At a 12-month well-child visit, which vaccines are typically administered according to the CDC immunization schedule?

The 12-MONTH VISIT is one of the most vaccine-intensive well-child visits. The CDC Advisory Committee on Immunization Practices (ACIP) schedule typically includes at 12-15 months: MMR (Measles, Mumps, Rubella) — first dose; VARICELLA (chickenpox) — first dose; HEPATITIS A — first dose (series of 2 doses, 6 months apart); PCV15 or PCV20 (pneumococcal) — 4th dose; Hib (Haemophilus influenzae type b) — 4th dose (in some series); plus INFLUENZA annually starting at 6 months.

MMR caution: live attenuated vaccine — contraindicated in immunocompromised patients; delay if client recently received blood products or immunoglobulin; obtain pregnancy screen for any female of childbearing age (contraindicated in pregnancy); avoid pregnancy for 4 weeks after; may cause fever and mild rash 7-12 days post-injection.

Varicella: also live attenuated — same precautions as MMR. PN NURSING RESPONSIBILITIES at vaccine visits: review immunization record and identify needed vaccines; check for contraindications (fever, immunosuppression, pregnancy, prior severe reaction, egg allergy for some vaccines); provide VIS (Vaccine Information Statement) to parents before each vaccine; document vaccine, lot number, manufacturer, site, and route; monitor for immediate allergic reaction after injection; document in state immunization registry if required.

Important: PN/LVN scope typically includes administering vaccines and educating patients; development of the vaccine schedule and decisions about significant contraindications are RN/provider level decisions.