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Paeds Vivasclinical-pharmacology-and-therapeutics

Paeds Vivas · clinical-pharmacology-and-therapeutics

Vaccines and immunobiology — branching viva

A branching viva following one family from the routine scheduled vaccination of a premature infant, through the live-versus-inactivated distinction and the four-week spacing rule, to a catch-up plan for an older sibling with an incomplete record, the contraindications to live vaccines in immunocompromise and pregnancy, and the recognition of anaphylaxis after a vaccine.

branching clinical structured oral6 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Prompt
A family presents for routine vaccination. The younger sibling is a two-month premature infant and the older sibling is a four-year-old with an incomplete overseas record. The examiner releases information in stages. The candidate must state the premature-infant chronological-age rule, the live-versus-inactivated distinction, the four-week spacing rule, the catch-up minimum-interval principle, the rotavirus age limits, and the recognition of anaphylaxis.

Branching cross-examination

This is a MedVellum formative viva. It is not an official RACP, MRCPCH, ABP, ACGME or RCPSC station, mark scheme, duration or pass standard. Release each update only after the candidate states the principle, the rule, and the safeguard. [1] [11]

Candidate brief

You are the paediatric registrar in a general paediatrics clinic seeing a family for routine vaccination. Speak as you would when vaccinating a premature infant and building a catch-up plan for an older sibling. State the rule and the safeguard at each step. This is one continuous case. Each escalation branch leads to the next update. [1]

Paediatrics Fellowship Pro

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References5ShowHide
  1. [1]Wiley CC Immunizations: vaccinations in general Pediatrics in review, 2015.PMID 26034255
  2. [2]Miller K; Leake K; Sharma T Advances in vaccinating immunocompromised children Current opinion in pediatrics, 2020.PMID 31790029
  3. [3]Omeñaca F; Vázquez L; Garcia-Corbeira P; Mesaros N; et al Immunization of preterm infants with GSK's hexavalent combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b conjugate vaccine: a review of safety and immunogenicity Vaccine, 2018.PMID 29336924
  4. [5]Koch J; Harder T; von Kries R; Wichmann O Risk of intussusception after rotavirus vaccination Deutsches Arzteblatt international, 2017.PMID 28468712
  5. [11]Michel R; Berger F; Ravelonarivo J; Dussart P; et al Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines? Vaccine, 2015.PMID 25843268
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