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Question #: 304

Question: IF A CHILD RECEIVES INFLUENZA VACCINE AT AGE 34 OR 35 MONTHS FOR THE FIRST TIME (0.25 ML DOSE) AND THEN RETURNS SECOND DOSE 37 MONTHS, SHOULD WE GIVE ANOTHER 0.25 0.5 THAT INDICATED AGES 3 OLDER?

Current Solution

The child should always receive the dose appropriate for his or her age at the time of the clinic visit; at age 37 months that would be 0.5 mL.

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Other Possible Solutions to this Question

  • WE HAVE NOTICED THAT CDC RECOMMENDS BEGIN VACCINATING WITH SEASONAL INFLUENZA VACCINE AS EARLY SEPTEMBER OR EVEN EARLIER. DOES PROTECTION FROM DECLINE WANE WITHIN 3 4 MONTHS OF VACCINATION? SHOULD I WAIT UNTIL OCTOBER NOVEMBER TO VACCINATE MY ELDERLY MEDICALLY FRAIL PATIENTS?

    CDC recommends that seasonal influenza vaccine be administered to all age groups as soon as it becomes available. Antibody to seasonal inactivated influenza vaccine declines in the months following vaccination. However, antibody level at a point several months after vaccination does not necessarily correlate with clinical vaccine effectiveness. There are no studies that compare vaccine effectiveness according to the month when the vaccination was given. The authors of a review on antibody declines among the elderly after vaccination reported, "In conclusion, we found no compelling evidence for more rapid decline of the influenza vaccine-induced antibody response in the elderly, compared with young adults, or evidence that seroprotection is lost at 4 months if it has been initially achieved after immunization." (See Skowronski, et al., Rapid Decline of Influenza Vaccine-Induced Antibody in the Elderly: Is it Real, or Is It Relevant? Journal of Infectious Diseases 2008;197:490-502).In addition, there is a lack of evidence for late-season outbreaks among vaccinated persons that can be attributed to waning immunity.

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    WE HAVE NOTICED THAT CDC RECOMMENDS BEGIN VACCINATING WITH SEASONAL INFLUENZA VACCINE AS EARLY SEPTEMBER OR EVEN EARLIER. DOES PROTECTION FROM DECLINE WANE WITHIN 3 4 MONTHS OF VACCINATION? SHOULD I WAIT UNTIL OCTOBER NOVEMBER TO VACCINATE MY ELDERLY MEDICALLY FRAIL PATIENTS?

  • A FIVE-YEAR-OLD CHILD RECEIVED HER SECOND MMR WEEK AGO. HOW LONG SHOULD SHE WAIT BEFORE RECEIVING LIVE ATTENUATED INFLUENZA VACCINE (LAIV)?

    LAIV can be administered simultaneously with another live vaccine (e.g., MMR, varicella), but if not given at the same time, ACIP recommends waiting four weeks before administering the second live vaccine.

    Click the link to add information to this solution:
    A FIVE-YEAR-OLD CHILD RECEIVED HER SECOND MMR WEEK AGO. HOW LONG SHOULD SHE WAIT BEFORE RECEIVING LIVE ATTENUATED INFLUENZA VACCINE (LAIV)?

  • WE'RE GLAD THAT CDC HAS MADE A UNIVERSAL INFLUENZA VACCINATION RECOMMENDATION TO VACCINATE EVERYONE 6 MONTHS AND OLDER. WOULD YOU TELL US HOW THIS CAME ABOUT?

    Prior to the 2010-11 vaccination season, only children ages 6 months through 18 years and adults age 50 years and older were universally recommended for vaccination; recommendations for adults ages 19 through 49 years were targeted to people with specific risk factors, although other adults could be vaccinated if they wanted protection. Collectively, these targeted risk groups made up 85% of the U.S. population. During the 2009 H1N1 outbreak, additional risk groups were identified, such as obese individuals. The recommendation made by ACIP in February 2010 for universal vaccination simplifies previous recommendations, making it easier for healthcare providers to determine whom to vaccinate. The universal recommendation also makes it easier for patients to remember to get vaccinated every year.

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    WE'RE GLAD THAT CDC HAS MADE A UNIVERSAL INFLUENZA VACCINATION RECOMMENDATION TO VACCINATE EVERYONE 6 MONTHS AND OLDER. WOULD YOU TELL US HOW THIS CAME ABOUT?

  • You built the first 36 inch Blue Chick for me. One of the V-Groove bearings on the X-axis froze. Is there a method of repairing this? Or do I order another and a spare. If so, what is the procedure to repair or order?

    If your bearing does not turn anymore, it is possible to repair the frozen bearing.

    You can carefully remove the shield on one side of the bearing. Use a very thin blade to remove the shield.

    Once the shield is removed, use WD-40 or kerosene to wash out and clean any debris that exists within the bearing. WD-40 is a cleaner, not a lubrication agent.

    You will then need to re-lubricate the bearing. Packing grease into the bearing will provide good protection not allowing too much metal on metal friction. There will be a layer of grease separating the ball bearings from the inner and outer races.

    If you have a production environment, you may want to purchase extra bearings so that you will not have any down time.

    If you have a rubber shield, just pry it out using any sharp object, like a utility knife. If your bearing has a metal shield, there may be a retaining ring along the outer race keeping the shield in place. Simply remove the retaining ring and the metal shield will fall out easily. If the metal shield does not have a retaining ring, that shield will not be able to be removed and a new bearing will need to be purchased to replace the frozen bearing.

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    You built the first 36 inch Blue Chick for me. One of the V-Groove bearings on the X-axis froze. Is there a method of repairing this? Or do I order another and a spare. If so, what is the procedure to repair or order?

  • WE'VE HEARD THAT ACIP HAS LIMITED THE USE OF ONE INFLUENZA VACCINE PRODUCTS FOR CHILDREN BEGINNING WITH 2010-11 VACCINATION SEASON. TRUE?

    Yes. You are referring to Afluria, which is manufactured in Australia by CSL Laboratories for the U.S. market. CSL's 2010 Southern Hemisphere influenza vaccine (Fluvax and Fluvax Junior) has been associated with increased post-marketing reports of fever and febrile seizures in children predominantly younger than age 5 years as compared to previous years. For this reason, on August 5, 2010, ACIP recommended that Afluria, 0.5 mL, licensed for use in people age 36 months and older, not be used in children younger than age 9 years. ACIP further recommended that Afluria could be administered to children ages 5 through 8 years who are at high risk for influenza complications if there is no other age-appropriate TIV available, after risks and benefits of using this vaccine in this age group have been discussed with the parent or guardian. The vaccine should not be given to children younger than age 5 years. For detailed information, go to www.cdc.gov/media/pressrel/2010/s100806.htm.

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    WE'VE HEARD THAT ACIP HAS LIMITED THE USE OF ONE INFLUENZA VACCINE PRODUCTS FOR CHILDREN BEGINNING WITH 2010-11 VACCINATION SEASON. TRUE?

  • WHEN A CHILD NEEDS 2 DOSES OF INFLUENZA VACCINE, CAN I GIVE 1 DOSE EACH TYPE (INJECTABLE AND NASAL SPRAY)?

    Yes. As long as a child is eligible to receive nasal spray vaccine (i.e., is in the proper age range and health status), it is acceptable to give 1 dose of each type of influenza vaccine. The doses should be spaced at least 4 weeks apart.

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    WHEN A CHILD NEEDS 2 DOSES OF INFLUENZA VACCINE, CAN I GIVE 1 DOSE EACH TYPE (INJECTABLE AND NASAL SPRAY)?

  • I am configuring a blackfoot with 1 CW8060 and 2 CW230's with linuxcnc and cannot figure out the proper settings for stepconf. Can you provide the default settings that should work with these motors?

    These are the recommend values(default) for our blackFoot CNC machine, the acceleration and velocity can be adjusted as high as the motor can rotate without stalling! Suggested increment's will be by 10's.

    blackFoot:
    X-axis
    “CW8060 (6.0A) Driver”
    Set to 1/16 Microstep, 5.43A
    Dipswitches: 01100110 (“0”=down, “1”=up)
    Motor Tuning: 914.29 steps/in, Velocity 400.02, Acceleration 4

    Y-axis
    “CW230 (3.0A) Driver”
    Set to 1/16 Microstep, 2.7A
    Dipswitches: 11001100
    Motor Tuning: 1422.22 steps/in, Velocity 400.02, Acceleration 4

    Z-axis
    “CW230 (3.0A) Driver”
    Set to 1/4 Microstep, 2.7A
    Dipswitches: 10101100
    Motor Tuning: 1600 steps/in, Velocity 79.98, Acceleration 5

    Additional Information:
    Thanks! What about step and direction config? I have:
    Step time: 2000ns
    Step space: 8000ns
    Direction hold: 5000ns
    Direction Setup: 5000ns

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    I am configuring a blackfoot with 1 CW8060 and 2 CW230's with linuxcnc and cannot figure out the proper settings for stepconf. Can you provide the default settings that should work with these motors?

  • Hi We are considering to buy the vakuum pump controller pressure switch and the vakuum pump 3 CFM together with it. We would like to build af setup that needs to hold a vakuum for up to 3-4 months. Does this pump and controller fit theese needs? Best regards Poul Larsen

    The vacuum pump and vacuum pressure switch sensor and controller are well suited together. As long as the vacuum pump is maintained, the pair will work together indefinitely.

    Additional Information:
    20

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    Hi We are considering to buy the vakuum pump controller pressure switch and the vakuum pump 3 CFM together with it. We would like to build af setup that needs to hold a vakuum for up to 3-4 months. Does this pump and controller fit theese needs? Best regards Poul Larsen

  • I am converting a 12x36 lathe over to CNC, I am interested in a 2 axis kit. I would love one stepper motor to be no smaller than 1200oz. , and another at 6000z. Is this something that you could offer? I have two other cnc machines but this is my first converstion on my own.

    We may be able to source those motors. Curious, the 6000 oz-in motor is pretty big. Do you mind explaining the application of the CNC machine and the structure that would require the large motor?

    Additional Information:
    The largest motors we can offer is 3900 oz-in without any mechanical help. 6000 oz-in can be resolved by mechanical means as an alternative.

    Click the link to add information to this solution:
    I am converting a 12x36 lathe over to CNC, I am interested in a 2 axis kit. I would love one stepper motor to be no smaller than 1200oz. , and another at 6000z. Is this something that you could offer? I have two other cnc machines but this is my first converstion on my own.

  • I purchase blackfoot cnc machine 4.1 resecentily cnc mech 3 upectedily plunging.I will cut one part and its fine the second I notice that it upectedily plunges and I dont have clue.. please help.

    If your CNC Router is plunging unexpectedly, it may be stalling in the upward movement. Check your velocity and acceleration for the z-axis. Recommended values for the blackFoot/blackToe CNC routers for acceleration and velocity is 80 ipm for velocity and 7 to 20 for acceleration. Test at the lower values to see if that helps. If it does help, then increase the values until the problem happens, then lower the values.

    If the acceleration is too high, there may be a stall at the beginning of the axis travel because the motor cannot compensate for the inertia of the axis assembly. If the velocity is too high, but the acceleration is low, then a stall may happen at the motor's top speed.

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    I purchase blackfoot cnc machine 4.1 resecentily cnc mech 3 upectedily plunging.I will cut one part and its fine the second I notice that it upectedily plunges and I dont have clue.. please help.

  • WHICH OF OUR PEDIATRIC PATIENTS WILL NEED 2 DOSES INFLUENZA VACCINE FOR THE 2011–12 VACCINATION SEASON?

    ACIP's influenza recommendations for children age 6 months through 8 years have changed for the 2011–12 season. According to the new algorithm, certain children need 2 doses of influenza vaccine this influenza season, separated by at least 4 weeks. Here is a summary:

    • Children age 6 months through 8 years who did not receive AT LEAST 1 dose of the 2010–11 vaccine should receive 2 doses, separated by at least 4 weeks, REGARDLESS of their previous influenza vaccination history.
    • Children age 6 months through 8 years whose influenza vaccination status from the previous season is not known should also receive 2 doses at least 4 weeks apart.
    • Children age 6 months through 8 years who received 1 dose of seasonal influenza vaccine during the 2010–11 season need ONLY 1 dose this season. This is because the vaccine strains are the same this season as last season.

    You may find this Immunization Action Coalition handout helpful: www.immunize.org/catg.d/p3093.pdf.

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    WHICH OF OUR PEDIATRIC PATIENTS WILL NEED 2 DOSES INFLUENZA VACCINE FOR THE 2011–12 VACCINATION SEASON?

  • I AM PUTTING TOGETHER THE BLACKFOOT AND USING A PORTER CABLE ROUTER. CONFUSED ON HOW TO RELAY ROUTETR WITH USB BOARD. IS THERE ANOTHER SWITCH THAT GOES BETWEEN BOARD ROUTER SO PLANET CNC CAN TURN PERHAPS VACUUM OFF?

    We are currently working on a relay board that will connect to USB breakout board, and the router/spindle for both the on/off function. Unfortunately we still do not have it completed or ready to be placed on our website, but it is in the final stages of testing. Please check back regularly for updated stock!

    Here is a link to a tutorial for a DIY relay circuit:



    There is no vacuum control on the Planet-CNC program, however you could use the same concept of the router/spindle on/off using the relay circuit. Although you will have to use either the flood or mist function for the vacuum.

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    I AM PUTTING TOGETHER THE BLACKFOOT AND USING A PORTER CABLE ROUTER. CONFUSED ON HOW TO RELAY ROUTETR WITH USB BOARD. IS THERE ANOTHER SWITCH THAT GOES BETWEEN BOARD ROUTER SO PLANET CNC CAN TURN PERHAPS VACUUM OFF?

  • SOME OF MY PATIENTS REFUSE INFLUENZA VACCINATION BECAUSE THEY INSIST "GOT THE FLU" AFTER RECEIVING INJECTABLE VACCINE IN PAST. WHAT CAN I TELL THEM?

    There are several reasons why this misconception persists: (1) Less than 1% of people who are vaccinated with the injectable vaccine develop flu-like symptoms, such as mild fever and muscle aches, after vaccination. These side effects are not the same as having influenza, but people confuse the symptoms. (2) Protective immunity doesn't develop until 1–2 weeks after vaccination. Some people who get vaccinated later in the season (December or later) may get influenza shortly afterward. These late vaccinees develop influenza because they were exposed to someone with the virus before they became immune. It is not the result of the vaccination. (3) To many people "the flu" is any illness with fever and cold symptoms. If they get any viral illness, they may blame it on the flu shot or think they got "the flu" despite being vaccinated. Influenza vaccine only protects against certain influenza viruses, not all viruses. (4) The influenza vaccine is not 100% effective, especially in older persons. For more information on this topic, go to: www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm

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    SOME OF MY PATIENTS REFUSE INFLUENZA VACCINATION BECAUSE THEY INSIST "GOT THE FLU" AFTER RECEIVING INJECTABLE VACCINE IN PAST. WHAT CAN I TELL THEM?

  • IF AN UNVACCINATED PATIENT HAS JUST RECOVERED FROM A DIAGNOSED CASE OF INFLUENZA COMES INTO OUR CLINIC, SHOULD WE VACCINATE HIM?

    Yes. Influenza vaccine commonly contains three influenza vaccine virus strains; two for A viruses and one for a B virus which are prepared based on circulating viruses from the previous influenza season. Infection from one virus type does not confer immunity to other types and it would not be unusual to have exposure to more than one type during a typical influenza season. By all means, vaccinate this person!

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    IF AN UNVACCINATED PATIENT HAS JUST RECOVERED FROM A DIAGNOSED CASE OF INFLUENZA COMES INTO OUR CLINIC, SHOULD WE VACCINATE HIM?

  • I purchased a 220V spindle with invertor last week and the ER20-A Clamping nut appears to milled incorrectly. I installed the spindle for the first time last night and was unable to screw the nut any distance with a bit inside. Looking inside the nut, there is a machined ring that is visibly off center.

    The ring inside the nut is purposely machined in this way to allow movement for the collet. Try threading the nut counterclockwise a little bit until it seems to be flush on the spindle extension. This should ensure the collet nut will thread correctly without stripping the threads on the pipe.

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    I purchased a 220V spindle with invertor last week and the ER20-A Clamping nut appears to milled incorrectly. I installed the spindle for the first time last night and was unable to screw the nut any distance with a bit inside. Looking inside the nut, there is a machined ring that is visibly off center.

  • my motors start clicking/stepping one step at a time and if I run a toolpath, the motors run runan inch or so them stop and make a lot of noise. Scretching almost. Any ideas.

    If your motors are making a strange noise as it begins a motion, or as it ramps up to the desired speed, then it is hitting it's maximum torque. First, make sure that your motor tuning (steps/inch, velocity and acceleration) are set correctly. The steps per inch should be set according to the microstepping set on the driver, and for the specific mechanics that is being used on that axis. Step/inch = (200 * microstepping) / (number of inches for one complete revolution). Second, make sure the correct current and microstepping is set on the driver for the motor that is having issues.

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    my motors start clicking/stepping one step at a time and if I run a toolpath, the motors run runan inch or so them stop and make a lot of noise. Scretching almost. Any ideas.

  • WHAT THE RECOMMENDED INTERVAL FOR RECEIVING INFLUENZA VACCINE AFTER AN ALLERGY INJECTION?

    Vaccines can be administered at any time before or after administration of an "allergy injection."

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    WHAT THE RECOMMENDED INTERVAL FOR RECEIVING INFLUENZA VACCINE AFTER AN ALLERGY INJECTION?

  • I have not used my CNC router (Mach3, USB interface board) for several months. When I tried to use it, all 3 stepper motors moved extremely slowly. Where should I start troubleshooting?

    If your motors turn very slowly using your Mach3 USB board, then either the pulse from the board is being output at a slow rate or the motor drivers are set to a higher than expected microstepping:

    The Mach3 USB board outputs the pulse rather than the computer, but Mach3 controls this pulse frequency within the motor tuning section. First, determine if the travel distance is correct with the computer and the physical travel of the machine.

    If the travel is different, then your stepper motor driver's microstepping is incorrect, or the steps per inch/mm in the motor tuning within Mach3 is incorrect.

    If the travel is correct, then simply change the velocity and acceleration parameters to your desired level. If Mach3 will not achieve the velocity you desire, then decrease your stepper motor driver's microstepping setting, readjust the step per inch/mm in mach3 and readjust the acceleration and velocity to your desired levels.

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    I have not used my CNC router (Mach3, USB interface board) for several months. When I tried to use it, all 3 stepper motors moved extremely slowly. Where should I start troubleshooting?

  • I have your Nema 24 electronics kit and am having problems with the Z axis dropping over time. I am using a PC 8902 motor. Any ideas on what the problem is? What should be the motor tuning values in Mach3? Thanks

    Make sure all your bolts/screws are tighten correctly and if using a lead screw make sure your anti-backlash nut is not offset. Now a default setting will be 10101100 for your driver dip switch settings and in motor tuning (mach3) 1600 steps per, 400.02 velocity, 4 in acceleration. now the acceleration and velocity can be adjusted to move your machine faster, but if set to high they could stall. Make sure you have the correct wiring from your motor to your driver (https://www.buildyourcnc.com/Documents/PN.SM60HT86-2008BF-U%20(inhouse%20PN.60BYGH303-13)%20(1).pdf).

    Click the link to add information to this solution:
    I have your Nema 24 electronics kit and am having problems with the Z axis dropping over time. I am using a PC 8902 motor. Any ideas on what the problem is? What should be the motor tuning values in Mach3? Thanks

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