device, direct them to
CDC's patient VIS download webpage during the visit,
www.cdc.gov/vaccines/pubs/vis/vis-downloads.htm.
Is a parent/patient
signature required
to acknowledge
receiving a VIS?
yy No state or federal law requires the signature of the
adult patient or of the parent/guardian of a minor
child to acknowledge receipt of a VIS.
Where can you
obtain reproducible
copies of VISs?
yy Download them from www.immunize.org/vis/
yy Call CDC-INFO at 800-CDC-INFO or 800-232-4636.
yy Call the Minnesota Immunization Program at 651-2015503 or 800-657-3970.
What VISs
translations are
available?
VISs are available in more than 40 languages. For the
most current versions, see www.immunize.org/vis/
Is documentation
that we provided a
VIS necessary?
It is required. The provider must document both the date
of the VIS (found at the bottom of the back page) and the
date the VIS was given to the patient or parent/guardian.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
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63
Five Steps to Take Before
You Immunize: Step 4
Discuss vaccine safety concerns
Providing patients -- especially parents -- with risk-benefit education is more important
than ever. As a result of our immunization success and low levels of vaccinepreventable diseases, some parents fear vaccines more than the diseases they
prevent.
We need to address these concerns in order to keep immunization rates high. If
we don't, diseases like measles and polio that still circulate in many parts of the
world can return and cause outbreaks in the U.S.
Common parent concerns
Parents depend on you to be knowledgeable and to reassure them that vaccines are
safe. To do that, you need to know what their common concerns are. Recent CDC
focus groups identified these issues:
yy Parents want and need to discuss vaccine safety issues. They resent having
their concerns dismissed.
yy Parents and patients identify their health care provider as their most trusted
source of immunization information.
yy Until a provider establishes rapport with them, parents do not want to hear
about the science of immunization.
yy Parents do not want to hear overblown claims (e.g., that vaccines are 100
percent safe and 100 percent effective). Using such claims comes across
as defensive and uninformed. That said, it is important to acknowledge that
vaccines are very safe and effective.
yy Parents only have the health and safety of their child in mind and often have
dutifully explored information about immunizations. Providers, who also
have the health of the child as a key goal of care, can take advantage of this
common value.
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Minnesota Department of Health, July 2011
Five Steps to Take Before
You Immunize: Step 4
Responding to vaccine-hesitant parents using the "CASE" framework
Alison Singer of the Autism Science Foundation has developed a framework
called CASE for responding to vaccine-hesitant parents. It suggests a sequential
discussion process based on focus group findings. The following information is
provided courtesy of Alison Singer.
Making the CASE for Vaccines
Corroborate
Acknowledge the parent's concern and find some
point on which you can agree. Set the tone for a
respectful, successful talk.
About Me
Describe what you have done to build your
knowledge base and expertise.
Science
Describe what the science says.
Explain/Advise
Give advice to the patient, based on the science.
"I want to spread out the shots so they won't
overwhelm my child's immune system."
C:Kids today certainly get more shots than kids did years ago.
A:Our practice follows the CDC schedule because it is carefully designed to
protect children at the time they are most vulnerable to disease. I recently
returned from a meeting...or I served on a committee that reviewed the
schedule...
S:Although kids get more shots today, they actually receive fewer antigens
than when they got fewer shots, because technology has enabled us to
make vaccines that have only the part of the cell that induces immune
response. Plus, the immunological challenge from a vaccine is nothing
compared to what kids fight off everyday. An ear infection is a bigger
immunological challenge. Immunizations are a "drop in the ocean"
compared to what kids fight off everyday.
E:We want all the kids in our practice to be immunized on time so that
they have the greatest chance for a long, healthy life. Anything less is
substandard care. I don't want that for your child. As hard as it was to
see my own children get a lot of shots, I knew it was important. My own
children are fully vaccinated.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
65
"I heard on TV that vaccines cause autism."
C:There's certainly been a lot of television coverage about vaccines and autism so I can understand why you have questions.
A: .I always want to make sure I'm up to date on the latest information so that
I can do what's best for my patients. So I've researched this thoroughly. In
fact, I just returned from a professional conference...
S:The scientific evidence does not support a link between vaccines and
autism. Several professional organizations and respected scientists from
the CDC, AAP, NIH, IOM (etc.) all reviewed the studies that have been
conducted and reached the same conclusion. Dozens of studies have
been done. None show a link. In fact, the latest autism science indicates...
E: .Vaccines are critical to maintaining health and well-being. They prevent
diseases that cause real harm. Choosing not to vaccinate does not protect
children from autism, but it does leave them open to diseases. Kids need
these vaccines.
"Measles isn't so bad; I had it and I was fine."
C:I can understand why you might feel that way. We just don't hear much
about how serious it can be.
A: .The vaccine program has been so successful and a lot of the diseases
that we feared, like polio and measles, are no longer a concern. Until last
year, I had never seen a case of Hib or measles, but now these diseases
are making a comeback. In my practice...
S:These diseases have come back in areas where vaccination rates are
low. For example, in 2010 five children died of Hib and 10 babies died
of pertussis in California. In Minnesota in 2011 almost half the children
who got measles were hospitalized. They have to be very sick for that to
happen.
E: We care about our patients and don't want to see your child or any others I
care for be hospitalized for a disease that can easily be prevented.
66
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Step 5: Assess future immunization needs
Help make sure patients get their next immunizations on time.
yy Before they leave the clinic, assess patients’ future immunization needs and
schedule the next appointment! Give them an appointment reminder card.
yy Use MIIC to help determine which immunizations are due and when.
yy Make certain that you observe the minimum interval necessary between
doses, see Table 1: Recommended and minimum ages and intervals between
vaccine doses on pages 94-95.
Use MIIC or the tools
in your EHR to create
lists of patients whose
immunizations are
overdue and generate
recall notices or labels.
yy Be sure each patient leaves with an updated personal immunization record
such as the MIIC record or the Minnesota Immunization Record (“Gold Card”).
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
67
68
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
For Determining Vaccines Needed
Key
Resources for General Immunization Recommendations
Screening and  Do I Need Any Vaccinations Today? (IAC)
Screening questionnaire for adult patients to help assess what shots they may need:
Assessing
www.immunize.org/catg.d/p4036.pdf


Recommended Immunization Schedules, Minnesota (MDH)
Minnesota vaccination schedule for adults and children and adolescents,
including catch-up schedules:
www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
Summary of Recommendations (IAC)
Reference table on appropriate use, scheduling, and contraindications of
childhood and adult vaccines:
www.immunize.org/catg.d/p2010.pdf (childh/teen)
www.immunize.org/catg.d/p2011.pdf (adult)
Specific Populations - Immunization Recommendations
Haven’t got time to read
through a 54-page ACIP
statement?
These resources pull
together often-used
information for easy access.
As always, if you need
more details or don’t find an
answer for your particular
situation, you can call the
CDC at 800-232-4636.






July 2011, Minnesota Department of Health
ACIP’s General Recommendations on Immunization:
Table 1: Recommended and minimum ages and intervals between vaccine doses
Table 3: Guidelines for spacing of live and inactivated antigens
Table 4: Guidelines for administering antibody-containing products and vaccines
Table 5: Recommended intervals between administration of antibodycontaining products and measles- or varicella-containing vaccine, by product
and indication for vaccination
Table 13: Vaccination of persons with primary and secondary immunodeficiencies
Table 14:Approaches to evaluation and vaccination of persons vaccinated
outside the United States who have no (or questionable) vaccination records:
www.cdc.gov/mmwr/pdf/rr/rr6002.pdf
Perinatal Hepatitis B Prevention Pocket Guide (MDH)
Guide to recommended strategies to prevent perinatal transmission of
hepatitis B including the vaccine schedule for infants born to HBsAg positive
mothers:
www.health.state.mn.us/divs/idepc/diseases/hepb/perinatal/hcp.html
Pneumococcal Vaccination Pocket Guide (MDH)
Guide to assist health care providers to determine who should receive a
pneumococcal vaccination:
www.health.state.mn.us/divs/idepc/diseases/pneumococcal/hcp/pocket.html
Pregnancy and Vaccination Pocket Guide (MDH)
Guide to assist health care providers with vaccinating pregnant women, page
91
Summary tables of ACIP recommendations on:
○ Vaccines Indicated for Infants, Children, and Adolescents Based on
Medical and Other Indications, page 101-103
○ Use of Immune Globulins, page 104
○ Vaccines Indicated by Occupation, page 105-107
Healthcare Personnel Vaccination Recommendations (IAC)
Vaccine specific recommendations for health care workers:
www.immunize.org/catg.d/p2017.pdf
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
69

Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages
(IAC)
Table to help providers interpret English disease names into Eastern and
Western European languages:
www.immunize.org/catg.d/p5122.pdf

Disease, Vaccine and Related Terms (CDC)
Table to help providers interpret vaccination records from other countries and
for translating vaccine-related terms
www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/foreignproducts-tables.pdf
Trade Names (CDC)
Table lists many vaccine products that are (or have been) used in the U.S. and
in international markets:
www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/foreignproducts-tables.pdf


Plan Ahead for Your Travel Shots (MDH)
Tips to planning ahead for international travel:
www.health.state.mn.us/divs/idepc/immunize/travel/travelshots.pdf
Minnesota Immunization Laws

Provider's Quick Reference on Minnesota's Immunization Laws (MDH)
Quick reference guide for health care providers, child care, and school
personnel on Minnesota's immunization laws:
www.health.state.mn.us/divs/idepc/immunize/laws/qreflaws.html
For Screening for Contraindications and Precautions


Guide to Contraindications and Precautions to Commonly Used
Vaccines (MDH)
Guide to help providers determine what symptoms and conditions
contraindicate vaccination:
www.health.state.mn.us/divs/idepc/immunize/hcp/vaccine.html
Screening Checklist for Contraindications (IAC)
Form patients fill out to help you evaluate which vaccines can be given at that
day's visit; reverse side includes information for professionals:
www.immunize.org/catg.d/p4060.pdf (child and teen)
www.immunize.org/catg.d/p4065.pdf (adult)
For Providing Risk-Benefit Education
70
www.health.state.mn.us/immunize

Instructions for the Use of Vaccine Information Statements (CDC)
Information sheet on the use of VISs, including recordkeeping requirements:
www.cdc.gov/vaccines/pubs/vis/downloads/vis-Instructions.pdf

Reliable Sources of Immunization Information (MDH)
Where to go for accurate and up-to-date information on vaccines and vaccine
safety; includes web sites, phone numbers, and publications:
www.health.state.mn.us/divs/idepc/immunize/safety/imminfo.pdf
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Your name: ____________________________________ Ê>ÌiʜvÊLˆÀ̅\ÚÚÚÚÉÚÚÚÚÉÚÚÚÚToday’s date:ÊÚÚÚÚÉÚÚÚÚÉÚÚÚÚ
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Many adults are behind on their vaccinations. This questionnaire will help you and your healthcare
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‰ I haven’t had my annual influenza vaccination yet this season — so I need it now.
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‰ I am age 65 or older, and I have never had a pneumococcal shot.
‰ I am age 65 or older and have had 1 or 2 doses of pneumococcal vaccine when I was younger than age 65; it has been 5 years or more since
the last shot.
‰ I am younger than age 65, I have not been vaccinated against pneumococcal disease, and at least one of the following applies to me:
Ê UÊI smoke cigarettes.
Ê UÊI have heart, lung (including asthma), liver, kidney, or sickle cell disease; diabetes; or alcoholism.
‰ I am younger than age 65, I have or have not been vaccinated against pneumococcal disease, and at least one of the following applies to me:
ÊÊ UÊʅ>ÛiÊ>ÊÜi>Ži˜i`ʈ““Õ˜iÊÃÞÃÌi“Ê`ÕiÊ̜ÊV>˜ViÀ]ʜ`}Žˆ˜½ÃÊ`ˆÃi>Ãi]ʏiՎi“ˆ>]ʏޓ«…œ“>]ʓՏ̈«iʓÞiœ“>]ʎˆ`˜iÞÊv>ˆÕÀi]Ê6É-ÆÊ
or I am receiving radiation therapy; or I am on medication that suppresses my immune system.
UÊʅ>Ûiʅ>`Ê>˜ÊœÀ}>˜ÊœÀÊLœ˜iʓ>ÀÀœÜÊÌÀ>˜Ã«>˜Ì°
Ê UÊʅ>Ûiʅ>`ʓÞÊëii˜ÊÀi“œÛi`]ʅ>Ûiʅ>`ʜÀÊ܈Ê…>ÛiÊ>ÊVœV…i>Àʈ“«>˜Ì]ʜÀʅ>Ûiʏi>Žˆ˜}Ê눘>ÊyՈ`°
‰ I live in a nursing home or other long-term care facility, and I have never had a pneumococcal shot.
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I have not had a pertussis-containing vaccine (Tdap) as an adolescent or adult (this applies to pregnant women, too).
‰ I have not yet had at least 3 tetanus- and diphtheria-containing shots.
‰Êʅ>Ûiʅ>`Ê>Ìʏi>ÃÌÊÎÊÌiÌ>˜ÕÇÊ>˜`Ê`ˆ«…Ì…iÀˆ>‡Vœ˜Ì>ˆ˜ˆ˜}ÊŜÌÃʈ˜Ê“Þʏˆvï“i]ÊLÕÌÊÊLiˆiÛiʈ̽ÃÊLii˜Ê£äÊÞi>ÀÃʜÀʓœÀiÊȘViÊÊÀiViˆÛi`ʓÞ
last shot.
‰ I have no idea if I ever received any tetanus- and diphtheria-containing shots in school, the military, or elsewhere.
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‰ÊÊÜ>ÃÊLœÀ˜Êˆ˜Ê£™xÇʜÀʏ>ÌiÀÊ>˜`ʘiÛiÀÊÀiViˆÛi`Ê>˜Ê,ÊŜÌʜÀÊÊ`œ˜½Ìʎ˜œÜʈvÊÊÀiViˆÛi`Ê>ÊŜ̰
‰ I am a woman thinking about a future pregnancy and do not know if I’m immune to rubella.
‰ÊÊ>“Ê>ʅi>Ì…V>ÀiÊܜÀŽiÀ]ÊÊ`œÊ˜œÌʅ>ÛiÊ>ʅˆÃ̜ÀÞʜvʓi>ÏiÃʜÀʓՓ«Ã]Ê>˜`ʽÛiʅ>`ʜ˜Þʜ˜iÊ`œÃiʜvÊ,ÊÛ>VVˆ˜i°
‰ÊÊÜ>ÃÊLœÀ˜Êˆ˜Ê£™xÇʜÀʏ>ÌiÀ]Ê>˜`ÊÊ>“ʈ˜VÕ`i`ʈ˜Êœ˜iʜvÊ̅iÊvœœÜˆ˜}Ê}ÀœÕ«ÃÊvœÀÊ܅œ“ÊÓÊ,ÊŜÌÃÊ>ÀiÊÀiVœ““i˜`i`]ÊLÕÌÊʅ>ÛiÊÀiViˆÛi`ÊÊ
only 1 shot.
UÊI am entering college or a post–high school educational institution.
UÊI had a blood test that shows I do not have immunity to measles, mumps, or rubella.
UÊI am planning to travel internationally.
Human papillomavirus (HPV) vaccination
‰ I am a woman age 26 or younger and haven’t completed a series of shots against human papillomavirus.
‰ I am a man age 21 or younger and haven’t completed a 3-dose series of shots against human papillomavirus.
‰ I am a man age 22 through 26, I have not completed a 3-dose series of HPV vaccine, and at least 1 of the following applies to me:
t I want to be protected from HPV.
t I have a weakened immune system as a result of infection (including HIV), disease, or medications.
t I have sex with men.
(continued on page 2)
‰ I am older than age 26 and although I started the series when I was younger, I never completed it.
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July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
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‰ I want to be vaccinated to avoid getting hepatitis B and spreading it to others.
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‰ I was vaccinated with hepatitis B vaccine in the past but never completed the full 3-dose series.
‰ I am in one of the following risk groups, and I haven’t completed the series of hepatitis B shots:
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monogamous relationship.
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of the world where hepatitis B is common, so I need testing and
UÊÊ>“Ê>ʅi>Ì…V>ÀiʜÀÊ«ÕLˆVÊÃ>viÌÞÊܜÀŽiÀÊ܅œÊˆÃÊiÝ«œÃi`Ê̜ÊÊ
may need vaccination.Î]{
blood or other body fluids.
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disabilities.
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‰ I have received 1 dose of varicella vaccine in the past, but never got a second shot.
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‰ I am age 21 or younger and am (or will be) in college, living in a residence hall, and haven’t had a meningococcal shot since my 16th birthday.
‰ I am traveling to an area of the world where meningococcal disease is common.1
‰Êʅ>ÛiÊÈVŽiÊViÊ`ˆÃi>Ãi]ʜÀʓÞÊëii˜ÊˆÃ˜½ÌÊܜÀŽˆ˜}ʜÀʅ>ÃÊLii˜ÊÀi“œÛi`]ʜÀÊʅ>ÛiÊ>Ê«iÀÈÃÌi˜ÌÊVœ“«i“i˜ÌÊVœ“«œ˜i˜ÌÊ`iwVˆi˜VÞ°
‰ I am a microbiologist routinely exposed to isolates of Neisseria meningitidis.
‰ ÊÜ>ÃÊ«ÀiۈœÕÏÞÊÛ>VVˆ˜>Ìi`ÊxʜÀʓœÀiÊÞi>ÀÃÊ>}œÊ>˜`ÊVœ˜Ìˆ˜ÕiÊ̜ÊLiÊ>ÌÊÀˆÃŽÊvœÀʓi˜ˆ˜}œVœVV>Ê`ˆÃi>Ãi°Ê œÌi\Ê̅ˆÃÊ`œiÃʘœÌÊ>««ÞÊ̜ÊÃÌÕ`i˜ÌÃÊÊ
whose only risk factor is attending college.
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72
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Recommended Immunization Schedule, Minnesota 2011
Ages 0–6 Years
Chart must be used with guidelines below.
Age
Vaccine
Hepatitis B1
Rotavirus
Birth
HepB
2
1
month
2
4
6
12
15
18
19-23
months months months months months months months
see
footnote 1
HepB
4-6
years
HepB
RV
RV
RV
Diphtheria, Tetanus, Pertussis3
DTaP
DTaP
DTaP
Haemophilus influenzae type b4
Hib
Hib
Hib4
Hib
Pneumococcal5
PCV
PCV
PCV
PCV
Inactivated Poliovirus6
IPV
IPV
Range of
recommended
ages
2
see
footnote 3
DTaP
DTaP
Supplemental PCV13
PPSV
IPV
Influenza7
Measles, Mumps, Rubella
9
Hepatitis A10
Catch-up
vaccination
Certain
high-risk
groups
IPV
TIV (annually)
8
Varicella
2-3
years
TIV or LAIV
MMR
MMR
VAR
VAR
HepA series
Meningococcal11
HepA series
MCV
• Additional vaccines may be licensed and recommended during the year. For updated information see www.cdc.gov/vaccines/pubs/ACIP-list.htm.
• Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not contraindicated and if approved by the Food and
Drug Administration for that dose of the series. Also consider provider assessment, patient preference, and potential for adverse events.
• Consult the respective ACIP statement for detailed recommendations.
• Report clinically significant adverse events that follow immunization to the Vaccine Adverse Event Reporting System (VAERS). For guidance on how to obtain and complete a VAERS form see
http://vaers.hhs.gov/index or call 800-822-7967.
1. Hepatitis B (HepB). Minimum age: birth.
At birth:
• Give monovalent HepB to all newborns within 12 hours of birth.
• If mother is HBsAg positive, give newborn HepB and 0.5 mL of hepatitis B immune globulin
(HBIG) within 12 hours of birth.
• If mother’s HBsAg status is unknown, give newborn HepB within 12 hours of birth. Determine
mother’s HBsAg status as soon as possible and if HBsAg positive, give newborn HBIG as soon
as possible and within 1 week.
Following the birth dose:
• Complete HepB series with either monovalent HepB or a combination vaccine containing
HepB. Give second dose at age 1 or 2 months and final dose no sooner than age 24 weeks.
Note: Combination vaccines are not indicated before age 6 weeks. It is permissible to give 4
doses of HepB when combination vaccines are given after the birth dose.
• Infants that didn’t receive a birth dose should receive HepB on a schedule of 0,1, and 6 months.
• Test infants born to HBsAg positive mothers for HBsAg and antibody to HBsAg after completion of
3 or more doses in HepB series, at age 9 through 18 months (generally at the next well-child visit).
4-month dose:
• If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.
2. Rotavirus (RV). Minimum age: 6 weeks.
• Give first dose at age 6 through 14 weeks. Do not start the series at age 15 weeks and older.
• Give final dose by age 8 months. Do not give a dose at age 8 months and older.
• If Rotateq was used for either of the first 2 doses, give a total of 3 doses.
• Rotarix only requires 2 doses at 2 months and 4 months.
3. Diphtheria, tetanus, and acellular pertussis (DTaP). Minimum age: 6 weeks.
• Fourth dose may be given as early as age 12 months, provided at least 6 months have elapsed
since third dose.
• Give final dose at age 4 through 6 years.
4. Haemophilus influenzae type b (Hib). Minimum age: 6 weeks.
• If PRP-OMP (PedvaxHIB or ComVax) is given at age 2 and 4 months, a dose at age 6 months
is not necessary.
• Hiberix should not be used for doses at age 2, 4, or 6 months but can be used as a booster
following any Hib vaccine in children age 12 months and older.
• Not routinely recommended for persons age 5 years and older; however, consider 1 dose for
unvaccinated children with sickle cell disease, leukemia, or HIV infection, or who have had a
splenectomy.
5. Pneumococcal (PCV, PPSV). Minimum ages: 6 weeks for pneumococcal conjugate
vaccine (PCV); 2 years for pneumococcal polysaccharide vaccine (PPSV).
Pneumococcal conjugate vaccine (PCV)
• Give 1 dose of PCV to any unvaccinated child age 2 through 4 years. If they are at risk for
invasive disease give a second dose 2 months after first dose.
• Give PCV13 to complete any series started with PCV7.
Minnesota Department of Health, IC#141-0188 (03/11)
www.health.state.mn.us/immunize
6.
7.
8.
9.
10.
11.
• Provide a single supplemental dose of PCV13 following a completed PCV7 series for:
○ Healthy children through age 4 years,
○ Children with certain medical conditions through age 5 years.
• Allow 8 weeks between pneumococcal vaccine doses.
• Consider a single supplemental dose of PCV13 for children age 6 through 18 years with anatomic
or functional asplenia including sickle cell disease, immunocompromising conditions including
HIV infection, cochlear implant, or CSF leaks.
Pneumococcal polysaccharide vaccine (PPSV)
• Give PPSV to certain high-risk groups age 2 years and older. See MMWR 2000; 49(RR-9):1-35.
• A single revaccination is recommended 5 years after initial dose for children age 2 years and
older with anatomic or functional asplenia or immunocompromising conditions.
Inactivated poliovirus (IPV). Minimum age: 6 weeks.
• Always give final dose between age 4 through 6 years, regardless of the number of doses
previously given.
• Give final dose at least 6 months after previous dose.
Influenza, seasonal (TIV, LAIV). Minimum ages: 6 months for trivalent inactivated influenza
vaccine (TIV); 2 years for live, attenuated influenza vaccine (LAIV).
• Give annually to all children: TIV for age 6 months through 2 years and TIV or LAIV for healthy
children age 2 through 18 years.
• Give 2 doses separated by at least 4 weeks to children younger than age 9 years who are
receiving influenza vaccine for the first time or who were vaccinated for the first time last season
and only received 1 dose.
Measles, mumps, and rubella (MMR). Minimum age: 12 months.
• Give first dose on or after first birthday.
• Give second dose at age 4 through 6 years. It may be given earlier provided at least 4 weeks
have elapsed since first dose.
Varicella (VAR). Minimum age: 12 months.
• Give first dose on or after first birthday.
• Give second dose at age 4 through 6 years. It may be given earlier provided that at least 3
months have elapsed since first dose. If second dose was given at least 28 days after the first
dose, it does not need to be repeated.
Hepatitis A (HepA). Minimum age: 12 months.
• Give 2 doses at least 6 months apart to all children at age 1 year. If not fully vaccinated by age
2 years child can be vaccinated at a subsequent visit.
• Consider catch-up vaccination for children through age 18 years.
Meningococcal conjugate vaccine (MCV). Minimum age: 2 years.
• Give 2 doses 2 months apart to children age 2 years and older with persistent complement
component deficiency, anatomic or functional asplenia, or HIV infection and 1 dose every 5
years thereafter.
• Give 1 dose of MCV to children through age 6 years who received meningococcal polysaccahride
vaccine (MPSV) or MCV three or more years previously and who remain at risk (i.e., travel to
endemic areas).
Page 2 of 4
CDC’s National Immunization Hotline (in English and Spanish):
800-CDC-INFO (1-800-232-4636), TTY 888-232-6348
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
73
Recommended Immunization Schedule, Minnesota 2011
Ages 7–18 Years
Chart must be used with guidelines below.
Age
Vaccine
Tetanus, Diphtheria, Pertussis1
2
Human Papillomavirus
Meningococcal3
7–10
years
11–12
years
13–18
years
see footnote 1
Tdap
Tdap
see footnote 2
HPV (3 doses)
HPV series
MCV
MCV
MCV
Influenza4
PPSV / PCV
Hepatitis A6
HepA series
Hepatitis B7
HepB series
Inactivated Poliovirus8
Catch-up
vaccination
Certain
high-risk
groups
TIV or LAIV (annually)
Pneumococcal5
Range of
recommended
ages
IPV series
Measles, Mumps, Rubella9
MMR
Varicella10
VAR
• Additional vaccines may be licensed and recommended during the year. For updated information see www.cdc.gov/vaccines/pubs/ACIP-list.htm.
• Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not contraindicated and if approved by the Food and
Drug Administration for that dose of the series. Also consider provider assessment, patient preference, and potential for adverse events.
• Consult the respective ACIP statement for detailed recommendations.
• Report clinically significant adverse events that follow immunization to the Vaccine Adverse Event Reporting System (VAERS). For guidance on how to obtain and complete a VAERS form see
http://vaers.hhs.gov/index or call 800-822-7967.
1. Tetanus, diphtheria, and acellular pertussis (Tdap). Minimum ages: 10 years
for Boostrix and 11 years for Adacel.
• Give Tdap at age 11 or 12 years for those who have completed the recommended
childhood DTP/DTaP series but have not received a Td booster dose.
• Give Tdap to adolescents age 13 through 18 years who have not already received a Tdap.
• Tdap can be administered regardless of the interval since the last tetanus and diphtheria
toxoid–containing vaccine.
• Persons age 7 through 10 years who are not fully immunized against pertussis
(including those never vaccinated or with unknown pertussis vaccination status)
should receive a single dose of Tdap. Refer to the catch-up schedule if additional
doses of tetanus and diphtheria toxoid–containing vaccine are needed.
2. Human papillomavirus (HPV). Minimum age: 9 years.
• Give 3-dose HPV series to all females at age 11 or 12 years and to all unvaccinated
females at age 13 through 18 years at intervals of 0, 2, and 6 months.
• Give HPV2 to prevent cervical cancer.
• Give HPV4 to prevent cervical, vaginal, and vulvar cancers and genital warts.
• Ideally, vaccine should be given prior to potential exposure through sexual activity;
however, sexually active females should still be vaccinated. Inform sexually active
females that they may not receive protection against all HPV types in the vaccine if
previously exposed to any of them.
• As appropriate also instruct females to receive annual Pap smears.
• HPV4 may be given to males age 9 through 18 years to reduce the likelihood of
acquiring genital warts.
3. Meningococcal conjugate vaccine (MCV). Minimum age: 2 years.
• Give 1 dose of MCV at age 11 or 12 years and a booster dose at age 16 years.
• Give 1 dose of MCV to unvaccinated adolescents age 13 through 18 years including
unvaccinated college freshmen living in dormitories. If vaccinated at age 13 through
15 years, give a booster dose at age 16 though 18 years (i.e., 3 years later).
• Give 2 doses 2 months apart to children age 2 years and older with persistent
complement component deficiency or anatomic or functional asplenia and 1 dose
every 5 years thereafter.
• Give 2 doses 2 months apart to adolescents age 11 through 18 years who are HIV
positive.
• Give 1 dose of MCV to children age 7 years and older who received meningococcal
polysaccahride vaccine (MPSV) or MCV five or more years previously and who
remain at risk.
Minnesota Department of Health, IC#141-0188 (03/11)
www.health.state.mn.us/immunize
4. Influenza, seasonal (TIV, LAIV). Minimum ages: 6 months for TIV; 2 years for LAIV.
• Give annually to all children age 6 months through 18 years.
• For healthy nonpregnant persons age 2 through 49 years, use either LAIV or TIV.
• Give 2 doses separated by at least 4 weeks to children younger than age 9 years who
are receiving influenza vaccine for the first time or who were vaccinated for the first
time last season and only received 1 dose.
5. Pneumococcal polysaccharide vaccine and pneumococcal conjugate
vaccine (PPSV and PCV). Minimum ages: 2 years for PPSV; 6 weeks for PCV.
• Give PPSV to certain high-risk groups. See MMWR 2010; 59(RR-11);1–24.
• A single revaccination is recommended 5 years after initial dose for children age
2 years and older with anatomic or functional asplenia or immunocompromising
conditions.
• Consider a single supplemental dose of PCV13 for children age 6 through 18 years with
anatomic or functional asplenia including sickle cell disease or immunocompromising
conditions including HIV infection, cochlear implant, or CSF leaks.
6. Hepatitis A (HepA). Minimum age: 12 months.
• Give 2 doses at least 6 months apart.
• Consider catch-up vaccination for children through age 18 years.
7. Hepatitis B (HepB). Minimum age: birth.
• Give a 3-dose series to unvaccinated children (see catch-up schedule).
• A 2-dose series 4 to 6 months apart of adolescent formulation Recombivax HB is
licensed for children ages 11 through 15 years.
8. Inactivated poliovirus (IPV). Minimum age: 6 weeks.
• Give 3 doses of IPV to unvaccinated children age 7 through 17 years (see catch-up
schedule).
• IPV is not routinely recommended for persons age 18 years and older.
• If both OPV and IPV were given as part of a series, a total of 4 doses should be given,
regardless of child’s current age.
9. Measles, mumps, and rubella (MMR). Minimum age: 12 months.
• Give 2 doses of MMR at least 4 weeks apart to all unvaccinated children.
10. Varicella (VAR). Minimum age: 12 months.
• Give 2 doses to persons without evidence of immunity (i.e., who have not received
2 doses of varicella or have no physician diagnosis of varicella or shingles disease).
੦ For persons younger than age 13 years give 2 doses at least 3 months apart. Do
not repeat second dose if given 28 days or more after first dose.
੦ For persons age 13 years and older give 2 doses at least 4 weeks apart.
Page 3 of 4
CDC’s National Immunization Hotline (in English and Spanish):
800-CDC-INFO (1-800-232-4636), TTY 888-232-6348
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
74
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Catch-Up Schedule and Minimum Intervals for Children and Adolescents
There is no need to restart a vaccine series no matter how much time has elapsed between doses.
Catch-Up Schedule for Ages 4 Months Through 6 Years
Minimum Interval Between Doses
Dose 2 to Dose 3
Dose 3 to Dose 4
Minimum Age
for Dose 1
Dose 1 to Dose 2
Birth
4 weeks
8 weeks1 (and 16 weeks after first
Rotavirus2
6 weeks
4 weeks
4 weeks if Rotateq was used for any
Diphtheria, Tetanus, Pertussis3
6 weeks
4 weeks
Vaccine
Hepatitis B1
dose).
previous dose(s).
4 weeks
4 weeks if first dose given before age
12 months.
Haemophilus influenzae type b4
8 weeks (as final dose) if first dose
6 weeks
Pneumococcal5
Inactivated Poliovirus6
Measles, Mumps, Rubella7
Varicella8
Hepatitis A9
6 weeks
12 months
12 months
12 months
Tetanus, Diphtheria;
Tetanus, Diphtheria,
Pertussis10
12 months
Birth
6 months
4 weeks
6 weeks
4 weeks
Measles, Mumps, Rubella7
12 months
4 weeks
3 months if person is younger than
Varicella8
12 months
Inactivated Poliovirus
Meningococcal12
No further doses needed for
healthy children if previous dose given
at age 24 months and older.
8 weeks (as final dose)
The fourth dose is only necessary for
children age 12 months to 5 years who
received 3 doses before age 12 months.
For at-risk children age 24 through 59
months give PCV if 3 doses received
previously.
4 weeks
6 months6
age 12 months.
6 months if first dose given at age
12 months and older.
4 weeks
6
children) if current age is 12 months
and older.
8 weeks if first dose given before
9 years
Hepatitis A
Hepatitis B1
8 weeks (as final dose for healthy
The fourth dose is only necessary for
children age 12 months to 5 years who
received 3 doses before age 12 months.
Minimum Interval Between Doses
Dose 2 to Dose 3
Dose 3 to Dose 4
Dose 1 to Dose 2
4 weeks
9
4 weeks if current age is less than 12
months.
4 weeks
4 weeks
3 months
6 months
7 years10
Human Papillomavirus11
12 months.
Catch-Up Schedule for Ages 7 Through 18 Years
Minimum Age
for Dose 1
Vaccine
6 months3
8 weeks (as final dose)4 if current age 8 weeks (as final dose)
given at age 12 through 14 months.
4 weeks if first dose given before age
12 months and current age is less than
24 months.
8 weeks (as final dose for healthy
children) if first dose given at age 12
months and older or current age is
24 through 59 months.
No further doses needed for
healthy children if first dose given at age
24 through 59 months.
6 months
4 weeks4 if current age is less than
is 12 months or older and second dose
given before age 15 months.
No further doses needed if
No further doses needed if first
previous
dose given at age 15 months
dose given at age 15 months and older.
and older.
6 weeks
Dose 4 to Dose 5
2 years
Dose 4 to Dose 5
6 months if first dose given before
age 12 months.
12 weeks (and at least 6 months after
first dose).
8 weeks (and 16 weeks after first dose).
6 months as final dose.
4 weeks if person has received both
IPV and OPV and requires 4 doses.
6 months6
age 13 years.
4 weeks if person is age 13 years
and older.
2 months
1. Hepatitis B (HepB).
• Final dose should not be given before age 24 weeks.
• A 2-dose series 4 to 6 months apart of adolescent formulation Recombivax HB is licensed for
ages 11 through 15 years.
2. Rotavirus (RV).
• Do not start the series at age 15 weeks and older.
• Do not give a dose on or after age 8 months.
• If Rotateq was used for either of the first 2 doses, give a total of 3 doses.
3. Diphtheria, tetanus, and acellular pertussis (DTaP).
• Fifth dose is not necessary if fourth dose was given at age 4 years or older.
• Not indicated for persons age 7 years and older.
4. Haemophilus influenzae type b (Hib).
• Consider 1 dose for unvaccinated high-risk persons age 5 years and older with sickle cell
disease, leukemia, or HIV infection, or who have had a splenectomy.
• If current age is under 12 months and first 2 doses were PRP-OMP (PedvaxHIB or ComVax),
give third (and final) dose at age 12 through 15 months and at least 8 weeks after second dose.
• If first dose was given at age 7 through 11 months, give 2 doses separated by 4 weeks plus a
booster at age 12 through 15 months.
5. Pneumococcal conjugate vaccine (PCV).
• Generally not recommended for children age 5 years and older.
• Give 1 dose to healthy children age 2 through 4 years who have not received at least 1 dose of
PCV on or after 12 months of age.
• Give at-risk children age 2 through 5 years 1 dose if 3 doses received previously or give 2 doses
8 weeks apart if child has received fewer than 3 doses.
• Consider a single supplemental dose of PCV13 for children age 6 through 18 years with anatomic
or functional asplenia including sickle cell disease, immunocompromising conditions including
HIV infection, cochlear implant, or CSF leaks.
6. Inactivated poliovirus (IPV).
• For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not
necessary if third dose was given at age 4 years or older and at least 6 months has elapsed
from previous dose.
CDC’s National Immunization Hotline: 800-CDC-INFO (1-800-232-4636), TTY 888-232-6348
• If both OPV and IPV were given as part of a series, give a total of 4 doses, regardless of child’s
current age.
• IPV is not routinely recommended for persons age 18 years and older.
• Always give final dose on or after age 4 years, regardless of the number of doses previously given.
• Give final dose at least 6 months from previous dose.
• In children age 6 months and younger; apply minimum age and intervals only if there is an
imminent risk of exposure, i.e., community outbreak or travel to endemic areas.
7. Measles, mumps, and rubella (MMR).
• Second dose is recommended routinely at age 4 through 6 years but may be given earlier.
• Give 2 doses of MMR at least 4 weeks apart to all previously unvaccinated children.
• MMR and varicella may be given simultaneously; otherwise separate them by at least 4 weeks.
8. Varicella (VAR). .
• Second dose is recommended routinely at age 4 through 6 years but may be given earlier.
• If the second dose is given at least 28 days following the first dose it can be considered valid.
9. Hepatitis A (HepA).
• Consider catch-up vaccination for children through age 18 years.
10. Tetanus and diphtheria (Td) and tetanus, diphtheria, and acellular pertussis
(Tdap).
• Substitute Tdap for one dose of Td in the primary catch-up series and use Td for other doses.
• Give Tdap in place of Td booster dose for children age 11 through 18 years.
11. Human papillomavirus (HPV).
• Give HPV2 or HPV4 series to all unvaccinated females at age 13 through 18 years. May give
HPV4 to males age 9 through 18 years.
• Follow the dose intervals of 0, 2, and 6 months as closely as possible.
12. Meningococcal conjugate vaccine (MCV).
• Give 1 dose of MCV to unvaccinated adolescents age 13 through 18 years. If vaccinated at
age 13 through 15 years, give a booster dose at age 16 though 18 years (i.e., 3 years later).
• Give 2 doses 2 months apart to adolescents age 11 through 18 years who are HIV positive.
• Give 2 doses 2 months apart to children age 2 years and older with persistent complement
component deficiency or anatomic or functional asplenia and 1 dose every 5 years thereafter.
Page 4 of 4
(03/11) Minnesota Department of Health: www.health.state.mn.us/immunize
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
75
76
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Charts must be used with footnotes on next page.
Recommended Adult Immunization Schedule
Assess the vaccination status of adult patients at every visit.
Vaccine
Age
19 through 26 years 27 through 49 years 50 through 59 years 60 through 64 years 65 years and older
1 dose annually
Influenza1*
Substitute 1-time dose of Tdap for next Td
Tetanus, Diphtheria, Pertussis2*
Human Papillomavirus3*
Td booster every 10 years
3 doses
(0, 1-2, 6 months)
2 doses (0, 4−8 weeks)
Varicella4*
1 dose (60 years and older)
Zoster5
1 - 2 doses
Measles, Mumps, Rubella6*
1 - 2 doses
1 - 2 doses
Pneumococcal7
1 dose
Hepatitis A8*
2 doses (0, 6 months)
Hepatitis B9*
3 doses (0, 1, 6 months)
Meningococcal10*
1 or more doses
Vaccines Indicated for Adults Based on Medical and Other Indications
Indication
Vaccine
HIV infection11,12
ImmunoAsplenia12 (including
CD4+ T
Men who Heart disease, elective splenectomy
compromising
Chronic
conditions (excluding lymphocyte count have sex chronic lung
and persistent
liver
Pregnancy human immunodewith men disease, chronic
complement
<200
≥200
disease
ficiency virus [HIV]
alcoholism
component
(MSM)
cells/μL cells/μL
infection)11,12
deficiencies)
Influenza 1*
1 dose TIV or
LAIV annually
1 dose TIV annually
Tetanus, Diphtheria,
Pertussis 2*
Human
Papillomavirus 3*
Diabetes,
Health
Kidney failure,
care
end-stage renal
personnel
disease, on
(HCP)
hemodialysis
1 dose TIV annually
1 dose TIV or
LAIV annually
Substitute 1-time dose of Tdap for next Td; then boost with Td every 10 years
3 doses for males and females through age 26 years
Varicella 4*
Contraindicated
Zoster 5
Contraindicated
Measles, Mumps,
Rubella 6*
Contraindicated
2 doses
1 dose
1 or 2 doses
1 or 2 doses
Pneumococcal 7
Hepatitis A 8*
3 doses females through age 26 years; males through age 21 years
2 doses
Hepatitis B 9*
Meningococcal 10*
3 doses
1 or more doses
*Covered by the National Vaccine Injury Compensation Program (see back for more information)
Recommended for all persons who meet the age requirements and who lack evidence of immunity (i.e., no documented vaccination, no evidence of prior
infection, or no laboratory evidence of immunity)
Recommended if some other risk factor is present (e.g., based on medical, occupational, lifestyle, or other indications)
Contraindicated
No recommendation
Minnesota Department of Health, IC#141-0316 (01/12)
www.health.state.mn.us/immunize
Page 2 of 4
CDC’s National Immunization Hotline (in English and Spanish):
800-CDC-INFO (1-800-232-4636), TTY 888-232-6348
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
77
1. Influenza, seasonal (TIV, LAIV) trivalent inactivated influenza vaccine (TIV); live attenuated
influenza vaccine (LAIV).
• Give LAIV or TIV to healthy (i.e., without high-risk medical conditions) nonpregnant adults
under age 50 years.
• Give TIV to:
○ Persons with high-risk medical conditions.
○ Persons age 50 years and older.
○ Health care personnel (HCP) who care for severely immunocompromised patients in
protective isolation.
2. Tetanus and diphtheria (Td) and tetanus, diphtheria, and pertussis (Tdap)
• Give 1 dose of Tdap to adults age 64 years and younger in place of their next 10-year booster
dose of Td. Td is recommended every 10 years as a booster for all adults.
• Tdap is recommended for adults having close contact with infants under age 1 year including
(parents, grandparents, child care staff, pregnant women after 20 weeks gestation, and HCP).
• Tdap can be given regardless of when the last Td was given.
• Adults with unknown or incomplete history of completing primary vaccination should
complete a 3-dose primary series of Td (see page 4 for catch-up schedule). Give Tdap for
1 of the 3 doses.
• Pregnant women not vaccinated during pregnancy should receive Tdap in the immediate
postpartum period.
• Adults age 65 years and older may also receive Tdap.
3. Human papillomavirus (HPV2, HPV4)
• Give HPV2 or HPV4 to all females through age 26 years and HPV4 to males through age
21 years.
• HPV4 is recommended for males through age 26 years who are immunocompromised or
men who have sex with men.
• HPV is given as a 3 dose series at intervals of 0, 1-2, and 6 months.
• Ideally, vaccine should be given prior to potential exposure through sexual activity; however,
sexually active persons should still be vaccinated. Inform them that they may not receive
protection against all HPV types in the vaccine if previously exposed to any of them.
• Instruct all females to continue to receive annual Pap smears.
• HPV4 may be given to males age 22 through 26 years.
4. Varicella (VAR)
• Give varicella vaccine as 2 doses separated by 4 to 8 weeks to all adults without evidence
of immunity, particularly those who will have close contact with persons at high risk for
serious complications (e.g., HCP and family contacts of immunocompromised persons),
or at high-risk of exposure (e.g., child care personnel, teachers).
• Evidence of immunity to varicella includes any of the following:
○ Documentation of 2 doses of varicella vaccine at least 4 weeks apart, or
○ U.S.-born before 1980, or
○ History of varicella disease verified by a health care provider, or
○ History of herpes zoster disease verified by a health care provider, or
○ Laboratory evidence of immunity.
• When assessing immunity of HCP or pregnant women the “U.S.–born before 1980” evidence
of immunity should not be considered.
○ HCP with no other evidence of immunity should be given 2 doses of varicella at least
4 to 8 weeks apart.
○ Pregnant women with no other evidence of immunity should be vaccinated upon
completion of pregnancy.
5. Zoster (ZOS)
• Give 1 dose of zoster vaccine to persons age 60 years and older, regardless of a previous
herpes zoster infection.
• Persons with chronic medical conditions may be vaccinated unless it is specifically
contraindicated, see Vaccines Indicated for Adults Based on Medical and Other Indications
chart on page 2.
6. Measles, mumps, rubella (MMR)
• Adults born before 1957 are generally considered immune to measles and mumps.
• Post-secondary students, persons working in health care facilities, and international travelers
need a second dose at least 4 weeks after their first dose.
• HCP born before 1957: If they lack evidence of immunity, i.e., documentation of immunization
or laboratory confirmation, give 2 doses of MMR at least 4 weeks apart.
• Issues specific to measles and mumps: Adults born in 1957 or later should receive 1-2
doses of MMR vaccine unless they have evidence of immunity, which includes:
○ Documentation of 1 or more doses of MMR (or measles vaccine), or
○ History of disease based on health care provider diagnosis, or
○ Laboratory evidence of immunity.
○ Revaccination is recommended for persons that received inactivated (killed) measles
vaccine or measles vaccine of unknown type received from 1963 to 1967.
• Rubella-specific issues: Women of childbearing age should have rubella immunity assessed
and be given MMR if susceptible. If assessment is performed during pregnancy and if
susceptible, give MMR upon completion of pregnancy.
Minnesota Department of Health, IC#141-0316 (01/12)
www.health.state.mn.us/immunize
7. Pneumococcal (PPSV)− Give pneumococcal polysaccharide vaccine (PPSV) to:
• All adults age 65 years and older.
• Adults younger than age 65 years with chronic cardiovascular disease, chronic pulmonary
disease including asthma, diabetes mellitus, alcoholism, chronic liver disease including
cirrhosis, CSF leaks, cochlear implants, anatomic or functional asplenia, HIV infection,
malignancy, chronic renal failure, nephrotic syndrome, receiving immunosuppressive
chemotherapy, who smoke cigarettes, or live in a nursing home or long-term care facility.
• Timing: Give PPSV at least 2 weeks prior to an elective splenectomy or when chemotherapy
or other immunosuppressive treatment is anticipated. Give PPSV to HIV positive persons
as soon as possible after diagnosis.
Revaccination
• Once-in-a-lifetime revaccination recommended if a person was vaccinated 5 or more years
ago and either:
○ Was under age 65 years when first vaccinated and is now age 65 years and older, or
○ Is under age 65 years and at highest risk for invasive pneumococcal infection:
chronic renal failure or nephrotic syndrome, anatomic or functional asplenia, or
immunocompromising conditions.
8. Hepatitis A (HepA)
• Give 2 doses of hepatitis A vaccine 6 months apart to:
○ Persons traveling to or working in countries with intermediate to high rates of HAV.
○ Men who have sex with men.
○ Persons who use street drugs.
○ Persons with chronic liver disease.
○ Persons who receive clotting factor concentrates.
○ Persons working with HAV in research settings or with HAV-infected primates.
○ Persons in close contact (e.g., household or regular child care contact) with an international
adoptee during the first 60 days after arrival of the adoptee from an intermediate or high
HAV endemic area. Vaccinate at least 2 weeks prior to adoptee’s arrival.
○ Other adults wishing to obtain immunity.
9. Hepatitis B (HepB)− Give 3 doses of hepatitis B vaccine at intervals of 0, 1, and 6 months
to all high-risk adults. Indications grouped by risk are as follows:
• Occupational: health care and public safety personnel who are exposed to blood or other
potentially infectious bodily fluids.
• Behavioral: sexually active persons who are not in a long-term mutually monogamous
relationship, injection-drug users, persons with a recently acquired STD, clients of STD
clinics, and men who have sex with men.
• Medical: those with HIV infection, chronic liver disease, persons younger than age 60 years
with diabetes, end-stage renal disease, or on dialysis.
• Other: household contacts and sex partners of persons with chronic hepatitis B virus (HBV)
infection, clients and staff of institutions for the developmentally disabled, jail and prison
inmates, persons in drug treatment, and international travelers to countries with intermediate
or high rates of HBV.
• Higher dosing of HepB is recommended for persons undergoing hemodialysis or who are
immunocompromised. Give Recombivax HB 40 mcg at intervals of 0, 1, and 6 months or
Engerix-B 20 mcg at intervals of 0, 1, 2, and 6 months.
10. Meningococcal (MCV, MPSV)
Meningococcal conjugate vaccine (MCV)
• Give a 2-dose series at intervals of 0, 2 months to:
○ Persons with persistent complement component deficiency, anatomic or functional asplenia.
○ Persons with HIV infection who are at risk due to other indicators (e.g., travel to endemic
areas, lab personnel working with N. meningitidis).
• Give 1 dose to:
○ Persons traveling to countries with endemic meningococcal disease. It is required for
travelers to Saudi Arabia during annual Hajj.
○ Military recruits.
○ Lab personnel working with N. meningitidis.
○ College students through age 21 years and living in freshmen dormitories if they have
not received MCV on or after their 16th birthday.
• Give MCV every 5 years following initial vaccination for adults who remain at risk and are
age 54 years and younger.
Meningococcal polysaccharide vaccine (MPSV)
• Give one dose of MPSV to adults age 56 years and older who have any of the above risk
factors.
• Give MPSV every 5 years to persons age 56 years or older who remain at risk for
meningococcal disease.
11. Immunocompromising conditions
• Inactivated vaccines generally are acceptable, e.g., pneumococcal, meningococcal, and
inactivated influenza vaccine. However, the immune response and efficacy may be reduced.
• Generally avoid live vaccines for persons with immune deficiencies or immunocompromising
conditions.
• Information on specific conditions is available at www.cdc.gov/vaccines/pubs/acip-list.htm.
12. Selected conditions for which Haemophilus influenzae type b (Hib) vaccine may
be used
• Consider 1 dose for any unvaccinated persons who have sickle cell disease, leukemia, HIV
infection, or who have had a splenectomy.
Page 3 of 4
CDC’s National Immunization Hotline (in English and Spanish):
800-CDC-INFO (1-800-232-4636), TTY 888-232-6348
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
78
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Catch-Up Schedule and Minimum Intervals for Adults
This catch-up schedule must be used together with the guidelines printed on the previous page(s).
Doses to be given and minimum intervals from previous dose for adults age 19 years and older
Vaccine
Minimum Interval Between Doses
Schedule
Tetanus, Diphtheria (Td)
Tetanus, Diphtheria, Pertussis (Tdap)
Human Papillomavirus (HPV)
0, 1, 7 months
Dose 1 to 2
Dose 2 to 3
Booster Dose
4 weeks
6 months
Td: 10 years after
completing the primary
series or since last
booster dose
Give Tdap for one of the doses in the series
0, 1-2, 6 months
4 weeks
Varicella (VAR)
0, 4 weeks
4 weeks
Measles, Mumps, Rubella (MMR)1
0, 4 weeks
4 weeks
Hepatitis A (HepA)
0, 6 months
6 months
Hepatitis B (HepB)
0, 1, 6 months
4 weeks
12 weeks and at
least 6 months after
first dose
8 weeks and at least
16 weeks after first
dose
1. Measles, mumps, and rubella vaccines
• May be given simultaneously, otherwise they must be separated by at least 4 weeks.
• A Mantoux test can be given simultaneously with any live or inactivated vaccine. If the patient already received MMR vaccine, the Mantoux
test must be delayed for at least 4 weeks after MMR vaccination. If the Mantoux was applied first, any vaccine, including MMR can be given
at any time.
Guidelines for Patients with an Incomplete or Nonexistent Vaccine History
• There is no need to restart a vaccine series no matter how much time
has elapsed between doses.
• For refugees and immigrants, provide vaccinations as you would for
any other adult patient. For translations of foreign vaccine terms and
vaccine products visit the Immunization Action Coalition website at
www.immunize.org/izpractices/p5122.pdf.
• Patients age 18 years and older, including foreign-born adults, do not
need polio vaccination unless they are traveling to a country where
wild poliovirus still exists.
• Count only documented vaccinations (i.e., including month, year, and
preferably, day of vaccination). If no documentation exists, assume
the patient is unvaccinated. It is always better to vaccinate when in
doubt, rather than miss an opportunity to provide protection.
National Vaccine Injury Compensation Program
When vaccinating adults with vaccines covered by the Vaccine Injury
Compensation Program, a Vaccine Information Statement (VIS) must
be given each time the patient receives vaccine. The date of the edition
of VIS given and the date the VIS was provided to the patient must be
documented in the clinic/patient record. Other required documentation
includes date of vaccination, name of the vaccine, manufacturer, and
lot number; and name, address, and title of the individual who gave the
vaccine. Download the most current VISs from the Immunization Action
Coalition website at www.immunize.org/vis.
Reporting Adverse Reactions
Report adverse reactions to vaccines through the federal Vaccine
Adverse Event Reporting System (VAERS). For information on reporting
reactions following vaccines given by private clinics, call the 24-hour
national toll-free information line, 800-822-7967. You may also visit
http://vaers.hhs.gov/index. Report reactions to vaccines given in public
clinics to the Minnesota Department of Health, 651-201-5414 or toll-free
877-676-5414.
Minnesota Department of Health, IC#141-0316 (03/11)
Disease Reporting
Report suspected cases of vaccine-preventable diseases to the local
health department or to the Minnesota Department of Health, P.O. Box
64975, St. Paul, MN 55164-0975, 651-201-5414 or toll-free 877-6765414.
Page 4 of 4
www.health.state.mn.us/immunize
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
79
80
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
81
Schedule for catch-up vaccination
and related issues
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Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years)
82
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
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Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t*GCMPPEQMBTNBBOEPSJNNVOFHMPCVMJO*(PS7;*(
XFSFHJWFOJOQBTUNTFF"$*1TUBUFNFOU
General Recommendations on Immunization*SFHBSEJOHUJNFUPXBJUCFGPSFWBDDJOBUJOH
t3FDFJQUPGTQFDJGJDBOUJWJSBMTJFBDZDMPWJSGBNDJDMPWJSPSWBMBDZDMPWJS
ISTCFGPSFWBDDJOBUJPOJG
QPTTJCMFEFMBZSFTVNQUJPOPGUIFTFBOUJWJSBMESVHTGPSEBGUFSWBDDJOBUJPO
t'PS..37POMZQFSTPOBMPSGBNJMZJFTJCMJOHPSQBSFOU
IJTUPSZPGTFJ[VSFT
Note:'PSQBUJFOUTXJUIIVNPSBMJNNVOPEFGJDJFODZPSMFVLFNJBTFF"$*1SFDPNNFOEBUJPOT
t(JWFEPTFBUBHFoN
t*GZPVOHFSUIBOBHFZST
TQBDFEPTFBOEBUMFBTU
t(JWFEPTFBUBHFoZST%PTF
PG7BSPS..37NBZCFHJWFOFBSMJFS NBQBSU*GBHFZSTPSPMEFS
TQBDFBUMFBTUXLTBQBSU
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UIFGJSTUEPTFJOUIJTBHFHSPVQ
t*G..3BOEFJUIFS7BS-"*7
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t(JWF..3BUBHFUISPVHINJG
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TQBDFUIFNBUMFBTUEBQBSU
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t8IFOVTJOH..37GPSCPUI
t(JWFEPTFBUBHFoZST%PTF
EPTFTNJOJNVNJOUFSWBMJTN
NBZCFHJWFOFBSMJFSJGBUMFBTUXLT
t8JUIJOISTPGNFBTMFTFYQP
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NBZCFHJWFOFBSMJFSJGBUMFBTUN
QPTUFYQPTVSFQSPQIZMBYJTUP
TJODFEPTF
TVTDFQUJCMFIFBMUIZDIJMESFO
t(JWFBOEEPTFUPBMMPMEFSDIJMESFO
BHFNBOEPMEFS
BOEUFFOTXJUIIJTUPSZPGPOMZEPTF
t..37NBZCFVTFEJODIJMESFOBHF
NUISPVHIZSTTFFOPUFBCPWF
Contraindications and precautions
NJMEJMMOFTTJTOPUBDPOUSBJOEJDBUJPO
Contraindications
t1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFUPBOZPGJUTDPNQPOFOUTJODMVEJOHFHHQSPUFJO
t'PS-"*7POMZBHFZPVOHFSUIBOZSTQSFHOBODZDISPOJDQVMNPOBSZJODMVEJOHBTUINB
DBSEJPWBTDVMBSFYDFQUIZQFSUFOTJPO
SFOBMIFQBUJDOFVSPMPHJDBMOFVSPNVTDVMBSIFNBUPMPHJDPS
NFUBCPMJDJODMVEJOHEJBCFUFT
EJTPSEFSTJNNVOPTVQQSFTTJPOJODMVEJOHUIBUDBVTFECZNFEJDBUJPOTPS
)*7
GPSDIJMESFOBOEUFFOTBHFTNUISPVHIZSTDVSSFOUMPOHUFSNBTQJSJOUIFSBQZGPSDIJMESFOBHF
UISPVHIZSTXIFF[JOHPSBTUINBXJUIJOUIFQBTUNQFSIFBMUIDBSFQSPWJEFSTUBUFNFOU
Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t)JTUPSZPG(VJMMBJO#BSSÏTZOESPNF(#4
XJUIJOXLTPGBQSFWJPVTJOGMVFO[BWBDDJOBUJPO
t'PS-"*7POMZ3FDFJQUPGTQFDJGJDBOUJWJSBMTJFBNBOUBEJOFSJNBOUBEJOF[BOBNJWJSPSPTFMUBNJWJS
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Schedule for catch-up
vaccination and related issues
(Page 2 of 4)
t7BDDJOBUFBMMDIJMESFOBOEUFFOTBHFNUISPVHIZST
t-"*7NBZCFHJWFOUPIFBMUIZOPOQSFHOBOUQFPQMFBHFoZST
t(JWFEPTFTTQBDFEXLTBQBSUUPDIJMESFOBHFNUISPVHIZSTXIP
BSFGJSTUUJNFWBDDJOFFTPS
GBJMFEUPSFDFJWFBUMFBTUEPTFPGUIF
oWBDDJOF
t'PS5*7HJWFN-EPTFUPDIJMESFOBHFoNBOEN-EPTFJG
BHFZSTBOEPMEFS
t*G-"*7BOEFJUIFS..37BSBOEPSZFMMPXGFWFSWBDDJOFBSFOPUHJWFO
POUIFTBNFEBZTQBDFUIFNBUMFBTUEBQBSU
Schedule for routine vaccination
and other guidelines
BOZWBDDJOFDBOCFHJWFOXJUIBOPUIFS
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years)
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
83
1147
Give IM
or SC
Pneumococcal
polysaccharide
Give IM
Pneumococcal
conjugate
1$7
Give IM
Hib
Haemophilus
influenzae
UZQFC
Vaccine name
and route
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TJDLMFDFMMEJTFBTFPSGVODUJPOBMPSBOBUPNJDBTQMFOJBHJWFBOE
EPTFPG1147ZSTBGUFSQSFWJPVT1147DPOTVMU"$*11147
SFDPNNFOEBUJPOTBUXXXDEDHPWWBDDJOFTQVCT"$*1MJTUIUN
**High-risk: 5IPTFXJUITJDLMFDFMMEJTFBTFBOBUPNJDPS
GVODUJPOBMBTQMFOJBDISPOJDDBSEJBDQVMNPOBSZPSSFOBM
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QSFTTJWFBOEPSSBEJBUJPOUIFSBQZPSXIPIBWFPSXJMMIBWF
BDPDIMFBSJNQMBOU
t'PSNJOJNVNJOUFSWBMTTFFSECVMMFUBUMFGU
t'PSBHFoN*GIJTUPSZPGEPTFTHJWFEPTFTPG1$7
XLTBQBSUXJUIBSEEPTFBUBHFoNJGIJTUPSZPGPS
EPTFTHJWFEPTFPG1$7XJUIBOEEPTFBUBHFoNBU
MFBTUXLTMBUFS
t'PSBHFoN*GVOWBDDJOBUFEPSIJTUPSZPGEPTFCFGPSFBHF
NHJWFEPTFTPG1$7XLTBQBSUJGIJTUPSZPGEPTFBU
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XLTBGUFSUIFNPTUSFDFOUEPTF
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XLTBGUFSUIFNPTUSFDFOUEPTFBOEBOPUIFSEPTFBUMFBTUXLT
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t'PSDIJMESFOBHFTUISPVHIZSTXJUIGVODUJPOBMPSBOBUPNJD
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1$7PS1147
All Hib vaccines:
t*GXBTHJWFOBUoNHJWFCPPTUFSJOXLT
t(JWFPOMZEPTFUPVOWBDDJOBUFEDIJMESFOBHFTUISPVHIN
ActHib:
tBOENBZCFHJWFOXLTBGUFSQSFWJPVTEPTF
t*GXBTHJWFOBUBHFoNPOMZEPTFTBSFOFFEFEJT
HJWFOoXLTBGUFSUIFOCPPTUBUBHFoNXBJUBUMFBTU
XLTBGUFSEPTF
PedvaxHIB and Comvax:
tNBZCFHJWFOXLTBGUFSEPTF
t"DU)JC1315
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t1FEWBY)*#PS$PNWBYDPOUBJOJOH1310.1
HJWFBUBHFNN
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t%PTFPG)JCWBDDJOFTIPVMEOPUCFHJWFOFBSMJFSUIBOBHFXLT
t(JWFGJOBMEPTFCPPTUFSEPTF
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)JCWBDDJOFTBSFBENJOJTUFSFEGPSEPTFBOEEPTFBUPUBMPG
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t"OZ)JCWBDDJOFNBZCFVTFEGPSUIFCPPTUFSEPTF
t)JCJTOPUSPVUJOFMZHJWFOUPDIJMESFOBHFZSTBOEPMEFS
t)JCFSJYJTBQQSPWFE0/-:GPSUIFCPPTUFSEPTFBUBHFNUISPVHIZST
t(JWFBUBHFTNNNoN
t%PTFNBZCFHJWFOBTFBSMZBTBHFXLT
t8IFODIJMESFOBSFCFIJOEPO1$7TDIFEVMFNJOJNVNJOUFSWBMGPS
EPTFTHJWFOUPDIJMESFOZPVOHFSUIBOBHFNJTXLTGPSEPTFT
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t(JWFEPTFUPVOWBDDJOBUFEIFBMUIZDIJMESFOBHFoN
t'PSIJHISJTLDIJMESFOBHFToN(JWFEPTFTBUMFBTUXLT
BQBSUJGUIFZQSFWJPVTMZSFDFJWFEGFXFSUIBOEPTFTHJWFEPTF
BUMFBTUXLTBGUFSUIFNPTUSFDFOUEPTFJGUIFZQSFWJPVTMZSFDFJWFE
EPTFT
t1$7JTOPUSPVUJOFMZHJWFOUPIFBMUIZDIJMESFOBHFZSTBOEPMEFS
Schedule for catch-up vaccination
and related issues
Schedule for routine vaccination and other guidelines
BOZWBDDJOFDBOCFHJWFOXJUIBOPUIFS
(Page 3 of 4)
1/12
Contraindication
1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPS
UPBOZPGJUTDPNQPOFOUT
Precaution
.PEFSBUFPSTFWFSFBDVUFJMMOFTT
Contraindication
1SFWJPVTBOBQIZMBYJTUPB1$7WBDDJOF
UPBOZPGJUTDPNQPOFOUTPSUPBOZ
EJQIUIFSJBUPYPJEDPOUBJOJOHWBDDJOF
Precaution
.PEFSBUFPSTFWFSFBDVUFJMMOFTT
Contraindications
t1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPS
UPBOZPGJUTDPNQPOFOUT
t"HFZPVOHFSUIBOXLT
Precaution
.PEFSBUFPSTFWFSFBDVUFJMMOFTT
Contraindications and precautions
NJMEJMMOFTTJTOPUBDPOUSBJOEJDBUJPO
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years)
84
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Human
papillomavirus
)17
)17$FSWBSJY
)17(BSEBTJM
Give IM
.JOJNVNJOUFSWBMTCFUXFFOEPTFTXLT
CFUXFFOBOEXLTCFUXFFO
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XLTCFUXFFOEPTFTBOE*GQPT
TJCMFVTFUIFTBNFWBDDJOFQSPEVDUGPS
BMMEPTFT
Contraindication
1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPSUPBOZPGJUT
DPNQPOFOUT
Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t*GQSFWJPVTMZWBDDJOBUFEXJUI.147
Meningococcal t(JWF.$7SPVUJOFMZBUBHFUISPVHIZSTBOEBCPPTUFSEPTFBU
BHFZST
PS.$7BOESJTLPGNFOJOHPDPD
conjugate,
DBMEJTFBTFQFSTJTUTSFWBDDJOBUFXJUI
quadrivalent t(JWF.$7UPBMMVOWBDDJOBUFEUFFOTBHFUISPVHIZSTJGWBDDJOBUFE
.$7JOZSTJGQSFWJPVTEPTFHJWFO
.$7
BUBHFoZSTHJWFCPPTUFSEPTFBUBHFoZST
Give IM
t(JWFJOJUJBMEPTFUPVOWBDDJOBUFEGJSTUZFBSDPMMFHFTUVEFOUTBHFoZST XIFOZPVOHFSUIBOBHFZST
PSJOZST
JGQSFWJPVTEPTFHJWFOBUBHFZSTPS
XIPMJWFJOSFTJEFODFIBMMTHJWFCPPTUFSEPTFJGNPTUSFDFOUEPTFHJWFO
PMEFS
5IFOHJWFBEEJUJPOBMCPPTUFS
XIFOZPVOHFSUIBOBHFZST
Meningococcal
EPTFTFWFSZZSTJGSJTLDPOUJOVFT
polysaccharide t(JWF.$7%.FOBDUSB
UPDIJMESFOBHFUISPVHINXIPIBWFQFS
TJTUFOUDPNQMFNFOUDPNQPOFOUEFGJDJFODZBSFBSFTJEFOUPGPSUSBWFMJOHUP t8IFOBENJOJTUFSJOH.$7UPDIJMESFO
.147
BDPVOUSZXJUIIZQFSFOEFNJDPSFQJEFNJDEJTFBTFPSBSFQSFTFOUEVSJOH
XJUI)*7JOGFDUJPOHJWFJOJUJBMEPTFT
Give SC
PVUCSFBLTDBVTFECZBWBDDJOFTFSPHSPVQHJWFEPTFTNBQBSUPSOP
TFQBSBUFECZXLT
TPPOFSUIBOXLTBQBSU
t(JWFFJUIFSCSBOEPG.$7UPVOWBDDJOBUFEDIJMESFOBHFNBOEPMEFS
XJUIQFSTJTUFOUDPNQMFNFOUDPNQPOFOUEFGJDJFODZPSBOBUPNJDPSGVOD
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JTHJWFOJU
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Give IM
t(JWFEPTFTFSJFTPGFJUIFS)17PS)17UPHJSMTBOEEPTFTFSJFTPG
)17UPCPZTBUBHFoZSTPOBoNTDIFEVMF.BZCFHJWFOBT
FBSMZBTBHFZST
t(JWFBEPTFTFSJFTPGFJUIFS)17PS)17UPBMMPMEFSHJSMTXPNFO
UISPVHIBHFZST
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UISPVHIBHFZST
XIPXFSFOPUQSFWJPVTMZWBDDJOBUFE
Contraindication
1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPSUPBOZPGJUT
DPNQPOFOUT
Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t1SFHOBODZ
t.JOJNVNJOUFSWBMCFUXFFOEPTFTJTN
t$IJMESFOXIPBSFOPUGVMMZWBDDJOBUFE
CZBHFZSTDBOCFWBDDJOBUFEBUTVCTF
RVFOUWJTJUT
t$POTJEFSSPVUJOFWBDDJOBUJPOPG
DIJMESFOBHFZSTBOEPMEFSJOBSFBT
XJUIOPFYJTUJOHQSPHSBN
t(JWFEPTFBTQPTUFYQPTVSF
QSPQIZMBYJTUPJODPNQMFUFMZWBDDJOBUFE
DIJMESFOBHFNBOEPMEFSXIPIBWF
SFDFOUMZEVSJOHUIFQBTUXLT
CFFO
FYQPTFEUPIFQBUJUJT"WJSVT
t(JWFEPTFTTQBDFEUPNBQBSUUPBMMDIJMESFOBUBHFZSoN
t7BDDJOBUFBMMQSFWJPVTMZVOWBDDJOBUFEDIJMESFOBOEBEPMFTDFOUTBHFZST
BOEPMEFSXIP
8BOUUPCFQSPUFDUFEGSPN)"7JOGFDUJPOBOEMBDLBTQFDJGJDSJTLGBDUPS
-JWFJOBSFBTXIFSFWBDDJOBUJPOQSPHSBNTUBSHFUPMEFSDIJMESFO
5SBWFMBOZXIFSFFYDFQU648&VSPQF/;FBMBOE"VTUSBMJB$BOBEB
PS+BQBO
)BWFDISPOJDMJWFSEJTFBTFDMPUUJOHGBDUPSEJTPSEFSPSBSFBEPMFTDFOU
NBMFTXIPIBWFTFYXJUIPUIFSNBMFT
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"OUJDJQBUFDMPTFQFSTPOBMDPOUBDUXJUIBOJOUFSOBUJPOBMBEPQUFFGSPNB
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MPXJOHUIFBEPQUFFTBSSJWBMJOUIF64
Hepatitis A
)FQ"
Give
orally
Contraindication
1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPSUPBOZPGJUT
DPNQPOFOUT
Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t1SFHOBODZ
1/12
Note: Use MPSV4 ONLY if there is a permanent contraindication or precaution to MCV4.
Contraindications
t1SFWJPVTBOBQIZMBYJTUPUIJTWBDDJOFPSUPBOZPGJUT
DPNQPOFOUT*GBMMFSHZUPMBUFYVTF37
t)JTUPSZPGJOUVTTVTDFQUJPO
t%JBHOPTJTPGTFWFSFDPNCJOFEJNNVOPEFGJDJFODZ4$*%
Precautions
t.PEFSBUFPSTFWFSFBDVUFJMMOFTT
t"MUFSFEJNNVOPDPNQFUFODFPUIFSUIBO4$*%
t$ISPOJDHBTUSPJOUFTUJOBMEJTFBTF
t4QJOBCJGJEBPSCMBEEFSFYTUSPQIZ
t%POPUCFHJOTFSJFTJOJOGBOUTPMEFS
UIBOBHFXLTEBZT
t*OUFSWBMTCFUXFFOEPTFTNBZCFBT
TIPSUBTXLT
t*GQSJPSWBDDJOBUJPOJODMVEFEVTFPG
EJGGFSFOUPSVOLOPXOCSBOET
BUPUBM
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t3PUBSJY37
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t3PUB5FR37
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t(JWFGJOBMEPTFOPMBUFSUIBOBHFNEBZT
Rotavirus
37
Contraindications and precautions
NJMEJMMOFTTJTOPUBDPOUSBJOEJDBUJPO
Schedule for routine vaccination and other guidelines
BOZWBDDJOFDBOCFHJWFOXJUIBOPUIFS
(Page 4 of 4)
Schedule for catch-up vaccination and
related issues
Vaccine name
and route
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years)
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
85
t (JWF EPTF FWFSZ ZFBS JO UIF GBMM PS XJOUFS
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œ>ˆÌˆœ˜ÊÊÊÊUÊÊÊÊ£xÇÎÊ-iLÞÊÛi˜ÕiÊÊÊÊUÊÊÊÊ->ˆ˜ÌÊ*>Տ]Ê Êxx£ä{ÊÊÊÊUÊÊÊÊ­Èx£®ÊÈ{LJ™ää™ÊÊÊÊUÊÊÊÊÜÜÜ°ˆ““Õ˜ˆâi°œÀ}ÊÊÊÊUÊÊÊÊÜÜÜ°Û>VVˆ˜iˆ˜vœÀ“>̈œ˜°œÀ}ÊÊÊÊUÊÊÊÊ>`“ˆ˜Jˆ““Õ˜ˆâi°œÀ}
/iV…˜ˆV>ÊVœ˜Ìi˜ÌÊÀiۈiÜi`ÊLÞÊ̅iÊ
i˜ÌiÀÃÊvœÀʈÃi>ÃiÊ
œ˜ÌÀœÊ>˜`Ê*ÀiÛi˜Ìˆœ˜]Ê>˜Õ>ÀÞÊÓä£Ó°
Contraindication
1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP BOZ PG JUT
DPNQPOFOUT
Precaution
.PEFSBUF PS TFWFSF BDVUF JMMOFTT
Contraindications
t1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF UP BOZ PG JUT
DPNQPOFOUT JODMVEJOH FHH QSPUFJO
t'PS -"*7 POMZ QSFHOBODZ DISPOJD QVMNPOBSZ JODMVEJOH
BTUINB
DBSEJPWBTDVMBS FYDFQU IZQFSUFOTJPO
SFOBM IFQBUJD
OFVSPMPHJDBMOFVSPNVTDVMBS IFNBUPMPHJD PS NFUBCPMJD
JODMVEJOH EJBCFUFT
EJTPSEFST JNNVOPTVQQSFTTJPO JODMVEJOH
UIBU DBVTFE CZ NFEJDBUJPOT PS )*7
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t)JTUPSZ PG (VJMMBJO#BSSÏ TZOESPNF (#4
XJUIJO XLT GPM
MPXJOH QSFWJPVT JOGMVFO[B WBDDJOBUJPO
t'PS -"*7 POMZ SFDFJQU PG TQFDJGJD BOUJWJSBMT JF BNBOUBEJOF
SJNBOUBEJOF [BOBNJWJS PS PTFMUBNJWJS
IST CFGPSF WBDDJOB
UJPO "WPJE VTF PG UIFTF BOUJWJSBM ESVHT GPS E BGUFS WBDDJOBUJPO
Contraindications and precautions
NJME JMMOFTT JT OPU B DPOUSBJOEJDBUJPO
(Page 1 of 4)
$PBMJUJPO *"$
XFCTJUF BU XXXJNNVOJ[FPSHBDJQ 5IJT UBCMF JT SFWJTFE QFSJPEJDBMMZ 7JTJU *"$T XFCTJUF
BU XXXJNNVOJ[FPSHBEVMUSVMFT UP NBLF TVSF ZPV IBWF UIF NPTU DVSSFOU WFSTJPO
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFO t(JWF EPTF JG VOWBDDJOBUFE PS JG QSFWJPVT
EBUJPOT GPS $IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHE WBDDJOBUJPO IJTUPSZ JT VOLOPXO
QQEG
t(JWF B UJNF SFWBDDJOBUJPO UP QFPQMF
t1FPQMF BHF ZST BOE PMEFS
"HF ZST BOE PMEFS JG TU EPTF XBT HJWFO
QSJPS UP BHF ZST BOE ZST IBWF FMBQTFE
t1FPQMF ZPVOHFS UIBO BHF ZST XIP IBWF DISPOJD JMMOFTT PS
TJODF EPTF PUIFS SJTL GBDUPST JODMVEJOH DISPOJD DBSEJBD PS QVMNPOBSZ EJTFBTF
JODMVEJOH BTUINB
DISPOJD MJWFS EJTFBTF BMDPIPMJTN EJBCFUFT
"HF UISPVHI ZST XIP BSF BU IJHI
$4' MFBLT DJHBSFUUF TNPLJOH BT XFMM BT DBOEJEBUFT GPS PS SFDJQJ
FTU SJTL PG GBUBM QOFVNPDPDDBM JOGFDUJPO
FOUT PG DPDIMFBS JNQMBOUT BOE QFPQMF MJWJOH JO TQFDJBM FOWJSPONFOUT
PS SBQJE BOUJCPEZ MPTT TFF UIF SE CVMMFU
PS TPDJBM TFUUJOHT JODMVEJOH "NFSJDBO *OEJBO"MBTLB /BUJWFT BHF
JO UIF CPY UP MFGU GPS MJTUJOHT PG QFPQMF BU
UISPVHI ZST JG SFDPNNFOEFE CZ MPDBM QVCMJD IFBMUI BVUIPSJ
IJHIFTU SJTL
BOE ZST IBWF FMBQTFE TJODF
UJFT
EPTF t5IPTF BU IJHIFTU SJTL PG GBUBM QOFVNPDPDDBM JOGFDUJPO JODMVEJOH
QFPQMF XIP
)BWF BOBUPNJD PS GVODUJPOBM BTQMFOJB JODMVEJOH TJDLMF DFMM EJT
FBTF
)BWF BO JNNVOPDPNQSPNJTJOH DPOEJUJPO JODMVEJOH )*7 JOGFD
UJPO MFVLFNJB MZNQIPNB )PEHLJOT EJTFBTF NVMUJQMF NZFMP
NB HFOFSBMJ[FE NBMJHOBODZ DISPOJD SFOBM GBJMVSF PS OFQISPUJD
TZOESPNF
"SF SFDFJWJOH JNNVOPTVQQSFTTJWF DIFNPUIFSBQZ JODMVEJOH
DPSUJDPTUFSPJET
)BWF SFDFJWFE BO PSHBO PS CPOF NBSSPX USBOTQMBOU
Schedule for vaccine administration
BOZ WBDDJOF DBO CF HJWFO XJUI BOPUIFS
People for whom vaccination is recommended
5IJT EPDVNFOU XBT BEBQUFE GSPN UIF SFDPNNFOEBUJPOT PG UIF "EWJTPSZ $PNNJUUFF PO *NNVOJ[BUJPO
1SBDUJDFT"$*1
5PPCUBJODPQJFTPGUIFTFSFDPNNFOEBUJPOTDBMMUIF$%$*/'0$POUBDU$FOUFSBU
WJTJU $%$T XFCTJUF BU XXXDEDHPWWBDDJOFTQVCT"$*1MJTUIUN PS WJTJU UIF *NNVOJ[BUJPO "DUJPO
Pneumococcal
polysaccharide
1147
Give IM or SC
-JWF BUUFOVBUFE
JOGMVFO[B
WBDDJOF
-"*7
Give
intranasally
Influenza
5SJWBMFOU
JOBDUJWBUFE
JOGMVFO[B
WBDDJOF
5*7
Give IM or ID
(intradermally)
Vaccine name
and route
Summary of Recommendations for Adult Immunization (Age 19 years & older)
86
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Give SC
;PT
Zoster
TIJOHMFT
Varicella
DIJDLFOQPY
7BS
Give SC
MMR
.FBTMFT
NVNQT
SVCFMMB
Give SC
Vaccine name
and route
1/12
Contraindications
t1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP BOZ DPNQPOFOU PG [PTUFS WBDDJOF
t1SJNBSZ DFMMVMBS PS BDRVJSFE JNNVOPEFGJDJFODZ
t1SFHOBODZ
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t3FDFJQU PG TQFDJGJD BOUJWJSBMT JF BDZDMPWJS GBNDJDMPWJS PS
WBMBDZDMPWJS
IST CFGPSF WBDDJOBUJPO JG QPTTJCMF EFMBZ
SFTVNQUJPO PG UIFTF BOUJWJSBM ESVHT GPS E BGUFS WBDDJOBUJPO
t(JWF UJNF EPTF JG VOWBDDJOBUFE
SFHBSEMFTT PG QSFWJPVT IJTUPSZ PG IFS
QFT [PTUFS TIJOHMFT
PS DIJDLFOQPY
t*G PS NPSF PG UIF GPMMPXJOH MJWF WJ
SVT WBDDJOFT BSF UP CF HJWFO‰..3
;PT BOEPS ZFMMPX GFWFS‰UIFZ
TIPVME CF HJWFO PO UIF TBNF EBZ *G
UIFZ BSF OPU TQBDF UIFN CZ BU MFBTU
E
t1FPQMF BHF ZST BOE PMEFS
Contraindications
t1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP BOZ PG JUT
DPNQPOFOUT
t1SFHOBODZ PS QPTTJCJMJUZ PG QSFHOBODZ XJUIJO XLT
t1FPQMF PO IJHIEPTF JNNVOPTVQQSFTTJWF UIFSBQZ PS XIP BSF
JNNVOPDPNQSPNJTFE CFDBVTF PG NBMJHOBODZ BOE QSJNBSZ PS
BDRVJSFE DFMMVMBS JNNVOPEFGJDJFODZ JODMVEJOH )*7"*%4
BMUIPVHI WBDDJOBUJPO NBZ CF DPOTJEFSFE JG $% 5MZNQIPDZUF
DPVOUT BSF HSFBUFS UIBO PS FRVBM UP DFMMT˜- 4FF MMWR
33
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t*G CMPPE QMBTNB BOEPS JNNVOF HMPCVMJO *( PS 7;*(
XFSF
HJWFO JO QBTU N TFF "$*1 TUBUFNFOU General Recommendations
on Immunization* SFHBSEJOH UJNF UP XBJU CFGPSF WBDDJOBUJOH
t3FDFJQU PG TQFDJGJD BOUJWJSBMT JF BDZDMPWJS GBNDJDMPWJS PS
WBMBDZDMPWJS
IST CFGPSF WBDDJOBUJPO JG QPTTJCMF EFMBZ SFTVNQ
UJPO PG UIFTF BOUJWJSBM ESVHT GPS E BGUFS WBDDJOBUJPO
t(JWF EPTFT
t%PTF JT HJWFO oXLT BGUFS EPTF
t*G EPTF JT EFMBZFE EP OPU SFQFBU
EPTF +VTU HJWF EPTF t*G PS NPSF PG UIF GPMMPXJOH MJWF
WJSVT WBDDJOFT BSF UP CF HJWFO‰
-"*7 ..3 7BS ;PT BOEPS ZFMMPX
GFWFS‰UIFZ TIPVME CF HJWFO PO UIF
TBNF EBZ *G UIFZ BSF OPU TQBDF UIFN
CZ BU MFBTU E
t.BZ VTF BT QPTUFYQPTVSF QSPQIZMBYJT
JG HJWFO XJUIJO E
Note: 3PVUJOF QPTUWBDDJOBUJPO TFSP
MPHJD UFTUJOH JT OPU SFDPNNFOEFE
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFOEB
UJPOT GPS $IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHE
QQEG
t"MM BEVMUT XJUIPVU FWJEFODF PG JNNVOJUZ
Note: &WJEFODF PG JNNVOJUZ JT EFGJOFE BT XSJUUFO EPDVNFOUBUJPO PG
EPTFT PG WBSJDFMMB WBDDJOF B IJTUPSZ PG WBSJDFMMB EJTFBTF PS IFSQFT
[PTUFS TIJOHMFT
CBTFE PO IFBMUIDBSFQSPWJEFS EJBHOPTJT MBCPSBUPSZ
FWJEFODF PG JNNVOJUZ BOEPS CJSUI JO UIF 64 CFGPSF XJUI UIF
FYDFQUJPOT UIBU GPMMPX
)FBMUIDBSF QFSTPOOFM )$1
CPSO JO UIF 64 CFGPSF XIP EP
OPU NFFU BOZ PG UIF DSJUFSJB BCPWF TIPVME CF UFTUFE PS HJWFO UIF
EPTF WBDDJOF TFSJFT *G UFTUJOH JOEJDBUFT UIFZ BSF OPU JNNVOF
HJWF UIF TU EPTF PG WBSJDFMMB WBDDJOF JNNFEJBUFMZ (JWF UIF OE
EPTF o XLT MBUFS
1SFHOBOU XPNFO CPSO JO UIF 64 CFGPSF XIP EP OPU NFFU BOZ
PG UIF DSJUFSJB BCPWF TIPVME FJUIFS CF UFTUFE GPS TVTDFQUJCJMJUZ EVS
JOH QSFHOBODZ BOE JG GPVOE TVTDFQUJCMF HJWFO UIF TU EPTF PG WBSJDFM
MB WBDDJOF QPTUQBSUVN CFGPSF IPTQJUBM EJTDIBSHF PS OPU CF UFTUFE
GPS TVTDFQUJCJMJUZ BOE HJWFO UIF TU EPTF PG WBSJDFMMB WBDDJOF QPTUQBS
UVN CFGPSF IPTQJUBM EJTDIBSHF (JWF UIF OE EPTF oXLT MBUFS
Contraindications
t1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP BOZ PG JUT
DPNQPOFOUT
t1SFHOBODZ PS QPTTJCJMJUZ PG QSFHOBODZ XJUIJO XLT
t4FWFSF JNNVOPEFGJDJFODZ FH IFNBUPMPHJD BOE TPMJE UVNPST
SFDFJWJOH DIFNPUIFSBQZ DPOHFOJUBM JNNVOPEFGJDJFODZ MPOH
UFSN JNNVOPTVQQSFTTJWF UIFSBQZ PS TFWFSFMZ TZNQUPNBUJD )*7
Note: )*7 JOGFDUJPO JT /05 B DPOUSBJOEJDBUJPO UP ..3 GPS UIPTF
XIP BSF OPU TFWFSFMZ JNNVOPDPNQSPNJTFE JF $% 5MZNQIP
DZUF DPVOUT BSF HSFBUFS UIBO PS FRVBM UP DFMMT˜-®
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t*G CMPPE QMBTNB BOEPS JNNVOF HMPCVMJO XFSF HJWFO JO QBTU
N TFF "$*1 TUBUFNFOU General Recommendations on Immunization* SFHBSEJOH UJNF UP XBJU CFGPSF WBDDJOBUJOH
t)JTUPSZ PG UISPNCPDZUPQFOJB PS UISPNCPDZUPQFOJD QVSQVSB
Note: *G 545 UVCFSDVMPTJT TLJO UFTU
BOE ..3 BSF CPUI OFFEFE
CVU OPU HJWFO PO TBNF EBZ EFMBZ 545 GPS oXLT BGUFS ..3
Contraindications and precautions
NJME JMMOFTT JT OPU B DPOUSBJOEJDBUJPO
t(JWF PS EPTFT TFF DSJUFSJB JO TU
BOE OE CVMMFUT JO CPY UP MFGU
t*G EPTF JT SFDPNNFOEFE HJWF JU OP
TPPOFS UIBO XLT BGUFS EPTF t*G B QSFHOBOU XPNBO JT GPVOE UP CF
SVCFMMB TVTDFQUJCMF HJWF EPTF PG
..3 QPTUQBSUVN
t*G PS NPSF PG UIF GPMMPXJOH MJWF
WJSVT WBDDJOFT BSF UP CF HJWFO‰
-"*7 ..3 7BS ;PT BOEPS ZFMMPX
GFWFS‰UIFZ TIPVME CF HJWFO PO UIF
TBNF EBZ *G UIFZ BSF OPU TQBDF UIFN
CZ BU MFBTU E
t8JUIJO IST PG NFBTMFT FYQPTVSF
HJWF EPTF BT QPTUFYQPTVSF QSPQIZ
MBYJT UP TVTDFQUJCMF BEVMUT
Note: 3PVUJOF QPTUWBDDJOBUJPO TFSP
MPHJD UFTUJOH JT OPU SFDPNNFOEFE
Schedule for vaccine administration
BOZ WBDDJOF DBO CF HJWFO XJUI BOPUIFS
(Page 2 of 4)
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFOEB
UJPOT GPS $IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHE
QQEG
t1FPQMF CPSO JO PS MBUFS FTQFDJBMMZ UIPTF CPSO PVUTJEF UIF 64
TIPVME SFDFJWF BU MFBTU EPTF PG ..3 JG UIFSF JT OP MBCPSBUPSZ FWJ
EFODF PG JNNVOJUZ PS EPDVNFOUBUJPO PG B EPTF HJWFO PO PS BGUFS UIF
GJSTU CJSUIEBZ
t1FPQMF JO IJHISJTL HSPVQT TVDI BT IFBMUIDBSF QFSTPOOFM QBJE VO
QBJE PS WPMVOUFFS
TUVEFOUT FOUFSJOH DPMMFHF BOE PUIFS QPTUoIJHI
TDIPPM FEVDBUJPOBM JOTUJUVUJPOT BOE JOUFSOBUJPOBM USBWFMFST TIPVME
SFDFJWF B UPUBM PG EPTFT
t1FPQMF CPSO CFGPSF BSF VTVBMMZ DPOTJEFSFE JNNVOF CVU
FWJEFODF PG JNNVOJUZ TFSPMPHZ PS EPDVNFOUFE IJTUPSZ PG EPTFT PG
..3
TIPVME CF DPOTJEFSFE GPS IFBMUIDBSF QFSTPOOFM
t8PNFO PG DIJMECFBSJOH BHF XIP EP OPU IBWF BDDFQUBCMF FWJEFODF PG
SVCFMMB JNNVOJUZ PS WBDDJOBUJPO
People for whom vaccination is recommended
Summary of Recommendations for Adult Immunization (Age 19 years & older)
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
87
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFOEBUJPOT GPS
$IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHEQQEG
t"MM QFPQMF XIP XBOU UP CF QSPUFDUFE GSPN IFQBUJUJT " WJSVT )"7
JOGFDUJPO BOE
MBDL B TQFDJGJD SJTL GBDUPS
t1FPQMF XIP USBWFM PS XPSL BOZXIFSF &9$&15 UIF 64 8FTUFSO &VSPQF /FX
;FBMBOE "VTUSBMJB $BOBEB BOE +BQBO
t1FPQMF XJUI DISPOJD MJWFS EJTFBTF JOKFDUJOH BOE OPOJOKFDUJOH ESVH VTFST NFO
XIP IBWF TFY XJUI NFO QFPQMF XIP SFDFJWF DMPUUJOHGBDUPS DPODFOUSBUFT
QFPQMF XIP XPSL XJUI )"7 JO FYQFSJNFOUBM MBC TFUUJOHT GPPE IBOEMFST XIFO
IFBMUI BVUIPSJUJFT PS QSJWBUF FNQMPZFST EFUFSNJOF WBDDJOBUJPO UP CF BQQSPQSJBUF
t1FPQMF XIP BOUJDJQBUF DMPTF QFSTPOBM DPOUBDU XJUI BO JOUFSOBUJPOBM BEPQUFF GSPN
B DPVOUSZ PG IJHI PS JOUFSNFEJBUF FOEFNJDJUZ EVSJOH UIF GJSTU EBZT GPMMPXJOH
UIF BEPQUFFT BSSJWBM JO UIF 64
t"EVMUT BHF ZST PS ZPVOHFS XJUI SFDFOU XJUIJO XLT
FYQPTVSF UP )"7 'PS
QFPQMF PMEFS UIBO BHF ZST XJUI SFDFOU XJUIJO XLT
FYQPTVSF UP )"7 JN
NVOF HMPCVMJO JT QSFGFSSFE PWFS )FQ" WBDDJOF
People for whom vaccination is recommended
Polio
*17
Give IM or SC
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFOEBUJPOT GPS
$IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHEQQEG
t/PU SPVUJOFMZ SFDPNNFOEFE GPS 64 SFTJEFOUT BHF ZST BOE PMEFS
/PUF "EVMUT MJWJOH JO UIF 64 XIP OFWFS SFDFJWFE PS DPNQMFUFE B QSJNBSZ TFSJFT
PG QPMJP WBDDJOF OFFE OPU CF WBDDJOBUFE VOMFTT UIFZ JOUFOE UP USBWFM UP BSFBT
XIFSF FYQPTVSF UP XJMEUZQF WJSVT JT MJLFMZ 1SFWJPVTMZ WBDDJOBUFE BEVMUT DBO
SFDFJWF CPPTUFS EPTF JG USBWFMJOH UP QPMJP FOEFNJD BSFBT PS UP BSFBT XIFSF UIF
SJTL PG FYQPTVSF JT IJHI
'PS QFPQMF UISPVHI BHF ZFBST DPOTVMU i4VNNBSZ PG 3FDPNNFOEBUJPOT GPS
$IJME5FFO *NNVOJ[BUJPOw BU XXXJNNVOJ[FPSHDBUHEQQEG
t"MM BEVMUT XIP XBOU UP CF QSPUFDUFE GSPN IFQBUJUJT # WJSVT JOGFDUJPO BOE MBDL B
Give IM
TQFDJGJD SJTL GBDUPS
t)PVTFIPME DPOUBDUT BOE TFY QBSUOFST PG )#T"HQPTJUJWF QFPQMF JOKFDUJOH ESVH
#SBOET NBZ
VTFST TFYVBMMZ BDUJWF QFPQMF OPU JO B MPOHUFSN NVUVBMMZ NPOPHBNPVT SFMB
CF VTFE
UJPOTIJQ NFO XIP IBWF TFY XJUI NFO QFPQMF XJUI )*7 QFPQMF TFFLJOH 45%
JOUFSDIBOHFBCMZ
FWBMVBUJPO PS USFBUNFOU IFNPEJBMZTJT QBUJFOUT BOE UIPTF XJUI SFOBM EJTFBTF UIBU
NBZ SFTVMU JO EJBMZTJT EJBCFUJDT ZPVOHFS UIBO BHF ZST EJBCFUJDT BHF ZST
BOE PMEFS NBZ CF WBDDJOBUFE BU UIF DMJOJDJBOT EJTDSFUJPO <TFF "$*1 SFDPNNFO
EBUJPOT>
IFBMUIDBSF QFSTPOOFM BOE QVCMJD TBGFUZ XPSLFST XIP BSF FYQPTFE UP
CMPPE DMJFOUT BOE TUBGG PG JOTUJUVUJPOT GPS UIF EFWFMPQNFOUBMMZ EJTBCMFE JONBUFT
PG MPOHUFSN DPSSFDUJPOBM GBDJMJUJFT DFSUBJO JOUFSOBUJPOBM USBWFMFST BOE QFPQMF
XJUI DISPOJD MJWFS EJTFBTF
Note: 1SPWJEF TFSPMPHJD TDSFFOJOH GPS JNNJHSBOUT GSPN FOEFNJD BSFBT *G QBUJFOU
JT DISPOJDBMMZ JOGFDUFE BTTVSF BQQSPQSJBUF EJTFBTF NBOBHFNFOU 'PS TFY QBSUOFST
BOE IPVTFIPME DPOUBDUT PG )#T"HQPTJUJWF QFPQMF QSPWJEF TFSPMPHJD TDSFFOJOH
BOE BENJOJTUFS JOJUJBM EPTF PG )FQ# WBDDJOF BU TBNF WJTJU
Hepatitis B
)FQ#
#SBOET NBZ
CF VTFE
JOUFSDIBOHFBCMZ
Give IM
Hepatitis A
)FQ"
Vaccine name
and route
t3FGFS UP "$*1 SFDPNNFOEBUJPOT SF
HBSEJOH VOJRVF TJUVBUJPOT TDIFEVMFT
BOE EPTJOH JOGPSNBUJPO
(JWF EPTFT PO B N TDIFEVMF
t"MUFSOBUJWF UJNJOH PQUJPOT GPS WBDDJOB
UJPO JODMVEF N N BOE N &OHFSJY CSBOE POMZ
t5IFSF NVTU CF BU MFBTU XLT CFUXFFO
EPTFT BOE BOE BU MFBTU XLT
CFUXFFO EPTFT BOE 0WFSBMM
UIFSF NVTU CF BU MFBTU XLT CFUXFFO
EPTFT BOE s3CHEDULE FOR THOSE WHO HAVE FALLEN
behind: *G UIF TFSJFT JT EFMBZFE CFUXFFO
EPTFT %0 /05 TUBSU UIF TFSJFT PWFS
$POUJOVF GSPN XIFSF ZPV MFGU PGG
'PS 5XJOSJY IFQBUJUJT " BOE # DPN
CJOBUJPO WBDDJOF <(4,>
GPS QBUJFOUT
BHF ZST BOE PMEFS POMZ HJWF
EPTFT PO B N TDIFEVMF 5IFSF
NVTU CF BU MFBTU XLT CFUXFFO EPTFT
BOE BOE BU MFBTU N CFUXFFO
EPTFT BOE "O BMUFSOBUJWF TDIFEVMF DBO BMTP CF
VTFE BU E oE BOE B CPPTUFS
BU N
t(JWF EPTFT TQBDFE oN BQBSU
t*G EPTF JT EFMBZFE EP OPU SFQFBU
EPTF +VTU HJWF EPTF Schedule for vaccine administration
BOZ WBDDJOF DBO CF HJWFO XJUI BOPUIFS
(Page 3 of 4)
1/12
Contraindication
1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP
BOZ PG JUT DPNQPOFOUT
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t1SFHOBODZ
Contraindication
1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP
BOZ PG JUT DPNQPOFOUT
Precaution
.PEFSBUF PS TFWFSF BDVUF JMMOFTT
Contraindication
1SFWJPVT BOBQIZMBDUJD SFBDUJPO UP UIJT WBDDJOF PS UP
BOZ PG JUT DPNQPOFOUT
Precautions
t.PEFSBUF PS TFWFSF BDVUF JMMOFTT
t1SFHOBODZ
Contraindications and precautions
NJME JMMOFTT JT OPU B DPOUSBJOEJDBUJPO
Summary of Recommendations for Adult Immunization (Age 19 years & older)
88
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
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(Page 4 of 4)
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Human
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)17 $FSWBSJY
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Vaccine name
and route
Summary of Recommendations for Adult Immunization (Age 19 years & older)
Front
Back
Perinatal Hepatitis B Prevention
Pocket Guide
Management of Pregnant Women
Prenatal HBsAg Testing
 Test ALL pregnant women within first trimester of EACH
pregnancy, even if tested before or had hepatitis B vaccines.
 Send copy of lab report with the HBsAg-positive results to the
hospital of delivery and the infant’s healthcare provider.
 Report to MDH all HBsAg-positive women within one working
day of knowledge of the pregnancy.
 Refer for or provide HBsAg-positive women counseling and
medical management. Give the following information:
9 Modes of hepatitis transmission.
9 Perinatal concerns (i.e. HBsAg-positive mothers may breastfeed,
treatment of newborns for exposure to hepatitis B).
9 Prevention of HBV to contacts, include vaccine prophylaxis for
infant(s) and testing and/or hepatitis B vaccination for household,
sexual, and needle-sharing contacts.
9 Substance abuse treatment and/or mental healthcare if appropriate.
9 Medical evaluation and possible treatment of chronic hepatitis B.
Management of Delivery and Infant
At admission for delivery:
 Review HBsAg status of all pregnant women. Perform HBsAg
testing as soon as possible on women who:
9 do not have a documented HBsAg test result,
9 were at risk for HBV infection during pregnancy, or
9 had clinical hepatitis since previous testing.
 Retest HBsAg-negative women (at time of hospital delivery)
with high-risk behaviors for infection:
9 Injection-drug use,
9 More than one sex partner in 6 months,
9 HBsAg-positive sexual partner,
9 Evaluation or treatment for sexually transmitted disease (STD),
9 Exhibits clinical hepatitis symptoms.
 Place copy of maternal HBsAg results on labor/delivery record,
infant’s delivery summary, and nursery medical record.
After delivery:
ALL infants
If mother’s
Also give infant:
should receive: HBsAg status is:
Positive
HBIG within 12 hours of birth
Hep B vaccine
within
Negative
No HBIG needed
12 hours
Give HBIG if test positive
Unknown
of birth
(at discharge)
Must be given within 7 days of birth
Minnesota Immunization Program 1-800-657-3970
 Preterm infants weighing less than 2,000g:
9 Born to HBsAg-positive mothers: give hep B vaccine and HBIG
within 12 hours of birth.
9 Born to HBsAg-negative mothers: give first dose of hep B vaccine at
one month of age.
9 Born to mothers whose HBsAg status is unknown: give hep B
vaccine and HBIG within 12 hours of birth.
 For HBsAg-positive mothers and mothers whose HBsAg status
is unknown at time of discharge
9 Fax “Hospital Report Form” to MDH within 1 working day of infant’s birth.
9 Alert infant’s pediatric provider.
 Record date and time vaccines were given on infant’s record.
Case Management of Infants Born to HBsAg-positive Mothers
 Completion of hep B vaccine series at 1-2 months and 6
months of age (using monovalent vaccine).
 If using a combination hep B vaccine (e.g. Hib-hep B or DTaPIPV-hep B), final dose should NOT be administered before age
24 weeks (164 days).
 Administration of 4 doses of hep B vaccine is permissible when
giving combination vaccines after the birth dose.
 Report all vaccine dates to local and/or state health departments.
 Perform post-vaccination serology at 12 months of age. (No
earlier than 9 months of age.)
 Test for both HBsAg and anti-HBs.
 Report test results to local and/or state health department.
Interpretation of Serology Results
Result
Follow-up needed
Anti-HBs positive
None. Infant is protected.
HBsAg-negative
No response. Infant is susceptible to infection.
3 doses of hep B vaccine series as soon as
Anti-HBs negative Repeat
possible. Schedule of 0,1,4 months. Recheck
HBsAg-negative
serology 4-6 weeks after last dose. Monovalent
hepatitis B vaccine must be used for second series.
Anti-HBs negative Infant infected with hepatitis B. Needs regular
HBsAg-positive
check-ups and liver function tests.
Remember to report HBsAg-positive test results to local and/or
state health department.
Immunization Program
P.O. Box 64975
St. Paul, MN, 55164-0975
651-201-5503 or 800-657-3970
www.health.state.mn.us/immunize
1/08
IC#141-1687
Available on the web at: www.health.state.mn.us/divs/idepc/diseases/hepb/perinatal/pocket.htmll
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
89
Front
Back
Pneumococcal Vaccination
Pocket Guide
Algorithm for (re)vaccinating persons age 65 years or older
Has the person been
vaccinated previously?
Pneumococcal polysaccharide vaccine (PPSV) is indicated for persons
age 65 years or older, or age 2 through 64 years with any of the following:
• Chronic cardiovascular disease (e.g., CHF, cardiomyopathies)
• Chronic pulmonary disease (e.g., emphysema or COPD, including
asthma)
• Cigarette smokers age 19 through 64 years
• Chronic liver disease, including persons with long-term alcoholism
• Diabetes mellitus
• CSF leaks
• Functional or anatomic asplenia (e.g. sickle cell disease or
splenectomy)
• Immunosuppressive conditions (e.g., HIV infection, leukemia,
congenital immunodeficiency, Hodgkin’s disease, lymphoma,
multiple myeloma, or generalized malignancy)
• Organ or bone marrow transplantation
• Therapy with alkylating agents, antimetabolites, or systemic
corticosteroids
• Chronic renal failure or nephrotic syndrome
• Cochlear implants
Was the person age 65
years or older at the time of
last vaccination?
Yes
No
Have 5 or more years
elapsed since the first dose?
Yes
Vaccination not indicated
No
WHO GETS A SECOND DOSE OF PPSV?
A maximum of two PPSV doses in a lifetime is all that is recommended.
A second dose is indicated for persons:
• Age 2 through 64 years with any of the following: functional or
anatomic asplenia, immunosuppression, transplant, chronic renal
failure, nephrotic syndrome.
• Age 65 years or older who received the first dose prior to age 65 years.
AGE OF PATIENT:
SPACING BETWEEN SHOTS:
Age 2 through 9 years
Age 10 through 64 years
Age 65 years or older
3 years apart
At least 5 years apart
At least 5 years apart
TALKING POINTS WITH PATIENTS
CONTRAINDICATIONS AND PRECAUTIONS
Previous anaphylactic reaction to PPSV or any of its components
Moderate to severe illness
•
•
UNKNOWN HISTORY
•
Make a reasonable effort to obtain a vaccination history. When
in doubt, vaccinate. The risks of invasive pneumococcal disease
outweigh the risks of revaccination.
•
VACCINE ADMINISTRATION
•
•
Administer 0.5 ml PPSV intramuscularly (IM) or subcutaneously (SC):
• IM: 1 - 1.5” 22-25 gauge needle OR
• SC: 5/8” 23-25 gauge needle
• Children age 2 years or older at risk for invasive pneumococcal
disease need PPSV. It should be separated by 8 weeks from a
dose of PCV.
Minnesota Immunization Program
(Re)vaccination indicated
Yes
INDICATIONS
•
•
No or
unsure
•
•
•
Most pneumococcal deaths are in people age 65 or older.
Flu and its most common complication, pneumonia, are the sixth
leading cause of death in Minnesota.
PPSV is 60-70% effective in preventing most strains of pneumonia
from spreading to the blood (bacteremia) or brain (meningitis)
Immunization can prevent prolonged hospitalization or death due
to invasive pneumococcal disease.
The vaccine is important because pneumococcal disease is
increasingly drug-resistant and hard to treat.
Medicare Part B and most health plans pay for the vaccine.
The vaccine is safe; the most common side effect is a sore arm
lasting 24-48 hours.
PPSV can be given at any time during the year.
It’s okay to get this shot at the same time as the flu shot or any
other vaccine.
1-800-657-3970
IC# 141-0837 (MDH, 12/2009)
Available on the web at: www.health.state.mn.us/divs/idepc/diseases/pneumococcal/hcp/pocket.html
90
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Minnesota Department of Health, July 2011
Front
Back
Pregnancy and Vaccination
Pregnant women may be at risk for infectious diseases and their
complications. Consider vaccination - even during pregnancy - to
protect the woman and the fetus.
Recommended
Vaccine
Contraindicated
BEFORE
pregnancy
If at risk
DURING
pregnancy
Hepatitis A (HepA)
If at risk
Hepatitis B (HepB)
If indicated
Human
Papillomavirus (HPV)
Age 9 through
26 years
Influenza (TIV)
Contraindicated,
under study
Avoid
conception
for 4 weeks
Measles, Mumps,
Rubella (MMR)
Avoid
conception
for 4 weeks
Avoid
conception
for 4 weeks
Contraindicated
Give immediately
postpartum if
susceptible
to rubella
If indicated
Pneumococcal
(PPSV)
If indicated
Tetanus, Diphtheria
(Td)
Varicella (VAR)
Age 9 through
26 years
Contraindicated
Meningococcal
(MCV)
one dose only
AFTER
pregnancy
1 dose annually
Influenza (LAIV)
Tetanus, Diphtheria,
Pertussis (Tdap)
If indicated
Preferred
If at risk of
pertussis,otherwise
Td preferred
Preferred
Tdap preferred
If indicated
Tdap preferred
Avoid
conception
for 4 weeks
Contraindicated
Give immediately
postpartum if
susceptible
MDH Immunization Program
Considerations
Recommended - Vaccine is recommended regardless of pregnancy.
Contraindicated - Vaccine is contraindicated for pregnant women
because of the theoretical risk of transmission of the vaccine virus to
the fetus.
If at risk - Certain vaccines have limited data regarding administration
and pregnancy. Only consider these vaccines for pregnant women if there
is a risk of exposure and subsequent disease (e.g., community outbreak).
If indicated - Certain vaccines are indicted based on patient risk factors
(e.g., medical, occupational, lifestyle, international travel) and should be
given if susceptible regardless of pregnancy.
Td/Tdap
• If last Td vaccination was 10 or more years ago, give Td during the
second or third trimester.
• If last Td vaccination was within the past 10 years, give Tdap during the
immediate postpartum period.
• In a pertussis outbreak Td can be deferred during pregnancy and Tdap
substituted in the immediate postpartum period, or Tdap can be given
instead of Td after discussing the risks and benefits with the pregnant
woman.
• Give Tdap to household contacts and caregivers to protect the newborn.
Vaccine-related prenatal serologic screening
• Test for rubella: if susceptible, vaccinate postpartum.
• Test for hepatitis B: vaccinate if susceptible and at risk. Send results
to birthing hospital; if HBsAg-positive, report results to the Minnesota
Department of Health.
Vaccinating household contacts of pregnant women
• Household contacts of pregnant women should receive Tdap and
influenza vaccines, as well as hepatitis B (if pregnant woman is HBsAgpositive).
• No vaccine - except smallpox - is contraindicated for household
contacts or the children of a pregnant woman.
Vaccinating breast-feeding women
• Neither inactivated nor live-virus vaccines given to a breast-feeding
woman affects the safety of breast-feeding for mothers or infants.
− Most live-virus vaccines are not secreted in breast milk; however, if
this does occur (i.e., with attenuated rubella vaccination) it produces
asymptomatic infection in infants.
• Breast-feeding does not adversely affect immunization and is not a
contraindication for any vaccine - except smallpox.
Vaccinating newborns
• Stress the importance of vaccinating newborns, starting with the
hepatitis B birth dose.
1-800-657-3970
IC# 141-3140 (12/10)
Available to order from the Minnesota Immunization Program, 1-800-657-3970.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
91
92
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Morbidity and Mortality Weekly Report
Recommendations and Reports / Vol. 60 / No. 2
January 28, 2011
General Recommendations on Immunization
Recommendations of the Advisory Committee
on Immunization Practices (ACIP)
Table 1: Recommended
andExamination
minimum available
ages and
intervals between vaccine doses.
Continuing Education
at http://www.cdc.gov/mmwr/cme/conted.html
Table 3: Guidelines for spacing of live and inactivated antigens.
Table 4: Guidelines for administering antibody-containing products and vaccines.
Table 5: Recommended intervals between administration of antibody-containing products and
Department of Health and Human Services
measles- or varicella-containing U.S.
vaccine,
by product and indication for vaccination.
Centers for Disease Control and Prevention
Table 13: Vaccination of persons with primary and secondary immunodeficiencies.
Table 14: Approaches to evaluation and vaccination of persons vaccinated outside the United
States who have no (or questionable) vaccination records.
Available on the web at: www.cdc.gov/mmwr/pdf/rr/rr6002.pdfl
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
93
Recommendations and Reports
TABLE 1. Recommended and minimum ages and intervals between vaccine doses*†
Recommended
age for this dose
Vaccine and dose number
HepB-1§
HepB-2
HepB-3¶
DTaP-1§
DTaP-2
DTaP-3
DTaP-4
DTaP-5
Hib-1§,§§
Hib-2
Hib-3¶¶
Hib-4
IPV-1§
IPV-2
IPV-3
IPV-4***
PCV-1§§
PCV-2
PCV-3
PCV-4
MMR-1†††
MMR-2†††
Varicella-1†††
Varicella-2†††
HepA-1
HepA-2
Influenza, inactivated¶¶¶
LAIV (intranasal)¶¶¶
MCV4-1††††
MCV4-2
MPSV4-1††††
MPSV4-2
Td
Tdap§§§§
PPSV-1
PPSV-2¶¶¶¶
HPV-1*****
HPV-2
HPV-3†††††
Rotavirus-1§§§§§
Rotavirus-2
Rotavirus-3¶¶¶¶¶
Herpes zoster******
Birth
1–2 months
6–18 months
2 months
4 months
6 months
15–18 months
4–6 years
2 months
4 months
6 months
12–15 months
2 months
4 months
6–18 months
4–6 years
2 months
4 months
6 months
12–15 months
12–15 months
4–6 years
12–15 months
4–6 years
12–23 months
≥18 months
≥6 months
2–49 years
11–12 years
16 years
—
—
11–12 years
≥11 years
—
—
11–12 years
11–12 years (+2 months)
11–12 years (+6 months)
2 months
4 months
6 months
≥60 years
Minimum age for this dose
Birth
4 weeks
24 weeks
6 weeks
10 weeks
14 weeks
12 months
4 years
6 weeks
10 weeks
14 weeks
12 months
6 weeks
10 weeks
14 weeks
4 years
6 weeks
10 weeks
14 weeks
12 months
12 months
13 months
12 months
15 months
12 months
18 months
6 months****
2 years
2 years
11 years (+8 weeks)
2 years
7 years
7 years
7 years
2 years
7 years
9 years
9 years (+4 weeks)
9 years (+24 weeks)
6 weeks
10 weeks
14 weeks
60 years
Recommended
interval to next dose
1–4 months
2–17 months
—
2 months
2 months
6–12 months
3 years
—
2 months
2 months
6–9 months
—
2 months
2–14 months
3–5 years
—
8 weeks
8 weeks
6 months
—
3–5 years
—
3–5 years
—
6–18 months**
—
1 month
1 month
5 years
—
5 years
—
10 years
—
5 years
—
2 months
4 months
—
2 months
2 months
—
—
Minimum interval to next dose
4 weeks
8 weeks
—
4 weeks
4 weeks
6 months**,††
6 months**
—
4 weeks
4 weeks
8 weeks
—
4 weeks
4 weeks
6 months
—
4 weeks
4 weeks
8 weeks
—
4 weeks
—
12 weeks§§§
—
6 months**
—
4 weeks
4 weeks
8 weeks
—
5 years
—
5 years
—
5 years
—
4 weeks
12 weeks†††††
—
4 weeks
4 weeks
—
—
See table footnotes on page 37
36
MMWR / January 28, 2011 / Vol. 60 / No. 2
Available on the web at: www.cdc.gov/mmwr/pdf/rr/rr6002.pdf
94
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Recommendations and Reports
TABLE 1. (Continued) Recommended and minimum ages and intervals between vaccine doses*,†
Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis; HepA = hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; HPV =
human papillomavirus; IPV = inactivated poliovirus; LAIV = live, attenuated influenza vaccine; MCV4 = quadrivalent meningococcal conjugate vaccine; MMR = measles,
mumps, and rubella; MMRV = measles, mumps, rubella, and varicella; MPSV4 = quadrivalent meningococcal polysaccharide vaccine; PCV = pneumococcal conjugate
vaccine; PPSV = pneumococcal polysaccharide vaccine; PRP-OMB = polyribosylribitol phosphate-meningococcal outer membrane protein conjugate; Td = tetanus
and diphtheria toxoids; TIV = trivalent inactiated influenza vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis; Var = varicella vaccine.
* Combination vaccines are available. Use of licensed combination vaccines is generally preferred to separate injections of their equivalent component vaccines.
When administering combination vaccines, the minimum age for administration is the oldest age for any of the individual components; the minimum interval
between doses is equal to the greatest interval of any of the individual components.
† Information on travel vaccines, including typhoid, Japanese encephalitis, and yellow fever, is available at http://www.cdc.gov/travel. Information on other vaccines
that are licensed in the United States but not distributed, including anthrax and smallpox, is available at http://www.bt.cdc.gov.
§ Combination vaccines containing the hepatitis B component are available (see Table 2). These vaccines should not be administered to infants aged <6 weeks
because of the other components (i.e., Hib, DTaP, HepA, and IPV).
¶ HepB-3 should be administered at least 8 weeks after HepB-2 and at least 16 weeks after HepB-1 and should not be administered before age 24 weeks.
** Calendar months.
†† The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3.
§§ For Hib and PCV, children receiving the first dose of vaccine at age ≥7 months require fewer doses to complete the series.
¶¶ If PRP-OMP (Pedvax-Hib, Merck Vaccine Division) was administered at ages 2 and 4 months, a dose at age 6 months is not necessary.
*** A fourth dose is not needed if the third dose was administered at ≥4 years and at least 6 months after the previous dose.
††† Combination MMRV vaccine can be used for children aged 12 months–12 years. See text for details.
§§§ The minimum interval from Varicella-1 to Varicella-2 for persons beginning the series at age ≥13 years is 4 weeks.
¶¶¶ One dose of influenza vaccine per season is recommended for most persons. Children aged <9 years who are receiving influenza vaccine for the first time or
who received only 1 dose the previous season (if it was their first vaccination season) should receive 2 doses this season.
**** The minimum age for inactivated influenza vaccine varies by vaccine manufacturer. See package insert for vaccine-specific minimum ages.
†††† Revaccination with meningococcal vaccine is recommended for previously vaccinated persons who remain at high risk for meningococcal disease. (Source:
CDC. Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for
meningococcal disease. MMWR 2009;58:[1042–3]).
§§§§ Only 1 dose of Tdap is recommended. Subsequent doses should be given as Td. For one brand of Tdap, the minimum age is 11 years. For management of a
tetanus-prone wound in persons who have received a primary series of tetanus-toxoid–containing vaccine, the minimum interval after a previous dose of any
tetanus-containing vaccine is 5 years.
¶¶¶¶ A second dose of PPSV 5 years after the first dose is is recommended for persons aged ≤65 years at highest risk for serious pneumococcal infection and those
who are likely to have a rapid decline in pneumococcal antibody concentration. (Source: CDC. Prevention of pneumococcal disease: recommendations of the
Advisory Committee on Immunization Practices [ACIP]. MMWR 1997;46[No. RR-8]).
***** Bivalent HPV vaccine is approved for females aged 10–25 years. Quadrivalent HPV vaccine is approved for males and females aged 9–26 years.
††††† The minimum age for HPV-3 is based on the baseline minimum age for the first dose (i.e., 108 months) and the minimum interval of 24 weeks between the
first and third dose. Dose 3 need not be repeated if it is administered at least 16 weeks after the first dose.
§§§§§ The first dose of rotavirus must be administered at age 6 weeks through 14 weeks and 6 days. The vaccine series should not be started for infants aged ≥15
weeks, 0 days. Rotavirus should not be administered to children older than 8 months, 0 days of age regardless of the number of doses received between 6
weeks and 8 months, 0 days of age.
¶¶¶¶¶ If 2 doses of Rotarix (GlaxoSmithKline) are administered as age appropriate, a third dose is not necessary.
****** Herpes zoster vaccine is recommended as a single dose for persons aged ≥60 years.
TABLE 2. FDA-licensed combination vaccines*
Vaccine†
Hib-HepB
DTaP/Hib
HepA-HepB
DTaP-HepB-IPV
MMRV
DTaP-IPV
DTaP-IPV/Hib
Trade name (year licensed)
Age range
Comvax (1996)
TriHIBit (1996)
Twinrix (2001)
Pediarix (2002)
ProQuad (2005)
Kinrix (2008)
Pentacel (2008)
6 weeks–71 months
15–18 months
≥18 years
6 weeks–6 years
12 months–12 years
4–6 years
6 weeks–4 years
Routinely recommended ages
Three-dose schedule at 2, 4, and 12–15 months of age
Fourth dose of Hib and DTaP series
Three doses on a schedule of 0, 1, and 6 months
Three-dose series at 2, 4 and 6 months of age
Two doses, the first at 12–15 months, the second at 4–6 years
Fifth dose of DTaP and fourth dose of IPV
Four-dose schedule at 2, 4, 6, and 15–18 months of age
Abbreviations: DT = diphtheria and tetanus toxoids; DTaP = diphtheria and tetanus toxoids and acellular pertussis; FDA = Food and Drug Administration; HepA =
hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; IPV = inactivated poliovirus; MMR = measles, mumps, and rubella; MMRV = measles, mumps,
rubella, and varicella; Td = tetanus and diphtheria toxoids; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis.
Source: American Academy of Pediatrics. Passive immunization. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red book: 2009 report of the Committee on
Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009.
* Although MMR, DTaP, DT, Td, and Tdap are combination vaccines, they are not included on this list because they are not available in the United States as single-antigen
products.
† A dash ( - ) between vaccine products indicates that products are supplied in their final form by the manufacturer and do not require mixing or reconstitution by
the user. A slash ( / ) indicates that the products must be mixed or reconstituted by the user.
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TABLE 3. Guidelines for spacing of live and inactivated antigens
Antigen combination
Recommended minimum interval between doses
Two or more inactivated*
Inactivated and live
Two or more live injectable†
May be administered simultaneously or at any interval between doses
May be administered simultaneously or at any interval between doses
28 days minimum interval, if not administered simultaneously
Source: American Academy of Pediatrics. Pertussis. In: Pickering LK, Baker, CJ, Kimberlin DW, Long SS, eds. Red book: 2009 report of the Committee on Infectious
Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009:22.
* Certain experts suggest a 28-day interval between tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and tetravalent meningococcal
conjugate vaccine if they are not administered simultaneously.
† Live oral vaccines (e.g., Ty21a typhoid vaccine and rotavirus vaccine) may be administered simultaneously or at any interval before or after inactivated or live injectable vaccines.
TABLE 4. Guidelines for administering antibody-containing products* and vaccines
Type of administration
Simultaneous (during
the same office visit)
Nonsimultaneous
Products administered
Recommended minimum interval between doses
Antibody-containing products and inactivated antigen
Can be administered simultaneously at different anatomic sites
or at any time interval between doses
Antibody-containing products and live antigen
Should not be administered simultaneously.† If simultaneous
administration of measles-containing vaccine or varicella
vaccine is unavoidable, administer at different sites and
revaccinate or test for seroconversion after the recommended interval (see Table 5)
Administered first
Antibody-containing products
Inactivated antigen
Antibody-containing products
Live antigen
Administered second
Inactivated antigen
Antibody-containing products
Live antigen
Antibody-containing products
No interval necessary
No interval necessary
Dose related†,§
2 weeks†
* Blood products containing substantial amounts of immune globulin include intramuscular and intravenous immune globulin, specific hyperimmune globulin (e.g.,
hepatitis B immune globulin, tetanus immune globulin, varicella zoster immune globulin, and rabies immune globulin), whole blood, packed red blood cells, plasma,
and platelet products.
† Yellow fever vaccine; rotavirus vaccine; oral Ty21a typhoid vaccine; live, attenuated influenza vaccine; and zoster vaccine are exceptions to these recommendations.
These live, attenuated vaccines can be administered at any time before or after or simultaneously with an antibody-containing product.
§ The duration of interference of antibody-containing products with the immune response to the measles component of measles-containing vaccine, and possibly
varicella vaccine, is dose related (see Table 5).
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TABLE 5. Recommended intervals between administration of antibody-containing products and measles- or varicella-containing vaccine, by
product and indication for vaccination
Product/Indication
Dose (mg IgG/kg) and route*
Tetanus IG
Hepatitis A IG
Contact prophylaxis
International travel
Hepatitis B IG
Rabies IG
Varicella IG
Measles prophylaxis IG
Standard (i.e., nonimmunocompromised) contact
Immunocompromised contact
Blood transfusion
RBCs, washed
RBCs, adenine-saline added
Packed RBCs (hematocrit 65%)§
Whole blood (hematocrit 35%–50%)§
Plasma/platelet products
Cytomegalovirus IGIV
IGIV
Replacement therapy for immune deficiencies¶
Immune thrombocytopenic purpura treatment
Postexposure varicella prophylaxis**
Immune thrombocytopenic purpura treatment
Kawasaki disease
Monoclonal antibody to respiratory syncytial virus
F protein (Synagis [MedImmune])††
Recommended interval before
measles- or varicella-containing
vaccine† administration (months)
250 units (10 mg IgG/kg) IM
3
0.02 mL/kg (3.3 mg IgG/kg) IM
0.06 mL/kg (10 mg IgG/kg) IM
0.06 mL/kg (10 mg IgG/kg) IM
20 IU/kg (22 mg IgG/kg) IM
125 units/10 kg (60–200 mg IgG/kg) IM, maximum 625 units
3
3
3
4
5
0.25 mL/kg (40 mg IgG/kg) IM
0.50 mL/kg (80 mg IgG/kg) IM
5
6
10 mL/kg, negligible IgG/kg IV
10 mL/kg (10 mg IgG/kg) IV
10 mL/kg (60 mg IgG/kg) IV
10 mL/kg (80–100 mg IgG/kg) IV
10 mL/kg (160 mg IgG/kg) IV
150 mg/kg maximum
None
3
6
6
7
6
300–400 mg/kg IV¶
400 mg/kg IV
400 mg/kg IV
1000 mg/kg IV
2 g/kg IV
15 mg/kg IM
8
8
8
10
11
None
Abbreviations: HIV = human immunodeficiency virus; IG = immune globulin; IgG = immune globulin G; IGIV = intravenous immune globulin; mg IgG/kg = milligrams
of immune globulin G per kilogram of body weight; IM = intramuscular; IV = intravenous; RBCs = red blood cells.
* This table is not intended for determining the correct indications and dosages for using antibody-containing products. Unvaccinated persons might not be protected fully against measles during the entire recommended interval, and additional doses of IG or measles vaccine might be indicated after measles exposure.
Concentrations of measles antibody in an IG preparation can vary by manufacturer’s lot. Rates of antibody clearance after receipt of an IG preparation also might
vary. Recommended intervals are extrapolated from an estimated half-life of 30 days for passively acquired antibody and an observed interference with the immune response to measles vaccine for 5 months after a dose of 80 mg IgG/kg.
† Does not include zoster vaccine. Zoster vaccine may be given with antibody-containing blood products.
§ Assumes a serum IgG concentration of 16 mg/mL.
¶ Measles and varicella vaccinations are recommended for children with asymptomatic or mildly symptomatic HIV infection but are contraindicated for persons with
severe immunosuppression from HIV or any other immunosuppressive disorder.
** The investigational VariZIG, similar to licensed varicella-zoster IG (VZIG), is a purified human IG preparation made from plasma containing high levels of antivaricella
antibodies (IgG). The interval between VariZIG and varicella vaccine (Var or MMRV) is 5 months.
†† Contains antibody only to respiratory syncytial virus
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TABLE 13. Vaccination of persons with primary and secondary immunodeficiencies
Primary
Specific immunodeficiency
Contraindicated vaccines*
Risk-specific
recommended vaccines*
Effectiveness and comments
Severe antibody deficiencies (e.g., X-linked
agammaglobulinemia and common
variable immunodeficiency)
OPV†
Smallpox
LAIV
BCG
Ty21a (live typhoid)
Yellow fever
Less severe antibody deficiencies (e.g.,
selective IgA deficiency and IgG subclass
deficiency
Pneumococcal
OPV†
BCG
Yellow fever
Other live vaccines appear to be safe.
All vaccines likely effective; immune response
might be attenuated.
Complete defects (e.g., severe combined
immunodeficiency [SCID] disease,
complete DiGeorge syndrome)
All live vaccines§,¶,**
Pneumococcal
Vaccines might be ineffective.
Partial defects (e.g., most patients with
DiGeorge syndrome, Wiskott-Aldrich
syndrome, ataxia- telangiectasia)
All live vaccines§,¶,**
Pneumococcal
Meningococcal
Hib (if not administered
in infancy)
Effectiveness of any vaccine depends on
degree of immune suppression.
Complement
Persistent complement, properdin, or factor
B deficiency
None
Pneumococcal
Meningococcal
All routine vaccines likely effective.
Phagocytic function
Chronic granulomatous disease, leukocyte
adhesion defect, and myeloperoxidase
deficiency.
Live bacterial vaccines§
Pneumococcal††
All inactivated vaccines safe and likely
effective.
Live viral vaccines likely safe and effective.
Secondary
HIV/AIDS
OPV†
Smallpox
BCG
LAIV
Withhold MMR and varicella in
severely immunocompromised
persons.
Yellow fever vaccine might have a
contraindication or a precaution
depending on clinical parameters
of immune function***
Pneumococcal
Consider Hib (if not
administered in infancy)
and meningococcal
vaccination.
MMR, varicella, rotavirus, and all inactivated
vaccines, including inactivated influenza,
might be effective.§§
Malignant neoplasm, transplantation,
immunosuppressive or radiation therapy
Live viral and bacterial, depending
on immune status§,¶
Pneumococcal
Effectiveness of any vaccine depends on
degree of immune suppression.
Asplenia
None
Pneumococcal
Meningococcal
Hib (if not administered in
infancy)
All routine vaccines likely effective.
Chronic renal disease
LAIV
Pneumococcal
Hepatitis B¶¶
All routine vaccines likely effective.
B-lymphocyte
(humoral)
T-lymphocyte
(cell-mediated and
humoral)
Pneumococcal
Consider measles and
varicella vaccination
The effectiveness of any vaccine is uncertain if
it depends only on the humoral response
(e.g., PPSV or MPSV4).
IGIV interferes with the immune response to
measles vaccine and possibly varicella
vaccine.
Abbreviations: AIDS = acquired immunodeficiency syndrome; BCG = bacille Calmette-Guérin; Hib = Haemophilus influenzae type b; HIV = human immunodeficiency virus; IG = immunoglobulin; IGIV = immune globulin intravenous; LAIV = live, attenuated influenza vaccine; MMR = measles, mumps, and rubella; MPSV4 = quadrivalent meningococcal polysaccharide vaccine;
OPV = oral poliovirus vaccine (live); PPSV = pneumococcal polysaccharide vaccine; TIV = trivalent inactivated influenza vaccine.
Source: Adapted from American Academy of Pediatrics. Passive immunization. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS eds. Red book: 2009 report of the Committee on Infectious
Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009:74–5.
* Other vaccines that are universally or routinely recommended should be given if not contraindicated.
† OPV is no longer available in the United States.
§ Live bacterial vaccines: BCG and oral Ty21a Salmonella Typhi vaccine.
¶ Live viral vaccines: MMR, MMRV, OPV, LAIV, yellow fever, zoster, rotavirus, varicella, and vaccinia (smallpox). Smallpox vaccine is not recommended for children or
the general public.
** Regarding T-lymphocyte immunodeficiency as a contraindication for rotavirus vaccine, data exist only for severe combined immunodeficiency.
†† Pneumococcal vaccine is not indicated for children with chronic granulomatous disease beyond age-based universal recommendations for PCV. Children with
chronic granulomatous disease are not at increased risk for pneumococcal disease.
§§ HIV-infected children should receive IG after exposure to measles and may receive varicella and measles vaccine if CD4+ T-lymphocyte count is ≥15%.
¶¶ Indicated based on the risk from dialysis-based bloodborne transmission.
*** Symptomatic HIV infection or CD4+ T-lymphocyte count of <200/mm3 or <15% of total lymphocytes for children aged <6 years is a contraindication to yellow
fever vaccine administration. Asymptomatic HIV infection with CD4+ T-lymphocyte count of 200–499/mm3 for persons aged ≥6 years or 15%–24% of total lymphocytes for children aged <6 years is a precaution for yellow fever vaccine administration. Details of yellow fever vaccine recommendations are available from
CDC. (CDC. Yellow fever vaccine: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2010;59[No. RR-7].)
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TABLE 14. Approaches to evaluation and vaccination of persons vaccinated outside the United States who have no (or questionable) vaccination records
Vaccine
Recommended approach
Alternative approach*
MMR
Revaccination with MMR
Serologic testing for IgG antibodies to measles, mumps,
and rubella
Hib
Age-appropriate revaccination
Hepatitis A
Age-appropriate revaccination
Hepatitis B
Age-appropriate revaccination and serologic testing for HBsAg†
Poliovirus
Revaccination with inactivated poliovirus vaccine
Serologic testing for neutralizing antibody to poliovirus types 1,
2, and 3 (limited availability)
DTaP
Revaccination with DTaP, with serologic testing for specific IgG
antibody to tetanus and diphtheria toxins in the event of a
severe local reaction
Persons whose records indicate receipt of ≥3 doses: serologic
testing for specific IgG antibody to diphtheria and tetanus
toxins before administering additional doses (see text), or
administer a single booster dose of DTaP, followed by serological testing after 1 month for specific IgG antibody to diphtheria
and tetanus toxins with revaccination as appropriate (see text)
Tdap
Age-appropriate vaccination of persons who are candidates for
Tdap vaccine on the basis of time since last diphtheria and
tetanus-toxoid–containing vaccines.
—
Varicella
Age-appropriate vaccination of persons who lack evidence of
varicella immunity
—
Pneumococcal conjugate
Age-appropriate vaccination
—
Rotavirus
Age-appropriate vaccination
—
HPV
Age-appropriate vaccination
—
Zoster
Age-appropriate vaccination
—
—
Serologic testing for IgG antibodies to hepatitis A
—
Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis; HBsAg = hepatitis B surface antigen; Hib = Haemophilus influenzae type b; HPV = human
papillomavirus; IgG = immune globulin G; MMR = measles, mumps, and rubella; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis.
* There is a recommended approach for all vaccines and an alternative approach for some vaccines.
† In rare instances, hepatitis B vaccine can give a false-positive HBsAg result up to 18 days after vaccination; therefore, blood should be drawn to test for HBsAg before
vaccinating (Source: CDC. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations
of the Advisory Committee on Immunization Practices [ACIP]; Part I: Immunization in Infants, Children, and Adolescents. MMWR 2005;54(No. RR-16.])
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Contraindicated
Contraindicated
Recommended
Recommended
If indicated
Contraindicated
If indicated
Recommended
If Indicated - Vaccine is indicated based on specific risk factors or timing
constraints.
Recommended
Recommended
Kidney failure,
end-stage renal
disease, on
hemodialysis
If indicated
Recommended
Recommended
If indicated
If indicated
Hematopoietic
cell transplant
recipients
(HCT)4
No recommendation.
Contraindicated - Vaccine is contraindicated based on the medical condition
of the person.
Recommended
Recommended
Asplenia
including elective
splenectomy
and persistent
complement
component deficiency
Recommended
Recommended
Recommended
Recommended
Recommended
Recommended - Vaccine is recommended for all persons who meet the age
requirements and who lack evidence of immunity (i.e., no documented vaccination
or no evidence of prior infection, or no laboratory evidence of immunity).
Varicella 13
Tetanus, diphtheria,
pertussis
Rotavirus12
polysaccharide11
Pneumococcal
conjugate10
Pneumococcal
ages 11-12 years
conjugate9
ages 2-10 years
Meningococcal
conjugate9
Meningococcal
Recommended
Recommended
Influenza 7
Recommended
Recommended
Inactivated
poliovirus
Measles, mumps,
rubella 8
Recommended
Recommended
Human
papillomavirus
Hepatitis B 6
If indicated
Non-severe
immunosuppression
Recommended
Severe immunosuppression
Hepatitis A
immunodeficiency
virus [HIV] infection)
Diabetes,
heart disease,
chronic lung
disease, chronic
alcoholism,
cochlear implants
Recommended
Prematurity
HIV infection3
CD4+ T lymphocyte count
Haemophilis
Influenzae type b5
Vaccine
1
Altered Immunocompetence2
(excluding human
Vaccines Indicated for Infants, Children, and Adolescents Based on Medical and Other Indications
Vaccines Indicated for Infants, Children, and
Adolescents Based on Medical and Other Indications
Footnotes:
1. Prematurity
yy Vaccinate premature infants, regardless of
birth weight, at the same chronologic age and
schedule as full-term infants, except for hepatitis
B; see Hepatitis B footnote (#6).
2. Altered immunocompetence (excluding HIV)
yy Includes congenital immunodeficiency,
leukemia, lymphoma, generalized
malignancy, or therapy with alkylating agents,
antimetabolites, radiation, or a high dose,
prolonged course of corticosteroids.
yy Inactivated vaccines generally are acceptable,
e.g., pneumococcal, meningococcal, and
inactivated influenza vaccine. However, the
immune response and efficacy may be reduced.
yy Generally avoid live vaccines for persons with
altered immunocompetence including immune
deficiencies or immunocompromising conditions.
3. HIV infection
ACIP and AAP define severe immunosuppression
in HIV infected children as:
yy CD4+ T-lymphocytes counts
○○less than 750 for children younger than 12
months,
○○less than 500 for children age 1 through 5
years, or
○○less than 200 for persons age 6 years or older;
yy Or CD4+ T-lymphocytes constituting:
○○less than 15% of total lymphocytes for children
younger than 13 years.
4. HCT recipients
yy Begin revaccination at least 12 months after
HCT.
yy For live virus vaccines, MMR and varicella,
begin revaccination at least 24 months after
HCT; see MMR and varicella footnotes (#8 and
#13).
5. Haemophilis Influenzae type b (Hib)
yy Consider 1 dose for unvaccinated high-risk
persons age 5 years and older with sickle cell
disease, leukemia, or HIV infection, or who have
had a splenectomy.
6. Hepatitis B (HepB)
yy Give hepatitis B vaccine and immune globulin
at birth to premature infants born to HBsAgpostive mothers.
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www.health.state.mn.us/immunize yy Delay the first dose of hepatitis B vaccine to
premature infants born to HBsAg-negative
mothers until the infant weighs at least 2000
grams.
7. Influenza
yy Give HCT recipients influenza vaccine 6 months
or more after HCT, and annually thereafter.
yy Give annually to all children age 6 months
and older regardless of medical and other
indications.
yy Give 2 doses separated by at least 4 weeks
to children younger than age 9 years who are
receiving influenza vaccine for the first time
or who were vaccinated for the first time last
season and only received 1 dose.
8. Measles, mumps, rubella (MMR)
yy Evaluation and testing of asymptomatic persons
to identify HIV infection is not necessary before
deciding to administer MMR or other measlescontaining vaccine.
yy Severely immunosuppressed HIV-infected
patients who are exposed to measles should
receive immune globulin, regardless of prior
vaccination status.
yy Give 1 dose to HIV-infected children with
non-severe immunosuppression (see #3) as
soon as possible after their first birthday. The
immunologic response to both live and killed
antigen vaccines may decrease as HIV disease
progresses; vaccination early in the course of
HIV infection may be more likely to induce an
immune response.
○○Consider giving the second dose of MMR
vaccine as soon as 28 days after the first dose
rather than waiting until the child is ready to
enter kindergarten or first grade.
yy Give 1 dose to HCT recipients 24 months after
transplant and if the HCT recipient is presumed
to be immunocompetent.
yy Give 1 dose to all asymptomatic HIV-infected
children without evidence of measles immunity.
9. Meningococcal conjugate (MCV)
yy Give 2 doses 2 months apart to children age
2 years and older with persistent complement
component deficiency, anatomic or functional
asplenia, or HIV infection and 1 dose every 5
years thereafter.
yy Give 1 dose of MCV to children who remain at
risk and are:
○○Age 6 years and older who received MPSV or
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MCV 3 or more years previously.
○○Age 7 years and older who received MPSV or
MCV 5 or more years previously.
10.Pneumococcal conjugate (PCV)
yy Consider a single supplemental dose of
PCV13 for children age 6 through 18 years
with anatomic or functional asplenia including
sickle cell disease and immunocompromising
conditions including HIV infection, cochlear
implant, or CSF leaks.
yy Give a single supplemental dose of PCV13
following a completed PCV7 series for children
with certain medical conditions through age 5
years.
11.Pneumococcal polysaccharide (PPSV)
yy A single revaccination is recommended 5 years
after initial dose for children age 2 years and
older with anatomic or functional asplenia or
altered immunocompetence.
yy Give 1 dose to HCT recipients at 12 and 24
months after HCT.
Notes:
yy For additional ACIP recommendations refer to
www.cdc.gov/vaccines/pubs/ACIP-list.htm.
yy Vaccines may be also be indicated during a
community outbreak of a disease.
Sources:
yy CDC. General Recommendations on
Immunization: Recommendations of the Advisory
Committee on Immunization Practices (ACIP).
MMWR 2011:60 [No. RR-02]:1-60.
yy American Academy of Pediatrics. Pickering LK,
Baker CJ, Kimberlin DW, Long SS, eds. Red
Book: 2009 Report of the Committee on Infectious
Diseases. 28th ed. Elk Grove Village, IL: American
Academy of Pediatrics; 2009.
12.Rotavirus (RV1, RV5)
yy Contraindicated in children with severe
combined immunodeficiency.
yy Assess children with altered
immunocompetence to determine the risk
of prolonged shedding versus the benefit of
protection against rotavirus disease.
13.Varicella (VAR)
yy Give a 2-dose series 3 months apart to
asymptomatic or mildly symptomatic HIVinfected children in CDC class N1 or A1 with
age-specific CD4+ T-lymphocyte percentages
of 25% or greater. Such children should receive
2 doses of vaccine with a 3-month interval
between doses.
yy Give 1 dose to HCT recipients 24 months after
transplant and if the HCT recipient is presumed
to be immunocompetent.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
103
Summary of ACIP Recommendations on Use of Immune Globulin
Immune
globulin
Not
immunocompromised
HIV-infected
Severely
immunocompromised1
yy Recommended for patients
yy Recommended for
exposed to measles
symptomatic patients
regardless of immunization
exposed to measles
status
regardless of immunization
status
yy Recommended for patients
yy Recommended for patients
exposed to hepatitis A
exposed to hepatitis A
yy Recommended for patients
yy Recommended for patients
who have not received
who have not received
hepatitis A vaccination
hepatitis A vaccination and
and are traveling within
are traveling within 2 weeks
2 weeks to hepatitis A
to hepatitis A endemic areas
endemic areas
Immune
globulin
(IG)
yy Recommended for infants and
adults exposed to measles with a
contraindication to measles vaccine
yy Recommended for hepatitis A postexposure in persons less than age 1
year and persons over age 40 years
Varicella
zoster
immune
globulin2
(VZIG)
yy Recommended for newborns of mothers yy Recommended for
who develop chickenpox within 5 days
susceptible infants and
before through 48 hours after delivery
adults after significant
exposure to varicella zoster
yy Recommended for exposed pre-term
infants age 28 or more weeks gestation
born to a susceptible mother
yy Recommended for exposed preterm infants younger than age 28
weeks gestation or less than 1000 g
regardless of mother's susceptibility
yy May be used for exposed, susceptible
adults, pregnant women, and infants
less than 28 days old
yy Strongly consider for exposed,
susceptible pregnant women
yy Recommended for those with serious
yy Same as for nonwounds who have received fewer than
immunocompromised
3 doses of tetanus toxoid vaccination in
their lifetime
yy Recommended for
susceptible infants and
adults after significant
exposure to varicella zoster
yy Recommended for prophylaxis of infants yy Same as for nonborn to HBsAg+ mothers and susceptible
immunocompromised
persons with percutaneous, sexual, or
mucosal exposure to hepatitis B virus
yy Recommended for post-exposure
yy Same as for nonprophylaxis of persons not previously
immunocompromised
vaccinated against rabies
yy Same as for nonimmunocompromised
Tetanus
immune
globulin
(TIG)
Hepatitis B
immune
globulin
(HBIG)
Human
rabies
immune
globulin
(HRIG)
Footnotes:
1. Severely immunocompromised includes primary or acquired immunodeficiency, neoplastic diseases, and immunosuppression.
2. Varicella zoster immune globulin (VZIG) yy The most important use of VZIG is for passive
immunization of persons at greater risk for
complications (e.g., neonates and susceptible,
severely immunocompromised persons) after
significant exposure to chickenpox or zoster.
yy Varicella-susceptible pregnant women may be at
higher risk for serious complications than are adults
in general.
104
www.health.state.mn.us/immunize yy Same as for nonimmunocompromised
yy Same as for nonimmunocompromised
yy VZIG protects pregnant women against severe
complications but does not prevent viremia and fetal
infection, congenital varicella syndrome, or neonatal
varicella.
Sources:
yy CDC. General Recommendations on Immunization:
Recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR 2011:60 [No.
RR-02]:1-60.
yy CDC. Prevention of Hepatitis A Through Active or
Passive Immunization: Recommendations of the
Advisory Committee on Immunization Practices (ACIP).
MMWR 2006:55 [No. RR-07]:1-23.
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
July 2011, Minnesota Department of Health If indicated
Not indicated -Vaccine is not indicated or no evidence of occupational risk.
Recommended
www.health.state.mn.us/immunize
105
Recommended
Recommended - Vaccine is recommended specifically because of their occupation.
Yellow fever13
Varicella12
Typhoid11
If indicated
If indicated
Pre-exposure
rabies9
Tetanus, diphtheria,
pertussis:Tdap10/Td
If indicated
Recommended
If indicated
If indicated
Recommended
Tdap
Recommended
If indicated
Recommended
Veterinarian,
animal handler
If indicated
(e.g., EMTs, paramedics,
police, etc.)
Sanitation or
sewage worker
If indicated
Laboratory
personnel
Meningococcal
conjugate8
Measles, mumps,
rubella 7
Japanese
encephalitis6
Child care, school
personnel
Give 1 dose of Tdap to all adults regardless
of the interval since the last dose of Td
If indicated
Inactivated
poliovirus4
Influenza5
Recommended
Health care
personnel
Hepatitis B3
Hepatitis A2
Anthrax1
Vaccine
Essential
community
service worker
Vaccines Indicated by Occupation
If indicated - Vaccine is indicated based on specific occupational risk factor.
Got Your Shots? Providers Guide - SCREENING & ASSESSING
If indicated
Recommended
College
student
Vaccines Indicated by Occupation
Footnotes:
1. Anthrax
yy Give 5 doses and an annual booster dose to
laboratory personnel who work:
○○with high concentrations or pure cultures of B.
anthracis spores,
○○with environmental samples associated with
anthrax investigations, or
○○in spore-contaminated areas or other settings
with exposure to aerosolized B. anthracis
spores.
Note: Consider giving anthrax vaccine to
veterinarians and other persons at risk for anthrax
if they handle potentially infected animals in
research settings or in areas with a high incidence
of anthrax cases.
2. Hepatitis A (HepA)
yy Give 2 doses to persons who work with hepatitis
A-infected primates or with the hepatitis A virus
in a research laboratory setting.
Note: Studies conducted among U.S. workers
exposed to raw sewage do not indicate increased
risk for hepatitis A infection. No other populations
have been demonstrated to be at increased risk
for hepatitis A infection because of occupational
exposure.
3. Hepatitis B (HepB)
yy Give 3 doses to all persons including health
care personnel whose tasks involve exposure to
blood or bodily fluids.
4. Inactivated poliovirus (IPV)
yy Give a booster dose to health care personnel
who have close contact with patients who may
be excreting polio virus.
yy Give a booster dose to laboratory personnel
who are routinely exposed to polio viruses.
5. Influenza
yy Give annually to all health care personnel
and persons whose occupation involves care
or close contact with infants less than age 6
months.
Note: Give to all persons regardless of occupation.
6. Japanese encephalitis (JE)
yy Give 3 doses to laboratory personnel routinely
exposed to Japanese encephalitis. Give a
booster dose 12 to 24 months after third dose.
7. Measles, mumps, and rubella (MMR)
yy Give 2 doses of MMR to students, health care
106
www.health.state.mn.us/immunize personnel, laboratory personnel, and child
care and school personnel unless they have
evidence of immunity which includes:
○○documentation of 2 MMR doses, or
○○history of measles, mumps, and/or rubella
disease verified by a health care provider, or
○○laboratory evidence of measles, mumps, and/
or rubella immunity.
Note: Give at least 1 dose of MMR to all persons
who lack evidence of immunity, regardless of
occupation.
8. Meningococcal conjugate (MCV)
yy Give 1 dose of MCV to previously unvaccinated
college freshmen who live in dormitories or
whose last dose was 5 or more years ago.
yy Give 1 dose to laboratory personnel who are
routinely exposed to isolates of N. meningiditis.
Give a booster dose every 5 years.
9. Pre-exposure rabies (RAB)
yy Give 4 doses to laboratory personnel directly
involved with testing or isolating rabies virus.
Check serum titers every 6 months and give a
booster dose if titers fall below protective levels
(i.e., complete neutralization at a 1:5 serum
dilution by the RFFIT).
yy Give 4 doses to veterinarians and animal
handlers. Check serum titers every 2 years and
give a booster dose if titers fall below protective
levels (i.e., complete neutralization at a 1:5
serum dilution by the RFFIT).
10.Tetanus, diphtheria, pertussis (Tdap/Td)
yy Give 1 dose of Tdap to adults age 64 years and
younger in place of their next 10-year booster
dose of Td.
yy Give Tdap to adults having close contact with
infants under age 1 year (e.g., parents, child
care and health care personnel) regardless of
when the last Td was given
Note: Tdap is recommended for all adults.
11.Typhoid, oral and inactivated
yy Inactivated: Give 1 dose to laboratory personnel
routinely exposed to Salmonella typhi. Give a
booster dose every 2 years.
yy Oral: Give 1 capsule every other day for 4 days
to laboratory personnel routinely exposed to
Salmonella typhi. Give a booster dose every 5
years.
12.Varicella (VAR)
yy Give 2 doses of varicella to health care
personnel, laboratory personnel, and child care
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
and school personnel unless they have evidence
of immunity, which includes:
○○documentation of 2 doses of varicella vaccine
at least 4 weeks apart, or
○○U.S.-born before 1980, or
○○history of varicella disease verified by a health
care provider, or
○○history of herpes zoster disease based on
health care provider diagnosis, or
○○laboratory evidence of varicella immunity.
Note: Give to all persons who lack evidence of
immunity, regardless of occupation.
13.Yellow fever (YF)
yy Give 1 dose to laboratory personnel routinely
exposed to yellow fever virus. Give a booster
dose every 10 years.
Notes:
yy For additional ACIP recommendations refer to
www.cdc.gov/vaccines/pubs/ACIP-list.htm.
yy Vaccines may also be indicated during a
community outbreak of a disease.
Sources:
yy CDC. General Recommendations on
Immunization: Recommendations of the Advisory
Committee on Immunization Practices (ACIP).
MMWR 2011:60 [No. RR-02]:1-60.
yy CDC. Human Rabies Prevention:
Recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR 2008:57
[No. RR-03]:1-26,28.
yy CDC. Immunization of Health-Care Workers:
Recommendations of the Advisory Committee on
Immunization Practices (ACIP) and the Hospital
Infection Control Practices Advisory Committee
(HICPAC). MMWR 1997:46 [No. RR-18]:1-42.
yy CDC. Prevention of Hepatitis A Through Active or
Passive Immunization: Recommendations of the
Advisory Committee on Immunization Practices
(ACIP). MMWR 2006:55 [No. RR-07]:1-23.
yy American College Health Association
(ACHA). Recommendations for Institutional
Prematriculation Immunizations. Linthicum, MD.
ACHA Vaccine Preventable Diseases Committee;
January 2009.
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
107
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
108
Healthcare Personnel Vaccination Recommendations1
Vaccine
Recommendations in brief
Hepatitis B
Give 3-dose series (dose #1 now, #2 in 1 month, #3 approximately 5 months after #2). Give IM. Obtain
anti-HBs serologic testing 1–2 months after dose #3.
Influenza
Give 1 dose of influenza vaccine annually. Give inactivated injectable influenza vaccine intramuscularly
or live attenuated influenza vaccine (LAIV) intranasally.
MMR
For healthcare personnel (HCP) born in 1957 or later without serologic evidence of immunity or prior
vaccination, give 2 doses of MMR, 4 weeks apart. For HCP born prior to 1957, see below. Give SC.
Varicella
(chickenpox)
For HCP who have no serologic proof of immunity, prior vaccination, or history of varicella disease,
give 2 doses of varicella vaccine, 4 weeks apart. Give SC.
Tetanus, diphtheria,
pertussis
Give a one-time dose of Tdap as soon as feasible to all HCP who have not received Tdap previously.
Give Td boosters every 10 years thereafter. Give IM.
Meningococcal
Give 1 dose to microbiologists who are routinely exposed to isolates of N. meningitidis. Give IM or SC.
Hepatitis A, typhoid, and polio vaccines are not routinely recommended for HCP who may have on-the-job exposure to fecal material.
Hepatitis B
Healthcare personnel (HCP) who perform tasks that may involve exposure to
blood or body fluids should receive a 3-dose series of hepatitis B vaccine at
0-, 1-, and 6-month intervals. Test for hepatitis B surface antibody (anti-HBs)
to document immunity 1–2 months after dose #3.
t If anti-HBs is at least 10 mIU/mL (positive), the patient is immune. No
further serologic testing or vaccination is recommended.
t If anti-HBs is less than 10 mIU/mL (negative), the patient is unprotected from hepatitis B virus (HBV) infection; revaccinate with a
3-dose series. Retest anti-HBs 1–2 months after dose #3.
– If anti-HBs is positive, the patient is immune. No further testing or vaccination is recommended.
– If anti-HBs is negative after 6 doses of vaccine, patient is a non-responder.
For non-responders: HCP who are non-responders should be considered
susceptible to HBV and should be counseled regarding precautions to prevent
HBV infection and the need to obtain HBIG prophylaxis for any known or
probable parenteral exposure to hepatitis B surface antigen (HBsAg)-positive
blood.1 It is also possible that non-responders are persons who are HBsAg
positive. Testing should be considered. HCP found to be HBsAg positive
should be counseled and medically evaluated.
Note: Anti-HBs testing is not recommended routinely for previously vaccinated HCP who were not tested 1–2 months after their original vaccine
series. These HCP should be tested for anti-HBs when they have an exposure
to blood or body fluids. If found to be anti-HBs negative, the HCP should be
treated as if susceptible.2
Influenza
All HCP, including physicians, nurses, paramedics, emergency medical technicians, employees of nursing homes and chronic care facilities, students in
these professions, and volunteers, should receive annual vaccination against
influenza. Live attenuated influenza vaccine (LAIV) may only be given to
non-pregnant healthy HCP age 49 years and younger. Inactivated injectable
influenza vaccine (TIV) is preferred over LAIV for HCP who are in close
contact with severely immunosuppressed persons (e.g., stem cell transplant
patients) when patients require protective isolation.
Measles, Mumps, Rubella (MMR)
HCP who work in medical facilities should be immune to measles, mumps,
and rubella.
tHCP born in 1957 or later can be considered immune to measles, mumps,
or rubella only if they have documentation of (a) laboratory confirmation of
disease or immunity or (b) appropriate vaccination against measles, mumps,
and rubella (i.e., 2 doses of live measles and mumps vaccines given on or
after the first birthday and separated by 28 days or more, and at least 1 dose
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and results are negative or equivocal for measles, mumps, and/or rubella,
these HCP should be considered to have presumptive evidence of immunity
to measles, mumps, and/or rubella and are not in need of additional MMR
doses.
tAlthough birth before 1957 generally is considered acceptable evidence of
measles, mumps, and rubella immunity, healthcare facilities should consider
recommending 2 doses of MMR vaccine routinely to unvaccinated HCP
born before 1957 who do not have laboratory evidence of disease or immunity to measles and/or mumps, and should consider one dose of MMR
for HCP with no laboratory evidence of disease or immunity to rubella.
For these same HCP who do not have evidence of immunity, healthcare
facilities should recommend 2 doses of MMR vaccine during an outbreak
of measles or mumps and 1 dose during an outbreak of rubella.
Varicella
It is recommended that all HCP be immune to varicella. Evidence of immunity
in HCP includes documentation of 2 doses of varicella vaccine given at least 28
days apart, history of varicella or herpes zoster based on physician diagnosis,
laboratory evidence of immunity, or laboratory confirmation of disease.
Tetanus/Diphtheria/Pertussis (Td/Tdap)
All HCPs who have not or are unsure if they have previously received a dose
of Tdap should receive a one-time dose of Tdap as soon as feasible, without
regard to the interval since the previous dose of Td. Then, they should receive
Td boosters every 10 years thereafter.
Meningococcal
Vaccination is recommended for microbiologists who are routinely exposed to
isolates of N. meningitidis. Use of MCV4 is preferred for persons age 55 years
or younger; give IM. Use MPSV4 only if there is a permanent contraindication or precaution to MCV4. Use of MPSV4 (not MCV4) is recommended
for HCP older than age 55; give SC.
References
1. CDC. Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 2011; 60(RR-7).
2. See Table 3 in “Updated U.S. Public Health Service Guidelines for the Management of
Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure
Prophylaxis,” MMWR, 2001; 50(RR-11).
For additional specific ACIP recommendations, refer to the official ACIP statements
published in MMWR. To obtain copies, visit CDC’s website at www.cdc.gov/vaccines/
pubs/ACIP-list.htm; or visit the Immunization Action Coalition (IAC) website at www.
immunize.org/acip.
Adapted from the Michigan Department of Community Health
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July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
109
110
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
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July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
111
gripa
MMR
rubeola
Human
papillomavirus
Influenza
MMR
Measles
veliki kašalj
dje ja paraliza
upala plu a
Rotavirus
male boginje
Pertussis
Poliomyelitis
Pneumococcal
conjugate
Rotavirus
Rubella
tetanus
tuberkuloza
ospice
Tetanus
Tuberculosis
Varicella
(chickenpox)
Immunization Action Coalition
veliki boginje
Smallpox
Shingles
(Herpes zoster)
zauŠnjaci
zauške
Mumps
y
ycka
y
(651) 647-9009
ветряная оспа
(вітрянка)
şi varicelă
(varicelă)
y
туберкулеѕ
столбняк
оспа
опоясывающий
лишай
tuberculozei
tetanosului
variola, variolei
Herpes zoster
(zona zoster)
краснуха
rubeola, rubeolei,
pojar German
St. Paul, MN 55104
ospy wietrznej (ospa
wietrzna)
gruzlica
tężcowi
ospa
półpasiec
r
ротавірусной
y
пневмококковоя
конъюгированной
пoлиомиелит
коклюша
свинка, ларотит
менингококковая
сопряженных
коpЬ
грипп
вирус папилломы
человека
гепатит B
rotavirus
pneumococic
conjugat
skoniugowanej
szczepionki
pneumokokowej
rotavirusy
poliomielita
tusei convulsive
polio
krztuścowi
oreionul, oreion
conjugate
meningococice
swinka
pojarul
meningokokom
sprzężenia
gripa
papilomavirus
uman
hepatita B
гепатит А
гемофільной
инфекции типа B
hepatita A
дифтерия
Haemophilus
influenzae tip b
boala
АКДС
Russian
difteriei
Di-Te-Per
Romanian
odra
grypa
1573 Selby Avenue
varicella (vodene
kozice)
tuberkuloza
tetanusa
veliki boginje
šindra
rubeola
rotavirusa
pneumokoka
konjugirano
dječje paralize
kašalj hripavac
meningokoknog
konjugirati
Meningococcal
conjugate
ospice
gripe
utica B,
hepatitisa B
papilomavirusi
čovjeka
utica B,
Hepatitis B
Ljudski
papiloma virus
Hepatitis B
wirusowemu
zapaleniu wątroby
typu A
wirusowemu zapaleniu wątroby typu B
wirus brodawczaka
ludzkiego
utica A,
hepatitisa A
utica A,
Hepatitis A
Hepatitis A
Haemophilus
influenzae typu b
Haemophilus
influenzae tipa b
Haemophilus
influenzae type b
Hemofili na
influenca tipa B
difterija
Diphtheria
Detepe
Polish
przeciwko błonicy
Detepe
DTP
Croatian
difterije
Bosnian
English
Eastern European Languages
y
(Page 1 of 2)
y
вітряної віспи
(вітрянка)
правця
оперізуючий герпес
(оперізуючий
лишай)
ротавірусної
пневмококковой
конъюгированной
поліомієліту
кашлюку
кір
менінгококова
сполучених
грипу
вірус папіломи
людини
гепатиту В
гепатиту S
гемофільної інфекції
типу B захворювань
дифтерії
Ukrainian
[email protected]
ovčím kiahňam
(ovčie kiahne)
Варицелла
(цхицкен
богиње)
www.immunize.org
tuberkulóza
tetanus
kiahne
pásového oparu
(pásový opar)
rubeola
Ροтавирус
konjugovaná
pneumokoková
detská obrna
čierny kašeľ
parotitis
meningokokove
j konjugovanou
morbilli, osýpky
chrípka
ľudský
papillomavírus
hepatitída B
hepatitída A
Haemophilus
influenzae typ b
ochorenia
záškrt
DiTePe
Slovak
Tuberkuloza
тетануса
veliki boginje
херпес зостер
(појасни херпес)
Ρубеοла
рота-вируса
Пнеумоцоццал
коњунговане
дечје парализе
великог кашља
Эаушκе
менингококне
коњуговано
Μале бοгиње
ΜMR
грип
људски
папилома вирус
хепатитиса Б
хепатитиса A
Хаемопхилус
инфлуензае тип
Б болести
дифтерије
Detepe
Serbian
Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages
112
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Got Your Shots? Providers Guide - SCREENING & ASSESSING
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Haemophilus
influenzae b
hepatitis A
Haemophilus
influenzae type b
Hepatitis A
y
Haemophilus
influenzae type b
Haemophilus
influenzae de
type b
BMR
mazelen
meningokokken
conjugaat
bof
MMR
Measles
Meningococcal
conjugate
Mumps
pneumokokken
conjugaat
rotavirus
rode hond
gordelroos
(herpes zoster)
pokken
tetanus
tering
varicella
(waterpokken)
Pneumococcal
conjugate
Rotavirus
Rubella
Shingles
(Herpes zoster)
Smallpox
Tetanus
Tuberculosis
Varicella
(chickenpox)
Immunization Action Coalition
poliomyelitis
Poliomyelitis
(Whooping cough)
kinkhoest
influenza (griep)
Influenza (“flu”)
Pertussis
grippe
humaan
papillovirus
Human
papillomavirus
y
varicella
tubercolosi
tetano
y
(651) 647-9009
vannkopper
(vannkopper)
tuberkulose
stivkrampe
kopper
helvetesild
(herpes zoster)
fuoco di
Sant’Antonion
(l’herpes zoster)
vaioloso
røde hunder
rotavirus
pneumokokk
komjugatvaksine
poliomyelitt
kikhoste
kusma
meningokokksykdom konjugert
meslinger
influensa
humant
papillomavirus
hepatitt B
hepatitt A
Haemophilus
influenzae tipe b
difteri
Norwegian
rosolia
rotavirus
pneumococcico
coniugato
poliomielite
(tosse asinina)
pertosse
parotite
coniugato meningococcico
morbillo
MPR
l’nfluenzae
il papillovirus
umano
epatite B
epatite A
Haemophilus
influenzae b
difterite
Italian
St. Paul, MN 55104
varizellen
(windpocken)
tuberkulose
wundstarrkrampf
pocken
1573 Selby Avenue
varicelle
tuberculose
tétanos
variole
gürtelrose
(herpes zoster)
röteln
- rubéole
- rubéola
zona
(l’herpès zoster)
rotavirus
pneumokokken
konjugat
kinderlähmung
keuchhusten
ziegenpeter
meningokokken
konjugatimpfstoff
masern
MMR
influenza (grippe)
humanen
papillovirus
hepatitis B
rotavirus
antipneumococcique conjugué
poliomyélite
coqueluche
oreillons
conjugué contre
le méningocoque
rougeole
ROR
papillovirus
humaines
hepatitis B
Hepatitis B
hepatite B
hepatite A
hepatitis A
diphtherie
diphtérie
difterie
Diphtheria
DT Coq, DTC
DKTP
German
DTP
French
Dutch
English
Western European Languages
y
y
varicela
www.immunize.org
varicella
(catapora)
y
vattkopper
tuberkulos
stelkramp
smittkopper
bältros
(herpes zoste)
röda hund
rotavirus
konjugerat
pneumokock
poliomyelitis
kikhosta
påssjuka
meningokockinfektion konjugatet
mässling
MPR
influensa
mänskliga
papillovirus
hepatit B
hepatit A
Haemophilus
influenzae typ b
difteri
trippel
Swedish
(Page 2 of 2)
[email protected]
tuberculínica
tétanos, tetánica,
tétano
tétano,
tetânica
tuberculose
viruela
zona de matojos
(herpes)
rubéola,
sarampión aleman
rotavirus
polio,
poliomielitis
antineumocócica
conjugada
(tos ferina)
coqueluche
paperas, parotiditis
sarampión,
sarampión comun
meningococo
conjugada
SRP
influenza (gripe)
Virus del papiloma
humano
hepatitis B
hepatitis A
Hemófilo tipo b,
Haemophilus
influenzae tipo b
Difteria
Spanish
varíola
zona
(herpes zoster)
rubéola
(sarampo alamão)
rotavírus
poliomielite,
paralisia Infantil
pneumocócica
conjugada
coqueluche
caçhumba
meningocóccica
conjugada
sarampo
SPR
influenza (gripe)
virus do papiloma
humano
hepatite B
hepatite A
doenca
Haemophilus
influenzae tipo b
difteria
Tríplice
Portuguese
Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages
The CDC is maintaning the following documents in the Pink Book as
table 1 and 2 of Appendix B:

Table 1: Disease, Vaccine and Related Terms (previously Vaccines and Biologics Used
in U.S. and Foreign Markets)

Table 2: Trade Names (previously Translation of Vaccine-Related Terms Into English)
Also available on the web at www.cdc.gov/vaccines/pubs/pinkbook/index.html
Foreign Language Terms
Aids to translating foreign immunization records.
Table 1:
Disease, Vaccine, and Related Terms. This table lists terms for vaccinepreventable diseases and vaccines, and other terms that might be found on an
immunization record, by language.
Table 2:
Trade Names. This table lists the names of specific vaccines that are used, or
have been used, internationally, along with the manufacturer and country or
region where the vaccine is produced or used, when known.
These tables have been adapted from (among other sources)
lists developed by
the Minnesota Department of Health Immunization Program
(now maintained by the Immunization Action Coalition)
and
Washington State Department of Health.
See also:
http://www.immunize.org/izpractices/p5120.pdf
http://www.immunize.org/izpractices/p5121.pdf
These lists are not comprehensive. We have checked sources,
but we cannot claim complete accuracy.
Centers for Disease Control and Prevention. Epidemiology and Prevention of VaccinePreventable Diseases (The Pink Book). Atkinson W, Wolfe S, Hamborsky J, eds. 12th ed.,
second printing. Washington DC: Public Health Foundation, 2012.
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
113
Foreign Vaccines
Table 1: Disease, Vaccine, and Related Terms
Difteria
Fruthi
Pertusisi
Tetanozi
Albanian
Arabic
Alhasiba
As’al
Athab
Difteria
El Safra
Has ‘ba
Shel’el
Bosnian
Beseže
Detepe
Difterija
Djeþja paraliza
Gripa
Male boginje
Ospice
Rubeola
Upala pluüa
Veliki boginje
Veliki kašalj
Zauške
Žutica
Croatian
Beseže
Detepe
Difterija
Djeþja paraliza
Gripa
Hri pavac
Kašalj hripavac
Upala pluüa
Veliki boginje
Vodene kozice
Zapaljenje
ZauŠnjaci
Žutica
Davivy Kasel
Difterie
Hepatitida
114
Czech
www.health.state.mn.us/immunize
Diphtheria
Measles
Pertussis
Tetanus
Rubella
Pertussis
Mumps
Diphtheria
Hepatitis
Measles
Polio
BCG
DPT
Diphtheria
Polio
Influenza
Rubella
Measles
Rubella
Pneumonia
Smallpox
Pertussis
Mumps
Hepatitis
BCG
DTP
Diphtheria
Polio
Influenza
Pertussis
Pertussis
Pneumonia
Smallpox
Varicella
Hepatitis
Mumps
Hepatitis
Pertussis
Diphtheria
Hepatitis
Parotitida
Pertuse
Poliomyelitis
Plané Nestovice
Spalnicky
Subinuira
Zardenky
Zaškrt
Zlutá Zimnice
Mumps
Pertussis
Polio
Chickenpox
Measles
Influenza
Rubella
Diphtheria
Yellow Fever
Danish
Bornelammelse
Difteritis
Faaresyge (Fåresyge)
Kighoste
Leverbetaendelse
Meslinger
MFR
Rode Hunde
Stivkrampe
Dutch
BMR
Bof
Difterie
DKTP
Gelekoorts
Gordelroos
Griep
Kinderverlamming
Kinkhoest
Longontsteking
Mazelen
Pokken
Rode hond
Stijfkramp
Tering
Waterpekkea
Polio
Diphtheria
Mumps
Pertussis
Hepatitis
Measles
MMR
Rubella
Tetanus
MMR
Mumps
Diphtheria
DTP + IPV
Yellow Fever
Varicella
Influenza
Polio
Pertussis
Pneumonia
Measles
Smallpox
Rubella
Tetanus
Tuberculosis
Chickenpox
Ethiopian (Oromiffaa)
Cufaa
Difteeriyaa
Gifira
Gifira farangli
Laamsheesaa
Qakkee
Shimbiraa
Hinkuyska
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Tetanus
Diphtheria
Measles
Rubella
Polio
Pertussis
Hepatitis
Finnish
Pertussis
Minnesota Department of Health, July 2011
Jaykkakouristus
Kurkkumata
Lapsihalvaus
Sikotauti
Tuhkarokko
Vihurirokko
Tetanus
Diphtheria
Polio
Mumps
Measles
Rubella
French
Coqueluche
Diphtérie
DTC, DT Coq
DTCP
Fievre jaune
Grippe
l’Haemophilus b
Oreillons
Poliomyélite
ROR
Rougeole
Rubéole
Tétanos
Tuberculose
Variole
Diphtherie
Pertussis
Diphtheria
DTP
DTP +Polio
Yellow Fever
Influenza
Hib
Mumps
Polio
MMR
Measles
Rubella
Tetanus
Tuberculosis
Smallpox
German
Diphtheria
Tick-borne
encephalitis
Yellow Fever
Influenza
Pertussis
Polio
Measles
Smallpox
Rubella
Tetanus
Tuberculosis
Tetanus
Mumps
FSME
Gelbfieber
Grippe
Keuchhusten
Kinderlähmung
Masern
Pocken
Röteln
Starrkramph
Tuberkulose
Wundstarrkrampf
Zei Genpeter
Greek
ǻȚQșJȡȓIJȚįĮ, ȉȑIJĮȞȠȢ țĮȚ ȀȠțțȪIJȘȢ
ȅ ǹȚȝȩQȚȜȠȢ IJȘȢ ȖȡȓʌʌȘȢ IJȪʌȠȣ
Ǻ
ȂȘȞȚȖȖȠțȠțțȚțȒ ǹıșȑȞJĮ ȠȝȐįĮȢ C
ǿȜĮȡȐ - ȂĮȖȠȣȜȐįJȢ – ǼȡȣșȡȐ
ȆȠȜȚȠȝȣJȜȓIJȚįĮ
ȉȑIJĮȞȠȢ țĮȚ ǻȚQșJȡȓIJȚįĮ
DTP
Hib
Meningococcal C
MMR
Polio
Td
Haitian Creole
Difteri
Epatit
Flou
Koklich
LawoujEl, LaroujEl
July 2011, Minnesota Department of Health
Diphtheria
Hepatitis
Influenza
Pertussis
Measles
Malmouton
Polyo
RibeyEl
Saranpyon
TetanEs
Mumps
Polio
Rubella
Varicella
Tetanus
Hmong
Hawb pob
Kabmob siab hom B
Kub cer
Qhua Maj
Qhua Pias
Qog
Tuag tes tuag taw
Ua npuag
Indonesian
Batuk rejan
Beguk
Biring Peluh
Campak
Difteri
Penyakit lumpuh
Radang hati
Italian
Antipolio inattivato
Difterite
Emofilo b
Epatite
Febbre Giallo
Morbillo
MPR (morbillo, parotite,
rosolia)
Parotite
Pertosse
Poliomielite
Polmonite
Rosolia
Tetano
Tosse Asinina
Tubercolosi
Vaioloso
Japanese
A ဳ⢄Ἳ
B ဳ⢄Ἳ
Fushin (㘑∐
Hashika (㤗∐QTߪߒ߆
Hashofu (⎕்㘑)
Hyakaseki (⊖ᣣຕ)
Jifuteria (ࠫࡈ࠹࡝ࠕ)
Otafukukuaze (ᵹⴕᕈ⡊ਅ⣼Ἳ
or߅ߚ߰ߊ߆ߗ)
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Pertussis
Hepatitis B
Diphtheria
Rubella
Measles
Mumps
Polio
Tetanus
Pertussis
Mumps
Rubella
Measles
Diphtheria
Polio
Hepatitis
IPV
Diphtheria
Hib
Hepatitis
Yellow Fever
Measles
MMR
Mumps
Pertussis
Polio
Pneumonia
Rubella
Tetanus
Pertussis
Tuberculosis
Smallpox
Hepatitis A
Hepatitis B
Rubella
Measles
Tetanus
Pertussis
Diphtheria
Mumps
www.health.state.mn.us/immunize
115
Sh naimahi (ࡐ࡝ࠝ)
ਃ⒳ᷙว
᳓∧or ߺߕ߷߁ߘ߁
⢖Ἳ⃿⩶
ࠗࡦࡈ࡞ࠛࡦࠩ⩶
ᣣᧄ⣖Ἳ
ࠗࡦࡈ࡞ࠛࡦࠩ
࠷ࡌ࡞ࠢ࡝ࡦ
ㅊടធ⒳
Malay
Batok rejan
Penyaakit bengok
Sakit champak
Sakit rengkong
Norwegian
Difteri
Kikhoste
Kopper
Kusma
Leverbetennelse
Meslinger
Poliomyelitt
RUde hunder
Stivkrampe
Vannkopper
Polish
Báonicy, Báonica, Báonnica
Dyfteria
Gruzlica
Grypa
Koklusz
Krztuscowi, Krztusiec
Odra
Ospa
Ospa Wietrzna
Paraliz dzieciecy
Pojar German
Pojarul, Pojarului
Przypominajace
Rozyczka
Swinka
Tezec, TĊžcowi
Zapalenie pluc
Zapalenie watroby
Zólta Goraczka
Portugese
Cachumba (papeira)
Coqueluche
Difteria
116
www.health.state.mn.us/immunize
Polio
DTaP
Varicella
Pneumococcal
Hib
Japanese
Encephalitis
Influenza
PPD
Booster
Pertussis
Mumps
Measles
Diphtheria
Diphtheria
Pertussis
Smallpox
Mumps
Hepatitis
Measles
Polio
Rubella
Tetanus
Varicella
Diphtheria
Diphtheria
Tuberculosis
Influenza
Pertussis
Pertussis
Measles
Smallpox
Chickenpox
Polio
Rubella
Measles
Booster
Rubella
Mumps
Tetanus
Pneumonia
Hepatitis
Yellow Fever
Mumps
Pertussis
Diphtheria
Febre Amarela
Gripe
Hepatite
Paralisia infantil
Parotidite epidémica
Poliomielite
Rúbéola
Sarampo
Tetânica, Tétano
Triplice
VAHB
VAP
Varicela
VAS
VASPR
VAT
Yellow Fever
Influenza
Hepatitis
Polio
Mumps
Polio
Rubella
Measles
Tetanus
DTP
Hepatitis B Vaccine
Polio Vaccine
Chickenpox
Measles Vaccine
MMR
Tetanus Vaccine
Romanian
AR
Difteria (Difteriei)
Di Te
Di-Te-Per
Febra Galbena
Gripa
Hepatita
Holera
Oreion, Oreionului
Pneumoniei
Poliomielitic
Rubeolei, Rubeola
Rujeola, Rujeolei
Tetanos,Tetanosul, Tetanosului
Tuse convulsiva,
Tusei convulsive
Varicelă, Varicelei
Variola, Variolei
Russian
ȻɰU
ȺɄȾɋ
Ⱦɢɮɬɟɪɢɬ, Ⱦɢɮɬɟɪɢɹ
Ƚɟɦɨɢɮɥɸɫ ɢɧɮɥɸɡɧɰɵ ɬɢɩɚ
Ȼ
Ƚɟɩɚɬɢɬ
Ƚɪɢɩɩ
Ʉɨɪɶ
ɋɜɢɧɤɚ, ɉɚɪɨɬɢɬ
Ʉɨɥɸɲ
ȼɨɫɩɚɥɟ ɥɺɝɤɢɯ ɉɧɟɜɦɨɧɢɹ
ɉɨɥɢɨɦɢɟɥɢɬ
Ʉɪɚɫɧɭɯɚ
Ɉɫɩɚ
ɋɬɨɥɛɧɹɤ, ɋɬɨɥɛɧɹɤɚ
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Measles
Diphtheria
DT
DTP
Yellow Fever
Influenza
Hepatitis
Cholera
Mumps
Pneumonia
Polio
Rubella
Measles
Tetanus
Pertussis
Varicella
Smallpox
BCG
DTP
Diphtheria
Hib
Hepatitis
Influenza
Measles
Mumps
Pertussis
Pneumonia
Polio
Rubella
Smallpox
Tetanus
Minnesota Department of Health, July 2011
Ɍɭɛɟɪɤɭɥɟɡ
ȼɟɬɪɹɧɤɚ
Ɇɚɧɬɭ
ȼɚɤɰɢɧɚ
ȼɚɤɰɢɧɚɰɢɹ
Ɋɟɜɚɤɰɢɧɚɰɢɹ
Mami
Misela
Rupela
Samoan
Serbian
Beseže
Detepe
Difterija
Djeþja paraliza
Gripa
Hri pavac
Male boginje
Pljuskavice, Kozice
Upala pluüa
Veliki boginje
Veliki kašalj
Zapaljenje
ZauŠnjaci
Žutica
Slovak
Chripka
Cierny kasel
Diftéria
DiTePe
Hepatitida
Krzamak
Osypky
Parotitis
Polyomyelitida
Priusnica
Ruzienka
Zápalplüc
Záskrt
Spanish
Cólera
Coqueluche
Difteria
Doble Antigen
Doble Viral
Duple
Gripe
Hemófilo tipo b
Numonía
July 2011, Minnesota Department of Health
Tuberculosis
Varicella
Mantoux (TB Test)
Vaccine
Series
Booster
Mumps
Measles
Rubella
BCG
DTP
Diphtheria
Polio
Influenza
Pertussis
Rubella
Varicella
Pneumonia
Smallpox
Pertussis
Hepatitis
Mumps
Hepatitis
Influenza
Pertussis
Diphtheria
DTP
Hepatitis
Measles
Measles
Mumps
Polio
Mumps
Rubella
Pneumonia
Diphtheria
Cholera
Pertussis
Diphtheria
Td (Mexico)
Measles-Rubella
(Mexico)
DT (Cuba)
Influenza
Hib
Pneumonia
Paperas, Parotiditis
Poliomielitis
Pulmonía
Rubéola
Sarampión, Sarampión Comun
Sarampión Aleman
SPR
Tetánica, Tétano
Tos Ferina
Varicela
Viruela
Somali
Bus-buska
Cagaarshowga
Cuno xanuun
Dabayl
Duf
Furuq
Gowracato
Gurra dhaabsis
Hablobaas
Haemophilus nooca b
Infilowense
Jadeeco
Jadeeco been,
Jadeeco jarmalka
Joonis
Kix
Qaamow-Qashiir
Qaaxo-Tiibi
Qanja Barar
Sambabaha
Tallaakla Qaaxada
Taytano
Wareento
Xiiqdheer
Swedish
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Varicella
Hepatitis
Diphtheria
Polio
Polio
Smallpox
Diphtheria
Mumps
Varicella
Hib
Influenza
Measles
Rubella
Hepatitis
Pertussis
Mumps
Tuberculosis
Mumps
Pneumonia
BCG
Tetanus
Pneumonia
Pertussis
Difteri
Duplex
Gula Febern
Kikhosta
Kolera
Mässling, Masslingormerly
Păssjura
Polio
RĘda Hund
Smittkoppor
Stelkramp
Trippel
Beke
Mumps
Polio
Pneumonia
Rubella
Measles
Rubella
MMR
Tetanus
Pertussis
Varicella
Smallpox
Tagalog
Diphtheria
DT
Yellow Fever
Pertussis
Cholera
Measles
Mumps
Polio
Rubella
Smallpox
Tetanus
DTP
Mumps
www.health.state.mn.us/immunize
117
Dipterya
Pertusis
Polyo
Tetano
Tigdas
Diphtheria
Pertussis
Polio
Tetanus
Measles
Turkish
Bomaca
Çocuk Felci
DBT
Difteri
Erken Yaz-Beyin IltihabȚ’na
Grip
KKK
Kabakulak
KȚzamȚk
KȚmamȚkçȚk
Meningekoklar
Kuduz
Pnömokoklar
Su Çiçei
Tetanos
Ukranian
Ʉɿɪ
ɉɨɥɿɨ
ɋɬɨɜŒɧɹɤ
Vietnamese
Bach Hâu
Bai liet
Ban Ĉo
Dai
Ho G%
Quai Bi
S%i Uon Ván
So’i
Sot T/ Li/t
Thuong h%n
Uon ván
Vi/m gan si/u vi B (VGSV B)
VNNB
118
www.health.state.mn.us/immunize
Pertussis
Polio
DPT
Diphtheria
Tick-borne
encephalitis
Influenza
MMR
Mumps
Measles
Rubella
Meningococcal
Rabies
Pneumococcal
Varicella
Tetanus
Measles
Polio
Tetanus
Diphtheria
Polio
Rubella
Rabies
Pertussis
Mumps
Tetanus
Measles
Polio
Typhoid
Tetanus
Hepatitis B
Japanese
encephalitis
April 2009
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Foreign Language Terms
Table 2: Product Names
Trade Name
Antigen(s)
Manufacturer, Country
A.D.T.
Diphtheria, tetanus, pertussis, polio,
Hib, hepatitis B
Diphtheria, tetanus (adsorbed)
A.K.D.S.
Diphtheria, tetanus, pertussis
UK
ACVax
GSK, UK
Acelluvax
Meningococcal (polysaccharide A & C)
Meningococcal (polysaccharide A, C, Y,
W135)
Pertussis (acellular)
ACTAcel
Diphtheria, tetanus, pertussis, Hib
Sanofi Pasteur, Argentina
Adifteper
Diphtheria, tetanus, pertussis
Ism, Italy
Adinvira A+B
Influenza (whole virus)
Imuna
Adiugrip
Influenza
Sanofi Pasteur
Admun
Influenza (whole virus)
Duncan
Admune GP
Influenza (whole virus)
Duncan
Agrippal
Influenza
Novartis
AH
Hepatitis B
Aimmugen
Hepatitis A (inactivated)
Aldiana
Diphtheria (adsorbed)
(Romania)
Chemo-Sero-Therapeutic
Resh Inst. Japan
Sevac, Czech Republic
Alditeana
Sevac, Czech Republic
Almevax
Diphtheria, tetanus (adsorbed)
Diphtheria, tetanus (adsorbed),
pertussis
Rubella
Alorbat
Influenza (whole virus)
Asta Pharma
Alteana Sevac
Tetanus
Institute of Sera and Vaccines
AM-BC
Meningococcal B & C
Cuba
Amaril
Yellow Fever
Sanofi Pasteur, France
AmBirix
Hepatitis A, Hepatitis B
GSK, Europe
AMC
Hib (polysaccharide)
Cuba
Anadifterall
Diphtheria (adsorbed)
Chiron, Italy
Anatetall
Tetanus (adsorbed)
Chiron, Italy
Anatoxal Di Te
Diphtheria, tetanus
Berna Biotech, Europe
Anatoxal Di Te per
Diphtheria, tetanus, pertussis
Berna Biotech, Europe
AP
Polio
(Romania)
AS
Measles
Cuba
Arilvax
Yellow fever
MEDI, UK
ATPA
Tetanus toxoid
(Romania)
AVAC-1, AVA
Anthrax
(for U.S. military use)
AVAXIM
Hepatitis A
Aventis Pasteur, France
B-Hepavac II
Hepatitis B
Merck, Singapore
6 in 1
ACWYVax
Alditerpera
July 2011, Minnesota Department of Health
GSK, Ireland
Commonwealth, Australia
GSK, UK
Chiron, Italy
Sevac, Czech Republic
Evans
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
119
Trade Name
Antigen(s)
Manufacturer, Country
Begrivac
Influenza (split virus)
Novartis
Betagen
Biaflu Zonale
Biken-HB
Bilive
Biviraten Berna
Buccopol Berna
BVAC
Hepatitis B
Influenza (whole virus)
Hepatitis B
Hepatitis A/Hepatitis B (recombinant)
Hepatitis B (recombinant, adsorbed,
yeast derived)
Measles, mumps (live)
Polio (oral)
Botulinum antitoxin
B-Vaxin
Hepatitis B
C.D.T.
CEF
Cacar
Campak Kerig
Celluvax
Chiromas
Cinquerix
Cocquelucheau
Cuadruple
Diphtheria, tetanus (pediatric, adsorbed)
Measles (Schwarz strain)
Smallpox
Measles
Pertussis (acellular)
Influenza (same as Fluad)
Diphtheria, tetanus, pertussis, Hib, polio
Pertussis (adsorbed)
Diphtheria, tetanus, pertussis, Hib
D-Immun
Diphtheria
Sanofi Pasteur
Farmabiagini, Italy
Biken, Japan
Sinovac, China
Chemo-Sero-Therapeutic
Resh Inst., Japan
Berna Biotech, Switzerland
Berna Biotech, Europe
(for U.S. military use)
Laboratorios Pablo Cassara,
Argentina
Commonwealth, Australia
Chiron, Italy
Indonesia
Pasteur Institute, Indonesia
Chiron, Italy
Novartis, Spain
GSK, Europe
Sanoti Pasteur, France
Mexico
Osterreichisches Institut,
Austria
Bimmugen
D.S.D.P.T.
D.T. Bis Rudivax
Di Anatoxal
Di Te Per Pol
Impfstoff
Diphtheria, tetanus, pertussis
(adsorbed)
Diphtheria, tetanus, rubella
Diphtheria
Sanofi Pasteur, France
Berna Biotech, Europe
Diphtheria, tetanus, pertussis, polio
Berna Biotech, Switzerland
Di-Te-Pol SSI
Diphtheria, tetanus, polio
Dif-Tet-All
Diftavax
Ditanrix
DiTe Anatoxal
Ditoxim
Double Anigen B.I.
DT Adulte
DT Bis
DT Coq
DT Polio
Diphtheria, tetanus
Diphtheria, tetanus
Diphtheria, tetanus
Diphtheria, tetanus (adsorbed)
Diphtheria, tetanus (adsorbed)
Diphtheria, tetanus
Diphtheria, tetanus (adult)
Diphtheria, tetanus (booster)
Diphtheria, tetanus, pertussis
Diphtheria, tetanus, polio
Diphtheria, tetanus Salmonella typhi,
Paratyphi A & B
Diphtheria, tetanus (pediatric)
Diphtheria, tetanus (pediatric)
Diphtheria, tetanus (adsorbed)
Diphtheria, tetanus, polio
Diphtheria, tetanus
Diphtheria, tetanus
DTwP-Hib-HepB
Measles, rubella (Schwarz & RA 27/3)
DT TAB
DT Vax
DT Wellcovax
Dual Antigen Sii
Dultavax
Dupla
Duplex
Easyfive
Ecolarix
120
www.health.state.mn.us/immunize
Dong Shit Pharm, Korea
Statens Seruminstitut,
Denmark
Chiron, Italy
Sanofi Pasteur
GSK, Europe
Berna Biotech, Switzerland
Dong Shin Pharm, Korea
Bengal Immunity Co., India
Sanofi Pasteur, France
Sanofi Pasteur, France
Sanofi Pasteur, France
Sanofi Pasteur, France
Sanofi Pasteur, France
Sanofi Pasteur, France
Chiron, UK
Serum Institute of India (Sii)
Aventis Pasteur, France
Instituto Butantan, Brazil
Sweden
India
GSK, Europe
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Trade Name
Antigen(s)
Manufacturer, Country
VEB, Sachsesches
Serumwerk Dresden
Chiron, Europe
Centro de Ingenieria Genetica
Y Biotecnologia, Cuba
Isi
CSL
GSK, Europe
Berna Biotech, Switzerland
GSK, Mexico
GSK, Belgium
Elvarix
Influenza (split virus)
Encepur
Tick-borne encephalitis
Enivac-HB
Hepatitis B (recombinant DNA)
Enterovaccino
Enzira
Eolarix
Epaxal Berna
Ervax
Ervevax RA 27/3
Euvax-B
Typhoid (IM)
Influenza
Measles, rubella (Schwartz & RA 27/3)
Hepatitis A – virosomal vaccine
Rubella (live)
Rubella (live)
(Hexavalent) Diphtheria, tetanus,
pertussis, polio, Hib, hepatitis B
Hepatitis B (recombinant DNA)
Fendrix
Hepatitis B (dialysis formulation)
GSK, Europe
Fluad
Influenza (adults >65)
Novartis, Europe, Asia, NZ
Flubron
Influenza (whole virus)
Pfizer
Flugen
Influenza
UK
Fluvax
Influenza
CSL, Australia
Fluvirine
Influenza
CellTech Pharma SA
FOH-M
Polio (inactivated)
Russia
FrocuoOke
Polio (inactivated)
Russia
FSME-IMMUNE
Tick-borne encephalitis
Baxter, Austria
FSPD
Measles
Russia
Funed-CEME
Diphtheria, tetanus, pertussis
Belo Horizonte, Brazil
Gen H-B-Vax
GenHevac B
Pasteur
Gene Vac-B
Hepatitis B
Merck-Behringwerke
Hepatitis B
Sanofi Pasteur
Hepatitis B
Serum Institute of India (Sii)
Gripax
Influenza (whole virus)
Hebrew University
Gripe
Influenza (whole virus)
Spain
Gripguard
Influenza (same as Fluad)
Novartis, France
Gripovax
Influenza (whole virus)
GSK
Gunevax
Rubella
Chiron, Italy
H-Adiftal
Diphtheria
Ism, Italy
H-Adiftetal
Diphtheria, tetanus
Ism, Italy
H-Atetal
HarPaBreHnr B
CtauOHAP
HAVPur
Tetanus
Ism, Italy
Rubella
Russia
Hepatitis A
Chiron, Germany
HB Vax Pro
Hepatitis B
SP
HBY
Hepatitis B (recombinant)
KGC, Japan
HDCV
Human Diploid Cell Rabies Vaccine
Heberbiovac HB
Hepatitis B
Heberbiotec, Cuba
Hepabest
Hepatitis A
Sanofi Pasteur, Mexico
Esavalenti
July 2011, Minnesota Department of Health
Italy
LG Chemical, South Korea
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
121
Trade Name
Antigen(s)
Manufacturer, Country
Hepacare
Hepatitis B (recombinant)
Chiron, Europe
Hepaccine-B
Hepatitis B (plasma derived)
Chiel Jedang, South Korea
Hepagene
Hepatitis B
Chiron, Europe
Hepativax
Hepatitis B
Sanofi Pasteur, Mexico
Hepatyrix
Hepatitis A, typhoid
Hepavax-B
Hepatitis B (plasma derived)
Hepavax-Gene
Hepatitis B (recombinant DNA)
Hepcare
Heprecomb
Hevac B
Hiberix
HIBest
Hepatitis B
Hepatitis B (yeast derived)
Hepatitis B (plasma derived)
Diphtheria, tetanus, pertussis, polio,
hepatitis B, Hib
Hib conjugate
Hib
Hinkuys karokoe
Pertussis (adsorbed)
HIS
Influenza
IBV
Polio (inactivated)
Immravax
Immugrip
Immunil
Imovax Parotiditis
Imovax Polio
Imovax Sarampion
Imovas D.T.
Imovas Gripe
Imovax D.P.T.
Imovax R.O.R.
Imovax Rubeola
Imovax Mumps
Imovax Oreillons
Imovax Rage
Imovax Tetano
Infanrix Quinta
Infanrix Tetra
Measles, mumps, rubella
Influenza
Pneumococcal (polysaccharide)
Mumps
Polio
Measles
Diphtheria, tetanus (adult)
Influenza
Diphtheria, tetanus, pertussis
Measles, rubella, mumps (live)
Measles
Mumps
Mumps
Rabies
Tetanus
Diphtheria, tetanus, pertussis, polio,
Hib, hepatitis B
Diphtheria, tetanus, pertussis, hepatitis
B, polio
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio
GSK
Korea Green Cross, South
Korea
Korea Green Cross, South
Korea
Chiron, Europe
Berna Biotech, Switzerland
Sanofi Pasteur, France
Sanofi Pasteur, Europe or
Mexico
GSK
Sanofi Pasteur
Natl. Public Health Institute,
Finland
Serbian Institute, Yugoslavia
Statens Seruminstitut,
Denmark
Sanofi Pasteur, Europe
Pierre Fabre Médicament
Sidus
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur Mexico
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Inflexal
Influenza
Influmix
Influpozzi Zonale
Influenza (whole virus)
Influenza (whole virus)
Influsplit SSW
Influenza (split virus)
Influvac
Influvirus
Influenza
Influenza
Hexavac (Hexavax)
Infanrix Hexa
Infanrix Penta
122
www.health.state.mn.us/immunize
GSK, France
GSK, Europe
GSK, Europe
GSK, Europe
Swiss Serum and Vaccine
Institute
Schiapparelli
Ivp
VEB Sachsecsches
Serumwerk Dresden
Solvay-Pharma
Ism, Italy
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Trade Name
Antigen(s)
Manufacturer, Country
Invirin
Ipad TP
IPV-Virelon
Isiflu Zonale
Istivac
Kaksoisrokote
Dubbelvaccin
Influenza (whole virus)
Tetanus, polio
Polio (inactivated)
Influenza (whole virus)
Influenza
Kikhoste-Vaksine
Pertussis
Koplivac
Kotipa
Krztuscowi
Ksztu
Measles (Edmonston strain)
Cholera, typhoid, paratyphoid
Pertussis
Pertussis
Lancy Vaxina
Smallpox
Lavantuu Tirokote
Typhoid
Liomorbillo
Liovaxs
Lirugen
LM – 3 RIT
LM – 2 RIT
Lteanas Imuna
Lyssavac N
M-M-Rvax
M-M-Vax
M-Vac
Massern-Impfstoff
SSW
Massling
MDPH-PA
Measavac
MenAfriVac
Measles
Smallpox
Measles
Measles, mumps, rubella (live)
Measles, mumps (live)
Tetanus (adsorbed)
Rabies
Measles, mumps, rubella
Measles, mumps
Measles (live)
Chiron, Italy
Sanofi Pasteur
Dong Shin Pharm, Korea
Dong Shin Pharm, Korea
Imuna sp., Slovakia
Berna Biotech, Europe
Chiron, Europe
Merck, Europe
Serum Institute of India (Sii)
Measles (live)
Chiron, Germany
Measles
Anthrax
Measles (Edmonston strain)
Meningococcal A Conjugate
Meningococcal Group A
(polysaccharide)
Meningococcal quadravalent
Meningococcal Groups A & C
(conjugate)
Meningococcal Group C (conjugate)
Meningococcal Group C (conjugate)
Meningococcal Group C (conjugate)
Meningococcal Group C (conjugate)
Meningococcal Groups A, C, Y & W135
(polysaccharide)
Meningococcal Groups A & C
Meningococcal Group B
Measles (Edmonston strain)
Measles (Schwarz strain)
Influenza (whole virus)
Influenza (whole virus)
Influenza
Sweden
Mencevax A
Mencevax ACWY
Mengivax A/C
Meningitec
Meningtec
Meninvact
Menjugate
Menpovax 4
Menpovax A+C
MeNZB
Mesavac
Mevilin-L
MFV
MFV-Ject
Miniflu
Diphtheria, tetanus (pediatric)
July 2011, Minnesota Department of Health
GSK
Sanofi Pasteur, France
Chiron, Europe
Isi, Italy
Sanofi Pasteur, Europe
Natl. Public Health Institute,
Finland
Statens Institutt for
Folkehelse, Norway
Philips-Duphar, Australia
Perum Bio Farma, Indonesia
Poland
Poland
Swiss Serum and Vaccine
Institute, Switzerland
Central Pub Health La,
Finland
Pfizer, UK
Africa
SmithKline/RIT, Belgium
GSK
Sanofi Pasteur, Europe
Wyeth, UK, Australia
Wyeth, Canada
Sanofi Pasteur
Novartis
Chiron, Europe
Chiron, Italy
Novartus, New Zealand
Pfizer, UK
Chiron, UK
Servier, UK
Sanofi Pasteur, Europe
Schiapparelli, Italy
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
123
Trade Name
Mo-Ru Viraten
Antigen(s)
Neotyf
Nilgrip
Measles, rubella
Pneumococcal 17-valent
(polysaccharide)
BCG
Measles, mumps (live)
Measles (live)
Measles, rubella (live)
Measles immunoglobulin
Measles, mumps, rubella (live)
Measles (live)
Mumps (live)
Influenza (whole virus)
Influenza
Influenza
Meningococcal Group C (conjugate)
Pneumococcal 23-valent
(polysaccharide)
Typhoid (live, oral)
Influenza
Nivgrip
Influenza (whole virus)
NorHOMHerHTA
Nothav
Polio (inactivated)
Hepatitis A
Okavax
Varicella (live)
Optaflu
Influenza (cell culture-based)
Oral Virelon
Pariorix
Pavivac
Polio (oral)
Mumps (live)
Mumps (live)
Diphtheria, tetanus, acellular pertussis,
Hib, polio
Diphtheria, tetanus, acellular pertussis,
Hib, polio
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, hepatitis
B, Hib
Diphtheria, tetanus, pertussis, polio, Hib
OR Diphtheria, tetanus, pertussis, polio,
hepatitis B
Diphtheria, tetanus, pertussis, polio, Hib
Measles, rubella
Pneumococcal 23-valent
(polysaccharide)
Diphtheria, tetanus, pertussis, polio, Hib
Polio (inactivated)
Polio (live, oral, trivalent)
Polio (oral)
Moniarix
Monovax / Monovac
Mopavac
Morbilvax
Morubel
Moruman Berna
Morupar
Movivac
Mumaten
Munevan
Mutagrip
Nasoflu
Neis Vac-C
Neumo Imovax
Pediacel
Penta
PENT-HIBest
Pentacel
Pentacoq
PentAct-HIB
Pentavac
Pentavalente
Pentavalenti
Pentaxim
Pluserix
Pneumopur
POLIAcel
Poliomyelite
Polioral
Polio Sabin
124
www.health.state.mn.us/immunize
Manufacturer, Country
Berna Biotech, Canada
GSK, Europe
Sanofi Pasteur, France
Sevac, Czech Republic
Chiron, Italy
Chiron, Italy
Berna, Switzerland
Chiron, Italy
Sevac, Czech Republic
Berna Biotech, Switzerland
Medeva
Sanofi Pasteur, Germany
GSK, Europe
Baxter, Europe & Canada
Sanofi Pasteur, Mexico
Chiron, Italy
CSL
Nicolau Institute of Virology,
Romania
Russia
Chiron, Italy
Biken / Sanofi Pasteur, Japan
& Europe
Novartis, Europe, Iceland,
Norway
Chiron, Germany
GSK, Mexico & Europe
Sevac, Czech Republic
Europe
Sanofi Pasteur, Europe
Sanofi Pasteur
Sanofi Pasteur, Canada
Sanofi Pasteur
Sanofi Pasteur, Europe
Sanofi Pasteur
Mexico
Italy
Aventis Pasteur, France
GSK, Mexico & Europe
Chiron, Europe
Sanofi Pasteur, Argentina
France
Novartis
GSK, Europe
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Trade Name
Antigen(s)
Poloral
Polio (oral)
Prevenar
Previgrip
Primavax
Priorix
Priorix-Tetra
Probivac-B
Procomvax
PRS
R-HB Vaccine
R-Vac
Rabdomune
Rabipur
Rabivac
Rasilvax
RDCV
Refortrix
Repevax
Revaxis
Rimevax
Rimparix
RIT-LM-2
RIT-LM-3
Pneumococcal 7-valent (conjugate)
Influenza
Diphtheria, tetanus, hepatitis B
Measles, mumps, rubella (live)
Measles, mumps, rubella, varicella (live)
Hepatitis B
Hib, hepatitis B
MMR
Pneumococcal 23-valent
(polysaccharide)
Diphtheria, tetanus, pertussis, hepatitis
B
Diphtheria, tetanus, acellular pertussis,
polio
Diphtheria, tetanus, acellular pertussis,
polio, Hib
Diphtheria, tetanus, pertussis, polio
Diphtheria, tetanus, pertussis, Hib
Diphtheria, tetanus, pertussis, polio
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, polio, Hib
Diphtheria, tetanus, pertussis, Hib,
Hepatitis B
Hepatitis B (recombinant)
Rubella (live)
Rabies
Rabies
Rabies
Rabies
“Rabies Diploid Cell Vaccine”
Diphtheria, tetanus (adult)
Diphtheria, tetanus, pertussis, polio
Tetanus, diphtheria, polio (adult)
Measles (live, Schwarz strain)
Measles, mumps (live)
Measles, mumps (live)
Measles, mumps, rubella (live)
Rorvax
Measles, mumps, rubella (live)
Rosovax
Rouvax
Rubavax
Rubeaten
Rubellovac
Rubilin
Rudi-Rouvax
Rudivax
Sahia
Sampar
Rubella
Measles (live)
Rubella (live)
Rubella (live)
Rubella (live)
Rubella (live)
Measles, rubella (live)
Rubella (live)
Polio (live oral)
Plague
Pulmovax
Q-Vac
Quadracel
QUADRAcel/Hibest
Quadravax
Quadruple
Quatro-Virelon
Quinivax-IN
Quintuple
Quinvaxem
July 2011, Minnesota Department of Health
Manufacturer, Country
Swiss Serum and Vaccine
Institute
Wyeth, France
Chiron, France
Sanofi Pasteur, Europe
GSK, Europe & Australia
GSK, Europe
Probiomed, Mexico
Sanofi Pasteur, Europe
Cuba
Merck
Serum Institute of India (Sii)
Sanofi Pasteur, Mexico
Sanofi Pasteur, Argentina
GSK
Mexico
Chiron, Europe
Valda Laboratori, Europe
GSK, Mexico
Novartis/Crucell
Mitsubishi Chem Corp, Japan
Serum Institute of India (Sii)
Impdfstofwerke, Germany
Chiron, Germany
Chiron, Germany
Chiron, Italy
GSK
Sanofi Pasteur
Sanofi Pasteur (Europe)
GSK, Mexico & Europe
GSK, Europe
Dong Shin Pharm, Korea
Dong Shin Pharm, Korea
Sanofi Pasteur, Europe &
Brazil
Ism, Italy
Sanofi Pasteur, Europe
Sanofi Pasteur, UK
Berna Biotech, Europe
Chiron, Germany
Chiron, UK
Sanofi Pasteur, France
Sanofi Pasteur, France
Multiple manufacturers
Sanofi Pasteur, Indonesia
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
125
Trade Name
Sandovac
Serap
Shanvac-B
SMBV
Sii Rabivax
Sii Triple Antigen
Stamaril
Antigen(s)
Subinvira
Synflorix
T. Polio
Influenza
Diphtheria, tetanus, pertussis
Hepatitis B
Rabies
Rabies
Diphtheria, tetanus, pertussis
Yellow fever (live)
Pneumococcal 23-valent
(polysaccharide)
Influenza (split virus)
Pneumococcal (10-valent, conjugate)
Tetanus, polio
T.A.B.
Typhoid, paratyphoid (A & B)
T-Immun
T-Vaccinol
T-Wellcovax
Tanrix
Td-Pur
Td-Virelon
Te Anatoxal
Telvaclptap
Tet-Aktiv
Tet-Tox
Tetagrip
Tetanus (adsorbed)
Tetanus
Tetanus
Tetanus
Tetanus, diphtheria (adult)
Tetanus, diphtheria, polio
Tetanus
Tetanus
Tetanus
Tetanus
Tetanus, influenza
Tetamun SSW
Tetanus (fluid, nonadsorbed)
Tetamyn
Tetano-difter
Tetanus
Tetanus, diphtheria
Tetanol
Tetanus (adsorbed)
Tetanovac
Tetanus
Tetasorbat SSW
Tetanus (adsorbed)
Tetatox
Tetavax
Tetracoq 05
TetrAct-HIB
Tetraxim
Theracys
Ticovac
Tifovax
Titifica
TOPV
Tetanus (adsorbed)
Tetanus (adsorbed)
Diphtheria, tetanus, pertussis, polio
Diphtheria, tetanus, pertussis, Hib
Diphtheria, tetanus, acellular pertussis,
polio
Diphtheria, tetanus, pertussis, hepatitis
B
Tetanus, diphtheria, pertussis, polio
BCG
Tick-borne encephalitis
Typhoid (Vi polysaccharide)
Typhoid and paratyphoid
Polio (oral, trivalent)
Trenin DPT Behring
Diphtheria, tetanus, pertussis
Streptopur
Tetravac Acellulaire
Tetravalenti
126
www.health.state.mn.us/immunize
Manufacturer, Country
Sandoz, Austria
Perum Bio Farma, Indonesia
Shantha, India
Sanofi Pasteur, Europe
Serum Institute of India (Sii)
Serum Institute of India (Sii)
Sanofi Pasteur, Europe
Chiron, Europe
Imuna, Czech Republic
GSK, Europe, Australia
SP (Canada)
- Institute Pasteur, Tunisia
- Egypt
- Pharmaceutical Industries
Corp., Burma
Baxter, Germany
Roehm Pharma, Germany
Wellcopharm, Germany
GSK, Europe
Chiron, Europe
Chiron, Europe
Berna Biotech, Switzerland
Yugoslavia
Tropon-Cutter, Germany
CSL Limited, Australia
SP, France
Veb Sachsisches Serumwerk,
Germany
Bioclon, Mexico
Celltech Pharma
Chiron, Sanofi Pasteur,
Europe & Mexico
Sanofi Pasteur, Mexico
Veb Sachsisches Serumwerk,
Germany
Berna Biotech, Italy
Sanofi Pasteur, Europe
Sanofi Pasteur, France
Sanofi Pasteur, Europe
Sanofi Pasteur, Europe
Italy
Sanofi Pasteur, Europe
Aventis Pasteur, Canada
Baxter SA
Sanofi Pasteur, Mexico
Italy
Multiple manufacturers
Chiron Behring GmbH,
Germany
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Trade Name
Antigen(s)
Tresivac
Measles, mumps, rubella (live)
Triacel
Diphtheria, tetanus, acellular pertussis
Triacelluvax
Trimovax
Tripacel
Diphtheria, tetanus, acellular pertussis
Measles, mumps, rubella (live)
Diphtheria, tetanus, acellular pertussis
Triple antigen
Diphtheria, tetanus, pertussis
Triple Sabin
Triple
Polio (live, oral)
Diphtheria, tetanus, pertussis
Triple viral
Measles, mumps, rubella
Triplice (VT)
Triplice Viral (VTV)
Diphtheria, tetanus, pertussis
Measles, mumps, rubella
Triplovax
Measles, mumps, rubella
Tritanrix
Diphtheria, tetanus, whole-cell pertussis
Diphtheria, tetanus, whole-cell
pertussis, hepatitis B
Diphtheria, tetanus, whole-cell
pertussis, hepatitis B, Hib
Diphtheria, tetanus (adsorbed),
pertussis
Diphtheria, tetanus (plain), pertussis
Diphtheria, tetanus (adsorbed),
pertussis
Diphtheria, tetanus, pertussis, Hib
Diphtheria, tetanus, pertussis
Measles, mumps, rubella (live)
Measles, mumps, rubella (live)
Measles, mumps, rubella
Pertussis
BCG
BCG
Typhoid (Vi polysaccharide)
Tritanrix-HB
Tritanrix-HB-Hib
Trivacuna Leti
Trivax
Trivax-AD
Trivax-Hib
Trivb
Triviraten
Trivivac
Trivivax
Tussitrupin Forte
Tuvax
Tyne
Typherix
Typhoparatyphoidique
Typhoral-L
Typh-Vax
Manufacturer, Country
Serum Institute of India (Sii)
Sanofi Pasteur, Europe &
Mexico
Chiron, Europe
Sanofi Pasteur,
Sanofi Pasteur, Europe
- Chowgule & Co., India
- CSL Limited, Australia
Mexico
Cuba, Mexico
- Mexico
- Immunology Institute,
Croatia
Instituto Butantan, Brazil
Instituto Butantan, Brazil
Sanofi Pasteur, Europe &
Brazil
GSK
GSK, Mexico
GSK
Laboratory Leti, Spain
Chiron, UK
Chiron, UK
GSK, Europe
Brazil
Berna Biotech, Switzerland
Sevac, Czech Republic
Sanofi Pasteur, Mexico
Staatliches Institut, Germany
Japan BCG Laboratory, Japan
Sweden
GSK, Europe & Australia
Typhoid and paratyphoid
France
Typhoid (Ty21a oral)
Typhoid
Berna Biotech, Germany
CSL Limited, Australia
Finlay Vacunas y Sueros,
Cuba
Finlay Vacunas y Sueros,
Cuba
Bioclon, Mexico
Cantacuzino Institute,
Romania
Va-Diftet
Diphtheria, tetanus
Va-Mengoc-BC
Meningococcal Groups B & C
Vac-DPT
Vaccin Difteric
Adsorbit
Vaccin Rabique
Pasteur
Vaccin Combinat
Diftero-Tetanic
Vaccin tuberculeux
attenue lyophilize
Diphtheria, tetanus, pertussis
Diphtheria (adsorbed)
Rabies
Pasteur Vaccins
Diphtheria, tetanus (adsorbed)
Cantacuzino Institute,
Romania
BCG
Sanofi Pasteur, France
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
127
Trade Name
Vaccinum
Morbillorum Vivum
Vacina Dupla
Vacina Triplice
Vacina Triplice Viral
Vacuna Doble
Vacunol
Vaksin Sampar
Vaksin Cacar
Vaksin Serap
Vaksin Campak
Kerig
Vaksin Kotipa
Antigen(s)
Diphtheria, tetanus
Diphtheria, tetanus, pertussis
Measles, mumps, rubella
Tetanus, diphtheria
Tetanus
Plague
Smallpox
Diphtheria, tetanus, pertussis
Moscow Research Institute,
Russia
Instituto Butantan, Brazil
Instituto Butantan, Brazil
Brazil
Instituto Biologico Argentino
Temis-Lostato, Brazil
Perum Bio Farma, Indonesia
Indonesia
Perum Bio Farma, Indonesia
Measles (live)
Perum Bio Farma, Indonesia
Cholera, typhoid, paratyphoid A, B & C
Rabies (purified vero cell)
Hepatitis A, typhoid
Cholera
Hepatitis B
Polio (inactivated)
Polio (live, oral trivalent)
Measles, mumps, rubella (live)
Perum Bio Farma, Indonesia
Institute of Immunology,
Croatia
GSK, Europe
Behringwerke
Aktiengesellischaft, Germany
Institute of sera and Vaccine,
Czech Republic
GSK, Australia, New Zealand
GSK, Europe & Mexico
Finlay Vacunas & Sueros,
Cuba
Chiron, Europe
Sanofi Pasteur, France
Sanofi Pasteur, Europe &
Australia
Riker, UK
Chiron, Italy
Cantacuzino Institute,
Romania
Cantacuzino Institute,
Romania
Sanofi Pasteur, France
Sanofi Pasteur, UK
Duncan Flockhart, UK
Ivax Pharmaceuticals, Mexico
Chiron, Germany
Chiron, Germany
Merck, Finland
Measles, mumps, rubella
Sweden
Polio (oral)
Human Papillomavirus
Diphtheria, tetanus, pertussis
PT Biofarma, Indonesia
Spanish
Instituto Butantan, Brazil
Measles, mumps, rubella
Brazil
Measles (live)
Vamoavax
Measles, mumps (live)
Varicella-RIT
Varicella
Varicellon
Zaricella zoster immunoglobulin
Varie
Smallpox (lyophilized)
Varilrix
Varirix
Varicella (live, Oka strain)
Varicella (live, Oka strain)
Vax-Tet
Tetanus
Vaxem-Hib
Vaxicoq
Hib (polysaccharide)
Pertussis (adsorbed)
Vaxigrip
Influenza
Vaxihaler-Flu
Vaxipar
Influenza (inhaler)
Mumps (live)
VCDT
Diphtheria, tetanus (pediatric)
VDA Vaccin Difteric
Adsorbit
Verorab
ViATIM
Vibriomune
Viralinte
Virelon C
Virelon T 20
Virivac
Virovac Massling,
Perotid, Rubella
Vopix
VPH
V T (Vacine Triplice)
V T V (Vacina
Triplice Viral)
Diphtheria
VVR
Measles (live)
Welltrivax Trivalente
X-Flu
Diphtheria, tetanus, pertussis
Influenza
128
Manufacturer, Country
www.health.state.mn.us/immunize
Cantucuzino Institute,
Romania
Spain
CSL
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Trade Name
Zaantide
Zaantite
Zaditeadvax
Zaditevax
Zamevax A+C
Zamovax
Zamruvax
Zapavax
Zaruvax
Zatetravax
Zatevax
Zatribavax
Zatrivax
July 2011, Minnesota Department of Health
Antigen(s)
Diphtheria antitoxin
Tetanus antitoxin
Diphtheria, tetanus
Diphtheria, tetanus
Meningococcal Groups A & C
(polysaccharide)
Measles (live)
Measles, rubella (live)
Mumps
Rubella (live)
Diphtheria, tetanus, pertussis,
parapertussis
Tetanus
Diphtheria, tetanus, pertussis
Measles, mumps, rubella (live)
Manufacturer, Country
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
Imunoloski Zavod, Croatia
February 2012
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
129
Vaccines for the international traveler
Traveling outside the United States?
Plan ahead for your international travel shots
Where can I get information on
international travel shots?
The Minnesota Department of Health does not
provide international travel health consultation
or international travel shots.
Information on international travel shots and
other travel health issues including disease and
concerns about food and water supplies is
available by country from the Centers for
Disease Control and Prevention (CDC):
x
CDC Travel website
www.cdc.gov/travel
How soon before I travel do I have
to get the vaccines I need?
Start planning now. Some vaccines take up to
six months for the entire series.
What vaccines will I need?
The international travel vaccines you need
depend on your travel destination, age, current
medical condition, occupation and lifestyle.
Where do I go to get international
travel shots?
It depends. If you are going to Europe, Canada,
Mexico, Japan, Australia, or New Zealand,
your health care provider should be able to give
you the shots you need.
If you are going to any other country than those
just listed, an international travel health clinic
is your best resource.
Where can I find an international
travel health clinic?
International travel health clinics in Minnesota
are listed on the back of this fact sheet.
Do I need yellow fever vaccine?
If you are going to Africa, Central America, or
South America, you may need yellow fever
vaccine or other vaccines your health care
provider might not have. International travel
health clinics are the only places that can give
yellow fever vaccine.
Are your routine immunizations up
to date?
Don’t just get your international travel shots!
It’s a good idea for adults and children to be up
to date with routine vaccines before they leave
the country.
Children. Children are vaccinated against 12
diseases in the United States. If you aren’t sure
your children are up to date with their routine
shots, call their health care provider.
Adults. Adults need routine vaccines too! If
you aren’t sure you are up to date, call your
health care provider.
Other information for the
international traveler
The State Department’s travel website includes
travel warnings, information on how to get
visas and passports, and a wealth of other
international travel tips. This information is
available at www.state.gov/travel.
Visit MDH’s website
This fact sheet and a list of international travel
health clinics in Minnesota are available on the
Web at www.health.state.mn.us/immunize
under “For Travelers.”
International travel health clinics in
Minnesota
(see back) 叝叝叝叝叝
Immunization Program
P.O. Box 64975
St. Paul, MN 55164-0975
651-201-5414 or 1-877-676-5414
www.health.state.mn.us/immunize
(MDH 10/2012)
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/travel/travelshots.html
130
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Minnesota Department of Health, July 2011
International travel health clinics serving Minnesota residents
The international travel health clinics listed below are authorized to administer yellow fever vaccine. They also provide a variety of
other pre- and post-travel services to travelers. Most international travel clinics require an appointment and may require you to see a
health care provider. ALWAYS call first.
Greater Minnesota clinics:
Mayo Health System Austin
1000 1st Drive NW
Austin, MN 55912
Phone: 507-433-7351
Sanford Clinic - Bemidji
1233 34th Street NW
Bemidji, MN 56601
Phone: 218-333-4944
Essentia Health Brainerd Clinic
2024 S. Sixth Street
Brainerd, MN 56401
Phone: 218-828-7100
Parkview Clinic
1400 First Street. NE
New Prague, MN 56071
Phone: 952-758-2535
Park Nicollet Clinic – Burnsville
14000 Fairview Drive
Burnsville, MN 55337
Phone: 952-993-3131
New Ulm Medical Center
1324 5th Street N.
New Ulm, MN 56073
Phone: 507-233-1000
Allina Medical Clinic/ Crossroads
Chaska
111 Hundertmark Road, Suite 220
Chaska, MN 55318
Phone: 952-448-2050
Allina Medical Clinic - Northfield
1400 Jefferson Road
Northfield, MN 55057
Phone: 507-663-9000
800-272-0508
Cambridge Medical Center
701 S. Dellwood Avenue
Cambridge, MN 55008
Phone: 763-689-8700
Northside Medical Center Ortonville Area Health Services
450 Eastvold Avenue
Ortonville, MN 56278
Phone: 320-839-6157
St. Luke’s Infectious Disease and
Travel Center
1001 East Superior Street, L201
Duluth, MN 55805
Phone: 218-249-7990
Owatonna Clinic
Mayo Health System
2200 26th Street NW
Owatonna, MN 55060
Phone: 507-444-5020
Essentia Health Duluth Clinic
400 East Third Street
Duluth, MN 55805
Phone: 218-786-3737
Mayo Clinic Tropical Travel &
Medicine
200 First Street SW
Rochester, MN 55905
Phone: 507-255-7763
Allina Medical Clinic – Faribault
100 State Avenue
Faribault, MN 55021
Phone: 507-334-3921
Hutchinson Medical Center
3 Century Avenue
Hutchinson, MN 55350
Phone: 320-587-2020
Immanuel St. Josephs
Mayo Health System
1015 Marsh Street
Mankato, MN 56002
Phone: 507-385-4700
Lake Region Healthcare Clinic
Services
615 Mill Street S.
Fergus Falls, MN 56537
Phone: 218-739-2221
Mankato Clinic
1230 East Main Street
Mankato, MN 56001
Phone: 507-625-1811
Olmsted Medical Center
210 9th Street SE
Rochester, MN 55904
Phone: 507-288-3443
CentraCare Clinic—Family
Medicine—Health Plaza
1900 CentraCare Circle
St. Cloud, MN 56303
Phone: 320-229-4917
Affiliated Community Medical
Center
101 Willmar Avenue SW
Willmar, MN 56201
Phone: 320-231-5070
Twin Cities metropolitan
area clinics:
MD Physicals, Inc.
14135 Cedar Avenue, Suite 300
AppleValley, MN 55124
Phone: 952-431-9655
Allina Medical Clinic/
Coon Rapids
Coon Rapids Medical Center
9055 Springbrook Dr.
Coon Rapids, MN 55433
Phone: 763-780-9155
N.W. Family Physicians
5700 Bottineau Boulevard
Crystal, MN 55429
Phone: 763-287-6500
Passport Health
6700 France Avenue S., Suite 150
Edina, MN 55435
Phone: 952-922-9089
Axis Medical Center
1801 Nicollet Avenue S.
Minneapolis, MN 55403
Phone: 612-823-2947
Airport Medical Clinic
7550 34th Avenue S.
Minneapolis, MN 55450
Phone: 612-727-1167
Boynton Health Services
410 Church Street SE
Minneapolis, MN 55455
Phone: 612-625-3222
Crown Medical Center
1925 1st Avenue S.
Minneapolis, MN 55403
Phone: 612-871-4354
Fairview Uptown Clinic
3033 Excelsior Boulevard, Suite 275
Minneapolis, MN 55416
Phone: 612-827-4751
Hennepin Faculty Associates
Internal Medicine
825 S. 8th Street, Suite 206
Minneapolis, MN 55404
Phone: 612-347-7534
Continued on next page Æ
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/travel/travelshots.html
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
131
International Travel Clinic AbbottNorthwestern
2545 Chicago Avenue S., Suite 200
Minneapolis, MN 55405
Phone: 612-863-1939
NorthPoint Health and Wellness
Center
1313 Penn Avenue N.
Minneapolis, MN 55411
Phone: 612-543-2522
Allina Medical Clinic/Woodbury
8675 Valley Creek Road
Woodbury, MN 55124
Phone: 651-501-3000
Clinics near Minnesota
borders:
North Iowa Mercy Internal
Medicine
Mason City, IA
Phone: 800-756-4423
Minneapolis VA Medical Center
U.S. Veterans only, 3-D Clinic
One Veterans Drive
Minneapolis, MN 55417
Phone: 612-467-1100
Fargo/Cass Public Health
Department
Fargo, ND
Phone: 701-298-6938
International Travel Clinic
Ridgedale Office Center
13911 Ridgedale Drive Suite. 484
Minnetonka, MN 55305
Phone: 952-405-8812
Where can I get travel
immunization information?
The Minnesota Department of Health
does not provide travel health
consultation or travel vaccines. Use
resources from the Centers for Disease
Control and Prevention to learn about
travel vaccines and other travel health
issues: CDC’s travel website
(www.cdc.gov/travel). If you have
insurance, call your health plan’s
member services office to see if you are
covered for your travel vaccines.
Altru Main Clinic
Grand Forks, ND
Phone: 701-780-6234
Sanford Health
Sioux Falls, SD
605-328-8120
Fairview RidgeValley
Medical Center
4151 Willowwood Street SE
Prior Lake, MN 55372
Phone: 952-226-2600
Gunderson Lutheran Medical
Center
LaCrosse, WI
Phone: 800-362-9567
Quello Clinic - Savage
6350 W 143rd Street, Suite. 102
Savage, MN 55378
Phone: 952-428-0200
St. Croix Regional Medical Center
St. Croix Falls, WI
Phone: 800-828-3627
Complete Home Health Services
4001 Stinson Boulevard, LL32
St. Anthony, MN 55421
Phone: 612-788-2273
HealthPartners Travel & Tropical
Medicine Center
5100 Gamble Drive Suite. 100
St. Louis Park, MN 55416
Phone: 952-967-7978
Park Nicollet Clinic
3800 Park Nicollet Boulevard
St. Louis Park, MN 55416
Phone: 952-993-3131
HealthPartners Travel & Tropical
Medicine Center
401 Phalen Boulevard
St. Paul, MN 55101
Phone: 952-967-7978
St. Paul Ramsey County
Department of Public Health
555 Cedar Street
St. Paul, MN 55101
Phone: 651-266-1234
Stillwater Medical Group
1500 Curve Crest Boulevard
Stillwater, MN 55082
Phone: 651-439-1234
Minnesota Department of Health, Rev October 2012
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/travel/travelshots.html
132
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Minnesota Department of Health, July 2011
Provider’s Quick Reference on Minnesota’s Immunization Laws
Be sure you have up-to-date information on Minnesota’s School Immunization Law by visiting the MDH
website at www.health.state.mn.us/immunize.
To help prevent over-immunization and missed opportunities, providers are encouraged to enroll in the
Minnesota Immunization Information Connection (MIIC) web-based application, which allows
immunization providers to enter and view all immunizations given to their patients.
Immunizations Required for Licensed Child Care Facilities and School Grades K - 12
Minnesota Statutes, section 121A.15, subd. 1
Age/Grade of Child1
PCV-13
Birth to 2 months
2 months to 15 months
15 months to
kindergarten age
Pre-kindergarten (3-4
years)
Kindergarten
st
1 grade through 6
years
7 years through grade 6
None
None
Age
3
appropriate
Age
appropriate
Age
3
appropriate
1
None
1
None
None
5
None
5
6
3
8
Grade 7
Grades 8 through 12
1
2
3
4
5
6
7
8
9
10
11
Number of Doses Required by Vaccine Type
DTaP/
Hib
DTP/
Polio
MMR
Varicella2
DT/Tdap/Td
None
None
None
None
None
Age appropriate
Age
appropriate
None
None
None
4
Age appropriate
Age
appropriate
1
1
None
4
4-5
1
1
None
4
2
2
3
7
1
None
None
3
1
None
None
3
2
2
11
2
None
None
None
None
Hep B
5
3-4
4
None
None
3 plus booster
9
None
None
3 plus booster
9
3
5
2-3
10
None
A vaccine dose administered four or fewer days before the minimum age required by law is considered valid.
As of September 1, 2010, only a health care provider (physician, nurse practitioner, or physician assistant) can verify history of
chickenpox disease for a child entering child care or school.
Pneumococcal vaccine is required for children 2 to 24 months of age.
Minnesota law requires children enrolled in a child care facility have at least one dose of Hib vaccine given at or after 12 months of
age; however it is always recommended to vaccinate children according to age appropriate recommendations.
MDH recommends that school “boosters” for DTaP/DTP/DT and polio be administered before entrance to kindergarten.
The fifth dose of DTaP is not required if the fourth DTaP was administered after the fourth birthday.
The fourth dose of polio vaccine is not required if the third dose of polio was administered after the fourth birthday.
Pertussis vaccine is not required of students 7 years of age or older.
If a child in grades 7 through 12 received a Tdap/Td booster after their seventh birthday but before age 11 they are exempt until 10
years have elapsed since that dose was given.
A two-dose hepatitis B adolescent schedule is acceptable; however, it must be clearly documented that the two-dose product, such
as Recombivax, was given.
Students age 18 years or older are exempt from the polio vaccine requirement.
Exemptions to the Child Care and K-12 School Immunization Law
Minnesota Statutes, 121A.15, Section 3
For a medical contraindication to the required vaccine(s), including anaphylactic reaction to a previous
dose or to vaccine component(s), the parent/guardian must have a signed statement by a physician
specifying the vaccine(s).
For laboratory evidence of immunity to a disease covered by the law, the parent/guardian must have a
signed statement by a physician specifying the vaccine(s).
For conscientious objection by a parent or legal guardian to one or more of the vaccine(s), the
parent/guardian must have a notarized statement that specifies the vaccine(s) and is signed by the
parent/guardian.
MDH, Immunization Program
(4/11) Page 1 of 2
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July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
133
Immunizations Required for Post-Secondary Schools and Colleges
Minn. Stat. Section 135.14
Required Vaccines
Number of Doses
Tetanus and diphtheria (Td or Tdap)
One dose given in the 10 years prior to initial enrollment
Measles, mumps, and rubella (MMR)
One dose given on or after the first birthday (a second dose is
recommended)
Recommended Vaccines
Number of Doses
Meningococcal
Medically acceptable standard
Hepatitis A and B
Medically acceptable standard
Exemptions to Post-Secondary School and College Immunization Law
Minnesota Statutes, section 135.14, subd. 3
A person who graduated from a Minnesota high school in 1997 or later is exempt from these
requirements because they will already have met them as a high school student.
For a medical contraindication to required vaccine(s), including anaphylactic reaction to a previous dose
or to vaccine component(s), the patient or parent/guardian must have a signed statement by a physician
specifying the vaccine(s).
For laboratory evidence of immunity to a disease covered by the law, the patient/parent/guardian must
have a signed statement by a physician specifying the vaccine(s).
For conscientious objection by the patient/parent/legal guardian to one or more of the vaccines, the
patient/parent/guardian must have a notarized statement specifying the vaccine(s) and signed by the
patient/parent/guardian.
Related Legal Requirements for Child Care, Schools, and Colleges
Exemption Information: It is a state law that any written materials given to parents of pediatric
patients about vaccines required for grades K-12 or child care must contain information on legal
exemptions. The exemption information must be in the same font size and style and on the same page
as the requirements.
Vaccine Information Statements: It is a federal requirement that providers must give a copy of the
Vaccine Information Statement (VIS) to any patient/parent/guardian receiving a vaccine.
Immunization Program
P.O. Box 64975
St. Paul, MN 55164-0975
651-201-5503 or 1-800-657-3970
www.health.state.mn.us/immunize
(4/11) Page 2 of 2
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/laws/qreflaws.html
134
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Guide to Contraindications and Precautions to Commonly Used Vaccines
Make sure you are aware of all possible contraindications and precautions for health conditions that might preclude
a particular vaccine. Also, don’t miss opportunities to vaccinate because of misperceptions of a contraindication or
precaution. Remember to screen patients each time you vaccinate because responses to the questions may change.
True Contraindications and Precautions
Not True (give vaccines)
Diphtheria,
tetanus,
pertussis
(DTaP)
Vaccine
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
• Encephalopathy (e.g., coma, decreased level of consciousness,
prolonged seizures) without an identified cause within 7 days of
administration of prior dose of DTP or DTaP
Precautions:
• Moderate or severe acute illness with or without fever
• Fever of 105°F or greater ( 40.5°C or greater) within 48 hours after a
previous dose of DTP or DTaP
• Progressive neurological disorder, including infantile spasms,
uncontrolled epilepsy, progressive encephalopathy: defer DTaP until
neurologic status clarified and stabilized
• Collapse or shock-like state (hypotonic hypo-responsive episode)
within 48 hours of receiving a previous dose of DTP/DTaP
• Seizure within 3 days of receiving a previous dose of DTP/DTaP
• Persistent, inconsolable crying lasting 3 hours or more within 48 hours
after receiving a previous dose of DTP/DTaP
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose
of tetanus toxoid-containing vaccine
• History of arthus-type reaction following a previous dose of
tetanus-toxoid containing vaccine; defer until at least 10 years from
previous dose (Arthus-type reactions are rare in childhood DTaP series.)
• Temperature less than 105°F or 40.5°C within
48 hours of receiving DTaP or DTP
• Fussiness or mild drowsiness after a previous
dose of DTP/DTaP
• Family history of seizures
• Family history of sudden infant death syndrome
• Family history of an adverse event after DTP or
DTaP administration
• Stable neurological conditions (e.g.,
cerebral palsy, well controlled convulsions,
developmental delay)
Diphtheria,
tetanus,
(DT and Td)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
Precautions:
• Moderate or severe acute illness with or without fever
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose
of tetanus toxoid-containing vaccine
• History of Arthus-type reaction following a previous dose of
tetanus-toxoid containing vaccine; defer until at least 10 years from
previous dose
Tetanus,
diphtheria,
pertussis
(Tdap)
• See page 3, tetanus, diphtheria, pertussis (Tdap)
Haemophilus
influenzae
type B
(Hib)
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
• Age less than 6 weeks
Precaution:
• Moderate or severe acute illness with or without fever
Hepatitis A
(HepA)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
Precautions:
• Moderate or severe acute illness with or without fever
• Pregnancy
Hepatitis B
(HepB)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
Precautions:
• Moderate or severe acute illness with or without fever
• Infant weighing less than 2000 grams1
• Pregnancy
• Autoimmune disease (e.g., systemic lupus
erythematosis, rheumatoid arthritis)
Immunization Program
P.O. Box 64975
St. Paul, MN 55164-0975
651-201-5503, 1-800-657-3970
www.health.state.mn.us/immunize
IC#141-0649 (05/11) Page 1 of 4
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/vaccine.html
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
135
Vaccine
True Contraindications and Precautions
Human
Papillomavirus
(HPV2, HPV4)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
Precautions:
• Moderate or severe acute illness with or without fever
• Pregnancy
•
•
•
•
•
Inactivated
polio vaccine
(IPV)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) to previous dose or to a
vaccine component
Precautions:
• Moderate or severe acute illness with or without fever
• Pregnancy
• Previous receipt of oral polio vaccine (OPV)
Influenza,
injected
trivalent
(TIV)
Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) to previous dose or to a
vaccine component, including egg protein
Precautions:
• Moderate or severe acute illness with or without fever
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose
of influenza vaccine
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) to previous dose or to a
vaccine component, including egg protein
• Aspirin therapy in children and adolescents
• Known severe immunodeficiency (e.g., hematologic and solid
tumors, congenital immunodeficiency, long term immunosuppressive
therapy4 including chemotherapy, severely symptomatic HIV infection)
• Pregnancy
Precaution:
• Moderate or severe acute illness with or without fever
• Children with recurrent wheezing or asthma
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose
of influenza vaccine
• Persons with chronic medical conditions for which yearly influenza
vaccination is recommended should not receive LAIV
• Receipt of specific influenza antivirals (i.e., amantadine, rimantadine,
or oseltamivir, or zanamivir) 48 hours before vaccination; if possible
delay resumption of these antiviral drugs for 14 days after vaccination.
• Non-systemic allergy to latex, thimerosal, or
egg
• Current administration of coumadin (warfarin)
or aminophylline
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
a vaccine component
• Known severe immunodeficiency (e.g., hematologic and solid
tumors, congenital immunodeficiency, long term immunosuppressive
therapy4 including chemotherapy, severely symptomatic HIV infection5)
• Within 24 months of a hematopoietic stem cell transplant (HSCT)
• Pregnancy
Precautions:
• Moderate or severe acute illness with or without fever
• Recent (within 11 months) receipt of antibody-containing blood
product (specific interval depends on product)6
• History of thrombocytopenia or thrombocytopenic purpura
•
•
•
•
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
a vaccine component
• Known severe immunodeficiency (e.g., hematologic and solid
tumors, congenital immunodeficiency, long term immunosuppressive
therapy4 including chemotherapy, severely symptomatic HIV infection5)
• Within 24 months of a hematopoietic stem cell transplant (HSCT)
• Pregnancy
Precautions:
• Moderate or severe acute illness with or without fever
• Personal or family history of seizures
• Recent (within 11 months) receipt of antibody-containing blood
product (specific interval depends on product)6
• History of thrombocytopenia or thrombocytopenic purpura
• Receipt of specific antivirals (i.e., acyclovir or valacyclovir) 24 hours
before vaccination; if possible delay resumption of these antiviral
drugs for 14 days after vaccination.
•
•
•
•
Influenza,
live attenuated
(LAIV)3
Measles,
mumps,
rubella
(MMR)3
Measles,
mumps,
rubella,
varicella
(MMRV)3
Not True (give vaccines)
Previous HPV infection2
Immunosuppression
Breastfeeding
History of genital warts
Previous questionable or abnormal PAP test
• Immunodeficient family member or household
contact
• Pregnant or breastfeeding family member or
household contact
• Breastfeeding
• Health care workers (those that care for
patients in protective isolation should receive a
TIV or defer care for 7 days following LAIV)
• Contacts of persons with chronic medical
conditions
•
•
•
•
•
•
•
•
•
•
Positive tuberculin skin test
Simultaneous TB skin testing7
Breastfeeding
Pregnancy of recipient’s mother or other close
or household contact
Recipient is female of childbearing-age
Immunodeficient family member or household
contact
Asymptomatic or mildly symptomatic HIV
infection5
Allergy to eggs
Receipt of RSV monoclonal antibody (Synagis)
Positive tuberculin skin test
Simultaneous TB skin testing7
Breastfeeding
Pregnancy of recipient’s mother or other close
or household contact
Recipient is female of childbearing-age
Immunodeficient family member or household
contact8
Asymptomatic or mildly symptomatic HIV
infection5
Allergy to eggs
Receipt of RSV monoclonal antibody (Synagis)
MDH Immunization Program
IC#141-0649 (05/11) Page 2 of 4
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/vaccine.html
136
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Vaccine
True Contraindications and Precautions
Meningococcal, Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
conjugate
a vaccine component
(MCV)
Precaution:
• Moderate or severe acute illness with or without fever
Not True (give vaccines)
• History of Guillain-Barré syndrome (GBS)
Meningococcal, Contraindication:
polysaccharide • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
a vaccine component
(MPSV)
Precaution:
• Moderate or severe acute illness with or without fever
Pneumococcal, Contraindication:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose of
conjugate
PCV7, PCV13 or any diphtheria containing vaccine or to their vaccine
(PCV)
components
Precaution:
• Moderate or severe acute illness with or without fever
Pneumococcal, Contraindication:
polysaccharide • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
a vaccine component
(PPSV)
Precaution:
• Moderate or severe acute illness with or without fever
• History of pneumonia or previous invasive
pneumococcal disease
Rotavirus
(RV1, RV5)
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
• Severe Combined Immunodeficiency (SCID)
Precautions:
• Moderate or severe acute illness with or without fever
• Chronic gastrointestinal disease
• Altered immunocompetence other than SCID
• History of intussusception
• Infants with spina bifida or bladder exstrophy (RV1 only)
Tetanus,
diphtheria (Td)
Tetanus,
diphtheria,
pertussis
(Tdap)
• See page 1, diphtheria, tetanus, (DT and Td)
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
• Encephalopathy (e.g., coma, decreased level of consciousness,
prolonged seizures) without an identified cause within 7 days of
administration of prior dose of DTP, DTaP, or Tdap
Precautions:
• Moderate or severe illness with or without fever
• Guillain-Barré syndrome (GBS) within 6 weeks after previous dose of
tetanus toxoid-containing vaccine
• Progressive or unstable neurologic disorder, uncontrolled seizures or
progressive neuropathy until stabilized
• History of Arthus-type reaction following a previous dose of
tetanus-toxoid containing vaccine; defer until at least 10 years from
previous dose
• Less than 10 years since previous dose of Td
• Temperature less than 105°F or 40.5°C within
48 hours of receiving DTaP or DTP
• Collapse or shock within 48 hours of receiving
DTaP or DTP
• Persistent, inconsolable crying lasting more
than 3 hours within 48 hours of receiving DTaP
or DTP
• History of severe limb swelling after receiving
DTaP or DTP
• Stable neurological conditions (e.g.,
cerebral palsy, well controlled convulsions,
developmental delay)
• History of bronchial neuritis
• Non-systemic allergy to latex
• Immunosuppression
• Breastfeeding
Varicella
(VAR)3
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
a vaccine component
• Known severe immunodeficiency (e.g., hematologic and solid
tumors, congenital immunodeficiency, long term immunosuppressive
therapy4 including chemotherapy, severely symptomatic HIV infection5)
• Within 24 months of a hematopoietic stem cell transplant (HSCT)9
• Pregnancy
Precautions:
• Moderate or severe acute illness with or without fever
• Recent (within 11 months) receipt of antibody-containing blood
product (specific interval depends on product)6
• Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir)
24 hours before vaccination, if possible; delay resumption of these
antiviral drugs for 14 days after vaccination.
• Pregnancy of recipient’s mother or other close
or household contact
• Immunodeficient family member or household
contact8
• Asymptomatic or mildly symptomatic HIV
infection5
• Humoral immunodeficiency
(e.g.,agammaglobulinemia)
• Receipt of RSV monoclonal antibody (Synagis)
• Immunodeficient family member or household
contact
• Mild diarrheal disease
• Prematurity
• Pregnant family member or household contact
• Receipt of RSV monoclonal antibody (Synagis)
MDH Immunization Program
IC#141-0649 (05/11) Page.3 of 4
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/vaccine.html
July 2011, Minnesota Department of Health Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
137
Vaccine
Zoster
(ZOS)3
True Contraindications and Precautions
Contraindications:
• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to
their vaccine components
• Primary or acquired immunodeficiency (e.g., leukemia, lymphoma,
AIDS or symptomatic HIV, long term immunosuppressive therapy4,
receiving chemotherapy for malignancy, undergoing stem-cell
transplantation, receiving immune mediators or modulators)
• Pregnancy
Precautions:
• Moderate or severe acute illness with or without fever
• Receipt of specific antivirals (i.e., acyclovir or valacyclovir) 24 hours
before vaccination, if possible; delay resumption of these antiviral
drugs for 14 days after vaccination.
What is a contraindication? A contraindication to a vaccine is a
condition in a patient that greatly increases the chance of a serious
adverse reaction. Generally, a vaccine should not be given if someone
has a contraindication to that vaccine.
Permanent contraindications to vaccine and for which specific
vaccines should not be given:
y A history of a severe allergic reaction (e.g., anaphylaxis) to a
previous dose of a specific vaccine or a component of that vaccine
y Specific to DTaP or Tdap: encephalopathy without a known cause
occurring within seven days of a dose of any pertussis-containing
vaccine is a permanent contraindication for DTaP or Tdap
What is a severe allergic reaction (e.g., anaphylaxis)? Sudden or
gradual onset of generalized itching, redness, or hives; swelling of
the lips, face, or throat; bronchospasm (wheezing); shortness of
breath; shock; abdominal cramping; or cardiovascular collapse.
There are two temporary contraindications to live attenuated
viral vaccines where vaccines should be given after these temporary
conditions no longer exist:
y Immunosuppression (in most cases)
y Pregnancy
The following are NOT a contraindication or precaution to
administration of any vaccine. Give vaccines:
• Mild acute illness with or without fever
• Mild to moderate local reaction (swelling, redness, soreness); fever
less than 105°F or 40.5°C after prior dose
• Lack of prior physical examination in well-appearing person
• On antibiotics
• Convalescent phase of illness
Footnotes
1.
2.
3.
4.
Not True (give vaccines)
• Short-term, low-dose, or local (e.g., topical or
non-systemic administration) corticosteroid
therapy4
• Receipt of blood products
• History of zoster not a consideration for
vaccination
• Contacts of patients with chronic diseases or
altered immunocompetence
• Low-dose treatment for rheumatoid arthritis,
psoriasis, polymyositis, sarcoidosis,
inflammatory bowel disease, or other
conditions10
• Premature birth (hepatitis B vaccine is an exception in certain
circumstances)1
• Recent exposure to an infectious disease
• Allergy to products not in the vaccine
•
What
is a local allergy reaction? Onset of itching or swelling
localized to the injection site or site of exposure. Usually not a
contraindication to vaccination.
What is a precaution? A precaution is a condition in a patient that
may increase the chance of a serious adverse reaction if vaccine
is given, or may compromise the ability of the vaccine to produce
immunity. Under normal circumstances, vaccines should be deferred
when a permanent or temporary precaution exists, but sometimes the
benefits outweigh the risks.
There are two common temporary precautions to vaccines:
y Moderate or severe acute illness (a precaution that applies to all
vaccines)
y Recent receipt of an antibody-containing blood product such as
immune globulin (e.g., MMR, MMRV, and varicella)
When to give a vaccine despite a precaution: In general, when a
precaution exists, a dose of vaccine is not recommended. However,
there may be situations when the benefit of vaccine outweighs the
risk, and the provider may choose to give the vaccine. For example,
a fever of 105°F / 40.5°C or greater within 48 hours after a previous
dose of DTP or DTaP vaccine is considered a precaution to giving
subsequent doses of pertussis vaccine to a child. But, if the child were
at high risk of pertussis infection (e.g., a pertussis outbreak in the
community), a provider may choose to vaccinate the child and treat
the adverse reaction if it occurs.
HIV-infected children may receive MMR and varicella vaccines if
their CD4 T-lymphocyte count is greater than 15 percent.
6. For details on receipt of anitbody-containing blood product
see page 39 of ACIP’s General Recommendations on
Immunization in the January 28, 2011 MMWR at www.cdc.gov/
vaccines/pubs/ACIP-List.htm.
7. Vaccination with measles-containing vaccine can temporarily
suppress tuberculin reactivity. However, measles-containing
vaccine can be given on the same day as tuberculin skin testing.
If not done on the same day postpone the skin test for 4 or more
weeks after the vaccination. If the skin test is urgent do it with the
understanding that the vaccine might reduce reactivity.
8. If a patient develops a presumed vaccine-related rash 7-25 days
after receiving varicella-containing vaccine, they should avoid
direct contact with immunocompromised persons for the duration
of the rash.
9. Providers should assess immune status and risk of varicella
on a case by case basis to determine need for vaccine before 24
months.
10. Low dose treatment is defined as 0.4 mg/kg/week or less of
methotrexate, 0.3 mg/kg/day or less of azathioprine, or 1.5 mg/
kg/day or less of 6-mercaptopurine.
5.
Defer hepatitis B vaccination for infants weighing less than 2,000
grams if the mother is documented to be HBsAg negative at the
time of the infant’s birth. Start vaccinating these infants at age 1
month (28 days). For infants born to HBsAg-positive women, give
HBIG and hepatitis B vaccine within 12 hours of birth regardless of
weight and give 3 additional doses starting at 28 days and using a
0, 1-2, 6 month interval schedule.
Unvaccinated sexually active women and those with a previous
HPV infection may not receive the full benefit of the vaccine
if they were already infected with an HPV type found in the
vaccine.
Live virus vaccines can be given at the same visit. However, if
not given at the same visit, they should be separated by at least
28 days.
Immunosuppressive steroid dose is defined as 2 weeks or
more of 20 mg/day or 2 mg/kg/day or more of prednisone or
equivalent. Non-immunosuppressive steroid dose is defined
as either short-term (less than 2 weeks) or low-to-moderate dose
(less than 20 mg/day or less than 2 mg/kg/day) of prednisone or
equivalent.
MDH Immunization Program IC#141-0649 (05/11) Page 4 of 4
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/hcp/vaccine.html
138
www.health.state.mn.us/immunize Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
*>̈i˜Ìʘ>“i\Ê
Ê>ÌiʜvÊLˆÀ̅\Ê
(mo.)
(yr.)
(day)
Screening Checklist for Contraindications to
Vaccines for Children and Teens
For parents/guardians: The following questions will help us determine which vaccines your child may
be given today. If you answer “yes” to any question, it does not necessarily mean your child should not be
vaccinated. It just means additional questions must be asked. If a question is not
Don’t
clear, please ask your healthcare provider to explain it.
Yes
No
Know
1. Is the child sick today?
…
…
…
2. Does the child have allergies to medications, food, a vaccine component, or latex?
…
…
…
3. Has the child had a serious reaction to a vaccine in the past?
…
…
…
4. Has the child had a health problem with lung, heart, kidney or metabolic disease
(e.g., diabetes), asthma, or a blood disorder? Is he/she on long-term aspirin therapy?
…
…
…
5. If the child to be vaccinated is between the ages of 2 and 4 years, has a healthcare
provider told you that the child had wheezing or asthma in the past 12 months?
…
…
…
6. If your child is a baby, have you ever been told he or she has had intussusception?
…
…
…
7. Has the child, a sibling, or a parent had a seizure; has the child had brain or other
nervous system problems?
…
…
…
8. Does the child have cancer, leukemia, HIV/AIDS, or any other immune system problem? …
…
…
9. In the past 3 months, has the child taken medications that weaken their immune
system, such as cortisone, prednisone, other steroids, or anticancer drugs, or had
radiation treatments?
…
…
…
10. In the past year, has the child received a transfusion of blood or blood products,
or been given immune (gamma) globulin or an antiviral drug?
…
…
…
11. Is the child/teen pregnant or is there a chance she could become pregnant during
the next month?
…
…
…
12. Has the child received vaccinations in the past 4 weeks?
…
…
…
œÀ“ÊVœ“«iÌi`ÊLÞ\ ___________________________________________ ÊÊÊÊ>Ìi\_________________
œÀ“ÊÀiۈiÜi`ÊLÞ\ÊÊ ___________________________________________ ÊÊÊÊ>Ìi\_________________
Did you bring your child’s immunization record card with you?
yes … no …
It is important to have a personal record of your child’s vaccinations. If you don’t have one, ask the child’s healthcare provider
to give you one with all your child’s vaccinations on it. Keep it in a safe place and bring it with you every time you seek medical
care for your child. Your child will need this document to enter day care or school, for employment, or for international travel.
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i˜ÌiÀÃÊvœÀʈÃi>ÃiÊ
œ˜ÌÀœÊ>˜`Ê*ÀiÛi˜Ìˆœ˜
ÜÜÜ°ˆ““Õ˜ˆâi°œÀ}ÉV>Ì}°`É«{äÈä°«`vÊÊUÊÊÌi“Ê›*{äÈäÊÊ­£äÉ£Ó®
I““Õ˜ˆâ>̈œ˜ÊV̈œ˜Ê
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July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
139
Information for Health Professionals about the Screening Checklist for Contraindications (Children & Teens)
Are you interested in knowing why we included a certain question on the screening checklist? If so, read the information below. If you
want to find out even more, consult the references listed at the bottom of this page.
1. Is the child sick today? [all vaccines]
There is no evidence that acute illness reduces vaccine efficacy or increases vaccine
adverse events (1, 2). However, as a precaution with moderate or severe acute ill˜iÃÃ]Ê>ÊÛ>VVˆ˜iÃÊŜՏ`ÊLiÊ`i>Þi`Ê՘̈Ê̅iʈ˜iÃÃʅ>Ãʈ“«ÀœÛi`°Êˆ`ʈ˜iÃÃiÃÊ­ÃÕV…Ê
>Ãʜ̈̈Ãʓi`ˆ>]ÊÕ««iÀÊÀiëˆÀ>̜ÀÞʈ˜viV̈œ˜Ã]Ê>˜`Ê`ˆ>ÀÀ…i>®Ê>ÀiÊ "/ÊVœ˜ÌÀ>ˆ˜`ˆV>̈œ˜ÃÊ
to vaccination. Do not withhold vaccination if a person is taking antibiotics.
2. Does the child have allergies to medications, food, a
vaccine component, or latex? [all vaccines]
If a person reports they have an allergy to egg, ask if they can eat lightly cooked eggs
(e.g., scrambled eggs). If they can, trivalent influenza vaccine (TIV) may be administered. If after eating eggs or egg-containing foods, they have a reaction consisting
of only hives, TIV may be given and the person should be observed for at least 30
minutes. If a person experiences a serious systemic or anaphylactic reaction (e.g.,
hives and either swelling of the lips or tongue, acute respiratory distress, or collapse)
after eating eggs, do not administer TIV or live attenuated influenza vaccine (LAIV). It
is possible that they may be eligible to be given TIV, but only after they have seen a
physician with expertise in the management of allergic conditions. If a person has ana«…ޏ>݈ÃÊ>vÌiÀÊi>̈˜}Ê}i>̈˜]Ê`œÊ˜œÌÊ>`“ˆ˜ˆÃÌiÀÊ6]ʓi>ÏiǓՓ«Ã‡ÀÕLi>Ê­,®]Ê
,³Û>ÀˆVi>Ê­,6®]ʜÀÊÛ>ÀˆVi>ÊÛ>VVˆ˜i°ÊʏœV>ÊÀi>V̈œ˜ÊˆÃʘœÌÊ>ÊVœ˜ÌÀ>ˆ˜`ˆV>̈œ˜°Ê
For a table of vaccines supplied in vials or syringes that contain latex, go to www.cdc.
}œÛÉÛ>VVˆ˜iÃÉ«ÕLÃÉ«ˆ˜ŽLœœŽÉ`œÜ˜œ>`ÃÉ>««i˜`ˆViÃÉɏ>Ìi݇Ì>Li°«`v°ÊœÀÊ>˜ÊiÝÌi˜ÃˆÛiÊ
table of vaccine components, see reference 3.
3. Has the child had a serious reaction to a vaccine in the past?
[all vaccines] History of anaphylactic reaction (see question 2) to a previous dose of
vaccine or vaccine component is a contraindication for subsequent doses (1). His̜ÀÞʜvÊi˜Vi«…>œ«>̅ÞÊ܈̅ˆ˜ÊÇÊ`>ÞÃÊvœœÜˆ˜}Ê/*É/>*ʈÃÊ>ÊVœ˜ÌÀ>ˆ˜`ˆV>̈œ˜ÊvœÀÊ
vÕÀ̅iÀÊ`œÃiÃʜvÊ«iÀÌÕÃÈÇVœ˜Ì>ˆ˜ˆ˜}ÊÛ>VVˆ˜i°Ê*ÀiV>Ṏœ˜ÃÊ̜Ê/>*Ê­˜œÌÊ/`>«®Êˆ˜VÕ`iÊ
̅iÊvœœÜˆ˜}\Ê­>®ÊÃiˆâÕÀiÊ܈̅ˆ˜ÊÎÊ`>ÞÃʜvÊ>Ê`œÃi]Ê­L®Ê«>iʜÀʏˆ“«Êi«ˆÃœ`iʜÀÊVœ>«ÃiÊ
within 48 hours of a dose, (c) continuous crying for 3 or more hours within 48 hours
of a dose, and (d) fever of 105°F (40°C) within 48 hours of a previous dose. There
are other adverse events that might have occurred following vaccination that constitute
contraindications or precautions to future doses. Under normal circumstances, vaccines are deferred when a precaution is present. However, situations may arise when
the benefit outweighs the risk (e.g., during a community pertussis outbreak).
4. Has the child had a health problem with lung, heart, kidney, or metabolic disease (e.g., diabetes), asthma, or a blood
disorder? Is he/she on long-term aspirin therapy? [LAIV]
Children with any of the health conditions listed above should not be given the intranasal, live attenuated influenza vaccine (LAIV). These children should be vaccinated with
the injectable influenza vaccine.
5. If the child to be vaccinated is between the ages of 2 and
4 years, has a healthcare provider told you that the child had
wheezing or asthma in the past 12 months? [LAIV]
…ˆÃ̜ÀÞʜvÊ«ÀˆœÀÊ/`>«ÆÊӮʘyÕi˜â>ÊÛ>VVˆ˜iÊ­/6ʜÀÊ6®\ʈvÊ-ʅ>ÃʜVVÕÀÀi`Ê܈̅ˆ˜ÊÈÊ
weeks of a prior influenza vaccination, vaccinate with TIV if at high risk for severe influenza complications.
8. Does the child have cancer, leukemia, HIV/AIDS, or any
other immune system problem? [LAIV, MMR, MMRV, RV, VAR]
ˆÛiÊۈÀÕÃÊÛ>VVˆ˜iÃÊ­i°}°]Ê,]Ê,6]ÊÛ>ÀˆVi>]ÊÀœÌ>ۈÀÕÃ]Ê>˜`Ê̅iʈ˜ÌÀ>˜>Ã>ÊˆÛi]Ê>Ìtenuated influenza vaccine [LAIV]) are usually contraindicated in immunocompromised
V…ˆ`Ài˜°ÊœÜiÛiÀ]Ê̅iÀiÊ>ÀiÊiÝVi«Ìˆœ˜Ã°ÊœÀÊiÝ>“«i]Ê,ʈÃÊÀiVœ““i˜`i`ÊvœÀÊ
asymptomatic HIV-infected children who do not have evidence of severe immunosuppression. Likewise, varicella vaccine should be considered for HIV-infected children
with age-specific CD4+ T-lymphocyte percentage at 15% or greater and may be
considered for children age 8 years and older with CD4+ T-lymphocyte counts of
greater than or equal to 200 cells/μL. Immunosuppressed children should not receive
LAIV. Infants who have been diagnosed with severe combined immunodeficiency
­-
®ÊŜՏ`ʘœÌÊLiÊ}ˆÛi˜Ê>ʏˆÛiÊۈÀÕÃÊÛ>VVˆ˜i]ʈ˜VÕ`ˆ˜}ÊÀœÌ>ۈÀÕÃÊ­,6®ÊÛ>VVˆ˜i°ÊFor
`iÌ>ˆÃ]ÊVœ˜ÃՏÌÊ̅iÊ
*ÊÀiVœ““i˜`>̈œ˜ÃÊ­{]Êx]ÊÈ®°
9. In the past 3 months, has the child taken medications that
weaken their immune system, such as cortisone, prednisone,
other steroids, or anticancer drugs, or had radiation treatments? [LAIV, MMR, MMRV, VAR]
ˆÛiÊۈÀÕÃÊÛ>VVˆ˜iÃÊ­i°}°]Ê,]Ê,6]ÊÛ>ÀˆVi>]Ê6®ÊŜՏ`ÊLiÊ«œÃÌ«œ˜i`Ê՘̈Ê>vÌiÀÊ
chemotherapy or long-term high-dose steroid therapy has ended. For details and length
œvÊ̈“iÊ̜ʫœÃÌ«œ˜i]ÊVœ˜ÃՏÌÊ̅iÊ
*ÊÃÌ>Ìi“i˜ÌÊ­£®°Ê/œÊw˜`ÊëiVˆwVÊÛ>VVˆ˜>̈œ˜ÊÃV…i`ՏiÃÊ
for stem cell transplant (bone marrow transplant) patients, see reference 7. LAIV can be
given only to healthy non-pregnant individuals age 2–49 years.
10. In the past year, has the child received a transfusion of
blood or blood products, or been given immune (gamma)
globulin or an antiviral drug? [LAIV, MMR, MMRV, VAR]
iÀÌ>ˆ˜ÊˆÛiÊۈÀÕÃÊÛ>VVˆ˜iÃÊ­i°}°]Ê6]Ê,]Ê,6]ÊÛ>ÀˆVi>®Ê“>Þʘii`Ê̜ÊLiÊ`iviÀÀi`]Ê
`i«i˜`ˆ˜}ʜ˜ÊÃiÛiÀ>ÊÛ>Àˆ>LiðÊ
œ˜ÃՏÌÊ̅iʓœÃÌÊVÕÀÀi˜ÌÊ
*ÊÀiVœ““i˜`>̈œ˜ÃʜÀÊ̅iÊVÕÀrent Red Book for the most current information on intervals between antiviral drugs, immune
globulin or blood product administration and live virus vaccines (1, 2).
11. Is the child/teen pregnant or is there a chance she could
become pregnant during the next month? [LAIV, MMR, MMRV, VAR]
ˆÛiÊۈÀÕÃÊÛ>VVˆ˜iÃÊ­i°}°]Ê,]Ê,6]ÊÛ>ÀˆVi>]Ê6®Ê>ÀiÊVœ˜ÌÀ>ˆ˜`ˆV>Ìi`ʜ˜iʓœ˜Ì…Ê
before and during pregnancy because of the theoretical risk of virus transmission to the
fetus (1, 6). Sexually active young women who receive a live virus vaccine should be
instructed to practice careful contraception for one month following receipt of the vaccine (5, 8). On theoretical grounds, inactivated poliovirus vaccine should not be given
during pregnancy; however, it may be given if risk of disease is imminent (e.g., travel to
endemic areas) and immediate protection is needed. Use of Td or Tdap is not contraindicated in pregnancy. At the provider’s discretion, either vaccine may be administered
during the 2nd or 3rd trimester (9).
Children who have had a wheezing episode within the past 12 months should not be
given the live attenuated influenza vaccine. Instead, these children should be given the
inactivated influenza vaccine.
12. Has the child received vaccinations in the past 4 weeks?
6. If your child is a baby, have you ever been told that he or
she has had intussusception? [Rotavirus]
If the child was given either live, attenuated influenza vaccine (LAIV) or an injectable
ˆÛiÊۈÀÕÃÊÛ>VVˆ˜iÊ­i°}°]Ê,]Ê,6]ÊÛ>ÀˆVi>]ÊÞiœÜÊviÛiÀ®Êˆ˜Ê̅iÊ«>ÃÌÊ{ÊÜiiŽÃ]Ê̅iÞÊ
should wait 28 days before receiving another vaccination of this type. Inactivated vaccines may be given at the same time or at any spacing interval.
Infants who have a history of intussusception (i.e., the telescoping of one portion of the
intestine into another) should not be given rotavirus vaccine.
7. Has the child, a sibling, or a parent had a seizure; has the
child had brain or other nervous system problem? [DTaP, Td, Tdap,
TIV, LAIV, MMRV] />*Ê>˜`Ê/`>«Ê>ÀiÊVœ˜ÌÀ>ˆ˜`ˆV>Ìi`ʈ˜ÊV…ˆ`Ài˜Ê܅œÊ…>ÛiÊ>ʅˆÃ̜ÀÞʜvÊ
i˜Vi«…>œ«>̅ÞÊ܈̅ˆ˜ÊÇÊ`>ÞÃÊvœœÜˆ˜}Ê/*É/>*°Ê˜Ê՘ÃÌ>LiÊ«Àœ}ÀiÃÈÛiʘiÕÀœœ}ˆVÊ«ÀœLi“ʈÃÊ>Ê«ÀiV>Ṏœ˜Ê̜Ê̅iÊÕÃiʜvÊ/>*Ê>˜`Ê/`>«]Ê>˜`Ê>Ê«Àœ}ÀiÃÈÛiʘiÕÀœœ}ˆVÊ
disorder in a teen is a precaution to the use of Td. For children with stable neurologic
disorders (including seizures) unrelated to vaccination, or for children with a family
history of seizures, vaccinate as usual (exception: children with a personal or family [i.e.,
«>Ài˜ÌʜÀÊÈLˆ˜}RʅˆÃ̜ÀÞʜvÊÃiˆâÕÀiÃÊ}i˜iÀ>ÞÊŜՏ`ʘœÌÊLiÊÛ>VVˆ˜>Ìi`Ê܈̅Ê,6ÆÊ
̅iÞÊŜՏ`ÊÀiViˆÛiÊÃi«>À>ÌiÊ,Ê>˜`Ê6,ÊÛ>VVˆ˜iî°ÊʅˆÃ̜ÀÞʜvÊՈ>ˆ˜‡>ÀÀjÊÃޘ`Àœ“iÊ­-®ÊˆÃÊ>ÊVœ˜Ãˆ`iÀ>̈œ˜Ê܈̅Ê̅iÊvœœÜˆ˜}\Ê
£®Ê/`É/`>«\ʈvÊ-ʅ>ÃʜVVÕÀÀi`Ê܈̅ˆ˜ÊÈÊÜiiŽÃʜvÊ>ÊÌiÌ>˜ÕÇVœ˜Ì>ˆ˜ˆ˜}ÊÛ>VVˆ˜iÊ>˜`Ê
decision is made to continue vaccination, give age-appropriate Tdap instead of Td if no
[LAIV, MMR, MMRV, VAR, yellow fever]
,iviÀi˜ViÃ\
£°Ê °Êi˜iÀ>ÊÀiVœ““i˜`>̈œ˜Ãʜ˜Êˆ““Õ˜ˆâ>̈œ˜]Ê>ÌÊÜÜÜ°V`V°}œÛÉÛ>VVˆ˜iÃÉ«ÕLÃÉ>Vˆ«‡ˆÃÌ°…Ì“°
Ó°Ê *°ÊÊRed Book: Report of the Committee on Infectious Diseases at www.aapredbook.org.
Î°Ê />LiʜvÊ6>VVˆ˜iÊ
œ“«œ˜i˜ÌÃ\ÊÜÜÜ°V`V°}œÛÉÛ>VVˆ˜iÃÉ«ÕLÃÉ«ˆ˜ŽLœœŽÉ`œÜ˜œ>`ÃÉ>««i˜`ˆViÃÉÉÊ Ê
excipient-table-2.pdf.
{°Ê °Êi>ÏiÃ]ʓՓ«Ã]Ê>˜`ÊÀÕLi>pÛ>VVˆ˜iÊÕÃiÊ>˜`ÊÃÌÀ>Ìi}ˆiÃÊvœÀÊiˆ“ˆ˜>̈œ˜Êœvʓi>ÏiÃ]ÊÀÕLi>]Ê>˜`ÊÊ
congenital rubella syndrome and control of mumps. MMWRÊ£™™nÆÊ{ÇÊ­,,‡n®°
x°Ê °Ê*ÀiÛi˜Ìˆœ˜ÊœvÊÛ>ÀˆVi>\Ê,iVœ““i˜`>̈œ˜ÃʜvÊ̅iÊ`ۈÜÀÞÊ
œ““ˆÌÌiiʜ˜Ê““Õ˜ˆâ>̈œ˜Ê*À>V‡Ê
tices. MMWRÊÓääÇÆÊxÈÊ­,,‡{®°
È°Ê °Ê*ÀiÛi˜Ìˆœ˜Ê>˜`Ê
œ˜ÌÀœÊœvʘyÕi˜â>p,iVœ““i˜`>̈œ˜ÃʜvÊ
*Ê>ÌÊÜÜÜ°V`V°}œÛÉyÕÉ«ÀœviÇÊ
sionals/vaccination/.
Ç°Ê °ÊÝViÀ«ÌÊvÀœ“ÊՈ`iˆ˜iÃÊvœÀÊ«ÀiÛi˜Ìˆ˜}ʜ««œÀÌ՘ˆÃ̈Vʈ˜viV̈œ˜ÃÊ>“œ˜}ʅi“>̜«œˆïVÊÃÌi“ÊViÊÊ
transplant recipients, MMWR ÓäääÆÊ{™Ê­,,‡£ä®]ÊÜÜÜ°V`V°}œÛÉÛ>VVˆ˜iÃÉ«ÕLÃÉ`œÜ˜‡œ>`ÃÉLڅÃV̇ÀiVð«`v°Ê
n°Ê °Ê œÌˆViÊ̜ÊÀi>`iÀÃ\Ê,iۈÃi`Ê
*ÊÀiVœ““i˜`>̈œ˜ÊvœÀÊ>ۜˆ`ˆ˜}Ê«Ài}˜>˜VÞÊ>vÌiÀÊÀiViˆÛˆ˜}Ê>ÊÊÊ
rubella-containing vaccine. MMWR 2001; 50 (49).
™°ÊÊ °Ê*ÀiÛi˜Ìˆœ˜ÊœvÊ«iÀÌÕÃÈÃ]ÊÌiÌ>˜ÕÃ]Ê>˜`Ê`ˆ«…Ì…iÀˆ>Ê>“œ˜}Ê«Ài}˜>˜ÌÊ>˜`Ê«œÃÌ«>ÀÌՓÊܜ“i˜Ê>˜`ÊÊ
Ê Ì…iˆÀʈ˜v>˜ÌÃ\Ê,iVœ““i˜`>̈œ˜ÃʜvÊ̅iÊ
*°ÊMMWRÊÓäänÆÊxÇÊ­,,‡{®°
““Õ˜ˆâ>̈œ˜ÊV̈œ˜Ê
œ>ˆÌˆœ˜ÊÊUÊÊÌi“Ê›*{äÈäÊÊUÊÊ«°ÊÓÊÊ
140
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Patient name:
Date of birth:
(mo.)
(yr.)
(day)
Screening Checklist for Contraindications to
Vaccines for Adults
For patients: The following questions will help us determine which vaccines you may be given today.
If you answer “yes” to any question, it does not necessarily mean you should not be vaccinated. It just
means additional questions must be asked. If a question is not clear, please ask your healthcare provider
to explain it.
Yes
No
Don’t
Know
1. Are you sick today?
…
…
…
2. Do you have allergies to medications, food, a vaccine component, or latex?
…
…
…
3. Have you ever had a serious reaction after receiving a vaccination?
…
…
…
4. Do you have a long-term health problem with heart disease, lung disease, asthma, kidney disease, metabolic disease (e.g., diabetes), anemia, or other blood disorder?
…
…
…
5. Do you have cancer, leukemia, HIV/AIDS, or any other immune system problem?
…
…
…
6. In the past 3 months, have you taken medications that weaken your immune system,
such as cortisone, prednisone, other steroids, or anticancer drugs, or have you had
radiation treatments?
…
…
…
7. Have you had a seizure or a brain or other nervous system problem?
…
…
…
8. During the past year, have you received a transfusion of blood or blood products, or been given immune (gamma) globulin or an antiviral drug?
…
…
…
9. For women: Are you pregnant or is there a chance you could become pregnant
during the next month?
…
…
…
10. Have you received any vaccinations in the past 4 weeks?
…
…
…
Form completed by: ___________________________________________
Date:_________________
Form reviewed by: ___________________________________________
Date:_________________
Did you bring your immunization record card with you?
yes … no …
It is important for you to have a personal record of your vaccinations. If you don’t have a personal record,
ask your healthcare provider to give you one. Keep this record in a safe place and bring it with you every
time you seek medical care. Make sure your healthcare provider records all your vaccinations on it.
Technical content reviewed by the Centers for Disease Control and Prevention
ÊÜÜÜ°ˆ““Õ˜ˆâi°œÀ}ÉV>Ì}°`É«{äÈx°«`vÊÊUÊÊÌi“›*{äÈxÊÊ­£äÉ£Ó®
I““Õ˜ˆâ>̈œ˜ÊV̈œ˜Ê
œ>ˆÌˆœ˜ÊUÊ£xÇÎÊ-iLÞÊÛi°ÊUÊ-Ì°Ê*>Տ]Ê Êxx£ä{ÊUÊ­Èx£®ÊÈ{LJ™ää™ÊUÊÜÜÜ°ˆ““Õ˜ˆâi°œÀ}ÊUÊÜÜÜ°Û>VVˆ˜iˆ˜vœÀ“>̈œ˜°œÀ}
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
141
Information for Health Professionals about the Screening Checklist for Contraindications To Vaccines for Adults
Are you interested in knowing why we included a certain question on the screening checklist? If so, read the information
below. If you want to find out even more, consult the references listed at the bottom of this page.
1. Are you sick today? [all vaccines]
There is no evidence that acute illness reduces vaccine efficacy or increases
vaccine adverse events (1). However, as a precaution with moderate or
severe acute illness, all vaccines should be delayed until the illness has improved. Mild illnesses (such as upper respiratory infections or diarrhea) are
"/ÊVœ˜ÌÀ>ˆ˜`ˆV>̈œ˜ÃÊ̜ÊÛ>VVˆ˜>̈œ˜°ÊDo not withhold vaccination if a person is
taking antibiotics.
2. Do you have allergies to medications, food, a vaccine component,
or latex? [all vaccines]
If a person reports they have an allergy to egg, ask if they can eat lightly
cooked eggs (e.g., scrambled eggs). If they can, trivalent influenza vaccine
(TIV) may be administered. If after eating eggs or egg-containing foods, they
have a reaction consisting of only hives, TIV may be given and the person
should be observed for at least 30 minutes. If a person experiences a serious
systemic or anaphylactic reaction (e.g., hives and either swelling of the lips
or tongue, acute respiratory distress, or collapse) after eating eggs, do not
administer TIV or live attenuated influenza vaccine (LAIV). It is possible that
they may be eligible to be given TIV, but only after they have seen a physician with expertise in the management of allergic conditions. If a person has
anaphylaxis after eating gelatin, do not administer MMR or varicella vaccine.
Local reactions are not contraindications. For a table of vaccines supplied
in vials or syringes that contain latex, go to www.cdc.gov/vaccines/pubs/
pinkbook/downloads/appendices/B/latex-table.pdf. For an extensive list of
vaccine components, see reference 2.
3. Have you ever had a serious reaction after receiving a
vaccination? [all vaccines]
History of anaphylactic reaction (see question 2) to a previous dose of vaccine or vaccine component is a contraindication for subsequent doses (1).
Under normal circumstances, vaccines are deferred when a precaution is
present. However, situations may arise when the benefit outweighs the risk
(e.g., during a community pertussis outbreak).
4. Do you have a long-term health problem with heart disease,
lung disease, asthma, kidney disease, metabolic disease (e.g.,
diabetes), anemia, or other blood disorder? [LAIV]
People with any of these health conditions should not be given the intranasal live attenuated influenza vaccine (LAIV). Instead, they should be
vaccinated with the injectable influenza vaccine.
5. Do you have cancer, leukemia, HIV/AIDS, or any other immune system problem? [LAIV, MMR, VAR, ZOS]
Live virus vaccines (e.g., LAIV, measles-mumps-rubella [MMR], varicella
[VAR], zoster [ZOS]) are usually contraindicated in immunocompromised
people. However, there are exceptions. For example, MMR vaccine is
recommended and varicella vaccine should be considered for adults with
CD4+ T-lymphocyte counts of greater than or equal to 200 cells/μL. Immunosuppressed people should not receive LAIV. For details, consult the ACIP
recommendations (3, 4, 5).
6. In the past 3 months, have you taken medications that weaken your immune system, such as cortisone, prednisone, other
steroids, or anticancer drugs, or have you had radiation treatments? [LAIV, MMR, VAR, ZOS]
Live virus vaccines (e.g., LAIV, MMR, VAR, ZOS) should be postponed until
after chemotherapy or long-term high-dose steroid therapy has ended. For
details and length of time to postpone, consult the ACIP statement (1, 5).
To find specific vaccination schedules for stem cell transplant (bone marrow
transplant) patients, see reference 6. LAIV can be given only to healthy nonpregnant people younger than age 50 years.
7. Have you had a seizure or a brain or other nervous system
problem? [influenza, Td/Tdap]
Tdap is contraindicated in people who have a history of encephalopathy
within 7 days following DTP/DTaP given before age 7 years. An unstable
progressive neurologic problem is a precaution to the use of Tdap. For
people with stable neurologic disorders (including seizures) unrelated to vaccination, or for people with a family history of seizure, vaccinate as usual. A
history of Guillain-Barré syndrome (GBS) is a consideration with the following: 1) Td/Tdap: if GBS has occurred within 6 weeks of a tetanus-containing
vaccine and decision is made to continue vaccination, give Tdap instead of
Td if no history of prior Tdap; 2) Influenza vaccine (TIV/LAIV): if GBS has
occurred within 6 weeks of a prior influenza vaccine, vaccinate with TIV if at
high risk for severe influenza complications.
8. During the past year, have you received a transfusion of blood
or blood products, or been given immune (gamma) globulin or an
antiviral drug? [LAIV, MMR, VAR]
Certain live virus vaccines (e.g., LAIV, MMR, VAR) may need to be deferred,
depending on several variables. Consult the most current ACIP recommendations for current information on intervals between antiviral drugs, immune
globulin or blood product administration and live virus vaccines. (1)
9. For women: Are you pregnant or is there a chance you could
become pregnant during the next month? [MMR, LAIV, VAR, ZOS]
Live virus vaccines (e.g., MMR, VAR, ZOS, LAIV) are contraindicated one
month before and during pregnancy because of the theoretical risk of virus
transmission to the fetus. Sexually active women in their childbearing years
who receive live virus vaccines should be instructed to practice careful contraception for one month following receipt of the vaccine. On theoretical
grounds, inactivated poliovirus vaccine should not be given during pregnancy;
however, it may be given if risk of disease is imminent and immediate protection is needed (e.g., travel to endemic areas). Use of Td or Tdap is not
contraindicated in pregnancy. At the provider’s discretion, either vaccine may
be administered during the 2nd or 3rd trimester. (1, 3, 4, 5, 7, 8)
10. Have you received any vaccinations in the past 4 weeks?
[LAIV, MMR, VAR, yellow fever] If the person to be vaccinated was given either LAIV
or an injectable live virus vaccine (e.g., MMR, VAR, ZOS, yellow fever) in the
past 4 weeks, they should wait 28 days before receiving another vaccination
of this type. Inactivated vaccines may be given at any spacing interval if they
are not administered simultaneously.
References:
1. CDC. General recommendations on immunization, at www.cdc.gov/vaccines/pubs/acip-list.htm.
2. Table of Vaccine Components: www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/
excipient-table-2.pdf.
3. CDC. Measles, mumps, and rubella—vaccine use and strategies for elimination of measles, rubella,
and congenital rubella syndrome and control of mumps. MMWR 1998; 47 (RR-8).
4. CDC. Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices.
MMWR 2007; 56 (RR-4).
5. CDC. Prevention and control of influenza—recommendations of ACIP, at www.cdc.gov/flu/professionals/vaccination.
6. CDC. Excerpt from Guidelines for preventing opportunistic infections among hematopoietic stem cell
transplant recipients, MMWR 2000; 49 (RR-10), www.cdc.gov/vaccines/pubs/downloads/b_hsct-recs.pdf.
Ç°Ê °Ê œÌˆViÊ̜ÊÀi>`iÀÃ\Ê,iۈÃi`Ê
*ÊÀiVœ““i˜`>̈œ˜ÊvœÀÊ>ۜˆ`ˆ˜}Ê«Ài}˜>˜VÞÊ>vÌiÀÊÀiViˆÛˆ˜}Ê>ÊÊÊ
rubella-containing vaccine. MMWR 2001; 50 (49).
8. CDC. Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and
their infants: Recommendations of the ACIP. MMWR 2008; 57 (RR-4).
““Õ˜ˆâ>̈œ˜ÊV̈œ˜Ê
œ>ˆÌˆœ˜ÊÊUÊÊÌi“Ê›*{äÈxÊÊUÊÊ«°ÊÓ
142
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Instructions for the Use of
Vaccine Information Statements
Required Use
1. Provide a Vaccine Information Statement (VIS) when a vaccination is given.
As required under the National Childhood Vaccine Injury Act (42 U.S.C. §300aa-26), all health care
providers in the United States who administer, to any child or adult, any of the following vaccines –
diphtheria, tetanus, pertussis, measles, mumps, rubella, polio, hepatitis A, hepatitis B, Haemophilus
influenzae type b (Hib), trivalent influenza, pneumococcal conjugate, meningococcal, rotavirus, human
papillomavirus (HPV), or varicella (chickenpox) – shall, prior to administration of each dose of the
vaccine, provide a copy to keep of the relevant current edition vaccine information materials that have
been produced by the Centers for Disease Control and Prevention (CDC):
• to the parent or legal representative* of any child to
whom the provider intends to administer such vaccine,
or
• to any adult† to whom the provider intends to administer
such vaccine.
If there is not a single VIS for a combination vaccine,
use the VISs for all component vaccines.
VISs should be supplemented with visual presentations
or oral explanations as appropriate.
*”Legal representative” is defined as a parent or
other individual who is qualified under State
law to consent to the immunization of a minor
child or incompetent adult.
†In the case of an incompetent adult, relevant
VISs shall be provided to the individual’s legal
representative. If the incompetent adult is living
in a long-term care facility, all relevant VISs
may be provided at the time of admission, or
at the time of consent if later than admission,
rather than prior to each vaccination.
2. Record information for each VIS provided.
Health care providers shall make a notation in each patient’s permanent medical record at the time
vaccine information materials are provided, indicating:
(1) the edition date of the Vaccine Information Statement distributed, and
(2) the date the VIS was provided.
This recordkeeping requirement supplements the requirement of 42 U.S.C. §300aa-25 that all health care
providers administering these vaccines must record in the patient’s permanent medical record (or in a
permanent office log):
(3) the name, address and title of the individual who administers the vaccine,
(4) the date of administration, and
(5) the vaccine manufacturer and lot number of the vaccine used.
Applicability of State Law
Current VIS Editions
Health care providers should consult their legal counsel
to determine additional State requirements pertaining to
immunization. The Federal requirement to provide the
vaccine information materials supplements any
applicable State laws.
DTaP/DT: 5/17/07
Hib: 12/16/98
Hepatitis A: 10/25/11†
Hepatitis B: 2/2/12†
HPV (Cervarix): 5/3/11†
HPV (Gardasil): 2/22/12†
Influenza (inactivated): 7/2/12†
Influenza (live): 7/2/12†
MMR: 4/20/12†
MMRV: 5/21/10†
Availability of Copies
Copies are available in English and many other languages
from CDC’s website at www.cdc.gov/vaccines/pubs/vis.
Single camera-ready copies may also be available from
State health departments.
July 2011, Minnesota Department of Health
Meningococcal: 10/14/11†
Pneumococcal (PCV13) 4/16/10†
Polio: 11/8/11†
Rotavirus: 12/6/10†
Tdap/Td: 1/24/12†
Varicella: 3/13/08†
Multi-Vaccine*: 9/18/08†
*An optional alternative when two or more routine childhood
vaccines (i.e., DTaP, hepatitis B, Hib, pneumococcal, polio, or
rotavirus) are administered at the same visit.
†Interim
Reference 42 U.S.C. §300aa-26
July 3, 2012
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
143
144
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011
Reliable Sources of Immunization Information
:KHUHSDUHQWVDQGSURYLGHUVFDQJRWRÀQGDQVZHUV
Websites
Vaccines.gov
U.S. Department of Health and Human Services
(HHS)
www.vaccines.gov
Consumer-focused immunization website providing
easy-to-understand health information to help make
informed decisions about immunizations. The content
is managed by HHS, but the site is done in collaboration
with other government agencies such as CDC and FDA.
Vaccine Education Center at Children’s Hospital
of Philadelphia
www.vaccine.chop.edu
Provides facts about each childhood vaccine as well
as how vaccines are made, how and why vaccines
work, who recommends them, and more. This site
notes that it receives no funding from pharmaceutical
companies.
National Network for Immunization Information
(NNii)
www.nnii.org
Provides current, science-based, extensively
reviewed information to health professionals, the
media, policy makers, and the public. This site notes
that it receives no funding from pharmaceutical
companies.
Centers for Disease Control and Prevention’s
(CDC) National Center for Immunization
www.cdc.gov/vaccines
Provides immunization information about vaccineSUHYHQWDEOHGLVHDVHVWKHEHQH¿WVRILPPXQL]DWLRQ
and the risk of immunization versus the risk of
disease, as well as educational materials and
resources.
Centers for Disease Control and Prevention (CDC)
For Parents: Vaccines for Your Children
www.cdc.gov/vaccines/parents/index.html
3URYLGHVLPPXQL]DWLRQLQIRUPDWLRQVSHFL¿FDOO\IRU
parents. The information can be viewed based on
your child’s age. There are also links to parent-friendly
immunization schedules and fact sheets about
diseases and the vaccines that prevent them.
American Academy of Pediatrics Immunization
Initiatives
www.cispimmunize.org
Provides comprehensive immunization information for
parents and health professionals.
Minnesota Department of Health (MDH)
Immunization Program
www.health.state.mn.us/immunize
Provides information on child, adolescent, adult
immunization schedules, policy, laws, and the
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vaccine safety, click on the vaccine safety link in the
left column.
Immunization Action Coalition
www.immunize.org and
www.vaccineinformation.org
These sites offer educational pieces for parents and
health professionals including many resources on
vaccine safety concerns.
Publications
Clear Answers & Smart Advice About Your Baby’s
Shots
By Ari Brown, MD, FAAP. This 6-page publication is
available for download at
www.immunize.org/catg.d/p2068.pdf.
Do Vaccines Cause That? A Guide for Evaluating
Vaccine Safety Concerns
By Martin G. Meyers, MD, and Diego Pineda. I4PH
Press. To purchase this book, visit your local bookstore
or go to www.immunizationinfo.org/bookstore.
Plain Talk About Childhood Immunizations
An easy-to-read online immunization booklet for
parents, available in English and Spanish from Seattle
and King Co. Public Health, WA. Download at
www.kingcounty.gov/healthservices/health/communicable/
immunization/plaintalk.aspx or call the Family Health
Hotline at 1-800-322-2588.
Minnesota Department of Health - Immunization Program
(8/12) Page 1 of 2
Available on the web at: www.health.state.mn.us/divs/idepc/immunize/safety/imminfo.html
July 2011, Minnesota Department of Health
Got Your Shots? Providers Guide - SCREENING & ASSESSING
www.health.state.mn.us/immunize
145
Vaccines and Your Child: Separating Fact from
Fiction, 2011
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University Press. This book answers questions about
the science and safety of modern vaccines. To
purchase, visit your local bookstore or
www.cup.columbia.edu.
Parent’s Guide to Childhood Immunizations
A 68-page booklet from CDC's National Immunization
Program. Available at www.cdc.gov/vaccines/pubs/
parents-guide/default.htm. Call 800-232-4636 for a
hard copy or complete the online order form at: www.
cdc.gov/vaccines/pubs/default.htm.
Vaccine Information Statements (VISs)
These fact sheets, produced by the federal Centers
for Disease Control and Prevention (CDC) explain the
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their parents, or their legal representatives. Federal
law requires that VISs be handed out before certain
vaccine doses are given. The VISs are available at
www.cdc.gov/vaccines/pubs/vis/default.htm or from
your health care provider. Also available in many
foreign languages at www.immunize.org/vis.
Vaccine Safety for Parents
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available at ZZZFGFJRYYDFFLQHVSXEVÀ\HUV
brochures.htm#vacsafe.
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common vaccine safety concerns.
Minnesota Department of Health Immunization
Program
A toll-free number for health care professionals and
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immunization questions.
1-800-657-3970 or 651-201-5503.
Videos
Vaccines: Separating Fact from Fear
Vaccines and Your Baby
Produced by the Children’s Hospital of Philadelphia.
These videos provide answers to parents questions
about vaccines. Also available in Spanish. View online
at www.chop.edu/service/vaccine-education-center/
order-educational-materials/#viewable-resources
or order a copy by calling 215-590-9990 or visiting
https://www.chop.edu/vaccine/vec/vec_order.cfm.
Vaccine-Preventable Disease – Family Stories
This website contains short videos about families
who were affected by vaccine-preventable diseases,
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online at www.pkids.org/im_videos.php.
Vaccine-Preventable Disease Videos
This website contains a variety of short videos about
vaccine-preventable disease.
www.vaccineinformation.org/video/index.asp
Phone Numbers
Centers for Disease Control and Prevention (CDC)
Immunization Information Hotline
A toll-free number for consumers and health
professionals who have questions about vaccinepreventable diseases and immunizations.
1-800-CDC-INFO (1-800-232-4636)
(Note: This line is for English and Spanish)
TTY: 1-800-232-6348
Adapted from the Immunization Action Coalition’s website.
Minnesota Department of Health - Immunization Program
IC# 141-1450
651-201-5503 or 1-800-657-3970
(8/12) Page 2 of 2
Print version available on the web at: www.health.state.mn.us/divs/idepc/immunize/safety/imminfo.html
146
www.health.state.mn.us/immunize
Got Your Shots? Providers Guide - SCREENING & ASSESSING
Minnesota Department of Health, July 2011