DIP Episode 250 - The Ultra HY Vaccine Podcast (and upcoming 2CK Course 8.8.20)

Okay, welcome. My name is Divine. This is episode 250 of the Divine intervention podcast. And in this podcast, I'm going to be talking about a topic that has been heavily requested by many people. And it's on high yield vaccines and vaccine schedules. And before I jump right into it, one thing I'm going to say is I'm not going to just read off a list of vaccines. Because I know this thing is memory intensive. I know a lot of it is stuff you have to memorize. But I'm going to try to make integrations with the way they tested on exams. I'm going to give you a few rolls here and there to help you remember things better. And I'm going to try to categorize things in a way that make it a little more memorable. And again, I'm not going to talk about every single vaccine. I'll talk about the vaccines that will probably represent like 99% of what you would see on a test. And as a quick reminder, I do offer a course. It's a Cptusy K course. It's 10 hours. We cover Peds. Surgery. I am OB-GYN Psycho-N Europe in a 10-hour period. I do that because it helps people also build like stamina for the exams. So we do from 6 to 10 a.m. Pacific time, take a tour break, known to 4 p.m. Pacific time, take a tour break, and then 6 to 8 p.m. Pacific time and do a tour break. I mean, then we're done. And I ultimately end up covering probably, again, I usually use the number like 700 like concepts, but it ends up being a lot more than that.

I mean, probably is probably a little closer to like a thousand, right? But we cover like I use like clinical vignettes, case scenarios, concept topics, and we review the high yields of all those different things in one day. And the next one will be taking place on the 8th of August. So if that's something you want to sign up for, can either send me an email through the website or better yet, this is probably a better option. Just shoot me an email at the Vine Intervention Podcasts with an SAD in that gmail.com. The course is held via Zoom, you know, and payments typically people may get in through Venmo or they can be through our people. But if you're interested, just reach out to me and I'll sign you up. You know, I sign people up as spaces available once I run out of spaces, you know, then I'll just stop signing people up until I plan to do it another time. Okay, so let's jump right into it. So we know vaccines, right? Vaccines are important because they help prevent against infection, right? You use them to prevent disease, right? And the thing is there are many types of vaccines, right? But for purposes of the USML exams, what are the two big ones you want to know? Right? You want to know that we have live-a-ten-rithead vaccines, right? So those live-a-ten-rithead vaccines, these vaccines, right? They tend to physically be a bug that has been severely weakened, but it still has, it retains the ability to infect yourself.

When it has the ability to infect yourself, you can generate a T cell response against it, right? So things like the MMR vaccine, the virus, and a vaccine that intran easily influenza vaccine, those are live-a-ten-rithead vaccine, right? And then we have the killed vaccine is the inactivated vaccine, right? So basically, you've pretty much destroyed the bug, right? But you know, you still keep some antigenic parts on it, right? That can stimulate the immune system. The thing with these killed or inactivated vaccines is that they tend to generate more humoral immunity. They don't generate any T cell response, unlike the live-a-ten-rithead, that gives you a T cell and a humoral response, right? That's why usually those live-a-ten-rithead vaccines, you can, you don't usually need to keep giving booster after booster after booster after booster, right? Versus the killed or inactivated where you have to like keep giving one booster after the other and it kind of makes things a little harder to learn there. Because most of the vaccines that you see me say, oh, give this then, give this then, give this then, give this then. It's just vaccines that they are killed or inactivated a vaccine, right? And then I mean, I guess one group I can throw in here are the toxicoid vaccines, right? So things, these are like, you take like a toxin, right, from the bug that can act on certain receptors in the body, right? The body can make antibodies against it, right?

So, so I just mean we give some examples and some special like common USMLE cases on these vaccines before we go into the vaccine schedules themselves, right? But, classic thing, they can give you on your test, is they can give you a question about a person like a newborn, right? They tell you that, oh, this newborn, his mom has like, head-be-surface antigen that's positive, right? That's obviously not ideal, right? So typically for those newborns, you want to give them head-be immune globuline, right? But at the same time, you will also want to give them the head-be vaccine, right? Before a kid lives the hospital, that kid should give the head-be vaccine regardless of mom's status, right? But if mom has head-be-surface antigen positive, it'd be prudent to give the head-be immune globuline and again give them in opposing extremities, right? Because you don't want to give the immune globuline and have it bind up the vaccine that we're giving the child, right? And then, don't forget the rotavirus vaccine, right? It's a live-atteninitid vaccine, but it's a live-atteninitid vaccine with a twist because typically as a general rule that you can take to the bank on MBM exams, live-atteninitid vaccines do not go to people that are less than a year old, but that rule does not apply to rotavirus, okay? That rule does not apply to rotavirus, right? Rotavirus is one of those live-atteninitid vaccines that actually goes to kids that are less than a year old.

In fact, you give it a two-four and six months, right? And one other thing I should say is they can give you an MBM equation and say, oh, give you a question about a child that's getting the rotavirus vaccine and then they can say which of the following is the most dangerous complication of this vaccine, right? Or the most likely, the most important dangerous complication of this vaccine, this would be into a perception, right? The rotavirus vaccine does in fact increase a person's risk for inter-susception. And remember, there are certain people that already have a high-preexisting risk for inter-susception that should not get the rotavirus vaccine, right? So common examples are if a person has had inter-susception already, right? They should not get the rotavirus vaccine. If a person has a history of mechols, diverticula, they should not get the rotavirus vaccine. If a person has a history of hygiene and frappathy, they should not get the rotavirus vaccine. If we have something that is hygiene and frappathy related like an auction line per per they should also not get the rotavirus vaccine. Remember, rotavirus is the most common cause of their own kids, right? And then, you know, some commonly-man activated vaccines you miss on your exam, right? So like the pertusses vaccine, like the T-dap, D-tap, whatever vaccine, right?

Those are all in activated vaccines, H-flu-t-i-b, remember H-flu-t-i-b, back in the days to cause a big little tightness, it's also in activated vaccine, right? Or the PCV-13, right? The pneumococococonigated vaccine, right? The pneumocococococonigated vaccine, PCV-13, that's also in activated, or the one we give for polio, right? Polio is pretty much is not a thing in this country, right? Although it's still a thing in some countries of the world, it's an in activated vaccine, right? The influenza vaccine, remember, there are two kinds of flu vaccine, right? There's the one that you get intramuscularly every year, right? That's actually in activated as well. But the live-a-tenifed one is the intraniso one, it's the one you can hear as a mist, right? And then some classic, also your hip-a vaccine, the hippy vaccine is actually part of the pediatric vaccine series, it's also, again, it's also in activated vaccine, right? The vaccine against like my serum and genitis, right? It's also in activated, remember? We don't have any vaccines against my serum, right? When my serum and genitis absolutely has an in activated vaccine, right? We do have vaccinations against my serum and genitis. And one key thing I think I want to mention, especially with the pneumocococcal vaccines, right? There's PCV13 and there's PPSB-23, I'll tease those apart in a bit actually. So the PCV13 vaccine is a conjugate vaccine, you can see there's a C in it, right?

The pneumococcal conjugate vaccine, right? The pneumococcal conjugate vaccine. So because it's a conjugate vaccine, it can actually give you a B and a T cell response. But PPSB-23 is not a conjugate vaccine, okay? It's just a polysaccharide vaccine, it is not conjugated to anything. So it only gives you a humoral response, it does not give you a T cell response. That's actually very high up to no, for example, right? Now, the thing I will tell you is one rule that may make your life easier out of the bad is PCV13, you should always get that first before you get PPSB-23. I'll see that again. So and it's easy to remember because 13 comes before 23, right? If you look at the number line, right? So you always give PCV13 first before you give PPSB-23. I feel like one pretty thing to do when you get these vaccine questions is just to do the process of elimination, right? If for example, a person has not got in the PCV13 in the Q-stem and it doesn't make sense to pick an answer choice that involves giving them PPSB-23 first, right? You can pretty much guarantee you're going to get those questions wrong, right? Now, the thing is the PCV13, and again, I'm going to specifics in a bit, but the PCV13 vaccine is for everybody. Everybody should get the PCV13 at some point in their lives, right? But PPSB-23 has some very specific indications. If you have over the age of 65, you should for sure get the PPSB-23 vaccine, but again, you get that after you have got in the PCV13 vaccine.

So if you're over the age of 65, your case is sealed, right? You should get the PPSB-23 vaccine, right? But if you're under 65, the PPSB-23 vaccine is not required, right? It is not required, right? But for people under 65, there are certain populations of people under the age of 65 that should get the PPSB-23 vaccine, right? Now, what are those people? Just think of the organs in the body that can have chronic disease, right? Like the lungs, the heart, the liver, the kidneys, right? If you're a smoker, if you have diabetes, right? Those people should get the PPSB-23 vaccine, even if they are under the age of 65, right? And then some other non-classic ones, you mission exams, right? Like if a person has like an implant in their cochlea, like they have like a cochlea implant, right? Or they have like chronic CSF leaks, right? So like a service panel through the leak, right? Or if a person is immunodeficient for some reason, right? Like they have HIV or they have some kind of immunodeficiency disease like Burton's or Skid or whatever, those people should get the PPSB-23 vaccine, right? And also if a person has no spleen, or if you have no spleen, right? So again, just so that you don't get bogged down in GT Os, you just think of the organs in the body from head to toe, right? The people can have chronic, like heart-like CHF, right? People can have chronic liver disease, they can have chronic kidney disease, right? They can have chronic lung disease like COP Ds, right?

And then think of the other classic chronic disease, right? Diabetes, right? People that smoke, right? Smoking is kind of related to COPD, right? So it's easy to remember that. And then if you immunodeficients in some bizarre way, right? So let's say you have HIV or any immunodeficiency disease, CV, and stuff like that, right? Or if you have no spleen, again, that's an immunocompromised state, right? Or if a person has like, again, the two like just weird out there scenarios, or if you have like a cochlea implant, right? So this will likely be an overperson on your test, or it can be a person like with, what is it called? Like a outboard syndrome, right? Or a person that has a CSFE, right? Again, those are rare scenarios on exams, but they do certainly show up, right? So again, hopefully that kind of clears things up for you, right? So, some other, I guess, so I think those are kind of like the big things I want to mention. And again, another thing I think I should mention is, again, live-attenuated vaccines. If you're pregnant, you don't get them, right? If you're pregnant, you should not be getting a live-attenuated vaccine. If you are less than a year old, you should not be getting a live-attenuated vaccine, right? But again, remember there is an exception to that role. That's the rotavirus vaccine, right? That's the rotavirus vaccine.

So if you're pregnant, if you're less than a year old, if your CD4 count is less than 200, you do not get any live-attenuated vaccines on exams, right? Again, super high auto-nother stuff, right? So let's kind of talk about the vaccines in kids, right? Let's talk about the vaccines in kids. So what is the role I would like to teach you for how to remember the vaccines in kids? This is an approximate role, but it works a lot. It's an approximate role, but it works a lot. Most key vaccines, so these are two high-yield rules to keep in mind. Most pediatric vaccines are at least three doses. It's not always true, but it's true like 80 to 90 percent of the time, right? So it's a role you want to remember, right? Most pediatric vaccines have at least three doses. That's one. Two, most pediatric vaccines are given at two, four, and six months of age. So remember that as the two, four, six role, just the consecutive even numbers, right? And then one way you can say, oh, okay, so which vaccines do not will be that second role I mentioned? Your live-attenuated vaccines, which I've already mentioned in the beginning, right? Remember your live-attenuated vaccines, I like your, your, again, the exception of the rotavirus vaccine, right? But the intran easily influenza vaccine, the MMR vaccine, the virus cell vaccine, right? That's an example. Those are all examples of a live-attenuated vaccine drink, live-attenuated vaccines.

Okay, so again, don't forget three doses, minimum, two, four, six role, right? So let's go into some specifics, right? So like for example, the HB vaccine, right? So the HB vaccine, this one is kind of unique. You need to get it before you get out of the hospital. Basically, the first day of life, the kid is going to get the first dose, right? You're going to get three doses total. First one is, you know, the first day of life, second one is like, you know, within the first 60 days, right? And then the third one is within the first six to 18 months, right? So again, first dose, first day of life. So remember, first dose, first day of life, right? Second dose, around two months of each, so two second dose, two, two months of each, right? Basically, before you hit two months of each, you get your second dose. And then your third dose, is between six to 18 months of each. If you notice, third dose is the number three, three, five, six is 18. So third dose, between six, right? To 18 months of each. So you take three, times six, 18, that kind of helps you remember that, right? And then the Roto virus vaccine, this is an awesome one. Obes that second row perfectly. It's a three dose vaccine and is giving a two, four and six, two months, four months, and six months of each, right? And then the D-tap vaccine, right? The D-tap, so a Detheria, Tetanus and E-cellana pertussis. This one actually has five doses and then there's some extra information to know.

I'll say that again, five doses and then some extra information to know. But again, guess what? The first three doses of, and the thing is, if you know the first three doses, you'll probably be able to get most of these questions right already. The first three doses follow that two, four, six rule that I keep harping on. Two months for the first dose, four months for the second dose, six months for the third dose, right? The fourth dose, you give it like right around like 15 to 18 months of each, right? And then the fifth dose, you get it like between four to six years of each, right? So two, four, six rule for the first three doses. Fourth dose is between 15 to 18 months. Fifth dose is between four to six years, right? And then the thing is, when you get older, when you get to your adolescent years, you get the T-dap vaccine and then you get a T-d booster every 10 years. I'll say that again, when you hit, so notice the first five doses are before you hit 10, right? Again, two, four, six for the first three doses, 15 to 18 months for the fourth dose, four to six years for the fifth dose, right? And then once you enter your adolescent years, you get the T-dap vaccine and then you, so you get one T-dap and then you get a T-d booster every 10 years, right? And then the H-flu type B vaccine, the H-flu type B vaccine, again, this is three doses as well, right? This is three doses. And fortunately for you, the first two doses will be that two, four rule, right?

So first dose at two months, second dose at four months, right? And then the third dose, you get it between like 12 to 15 months, right? So once you hit a year old and you know up to a year and three months, you get the second dose, right? So again, I feel like there's one key thing you want to come into memory with these pediatric vaccines, two four and six, two four and six, right? And then the PCV 13 vaccine, right? The PCV 13 vaccine, again, it's four doses, right? It's four doses, right? The PCV 13 vaccine is four doses, at least in kids, right? And again, the first three doses, guess what? It's a base-doat, the two four six row, it'll be the two four six row. And then the fourth dose, you give between 12 to 15 months, okay? Between 12 to 15 months. And then the polio vaccine, guess what? The polio vaccine is four doses, but surprise, surprise, the first three doses obey what? The two four six row. Are you seeing a common theme here, right? The first dose is a two months, second dose is a four months, third dose is at six months, although you can stretch it up to 18 months, right? And then the fourth dose, remember the fourth dose between the ages of four to six, between the ages of four to six. And then the influenza vaccine, this one you should know, right? You get it every year as a kid, right? Although you can get it at less than six months as a kid, even if it's the intramuscular one, right? You get it every year.

And then obviously, right, if a kid is less than a year old, you're not going to be giving them the intramus cell one, right? That kind of violets or role that I've mentioned initially, right? And then the specialized live-atteninated vaccines, right? Like MMR, Varycella, right? So like MMR, Varycella, I want you to group all these two together, right? They have the same vaccine schedule. MMR, Varycella, they both have the same schedule. The first dose, again, obviously, is not going to be less than a year of age, right? Because of a role I've talked about, the first dose is between 12 to 15 months. And then the second dose is between four to six years. That's it, right? So MMR, Varycella, two, those are two, they have the same vaccine schedule, right? 12 to 15 months for the first dose. Second dose is at four to six years, right? And the thing is the head A vaccine also kind of follows a similar room, even if it's not live-attenuated, within the second year of life, just remember, you get two doses for head A, the first dose is within the second year of life, so you can give it at less than 12 months. And then the second dose, you give it six months after the first dose, okay? So the first dose within the first second year of life, sorry, within the second year of life, and then the second dose, you give it like six months after the first dose, right? And then as an adolescent, right?

Again, so typically, again, that first T-dap that you get, again, I said, you get it as an adolescent, usually between 11 to 12, you get it, and then you get a TD booster every, every 10 years, right? And then another classic one that you may see, like, you know, like, again, in that children, like, from 10 to 18 each bracket, is the meningocococ vaccine, right? The meningocococ vaccine, the way I just think about it is a vaccine you get when you're about to enter, like, sliding good, like, my middle or high school or anything in the US, right? So, let me just give the actual age, but, you know, between 11 to 12 years of age, that's where you get your first meningocococ vaccine, right? And then the second dose, you get it at 16, right? You get your second dose at 16. So, your first dose, 11 to 12 years of age, second dose at 16. And again, please do not forget the HPV vaccine, you can start giving it as early as the age of mine, right? You can give it as early as the age of mine on an MD exam. I mean, in some populations, they extend it all the way to the age of 40, right? But, you know, for the most part, 9 to 26 is probably a nice safe answer to keep in mind, for example, right? My safe answer to keep in mind, for example. And remember the, I guess I feel like I should mention this, right? But, there are some specialized vaccines in older people, right? Like, probably the big one to remember is like the Zoster vaccine, right?

The Zoster vaccine, you get it when you hit the age of 50. Remember, the very cell of vaccine, it's not the same thing as the Zoster vaccine. The Zoster vaccine, you get it when you hit the age of 50, right? And you get two doses, right? About six months apart, roughly, although it can be as lost two months apart, but you know, the Zoster vaccine, get it when you hit the age of 50, you don't get it less than that, right? And again, I've talked about the PCV 13. I said, PCV 13, everybody gets PCV 13, everybody gets PCV 13, right? And remember, you always get PCV 13 before you get PPSB 23, right? And then I said PPSB 23 is not necessary for everybody, right? If you over 65, everyone over 65, forget it. If you're under 65, right? But over the age of 19, right? Again, chronic disease of the major organs in the body, immunodeficiency disease, cochlear implant, CSF leak. That's the big way to remember that, right? And then just some special situations, I guess, as you kind of mentioned, right? Like, if a woman is pregnant, right? At every pregnancy, you're actually supposed to get the T-Dap vaccine. I'll say that again, at every pregnancy, you're supposed to get the T-Dap vaccine. You're supposed to get it within 27 to 36 weeks, right? Within 27 to 36 weeks. I'll say that again, within 27 to 36 weeks, right? And then, you know, if you have no spleen, right?

Like sickle cell disease person or person had mono, didn't listen to the doctor, the went and played basketball, and then they got smashed in their spleen, right? Those people are going to need vaccination against those shen organisms, right? Like strep pneumo, H-flu, my seramine, and Giddis. And they're strep pneumo, right? Because they have no spleen, that's a somewhat immunodeficiency state. They're going to get PCV 13, and even if they're less than 65, they're going to get PPSV 23, right? So strep pneumo, H-flu, my seramine, and Giddis, right? Strep pneumo, H-flu, my seramine, and Giddis. And the thing is, typically, if a person gets the PCV 13 vaccine, you know, you can wait a couple of months, and then after that, you give the person the PPSV 23 vaccine, right? Give the person the PPSV 23 vaccine. At least you want to wait for at least two months before you give the PPSV 23, right? Before you give the PPSV 23, and again, don't forget, if a person has sickle cell disease, because they have no spleen, right? In addition to all the stuff, right? Those people also need to be on a penicillin or a moxicillin every day, until the age of five, right? Until they hit the age of five. For the most part, that's just a nice safe general, or to keep in mind. And again, remember, if you have HIV, if your CD4 is listed in 200, they're not going to be getting any live-attenuated vaccines.

Some classic things they can give is, oh, if a person has an egg allergy, is there some kind of vaccine you want to avoid? You want to avoid the yellow fever vaccine, right? But the MMR vaccines, the virus, cello vaccines, all those things, those are fine, even people that have an egg allergies. Okay, so I think those are the big things I kind of want to talk about. Yeah, I think these are the big things I want to talk about. And I guess I want to talk about a life lesson right now, actually. My life lesson is, oh, let me not forget my format, right? So, I don't forget, right? So please, I have a You Tube channel, it's called Divine Intervention, you podcasts and videos, please subscribe to that. I have many of my podcasts on Spotify, Apple, podcasts, Google Play, please subscribe. And then I have a website, right? Divine Intervention podcasts with an S. Not come. And again, if you have any questions on my tutoring services or my classes, you're just sending an email through the website or you know, should me an email at Divine Intervention podcasts with an S. At the end at Gmail.com, right? And then my life lesson for today is going to be on the value of planning, right? Planning. I mean, you've heard this, right? If you feel to plan, you plan to fill. In fact, my pastor in church this morning said that, if you don't plan, you very likely won't get to your destination in life, right? It's almost like traveling without some kind of itinerary, right?

You're like, and I'll just see where the plane takes me. They probably won't even let you on the plane in the first place, right? So it's very important to plan. When you plan, like if I had to tell people this, the easiest way to deal with challenging situations in life is to come up with a plan. That is one thing I do with many people like tutor, right? I tutor them and I make a plan with them. When I make a plan and they follow that plan diligently, the almost always come out on top on the other end of things, right? I mean, there is even a part of the Bible that says to write the vision. It's a thing. It's in the book of Habakkuk, chapter two, or something like that. I think it's Habakkuk, like, two verse three, or something like that. You know, look me up on that. But it says writes the vision. Make it plain, right? So that it will be, it will be the person that writes it will be able to run with it, right? If you know that, oh, okay, I want to take step one and I want to get this particular score. Your planning for step one, those most start a month before your test. No, you should start from the time you begin med school, right? Or you want to succeed. Like when you see people that are poised for success in med school, those are people that come into med school with a plan, right? I'm not saying you shouldn't enjoy your life. You should enjoy your life. I enjoy my life, right? I mean, thank God the MBA is coming back.

So I'm going to watch my leakers starting this Thursday, right? But it is extremely important. Absolutely, absolutely important, absolutely important to go through life with a plan. Your step one, your step two CK, even the way you're around on patients. I've talked about this many times. The way you're around on patients, the way you see your patients, the way you write your notes, the way you do this. If you want to get married, right? Marriage is not all about, oh, I love you, I love you, I love you. No, no, no, no, no, you need to plan, right? Again, a marriage that is successful is a marriage that starts with a plan. Like, oh, what are we going to do with our kids? How are we going to raise them? What schools are they going to go to? Oh, or even if you want to be financially independent in life, because this is unfortunately a problem many physicians running to, right? They see, oh, we're making a ton of money. They buy huge homes, huge cars, getting to debt, no plan for life, because they're like, oh, at the end of the month, I'm going to get this huge paycheck. The thing is, people do not become financially independent by mistake. People become financially independent, because they have a plan for their financial futures, right? So that's the thing like, you just need to plan, just plan. And planning, it's one of these things where it's a small intervention, but it can have profound benefits in your life.

And not planning is one of these things that, oh, it's a small life of hand, where it can have profound consequences for a person's life, right? So the thing is, you set yourself up for success, you put yourself in a position to succeed when you make a plan, right? When you make a specific plan, and the thing is, when you're making plans, try to not make plans that have to any moving parts, right? Like, for example, when I tutor people for step two, see here one on one, right? When you make a plan that involves content review, like learning new content, reviewing that content, and doing questions, that's it. I don't tell them, oh, do these ten resources, right? No, we don't do any of those things, because those plans that have to many moving parts, they are less likely to get accomplished. So again, and don't just imagine these plans in your head, just kind of write it down, right? Write it down. So that's the thing, like, this is insurance against tough situations in life, right? If you're about to start a residence, you're scared, or you're about to start a new rotation, you're scared, just plan for it. If you plan, you are setting yourself up for success from the get go, right? And it means, obviously for me, I mean, as some of you already know this, you know, I'm a Christian, so you know, I pray, commit things into God's hands, and you know, again, things usually go pretty well for me. So again, but it's very important to plan, right?

You can pray, pray, pray, pray, pray, all you want. You're not going to get any result. If you also don't put in some work, right? Faith without works is dead, right? Oh, I believe I'm going to crush my exams. I believe I'm going to get a 270 on step one. Make all the positive confessions you want, but if you do not add works to that faith, to those positive things you're saying, guess what? You're not going to get any result, right? You're not going to get any results. So again, just kind of keep those things at the back of your mind as you go through life. So thank you for listening to my podcast, and I hope you find this vaccine schedule podcast to be high old. Thank you. God bless you. I'll see you next time.

Live-attenuated vaccines and Inactivated (killed) vaccines.

Live-attenuated vaccines (e.g., MMR, Varicella).

Live-attenuated generate both T cell and humoral responses; Inactivated primarily generate humoral immunity.

MMR and Varicella.

PCV13 must always be given before PPSB23.

Within 27 to 36 weeks of gestation.

Pregnancy, being less than one year old (with the exception of Rotavirus), or having a CD4 count < 200.

Intussusception.

Tdap/Dtap, H-flu-tib, PCV13, Polio, HiB, Varicella, HPV, etc. They are vaccines that stimulate the immune system using various components (e.g., toxoids or polysaccharides).

Most have at least three doses, often given at 2, 4, and 6 months of age.

First, give PCV13; then, wait two months before giving PPSB23.

Start at age 50, given in two doses approximately six months apart.

Pneumococcal vaccines (PCV13 and PPSB23), H-flu, Measles/Meningitis/etc. (Strep pneumo, H-flu, etc.).

As early as age 9 to 26 years.

Intussusception.

Tdap/Dtap, H-flu-tib, PCV13, Polio, HiB, Varicella, HPV, etc. They are vaccines that stimulate the immune system using various components (e.g., toxoids or polysaccharides).

Most have at least three doses, often given at 2, 4, and 6 months of age.

First, give PCV13; then, wait two months before giving PPSB23.

Start at age 50, given in two doses approximately six months apart.

Pneumococcal vaccines (PCV13 and PPSB23), H-flu, Measles/Meningitis/etc. (Strep pneumo, H-flu, etc.).

As early as age 9 to 26 years.