VACCINES
Vaccines 1 yo 2yo 4-6yo >9yo TOTAL
BCG 1 birth 1
<12mos 0.05mL
>12mos 0.1mL
*Hep B 3 1 birth, 3 doses 1 booster 3 or 4
(6-10-14)
DPT 5
3 (6-10-14) DTP 12- DTP 4-7yo Tdap: 9-
18mos 15yo
Then every 10
years
Hib 3 (6-10-14) 4
1 booster at 12-
15mos
Min interval of 6 mos
from last dose
OPV 3 (6-10-14) (NIP) 3
nd
IPV LHC: 2 booster
1 at 14 weeks 3 primary
2nd dose: 9mos old th
6 mos apart 3 booster
together w
measles 3rd booster (4
onwards)
Or private
3 (6-10-14)
1st booster: 6mos
apart after 3rd dose
PCV 3 (6-10-14) Unvaccinated 12mos-23mos 4
PCV 10: booster at PCV 13: 2 doses, 8 weeks
least 6mos apart
*Preterm:
4 doses 4th dose: PCV 13: Unvax: 2-5yo: 1 dose only
11-15mos old,
2 mos from 3rd dose
Unvaccinated 7-11:
3 doses
2, 4 wks apart
3rd dose, 8 weeks
from 2nd
Rotavirus 2 rotarix, 3 rotateq 2 or 3
4 weeks apart; 1st dose
<32wks or 8mos old not later
than
15wks
Measles 1 1
6mos outbreak
9mos usual
Flu 2 Yearly 2 then
6mos-8yo: 2 doses, 4 weeks apart (Feb-June) yearly
6-35mos: 0.25mL >3yo 0.5mL
Jap Enceph 9mos Booster 12- 2
24mos after
MMR 1 1 booster 2
Varicella 1 1 booster 2
Hepatitis A 1; 2
booster: 6months
KGZ, 2023
from 1st dose
Typhoid 1 Booster:
every 3 years
**HPV 9-14yo: 2 or 3
Bivalent: 0,
1mos, 6mos
>15yo
Quadri: 0,
2mos, 6mos
Common side effects: fever, rash or soreness at the injection site
Documented Fever (very rare):
Hep B, Penta, PCV/PPSV (<1%), MMR, JE (high fever), HPV (10%)
Rubella- temporary arthritis 1-3wks post vax post pubertal females (reached sexual maturity)
Mumps- temporary parotid sweliing
Serious AE in MMR: thrombocytopenia, anaphylaxis, enceph
Slight discomfort is normal and should not be a cause for alarm. Paracetamol may be given if
your child develops fever while cold compress may be applied for the pain and swelling at the
injection site (parent education after giving of vaccines)
Rare side effects: high fever or incessant crying. Signs of a serious allergic reaction when
present, will often be observed within 30 minutes of the vaccination. These will include
difficulty of breathing, hoarseness, rashes, paleness, weakness or dizziness
*HBV
HbSAg (+) Mother HBV and HBIG within 12 hours or not later than 7 days
Unknown >2 kg: HBV, determine status (if +, give HBIG not later than 7 days)
<2kg: HBV and HBIG within 12 hours
Preterm <2kg: give 1st dose at birth but not counted as part of series; additional 3
doses
Medically stable, 1st dose at 30days chronological age regardless of
weight, counted as part of 3-dose primary series or prior to discharge
**HPV
The anti-cervical cancer vaccine is intended to prevent infections with the types of
human papilloma virus most commonly associated with genital warts and changes in the
cervix which can lead to cervical cancer.
Males can benefit from the vaccine in the prevention of genital warts.
Brand Names
5-in-1 Pentaxim
DTaP-HepB- Hib Infarix
6-in-1 Infanrix Hexa
DTaP-IPV-Hib-HepB
2mos-4mos,6mos; 1 month interval
Booster: 1, 6mos after before 18mos old
Flu Fluarix, Influvac, Vaxigrip
Hepatitis A Havrix
Rotavirus RotaTeq (pentavalent)
Rotarix (monovalent)
PCV13 Prevaner
PPSV23 Pneumo23
Pneumovax
Min: 2yo, every 5 years
KGZ, 2023
HPV Quadri Gardasil (HPV 6,11,16,18)
Varicella Varilix, Okavax
Tdap Adacel
Dtap Boostrix
Hepa B Engerix, Euvax
Protective titer: >10IU/L
<15yo= 0.5mL or 10mcg; >16yo = 1mL or 20mcg
Routes
SC 45degrees Measles, MMR, Varicella, Jap Enceph
ID Parallel BCG
PO Rotavirus, OPV
The rest IM
Antigen for Active Immunization
Live Attenuated/Weakened Inactivated
*vaccines NOT administered IM *administered IM
BCG HepB, DTP/TdaP, Hib, PCV, Hepa, Meningo,
SC: MMRV, Rotavirus, Jap Enceph, Dengue, Flu, typhoid, Rabies, IPV
Oral: Polio, cholera, typhoid
Contraindications and Precautions
*Precaution- health condition in the recipient might increase the chance or severity of a serious
adverse reaction or might compromise ability of vaccine to immunity, or might cause diagnostic
confusion; injury could result but the chance of this happening if less than with a
contraindication.; RISK vs BENEFIT
Contraindications and Precautions
KGZ, 2023
Others
PPSV
Min: 2 years old
For high risk population
PCV13 and PPSV23: give PPSV23 8 weeks after final dose of PCV
1 dose Chronic heart diseases, cardiomyopathies, heart failures
COPD, Asthma, emphysema
Diabetes
CSF leak, cochlear implant
2 doses, 5 years apart Congenital immunodeficiencies, HIV, nephrotic sx, chronic renal
failure
Leukemia, lymphoma, generalized malignancy
Solid organ transplant
Iatrogenic immunosuppression (immunosuppressive drugs, radiation
therapy)
Meningococcal
1. Menactra (MCV4-D)
Minimum: 9 months
9-23mos 2 doses, 3 months apart
>2 yo 1 dose
Booster: 15-55 yo at continued risk for meningococcal disease if at least 4 years have
elapsed since the prior dose
MCV and PCV13 in a child with asplenia, sickle cell of HIV: do not administer until 2yo
and at least 4 weeks after completion of PCV doses
2. Nimenrix (Tetravalent Meningococcal polysaccharide groups A, C, W-135 and Y
conjugate vaccine)
Minimum: 6 weeks old, 2 doses 2 months apart; booster at 12mos old
12mos-55yo: 1 dose only
Timing and Spacing
Two live parenteral: 4 weeks apart; repeat second dose if given <4 weeks
Prior to immunosuppression
Live Vaccine >4 weeks; avoid within 2 weeks of initiation
Inactivated >2 weeks
Post covid patients: 14 days after resolution of symptoms
COVID contact (significant exposure): wait for 2 weeks
Suggested Intervals between IVIG, immunoglobulin, or Blood Transfusion AND
ACTIVE Immunization (MMR, MMRV, or Varicella)
KGZ, 2023
Post Exposure Prophylaxis for Common Viral Exanthems
*must be given within exposure
Exanthem Vaccine Immunoglobulin
Measles 3 days 6 days
Rubella 3 days Not routine
Varicella 5 days For pregnant and immunocompromised: 96 hours or 4 days
Newborn with varicella-infected mothers: 5 days BEFORE
delivery to 2 days AFTER delivery
Immunosuppressed Persons
NO LIVE VACCINES to severely immunosuppressed
Isolated B-cell deficiency: may receive varicella
Inactivated vaccines are safe to use but decreased response
KGZ, 2023
COVID VACCINE
References:
PrevPeds 2018
Pedia Plantinum
PPS 2020 Convention
PPS Infobox on vaccines
KGZ, 2023
