Annotations: Vaccines inthe pink area, enclosed in parenthesis are vaccines given in the Philippine Expanded Program of Immunization (EP) of the Department of Health Vaccines inthe EP include: BCG, DIP, OPV, Measles, and Hepatitis 8, MMI, Hib (OTHER RECOMMENDED VACCINES: (Other Recommended Vaccines are the vaccines futside the pink area. These vaccines ate not part of {the Philippine EP but because of mei are advocated by the Phillppine Pediatic Society (PPS), Pediatric Infectious Disease Society of the Philippines (PIDSP), and the Philippine Foundation for Vaccination (PF. Other recommended vaccines include: MMV, Hepatitis A, DTA, Tdop, PV, Pneumococcal, Rotavirus, Influenza, and Human Papilloma virus (HPV) Vaccine, VACCINES FOR SPECIAL GROUPS: ‘Treseare vaccines which ae nat part ofthe Philippine Pl oF Other Recommended Vaccines but availble data supportitsuse in certain conditions rin selected populations. Vaccines for Special Groups Include: Meningococcal, Typhoid and Rabies Vaccines. ace {Given ftradermaly (0) [BCG should be given at the earliest possble age after birth preferably within the fest 2 months of Ife. For healthy infants and children >2 months who are not given BCGar birth, PPD prior to BCG vaccination isnot ecessary.. However, PPD is recommended prior to BBCG vaccination if any of the following are present suspected congenital TB, history of close contact to known or Suspected infectious cases of TB, clinical findings suggestive of TB and/or chest. cay suggestive of TB. In the presence of any of these Conditions, an induration of >5mm is considered positive The dose of 8CG is 005ml for infants <12 months of ageand 0.1 mlforchikéren >12 months ofage. MEASLES Given subcutaneously (SC) ‘Measles vacane Is given 8t 9 months of age but may bee given as early a5 6 months of age in cases of cutbreske HEPATITIS B VACCINE Given intramuseiody (MW) The first dose s given within the fst 12 hours of life “Thehepatits Birth dose may be usedas he fst dose Ina 3dose primary sees. Doses are given at least 4 weeks apart A fourth dose is naeded for the following + ithe third dose is given at age <6 months + if no bith dose is given Using the EPI schedule of 6, 10,and 14 weeks + For preterms less than 2 kgs. the ital dose should not be counted. in the 3-dose immunization schedule, PNEUMOCOCCAL VACCINES (PnCV/PPY) Given intramusearty The minimum age fer pneumococcal conjugate vaccine (PnCV) 1s 6 weeks of age and for [pneumecoccal polysaccharide vaccine (PPV) is at 2 Years of age. ‘PPV is recommended for high risk children >2 years of age in addition to PRCV. For healthy children, no adklttonal doses of PPV are ‘needed ithe PnCY series fs complete. HEPATITISA Given intramuscularly (iM) Hepatitis A vaccine Is recommended forall children aged >12 months. A second dose of the vacine Is ‘iven 60 12 months after the frst dose, ROTAVIRUS VACCINE (RV} Given per orem (PO) The monovalent human rotavirus vaccine (RVI) civen as a 2-dose series, The pentavalent human bovine rotavirus vaccine (RVS) i given as a 3-dose Series, The fist dose ofthe vaccine is administered from age 6 weeks {0 14 weeks and 6 days. There insufficient data on safety ofthe frst dose of rotavirus vaccine in older infants, The minimum interval between doses is 4 weeks, The second dase of FVT should not be administered later than 24 weeks of age. The 31d dose of FVS should not be administered later than 32 weeks of ge ‘}MEASLES, MUMPS, RUBELLA (MMI) (SC) Given subcutaneously (SC) Minimum age is 12 months, Administer the second dove at age 4 through & years. However, the second dove may be administered before age 4 provided an interval of28 days has lapsed since the first dase. -+MEASLES, MUMPS, RUBELLA, VARICELLA (MMRV) (SC) Given subcutaneously (SC) Combination MM may be given as an alternative 10 separately administered MMR and Varicela vaccine for healthy chideen 12 months to 12 years of age. ++VARICELLA VACCINE Given subcutaneously (SC) The fist dose ofthe vaccine s administered fom age 1215 months. The second dose of the varicella vaccine's administered at age 4-6 yeas or at an eater age provided the interval between the fist and the Second dose lsat least months Asecond dose ofthe vaccine is recommended for chien, adolescents, and adults who previously received only one dose of the vaccine. all indvidls aged >13 years and ‘without previous evidence ofimmunity should receive 2 doses of varicella vaccine given at least 4 weeks apart INFLUENZA VACCINE (IM/SC) {Given intramuscularly or subcutaneously (IM/SC) Al chileen fram 6 months to 18 years should receive loflsenza vaccine CChidren 6 months 10 8 years receving influenza vaccine forthe frttime should ecewe 2 doses ofthe vaccine separated by at least 4 weeks. IFonly one dose was administered “during the previous influenza Season, administer 2 doses of the vaccine then one dose yearly thereater, Children who received 2 single dose of influenza vaccine for 2 consecutive years should continue receiving single annual doses. Yearly. vaccination should preferably be gwen between February to June, HUMAN PAPILLOMAVIRUS VACCINE (HPV) {Given intramuscularly (MD Primary vaccination consists of a 3:dose series ‘adminstered to females 10-18 years of age. The recommended schedule 3s follows: Bivalent HPV at 0,1 and 6 months: Quadvalent HPV 310,2,and6 months. ‘The minimum interval between the fist nl second doses atleastone month ani the minimum interval between the second and third dose is at least 3 months * Use in males 10-18 years ofage forthe prevention of anogenital warts is optional TETANUS AND _DIPTHERIA TOXOIDS AND [ACELLULAR PERTUSSIS (Tap) ‘Given intramuscularly (IM) Children and adolescents 10-18 years of age should receivea single dose of Tdap instead of for booster immunization against tetanus, diphtheria, and pertussis if they have not completed the fecommended childhood DTwP/DTaP immunization Seties and if they have not received either Td or Tap. Thereafter, Td booster given every 10 years is recommended. An interval of atleast 5 years from the last TA dose I recommended ifTdap is used as booster toreduce the isk of local an systemic reactions. TYPHOID VACCINE Gwen intramuscular iM) Recommended for travelers toareas where theres risk fof exposure to S. typhi and for persons with frequent ‘exposure to 5, typhi. A single dase may be given as cary as 2 years oF age with evaccintion every 2 03 years if there's continued exposure S. typhi [MENINGOCOCCAL VACCINE “Given intramusculay or subcutaneously MSC [A single dose of meningocaccal vaccine Is recommended foal children aged »2 years known 10 ‘beat high risk for disease in outbreak situations, infants <2 years of age {minimum of 3 months ofage] may be given 2 doses of the vaccine 3 months apart Revaccination may be considered 35 years after the frst dose for persons who remain at high risk for infection. RABIES VACCINE Given intramuscularly or intradermally (M/10) The Antivabies Act of 2007 recommends routine rabies pre-exposure (reP) for children aged 5-14years In areas where there 1s high incidence of rabies {incidence > 25 human rebiesmilion population) There are 2 recommended regimens for pre-exposure prophyloss: * Intramuscular dose: PVRV 05ml or PCECY Imi given ‘on ays 07.21 oF 28. + Ivadermal dose: PUR oF PCECY 0.1mi given on days 07.21 0128. Rabies vaccine should never be glen in the oluteal area since absorption is unprediciable. For the intradermal dose a repeat dose shouldbe given ithe ‘vaccines inadvertently given subcutaneously. ‘After completion of 3 doses of rabies vaccine a5 pre-exposure prophylaxis, periodic booster doses in theabsence of exposure arenet recommended forthe ‘general population. Any exposure, regardless of inerval between re-exposure and last dose of the vaccine should receive two @) booster doses. as follows DayO= 1 dose Day3- tdose [Doses may be given intamusculavty (0m) PVRY oF ‘ml PCECY) or intradermally (0.1m PVRV or PCECV) There sno need to give ables immune globulin (Ri The Childhood Immunization Schedule present ‘recommendations for immunization for children and fadolescents based on the knowledge experience and premises currentat the time of publication. The schedule ‘represents consensus with which physicians may at ‘mes alsagree. No claim's made fo infelibity, and the PPS, PIDSP and PFV acknowledge thot individual circumstances may warrant decisions eflerng fiom the recommendations given here. The recommendations are fot absolute, Physicians must regularly update their knowledge about specie vaccines and ther use because information about safety and efficacy of vaccines and recommendations ‘elatwe to their administration continue to develop after a vaccines censed.