Recommended Immunization Schedules For Children And Adolescents,
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Recommended Immunization Schedules for Children and Adolescents,
2007CRISBERT I. CUALTEROS, CRISBERT I. CUALTEROS,
M.D.M.D.http://http://
crisbertcualteros.page.tlcrisbertcualteros.page.tl
2007 Schedule Major Changes
• The addition of oral live rotavirus vaccine for routine administration to all infants at ages 2, 4, and 6 months of age.
• Routine administration of a second dose of varicella vaccine at 4 to 6 years of age.
2007 Schedule Major Changes
• The addition of human papillomavirus vaccine for girls 11-12 years of age, with catch-up immunization of girls 13-18 years of age. This vaccine, administered intramuscularly in a 3-dose series at 0,2, and 6 months is expected to prevent most cases of cervical cancer and genital warts.
2007 Schedule Major Changes
• The age range for annual administration of influenza vaccine has been expanded to children 6 to 59 months old. Vaccine is also recommended for close contacts of children 0 to 59 months old.
Recommended Immunization Schedule for
Ages 0-6 years
Hepatitis B vaccine (HepB)
• 1st Dose: At birthALL NEWBORNS prior to discharge.Monovalent hepB
• 2nd dose: 1-2 months old• Final Dose: age ≥ 24 weeks• Permissible to administer 4 doses
of Hepa B when combination vaccines are given after the birth dose.
• >90% efficacy; probably 5 years or longer immunity
Inactivated Polio Vaccine (IPV)
• Minimum age: 6 weeks• Schedule: age 2,4,6 months
with booster at 4-6 years• Dose: 0.5ml SQ• >95% efficacy
Inactivated Polio Vaccine (IPV)
• Indications:• Persons with immunocompromised
immunity who are unimmunized or partially immunized
• Household contacts of an immunodeficient individual
• Unimmunized adults at future risk of exposure to poliomyelitis who have been partially immunized with OPV or IPV
• Adults at future risks of exposure to poliomyelitis who have had a primary series of IPV
• Individuals refusing OPV immunization
Rotavirus vaccine
• Minimum age: 6 weeks• 1st dose: between 6-12 weeks of
age• Do not start the series later than age 12
weeks!
• Schedule: 2,4,6 months• Final Dose: by 32 weeks of age
• No more than age 32 weeks.
• Insufficient data on safety and efficacy
Diphtheria & Tetanus toxoids and Acellular
Pertussis vaccine (DTaP)• Minimum age: 6 weeks• Schedule: 2,4,6 months with
booster as early as age 12 months, provided that 6 months have elapsed since the 3rd dose.
• Dose: 0.5 ml IM• Administer the final dose in the
series at age 4-6 years• 100% efficacy/length of immunity
for 10 years except pertussis component
Diphtheria & Tetanus toxoids and Acellular
Pertussis vaccine (DTaP)• Pertussis component- not recommended
after the age of 6 years because of the increased risk for neuroparalytic reactions.
• Subsequent doses are not recommended if the previous dose was followed by reactions such as:
• Collapse• Shock-like state• Persistent screaming • Fever >40.5 C• Convulsions• Alterations in level of consciousness or other
neurologic sx
Haemophilus influenzae type B (HiB)
• Minimum age: 6 weeks• Schedule: 2,4,6 months with
booster at 12-15 months old• Dose: 0.5ml IM• Possible reaction: pain, redness
and/or swelling at injection site in 25%; rarely fever and irritability
• 90-100% effective
Pneumococcal vaccine
• Minimum age: • 6 weeks for PCV (Pneumococcal
conjugate vaccine)• 2 years for PPV (Pneumococcal
polysaccharide vaccine)
• Administer PCV at ages 24-59 months in certain high-risk groups
• Administer PPV to certain high-risk groups aged ≥ 2 years
Influenza vaccine
• Minimum age: • 6 months for trivalent influenza vaccine
(TIV)• 5 years for live attenuated influenza
vaccine (LAIV)
• All children aged 6-59 months and close contacts of all children aged 0-59 months
• Recommended annually for children aged ≥ 59 months with certain risk factors.
• For healthy persons aged 5-49 years, LAIV may be used as an alternative to TIV
Measles, mumps and rubella vaccine (MMR)
• Minimum age: 12 months• Schedule: 12-15 months with booster
at 4-6 years old.• MMR may be given prior to age 4-6
years, provided that ≥ 4 weeks have elapsed since the first dose and both doses are administered at age ≥ 12 months.
• Dose: 0.5 mL SQ• >95% efficacy and long-lasting
immunity
Varicella vaccine• Minimum age: 12 months• Schedule: 12-15 months with second
dose at 4-6 years old.• The second dose may be administered
prior to age 4-6 years, provided that ≥ 3 months have elapsed since the 1st dose and both doses are administered at age ≥ 12 months.
• Dose: 0.5 ml SC• Possible reaction: Fever,
papulovesicular eruptions in 3%• Close to 100% efficacy
Hepatitis A vaccine (HepA)
• Minimum age: 12 months• All children at 1 year of age
(i.e. 12-23 months)• 2 doses should be administered
at least 6 months apart.• Children not fully vaccinated by
age 2 years can be vaccinated at subsequent visits.
Meningococcal polysaccharide vaccine (MPSV4)
• Minimum age: 2 years• Administer to children aged 2-
10 years with terminal complement deficiencies ot anatomic or functional asplenia and certain other high risk groups
Recommended Immunization Schedule for Persons Aged 7-18 years
Tetanus and Diphtheria toxoids and acellular
pertussis vaccine (Tdap)• Administer at age 11-12 years for those
who have completed the recommended childhood DPT/DTaP series and have not received a tetanus & diphteria toxoids vaccine (Td) booster dose
• Adolescents aged 13-18 years who missed the 11-12 year Td/Tdap booster dose should receive a single dose of Tdap if they have completed the recommended childhood DTP/DTaP vaccination series.
Human Papillomavirus vaccine(HPV)
• Minimum age: 9 years• 1st dose: females at 11-12 years• 2nd dose: 2 months after the 1st
dose• 3rd dose: 6 months after the 2nd
dose• Administer the HPV vaccine series
to females at age 13-18 years if not previously vaccinated.
Meningococcal vaccine
• Minimum age: 11 years for MCV4; 2 years for MPSV4)
• Administer MCV4 at age 11-12 years and to previously unvaccinated adolescents at high school entry
• Administer MCV4 to previously unvaccinated college freshmen living in dormitories; MPSV4 is an acceptable alternative.
Pneumococcal polysaccharide vaccine (PPV)
• Minimum age: 2 years• Administer or certain high risk
groups
Influenza vaccine
• Children aged <9 years who are receiving influenza vaccine for the 1st time should receive 2 doses
• Separated by ≥ 4 weeks for TIV• By ≥ 6 weeks by LAIV
Hepatitis A vaccine
• 2 doses should be given at least 6 months apart
Hepatitis B vaccine (HepB)
• Administer the 3-dose series to those who are not previously vaccinated.
• A 2-dose series of Recombivax HB® is licensed for children aged 11-15 years
Inactivated Polio Vaccine (IPV)
• For children who received an all-IPV or all-OPV series, a fourth dose is not necessary if the third dose was administered ≥ 4 years.
• If both IPV and OPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age.
Measles, Mumps, and Rubella
vaccine (MMR)• If not previously vaccinated,
administer 2 doses of MMR during any visit, with ≥ 4 weeks between the doses.
Varicella vaccine
• 2 doses:– Persons without evidence of
immunity– Persons aged <13 years at least
3 months apart– Persons aged ≥ 13 years at least
4 weeks apart
addendum
Bacillus-Calmette Guerin vaccine(BCG)
• Given anytime after birth• 1 dose: 0.05 mL ID over deltoid area• Booster: school entrants (0.1 mL)• If given at the earliest possible age
protects against the possibility of infection from other family members
• 50% efficacy• Possible reaction: Keloid scar,
suppurative regional adenitis; disseminated BCG infection & osteomyelitis in immunocompromised
Oral Polio Vaccine (OPV)
• Given at 2,4,6 months • Minimum age: 6 weeks• 1st booster: 1 year after the primary dose• 2nd booster: 4-6 years• Dose: 0.5 ml orally for single dose
preparation or 2 drops for multiple dose preparation
• Lifelong immunity with >90% efficacy• Possible reaction: paralytic polio -
extremely rare• Advantage over IPV: ease of
administration and better intestinal immunity conferment
Measles Vaccine
• Live attenuated virus• Given at 9 months or later; maybe
given as early as 6 months• 1 dose SQ• Booster: 2nd dose given at 15mos. If 1st
dose given below 1 year• 3rd dose given at 5-12 years as part of
MMR• 95% efficacy with at least 12 years of
immunity• Possible reaction: fever and rash 5-10
days after dose
Expanded Program of Immunization for Infants
(EPI)Vaccine Minimum
age at 1st dose
Number of Doses
Minimum Interval
Between Doses
1) BCG Birth or anytime after birth
1
2) DPT 6 weeks 3 4 weeks
3) OPV 6 weeks 3 4 weeks
4) Hepa B vaccine
At birth 3 4 weeks
5) Measles vaccine
9 months 1
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