Patient Encounter 1

A 1-year-old child is brought to the pediatrician's office for a routine 1-year checkup. The child is healthy and meeting all growth and developmental targets. The child has received all vaccinations to date. The pediatrician discusses with the mother the need for more vaccinations during this visit.

Which vaccine should the child receive during this visit?

Is there a way to minimize the number of shots the child receives?

What risks are involved with vaccinating this child?

Herd immunity refers to high levels of immunization in one population resulting in protection of another unvaccin-ated population. For example, concentrated vaccination of children with the 7-valent pneumococcal conjugate vaccine resulted in decreased invasive Streptococcus pneumoniae infection not only in the vaccinated children, but also in elderly persons within the same community.

Cocoon immunization is a strategy used to immunize all persons surrounding another high-risk individual, such as vaccinating parents, siblings, and grandparents of a new infant who is too young to be vaccinated. This strategy is used to protect individuals who are not able to be vaccinated themselves.

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