Hospitalists are uniquely positioned to ensure in-hospital vaccinations for diseases ranging from tetanus to influenza. The following module discusses appropriate tetanus, pertussis, pneumococcal, influenza, hepatitis, and post-splenectomy immunizations. Moreover, strategies for improving compliance with recommended protocols and indications and contraindications for various vaccines are reviewed.

To provide hospitalists with current information and guidelines for vaccines and health maintenance.

This activity is designed for hospitalists. No prerequisites required.

After completing the module, the participant should be able to:

1. Describe the most appropriate forms of tetanus prophylaxis [MK] and design a strategy to improve compliance with recommended tetanus prophylaxis protocols. [PC, PB]
2. Outline indications and contraindications for tetanus toxoid and reduced diphtheria toxoid vaccine and for tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine. [MK]
3. Summarize current Advisory Committee on Immunization Practices guidelines for immunoprophylaxis in patients with asplenia and hyposplenia. [MK]
4. Identify patients at risk for hepatitis B and C and define current recommendations for hepatitis A and B vaccination to prevent complications. [MK, PB]
5. Identify patients at risk for pneumococcal infection [MK] and formulate a plan to remove barriers to pneumococcal vaccination. [PC, PB]
6. Define current recommendations for influenza immunization [MK] and identify opportunities to vaccinate individuals at risk for influenza complications. [MK]

Accreditation Council for Graduate Medical Education General Competency Assignments

PC Patient Care

MK Medical Knowledge

IC Interpersonal & Communication Skills

PR Professionalism

SB Systems-Based Practice

PB Practice-Based Learning & Improvement

Source: Accreditation Council for Graduate Medical Education. Common Program Requirements: General Competencies. Available at: http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Published: September 28, 1999. Accessed December 4, 2009.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: February 27, 2010. Expiration date: February 27, 2012.

Estimated time to complete activity: 2 hours

Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

^*Professor of Pediatrics and Internal Medicine, Chair, Division of Pediatric Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia.

^†Assistant Professor of Pediatrics and Internal Medicine, Hospitalist, Division of General Pediatrics, Virginia Commonwealth University, Richmond, Virginia.

Conflict of Interest: Drs Lavoie and Friedel report having no relationships with commercial interests related to this activity.

Off-Label Product Discussion: The authors have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Suzanne R. Lavoie, MD, Professor of Pediatrics and Internal Medicine, Chair, Division of Pediatric Infectious Diseases, Virginia Commonwealth University, Sanger Hall 12-041b/Box 980163, Richmond, VA 23298. E-mail slavoie@mcvh-vcu.edu.

Click here to download the references for this educational activity.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, a study activity, and a CME post-test. All 3 sections must be completed to receive CME credit.

Supported by an educational grant from Merck & Co., Inc.