Case Study 1. The hepatitis B (Hep B) vaccine is mandatory for all newborns. It must be provided within 24 hours of birth, even if they receive combined immunizations afterward, culminating in more than three significant dosages of the Hep B vaccine (CDC, 2020). The CDC states that giving a birth dose of the hepatitis B vaccine \"serves as post-exposure prophylaxis to prevent perinatal HBV infection among infants born to HBV-infected mothers. Moreover, that administration of a birth dose to all infants (even without HBIG) serves as a safeguard to prevent perinatal transmission among infants born to HBs Ag-positive mothers not identified prenatally\" (Schillie et al., 2018, p. 10). The CDC recommends that all infants who might have in-utero hepatitis B infection, which encompasses all infants, must be vaccinated from birth. If the mother has Hepatitis B, the newborn should be given Hep B #1 and Hepatitis B immunoglobulin globulin (HBIG) 12 hours after delivery. Kids between the ages of 9 and 19 who are born to Hepatitis B positive mothers must be rechecked for infection. Usually, the visitation after they complete their clinic cycles and not before nine months of age to ensure the test does not emanate the effects of HBIG given at birth (CDC, 2020). Hep B #1 should be administered within 12 hours of delivery if the mother\'s hepatitis B condition is undetermined. The mother\'s Hep B status will be tested next. If she is negative, no additional treatment is required at this time. If it may not be sure she does not have Hep B, the infant should be administered HBIG within a week after birth. After seven days, HBIG has minimal effect. The HBIG is most efficient when administered as quickly as possible after infection. Schillie et al., 2018, p. 10). Case Study 2 Hep B #2, Oral rotavirus #1, DTaP #1, Hib #1, PCV13 #1, and IPV #1 At two months of age, she should receive the Hep B 2nd dose, DTaP 1st dose (diphtheria, tetanus, and pertussis), Hemophilus influenza type B disease (Hib) first dose, polio first dose, pneumococcal disease (PCV13) first dose and Rotavirus (RV) first dose. There are two rotaviruses (RV) vaccinations available. RV1 is a two-dose series that is administered at 2 and 4 months old. RV5 is a three-dose oral vaccine given at 2, 4, and 6 months. While receiving the very first dosage of RV, the baby must be at minimum six weeks old, and the cycle cannot begin until the newborn is 14 weeks and six days old. The final dosage must always be administered even before the baby reaches the age of eight months (CDC, 2020). At four months, she should return for the next visit to receive vaccinations such as DTaP 2nd dose, Hib 2nd dose, polio second dose, PCV 13 2nd dose, and Rotavirus 2nd dose. The guidelines suggest giving children combination immunizations to cut down on the number of needles sticks they receive. Before guaranteeing parents this restricted number of legitimate doses, constantly check the status with staff nurses (CDC, 2020). Whenever feasible, proceed with the same quantity; nevertheless, immunization should not be delayed if the same combination is not easily accessible. Offer patients any variety have in the facility. The specific combination vaccines for children in the US are ProQuad, which combines MMR (mumps, measles, and rubella) and varicella (chickenpox). Another combination is Pediarix, which combines DTaP, Hep B, and IPV (polio). Pentacel combines DTaP, IPV (polio), and Hib. Also, Twinrix combines Hep A and Hep B. Kinrix, which combines DTaP and IPV (polio), and Comvax, which combines Hib and Hep B (CDC, 2020). Case Study 3. DTaP #5 IPV #4 MMR #2 Varicella #2 Influenza At 4-6 years of age, she should receive DTaP 5th dose, IPV 4th dose, MMR 2nd dose, Varicella 2nd dose, and influenza vaccine every year. All children between the age of six months and eight years who are being immunized for the first time require two doses spaced over four weeks. An infant getting the flu vaccine at this age must be warned that frequent adverse effects are soreness, erythema or inflammation where the shot was administered, migraine, chills, vomiting, and muscle pain (CDC, 2019). According to Clinical Vaccination Management, children\'s Tylenol can be administered for discomfort or illness, although this could impair the immune response to vaccination in kids. It is critical to remember that it takes two weeks after getting the flu vaccination to develop immunity to the flu virus (CDC, 2019). There is no contraindication for vaccination today. It can be contraindicated in some instances, such as previous severe allergy or allergies to eggs, asthma, and a history of being immunocompromised (CDC, 2019). The infant will require two immunizations one month apart. All children must get an IPV booster on or after their fourth birthday. If this child received a fourth IPV before her fourth birthday, she should have a fifth supplemental dosage today (Immunization Action Coalition, 2020). Case Study 4 Tdap booster Men ACWY HPV9 (preferred) The recommended vaccinations for 11 years are the first dose of HPV series, MenACWY vaccine, Tdap, and annual influenza vaccine. The two new vaccines are HPV, recommended to protect the child against Human Papillomavirus, and MenACWY, to protect against meningococcal disease (CDC, 2019). The nurse practitioner should inform the mother that the HPV vaccine was found to be approximately 100 percent effective in preventing cervical cancer in clinical testing. About 20 million Americans, or 15% of the population, are infected with HPV. Both girls and boys should get the HPV vaccine. When starting HPV vaccination before 15 yrs old, the ACIP now proposes a two-dose schedule (0, 6 months). The three-dose plan should be utilized if starting the HPV series after 15. (0, 1-2 months, 6 months) (CDC, 2020). The ACIP does not advocate the re-vaccination of anyone who has already received the HPV4 vaccine. Even if the patient already had HPV4 vaccines, she should finish the HPV series with HPV9. Progressive neurodegenerative meningitis is a prominent cause of bacterial meningitis in kids under the age of 18 in the United States, and this vaccination can assist the child in being safeguarded against such infections, as the most common adverse effects are tiredness, discomfort at the site of injection, and a migraine (CDC, 2020). On the other hand, the influenza vaccine will assist in safeguarding her daughter and the people surrounding her from the flu virus.

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