A healthy 2-month-old child was brought to your clinic by her parents

A healthy 2-month-old child was brought to your clinic by her parents. The child is a full-term infant with no concerns. Her exam is normal, and she had received her Hep B #1 in the nursery. 

Q1. What vaccines does she get? What combinations are available at your clinic?

 Q2. The child comes back at 12 months after completing her primary series of vaccines at 2, 4, and 6 months of age. Her vaccines are right on schedule, and her parents have no concerns, she is developing normally, and her exam is normal. What vaccines can she get today? 

Q3. Which groups of patients are at higher risk for pneumococcal disease, and need PPSV23 early starting at 2-years old?

A 25-year-old woman comes to your office asking for oral contraceptive refills. She stated that she was feeling depressed and heard about St. John's wort used in depression which she started taking a week ago.

 Q4. How might concomitant administration of St. John's wort affect the efficacy of drugs this patient is taking such as the oral contraceptives? Discuss another example of a possible drug interaction that might occur with St. John's wort? 

 The 25-year-old woman stated that her 4-year-old child has been coughing and sounds congested. She wants to know if echinacea might help her child.

 Q5. What is echinacea used for and how is it taken? 

 Q6. Is it safe for this mother to give her child echinacea?