Week 2 response 1

Case Scenario 4

Ms. Lee presents with her 12-month-old daughter because she has had a runny nose for 2 days and has a “fever” of 99° F. After reviewing her immunization records, you note that she has not received any immunizations since her 4-month well-infant exam.

• Are there contraindications for vaccinating this toddler today? • What vaccinations should the APRN order for this toddler today per CDC guidelines? • What type of anticipatory guidance should the APRN provide for Ms. Lee regarding

vaccine schedule? • What are some strategies the APRN can use to overcome vaccine hesitancy?

Identify any contraindications to vaccinating this toddler today.

There are no contraindications to vaccinating this child today. A low-grade fever of 99 F and mild illness with runny nose symptoms are not listed by the CDC as reasons to withhold vaccines. Parents should withhold vaccines only if their child has moderate or severe acute illness or high fever. Another contraindication is a previous severe allergic reaction to vaccine component or dose. If this child has no allergies or previous bad reactions to vaccines and is experiencing only minor upper respiratory symptoms, it is safe to administer recommended vaccines today (Centers for Disease Control and Prevention [CDC], 2025; Burns et al., 2020). What vaccinations should the APRN order for this toddler today per CDC guidelines?

Because this child has not received any vaccinations since his 4-month visit, the APRN will place him on a catch-up immunization schedule. The vaccines that should be administered include: DTaP – 3rd dose Haemophilus influenza type b – catch-up dose Pneumococcal conjugate vaccine(PCV15 or PCV20) – catch-up dose Inactivated poliovirus vaccine(IPV) – 3rd dose

MMR – 1st dose Varicella – 1st dose Giving this patient these vaccinations will allow him to be on track to reach a normal CDC vaccination schedule and will protect him against harmful and infectious diseases (CDC, 2025; Burns et al., 2020). What type of anticipatory guidance should the APRN provide for Ms. Lee regarding the vaccine schedule?

The APRN should begin by informing Ms. Lee that her child has fallen behind on vaccines and will need several catch-up vaccinations. The next few appointments will be needed to become up-to-date on vaccines. Informing parents how vaccines prevent life- threatening diseases such as measles, whooping cough (pertussis), and pneumococcal disease, describing common vaccine side effects such as mild fever and redness/swelling where shot was given, reviewing when to call the office or get medical attention for rare side effects such as fever over 104 F that doesn’t go away or signs of an allergic reaction are all anticaptory guidelines that must be explained to the guardian/caretaker. Stressing importance of well-child visits to finish catch-up schedule, reassuring the patient vaccines are safe and have been studied for many years, and letting the parent ask questions and giving written handouts can help ensure they understand (CDC, 2025; Burns et al., 2020). What are some strategies the APRN can use to overcome vaccine hesitancy? Listening and asking questions Educating parent on vaccines with factual information Discussing how vaccines are recommended by the CDC as well as the American Academy of Pediatrics Talking about risks associated with not vaccinating vs minimal risk of side effects Providing handouts and websites for you to educate yourself