Bacillus Calmette Guerin (BCG) Hepatitis B vaccine DTP Poliovirus (OPV/IPV) Haemophilus influenza B Rotaviru

(Hib)
Type Live Inactivated P: whole cell inactivated OPV: Live Polysaccharide protein Live
(wP) or acellular (aP) IPV: Inactivated conjugate
Dose 0.05 mL (birth-12 mos) 0.5 mL/10 mcg (newborn-19 y/o) 0.5 mL 0.5 mL (IM, IPV) 0.5 mL 1.5 mL
0.1 mL (>12 mos) 1.0 mL/20 mcg (>19 y/o)
Route ID (R deltoid) IM (anterolateral thigh) IM OPV: Oral IM Oral susp
IPV: IM
Schedule Earliest possible time (birth-2 Birth, 6, 10, 14 weeks 6, 10, 14 wks 6, 10, 14 wks 6,10,14 wks 1st: 6-14
mos) (alt: 0, 1, 6 mos) 4th: 1 yr after 3rd 4th: 12-18 mos Booster: 1-5 y/o 2nd: 10-3
PPD prior to vaccination: 5th: 4-6 y/o 5th: 4-6 y/o Alt: 2, 4, 6 mos;
Booster: 1 yr(6 mos in plat)
congenital TB, hx of close *Booster: 4 y/o (plat) Do not b
after 3rd
contact to known TB cases,
clinical s/s or CXR suggestive of Not routinely given >5y/o
TB
Usual Reaction Induration: 2-4 wks Low-mod fever (72 hrs)
Pustule: 5-7 wks Restlessness
Scar: 2-3 mos Irritability
Pain & swelling
Adverse Reaction Abscess at site of injection Pain High fever (40°C) Paralysis (OPV) Low grade fever Intussusce
Regional lymphadenopathy Swelling Seizure Pain
Osteitis of epiphysis of long boned Severe irritability Swelling
(several years after BCG) Somnolence
Lethargy
Inconsolable crying (3-6 hrs)
Contra-indications Immunodeficiency Altered immune states
Progressive dermatoses near Antineoplastics/ chemotherapy
the site of injection High dose steroids
HIV
Pregnancy
Radiation
Household contacts of IC px
Comments For healthy infants > 2 mos not Booster not recommended w/ May use aP if adverse effect IPV: decrease incidence of VAPP High risk infants unimmunized Clear, colo
given BCG at birth, PPD not normal immune status with wP (vaccine associated paralytic (5 yrs): 1 dose if: sickle cell particle; R
necessary unless: suspected, clin High-risk px (HD, bld tx): depend Toxoids: safe in pregnancy polio) disease, leukemia, HIV, reconstitu
findings, hx of close contact with TB on anti-HBs level splenectomy Can be giv
(> 5mm induration) If mother (+) HBsAg, give w/in 12 *Health centers: whole EPI
hrs: HepB (0.5 mL IM, birth), HBIg *clinics: acelluar Position o
(0.5 mL IM) semi-recli
Breastfeeding of (+) HBsAg: give mouth; an
 HepB vacc & HBIg cheek

Pneumococcal Measles MMR Influenza Varicella Hepatitis A Hum

(PCV/PPV)
Type PCV: polysaccharide Live attenuated Live attenuated Inactivated Live attenuated Inactivated Inac
protein conjugate
Dose 0.5 mL 0.5 mL 0.5 mL 0.25 mL (6-35 mos) 0.5 mL 0.5 mL/720 U (1-18 0.5 m
0.5 mL ( 3 y/o) y/o)
1.0 mL/1440 U (>19
y/o)
Route IM SC SC IM SC IM IM
SC
Schedule 6, 10, 14 wks (alt: 2, 4, 9 mos 1st: 12-15 mos 2 doses 1 Annual, before flu season (Feb- 1st: 12-15 mos 1st: >12 mos 9 y/o
6 mos) 6 mos (outbreaks) mo apart Jun) 2nd: 4-6 y/o 2nd: 6-12 mos after
Booster: 6-12 mos 2nd: 4-6 y/o 6 mos – 8 y/o: 2 doses 4 weeks 1st Befo
apart
after 3rd Booster as MMR sexu
<12 mos who received male
2-5 y/o healthy w/o measles: 2 addt’l doses of
prev. vacc: MMR 9-26
PCV10 - 1 dose imm
PCV 13- 2 doses 8 wks dose
apart Preg
reco
Not routinely given
>5y/o
Adverse Reaction Fever +/- rash (5-12 Me: Fever +/- 5-12 days after Varicella-like lesions 2/3 Pain
days after) Mu: swelling of parotid glands wks-1 mo; may develop Swelling
Transient arthritis/arthralgia shingles (herpes-zoster)
Post-auricular
lymphadenopathy
Contra-indications Immunocompromised Immunocompromised Immunocompromised
Pregnant Pregnant Pregnant

Comments PPV: >2 y/o with: Indications: 6-59 mos; high Prophylaxis: w/in 5 days Indications: 12 y/o; Biva
anatomic/ functional risk children (chr CV dse, chr from exposure areas with high 16, 1
asplenia; HIV; IC px pulm dse incldg asthma, chr Safety: not transferred prevalence; Qua
(chronic lung dse, metab dso incldg DM, chr from vaccinated; can be occupational HPV
 renal dse, cochlear renal dso, IC incldg HIV/AIDS, given to children whose hazards; immunity cerv
implants, CSF leaks) Hbopathies); long term household has weak is desired canc
salicylate therapy; household immune system; can be canc
contacts; adults >60 y/o given to pregnant fema

Rules/Reminders:
1. Unknown immunization status: can start all over again
2. Lapse in immunization status: no need to start all over again
3. Can be given at the same visit: follow minimum age requirements
4. If not simultaneous: follow appropriate intervals
5. Spacing and administration of live & inactivated antigens
a. > 2 inactivated: no minimum interval
b. Inactivated + live: simultaneous/any interval
c.  2 live parenteral: 4 weeks interval if not given simultaneously
d.  live oral: non if given simultaneously
6. Live vaccines: wait 2 weeks before giving Ig
7. Immunoglobulins: wait  3 months before giving vaccines
8. >/=2 IM injections: distance of 2.5 cm if given in the same thigh
9. Anaphylaxis: epinephrine (1:1000) – 0.01 mL/kg up to 0.5 mL IM
10. Vaccine storage & transport