4Three HPV vaccines are available for use: (1) quadrivalent vaccine (HPV4) and (2) 9-valent vaccine (HPV9) for the prevention of cervical, vaginal, and vulvar cancers (in females) and genital warts (in males and females), and (3) bivalent vaccine (HPV2) for the prevention of cervical cancers in females.
5Td is tetanus and diphtheria toxoids for use in persons ≥7 years of age (contains less diphtheria toxoid than DPT and DT). DT is tetanus and diphtheria toxoids for use in persons <7 years of age (contains the same amount of diphtheria toxoid as DPT).
TABLE A–2 Recommended routine childhood immunization schedule.
1Three Hib conjugate vaccines are available for use: (1) oligosaccharide conjugate Hib vaccine (HbOC), (2) polyribosylribitol phosphate-tetanus toxoid conjugate (PRP-T), and (3) Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) (PRP-OMP). Children immunized with PRP-OMP at 2 and 4 months of age do not require a dose at 6 months of age. PRP-T should only be used for the booster dose in children aged 12–15 months.
2Two RV vaccines are available for use: (1) RV-1 (Rotarix) monovalent live, oral, human attenuated rotavirus vaccine is approved for a two-dose series, and (2) RV-5 (RotaTeq) pentavalent live, oral, human-bovine reassortant rotavirus vaccine is approved for a three-dose series.
3Three HPV vaccines are available for use: (1) quadrivalent vaccine (HPV4) and (2) 9-valent vaccine (HPV9) for the prevention of cervical, vaginal, and vulvar cancers (in females) and genital warts (in males and females), and (3) bivalent vaccine (HPV2) for the prevention of cervical cancers in females.
Adapted from MMWR Morb Mortal Wkly Rep 2013;62(Suppl 1).
hypersensitivity reactions to immune globulin that may limit therapy. Conventional immune globulin contains aggregates of IgG; it will cause severe reactions if given intravenously. However, if the passively administered antibodies are derived from animal sera, hypersensitivity reactions ranging from anaphylaxis to serum sickness may occur. Highly purified immunoglobulins, especially from rodents or lagomorphs, are the least likely to cause reactions. To avoid anaphylactic reactions, tests for hypersensitivity to the animal serum must be performed. If an alternative preparation is not available and administration of the specific antibody is deemed essential, desensitization can be carried out.
Antibodies derived from human serum not only avoid the risk of hypersensitivity reactions but also have a much longer half-life in humans (about 23 days for IgG antibodies) than those from animal sources (5–7 days or less). Consequently, much smaller doses of human antibody can be administered to provide therapeutic concentrations for several weeks. These advantages point to the desirability of using human antibodies for passive protection
TABLE A–3 Materials available for passive immunization.1
Black widow Antivenin (Latrodectus One vial (6000 units) IV or IM. Some For persons with hypertensive cardiovascular disease spider bite mactans), equine patients may require a repeat dose. or aged <16 or >60 years.