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

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 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

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 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

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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)

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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

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COVID VACCINE

References:
PrevPeds 2018
Pedia Plantinum
PPS 2020 Convention
PPS Infobox on vaccines

KGZ, 2023