IMMUNIZATION

BCG
Type Live attenuated

Composition Danish 1331 strain of M. bovis.

Freeze dried form (lyophilized). Stored in dark colored ampoules (light sensitive)
Reconstituted with Normal saline. No antibiotics or preservatives(Can cause TSS).
Indication for immunization Given to all children at birth to prevent TBM & Miliary TB

Dosage 0.1 ml

Schedule Single dose from birth to within 1st month of life

Catch up: till 1 year of age under UIP, till 5 years of age as per IAP guidelines
Mode of administration Intradermal at left deltoid just above its insertion into humerus. Wheal of 5-7mm
using tuberculin syringe.
Prior cleaning with only saline
Adverse reactions Local: swelling, tenderness, abscess, non healing ulcer, secondary bacterial
infection, keloid
Regional: Left axillary lymphadenopathy
Systemic: fever, erythema nodosum, mediastinal lymphadenitis, osteomyelitis,
disseminated TB
Contra-indications Immunodeficiency, immunosuppressant drugs, allergy to vaccine components

Storage 2-8o C. After reconstitution, use within 4 hrs

Additional note Post immunization changes:

-Wheal disappears within few minutes
-Papule develops by 2-4 weeks
-Increases in size to 5-8mm by 6 weeks
-Develops into an ulcer which heals by 8-12 weeks
 Oral Polio Vaccine(OPV) Inactivated Polio Vaccine (IPV)
Type Live attenuated Killed (grown in tissue culture and inactivated in formalin)

Composition Sabin vaccine. Bivalent Contains Type 1 and 3 poliovirus. No Salk vaccine. Trivalent type 1,2 & 3 poliovirus
preservative. Neomycin present.
Indication for immunization All infants and children. Included in UIP All infants and children. Included in UIP

Dosage 2 drops 0.5ml (IM)

Fractional dose: 0.1ml (ID)
Schedule At birth dose of OPV is must. Given in place of IPV when it is not 6,10,14 weeks IM as combination vaccine or two fractional
feasible. Extra doses to be given on all supplementary immunization doses ID at 6& 14 wks. Booster at 16-18 months and 4-6
activities (Pulse polio immunization) years
Catch up: till 5 years of age Catch up: till 5 years of age. Two doses at an interval of 8
weeks. Followed by booster 6 months later
Mode of administration Oral IM anterolateral aspect of thigh in infants & young children
and deltoid in older children or fractional dose ID
Adverse reactions Vaccine associated paralytic poliomyelitis (VAPP) Local pain, redness, swelling, fever, allergic reactions
Vaccine derived polio viruses (VDPV)
Contra-indications Immunodeficiency, fever, diarrhea Allergy, fever

Storage Extremely thermo-labile. - 20 o C at manufacturer/distributer level (up 2-8o C

to 2 yrs). 6 months at 2-8o C. 1-3 days at room temperature. Has Vaccine
Vial Monitor
Additional note Efficacy of vaccine after single dose is low. Hence multiple doses
required. Provides mucosal immunity (IgA antibodies) & herd immunity.
 Hepatitis B Hib Vaccine
Type Recombinant vaccine All vaccines are conjugated

Composition Surface antigen of Hep B produced by recombinant technology in PRP-T: Type b capsular polysaccharide
yeast cells & adsorbed onto aluminum hydroxide conjugated with carrier protein tetanus toxoid
HBOC: carrier protein diphtheria toxoid

Indication for immunization All children, adults at high risk such as health care workers, All children below 5 years of age, unimmunized
recipients of frequent blood transfusions, uses of IV drugs, children above 5 years of age having functional
household contacts or anatomic asplenia (sickle cell, splenectomy),
immunodeficient (HIV, malignancy, congenital)
Dosage 0.5 ml less than 18 yrs and 1 ml in more than 18 yrs 0.5ml

Schedule Any one of the following: 0 -1 mon-6 mon/ 6-10-14 wk (along Routine: 6,10,14 weeks as pentavalent(UIP).
with DPT)/ total 4 doses permissible 0-6-10-14 wks. 6,10,14 weeks & booster at 12-18 months (IAP)
Catch up: : 0-1 mon-6 mon Catch up under IAP schedule: up to 5 years
6-12 mon: 2 primary doses 8 weeks apart &
booster at 12-18 months
12-15 mon: one primary dose & booster after 8
weeks
> 15 mon: single dose
Mode of administration IM anterolateral aspect of thigh in infants & young children and IM anterolateral aspect of thigh
deltoid in older children

Adverse reactions Local pain, fever, allergic reaction, vey rare myalgia, diarrhea, Pain, redness, swelling
abdo pain, GBS Rare: fever, rashes, urticaria, vomiting, diarrhea
Contra-indications Known hypersensitivity, severe febrile illness Known hypersensitivity, severe febrile illness
 DwPT DaPT Tdap dT TT
Type Whole cell DPT vaccine Acellular Pertusis Vaccine Standard dose tetanus & Standard dose Tetanus Toxoid
reduced dose diptheria & tetanus & reduced
acellular pertusis dose diptheria
Composition Diptheria toxoid: 25Lf Instead of using whole Diptheria toxoid: 2 Lf Diptheria toxoid: 2 5 Lf of tetanus
Tetanus toxoid:5Lf cell, certain key Tetanus Toxoid: 5 Lf Lf toxoid
Killed whole cell B.Pertusis baccili: components of pertussis Pertusis antigens reduced Tetanus Toxoid: 5
20000-30000 million important for inducing dose: PT, FHA, PRN,FIM Lf
Adsorbed Aluminum Phosphate immunity are used i.e
Thiomersal as preservative Pertusis toxin(PT),
Filamentous
hemagglutinin(FHA),
Pertactin (PRN)& Fimbrial
hemaggliutinins (FIM).
Treated with formalin to
obtain toxoids & adsorbed
onto aluminium salts
Indication for According to UIP & IAP all children Current recommendation Due to shift of pertussis -Routine
immunization 6weeks to 5 years is to use either DTaP or infection in older immunization at 10
DTwP. population over time, & 16 yrs &
DTaP especially to those pertussis vaccination with pregnancy. Now
who developed rare reduced dose has been replaced by Tdap &
systemic side effects with considered in adolescents td
DTwP & adults -During injury
Dosage 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml

Schedule Routine: 3 doses at 6-10-14 Same as DTwP Children who received primary immunization + During injury
wks(as pentavalent in UIP), two DPT boosters: Tdap at 10-12 yrs & then Td In fully immunized
booster at 16-18 months & 5-6 yrs 10 yearly. children:
 Pneumococcal Polysaccharide Pneumococcal Conjugate Vaccine
Vaccine (PPSV)
Type Pneumococcal Polysaccharide Protein conjugate

Composition (Pneumovax) 10 valent (Synflorix)

Contains purified capsular polysaccharides of 23 strains of 13 valent (Prevenar)
S. pneumoniae Polysaccharide capsule of different serotypes of S
pneumoniae are conjugated to carried protein to make
them immunogenic in infants, confer long lasting
protection and induce immunogenic memory
Indication for immunization High risk grp: Functional or anatomic asplenia, Nephrotic PCV 10 & 13 are being introduced in EPI in phased manner.
syndrome, Immunocompromised pt such as those with Offered to all affordable children under 5 yrs of age
HIV, Chronic cardiac/pulmon/renal disease
Dosage 0.5ml 0.5ml

Schedule Not recommended below 2 years of age. EPI schedule: 2 primary doses 6&14 wks of age and
One dose of PPSV 8 weeks after completing all doses of booster at 9 months of age.
PCV in high risk grp Catch up under EPI: If child less than 1 yr of age , all 3
doses to be separated by atleast 2 months. Above 1 yr of
age, only if child has received one dose before 1 yr of age
IAP schedule:
2-6month old child: 6,10,14 wks & booster in second yr of
life
7-11 month old child: 2 primary doses 4 wks apart &
booster inn second yr of life
12-23 month old child: 2 doses 8 wks apart
Children 2-5 yr old: single dose
 Hepatitis A Vaccines Typhoid Vaccines Rotaviral Vaccines
Vi Capsular Vi Conjugate
Biovac Havarix Polysacharide Vaccine Rotavac Rotarix
vaccine (typbar)
(Bio typh)
Type Live attenuated Inactivated Subunit vaccine Subunit vaccine Live attenuated Live attenuated

Composition H2 attenuated strain of HM 175 Hep A Purified & Conjugated to Indian Neonatal Human
Hep A. Lyophilized form virus strain inactivated Vi tetanus toxoid Rotavirus live Monovalent Live
propagated in capsular Vaccine 116E Vaccine RV1
human diploid polysaccharide of S. (monovalent, Lyophilized powder
cells, aluminum Typhi with phenol bovine-human form
hydroxide adjuvant as preservative reassortant
. Formalin strain,vero cell
inactivated derived)

Indication for Healthy children above 1 year of age. Not Not recommended Not recommended Given under UIP to Not recommended
immunization recommended for use in UIP. Offered to for use in UIP. for use in UIP. all infants less than for use in UIP.
affordable patients. Offered to Offered to 1 year of age Offered to
Special emphasis on: Chronic liver disease, affordable patients affordable patients affordable patients
Carrier of Hep B & C, travelers to endemic
region, household contacts of Hep A pt, food
handlers

Dosage 0.5 ml 0.5 ml 0.5 ml 0.5 ml 5 drops (0.5 ml) 1 ml

Schedule Single dose 12-24 2 doses. Minimum Single dose in Single dose in 3 doses 6,10,14 Only 2 doses at
st
 MMR Varicella Influenza Japanese
vaccine Encephalitis
Vaccine
Type Live attenuated Live attenuated Inactivated Live attenuated/ Inactivated

Composition Measles: Edmonston Zagreb OKA strain obtained by Split viron -Live attenuated SA 14-14-
Mumps: Leningrad Zagreb strain propagation of the virus in Quadrivalent 12
Rubella: RA 27/3 strain human diploid cell culture. -Inactivated (jeev) Vero cell
Freeze dried vaccine, to be diluted Lyophilized form culture derived
with sterile water Cell culture derived
Indication for Not included in UIP. May be offered Healthy children above 1 Children 6 mon-5 years, Individuals living in endemic
immunization to any affordable child year, close contacts of pts High risk children > 5 yrs eg areas & travellers to JE
with chickenpox without chronic endemic areas (included in
history of cardiac/pulmonary/renal UIP)
disease/vaccination in the disease, lab workers &
past, immunocompromised healthcare personnel
children Not included in UIP
Not included in UIP
Dosage 0.5 ml 0.5 ml 0.5 ml 0.5ml

Schedule Routine: 1st dose 12-15 months, Routine: 1st dose 12-15 6 months to 8 yrs: 2 doses 4 Live attenuated: 1st dose at
2nd dose 5-6 yrs of age months, 2nd dose 3-6 weeks apart & yearly 9 months followed by
Catch up: 2 doses 6-8 weeks apart months after 1st dose booster booster at 16-18 months
Catch up: 2 doses 6-8 weeks >8yrs: 1 dose yearly Inactivated: 2 doses 4 weeks
apart apart for children aged > 1
year
 Rabies Vaccine Human anti-tetanus
immunoglobulin
Type Three types: Immunoglobulin
1) Neural tissue vaccine: poorly immunogenic, severe
neurological reactions
2) Purified duck embryo vaccine: allergic reactions
3) Tissue culture vaccine: extremely safe and require
fewer doses. Two generations
- Human diploid cell vaccine (HDCV)
- Purified chick embryo culture vaccine(PCECV) & Purified
vero cell rabies vaccine (PVRV)
Composition Rabipur: PCEVC. available in lyophilized form Human IgG specific to tetanus toxin
Inactivating agent: BPL
Indication for immunization Pre-exposure immunization in veterinarians, animal Vaccination status unknown/<3 doses,
handlers, lab technicians involved in vaccine production immunodeficient patients with any type of
Post exposure in dog,cat,bats,foxes, racoons, skunks in wound
Category II and III wounds
Dosage 1 ml IM for both pre & post exposure 250-500 IU
0.1 ml ID for pre-exposure
Schedule Pre-exposure immunization: 0,7,28 days Single dose
Post exposure :
Essen schedule: 0,3,7,14,28 days
Zagreb Schedule: 2 doses on day 0, 1 dose on day 7 & 21
Mode of administration IM anterolateral aspect of thigh in infants & young children IM
and deltoid in older children (never in gluteal region)