Philippine Expanded program of Immunization | Vaccines | Public Health

BCG  Hepatitis B  Measeles  Oral Polio Vaccine (OPV)  DTwP  Hib  MMR  RV

DTaP  Hepatitis A  HPV  IPV  Influenza  MMRV  Pneumococcal  Tdap  Varicella

Typhoid  Meningococcal  Rabies

Given Intradermally (ID)  Given at the earliest possible age after birth, (1st 2 months of life)  PPD is recommended prior to BCG Vaccination if any of the following are present:

› Suspected congenital TB › Hx of close contact to known or suspected

infectious cases of TB › Clinical findings suggestive of TB and/or CXR suggestive of TB

The dose of BCG is 0.05 ml for infants <12 months and 0.1 ml for children > or = 12 months of age.

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Diptheria and Tetanus Toxoids and Acellular Pertussis Vaccine IM Minimum age of 6 weeks with a minimum interval of 4 weeks. The 4th dose may be given as early as 12 months provided there is minimum interval of 6 months from the 3rd dose. The 5th dose may not be given if the 4th dose was administered at age 4 years or older.

IM  1st dose = 1st 12 hours of life, and may be counted as part of the 3-dose primary series  At least 4 weeks apart  The 3rd dose preferably given not earlier than 24 weeks of age.

3rd dose given at age less than 24 weeks  Using EPI schedule of birth, 6th and 14 weeks  Preterm infants less than 2kgs, 1st dose=birth

› Preterm infants with HBsAg (-) mothers may

be given the 1st dose of HBV at 30 days of chronological age regardless of weight, and this can be counted as part of the 3-dose primary series

Mother is HBsAg (+), administer HBV and HBIG (0.5 ml) within 12 hours of life.  If HBsAg status is unkown, administer HBV within 12 hours of life and determine mother’s HBsAg as soon as possible.  If HBsAg (+), administer HBIG no later than 7 days of life.

Haemophilus Influenzae Type B Conjugate Vaccine  IM  Minimum age of 6 weeks, minimum interval of 4 weeks  1st dose = bet 7-11 months of age, 2nd dose should be given at least 4 weeks later and 3rd dose = at least 8 weeks from 2nd dose

A booster dose should be given between 12-15 months with an interval of 6 months from the 3rd dose.  1 dose of Hib = unimmunized children age 5 years or older who have sickle cell disease, leukemia, HIV infection, or who has splenectomy.

SC  Children who received a dose of measles containing vaccine at less than 12 months should be given 2 additional doses beginning at 12 through 15 months of age and separated by at least 4 weeks, (MMR)  May be given as early as 6 months of life

Measles, Mumps, Rubella  SC  Minimum age = 12 months  2nd dose = age 4 through 6  May be administered at an earlier age provided the interval bet 1st and 2nd dose = 4 weeks

Children below 12 months of age given any measles-containing vaccine (Measles, MR, MMR) should be given 2 additional doses of MMR.
› 1st dose = 12 to 15 months of age › 2nd dose = age 4 through 6 years

Children 12 months or older given any measles-containing vaccine (Measles, ME, MMR) should be given one dose of MMR vaccine, separated by at least 4 weeks from the 1st measles-containing vaccine.

Poliovirus Vaccine  PO  Minimum age of 6 weeks with minimum interval of 4 weeks  Final dose should be given on or after the 4th birthday and at least 6 months after the previous dose

If 4 or more doses have been given prior to age 4 years, an additional dose should be administered at age 4 through to 6 years.

Rotavirus Vaccine  PO  The monovalent human rotavirus vaccine (RV1) is given as a 2-dose series  1st dose = 6 weeks of age  2nd dose = not later than 24 weeks of age

The pentavalent human bovine rotavirus vaccine (RV5) is given as a 3-dose series,  1st dose = between 6 weeks to 14 weeks of age  3rd dose = not later than 32 weeks of age  Interval between doses is 4 weeks

IM  Recommended for all children > 12 months.  2nd dose = is given 6 to 12 months after the 1st dose.

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Human Papillomavirus Vaccine IM Primary vaccination consists of 3-dose series administered to females 10-18 years of age. Bivalent HPV : 0, 1, 6 months Quadrivalent HPV: 0, 2, 6 months Minimum interval between 1st and 2nd dose is at least 1 month and for the 2nd and 3rd dose is at least 3 months.

IM or SC  All children from 6 months to 18 years should receive influenza vaccine.  6 months to 8 years = 2 doses  It is recommended that children ages 6 months to 8 years old who received at least one dose of the 2011 vaccine will require only one dose of the 2012 vaccine.

Children who received single dose of influenza vaccine for 2 consecutive years should continue receiving single annual doses.  Annual vaccination should preferably be given between February to June, but may be given throughout the year.

Measles, Mumps, Rubella, Varicella  SC  For healthy children 12 months to 12 years of age.  2nd dose of MMRV is administered at 4-6 years old or at an earlier age provided the interval between the 1st and 2nd dose is at least 3 months.

Pneumococcal Conjugate Vaccines / Pneumococcal Polysaccharide Vaccine  IM  PCV = Minimum age is 6 weeks  PPV = 2 years of age  A single dose of PCV is recommended for healthy children 2 to 5 years with any incomplete PCV schedule.

PPV is recommended for high risk children > 2 years of age in addition to PCV.  PPV sshould be administered at least 8 weeks after PCV

SC  1st dose – age 12 to 15 months  2nd dose – 4-6 years or at an earlier age provided the interval between the 1st and 2nd month is at least 3 months.

A 2nd dose of the vaccine is recommended for children, adolescents, adults who previously received only one dose of the vaccine.  All individual > 13 years and without previous evidence of immunity should receive 2 doses of varicella vaccine at least 4 weeks apart.

Tetanus and Diptheria Toxoids and acellular pertussis  IM  Td booster doses should be given every 10 years.  A single dose of Tdap can be given in place of the due Td dose and can be administered regardless of the interval sine the last tetanus and diptheria toxoid-containing vaccine.

7-18 years of age who are not fully immunized with DPT Vaccine should be given a single dose of Tdap. Remaining doses are given as Td.  Never been immunized with DPT vaccine = 3 dose series of tetanus containing vaccine 0,1,6 months sched. A single dose of Tdap is given, 1st dose. Remaining doses are given as Td.

IM  Travelers  Outbreak situations  Single dose as early as 2 years of age with revaccination every 2 to 3 years if there is continued exposure to S.typhi

Tetravalent meningococcal (MCV4) = IM  Meningococcal polysaccharide (MPSV 4) = SC  Bivalent meningococcal polysaccharide A and C = IM/SC  Individuals at high risk (anatomic or functional asplenia, compliment or factor deficencies, HIV)

2-18 years of age = 2-dose primary series of MCV4 given at 2 months apart  If MPSV4 or bivalent meningococcal polysaccharide A and C vaccines were used as the 1st dose, a 2nd dose using MCV4 should be given with minimum interval of 2 months from the 1st dose.  Reactivation with MCV4 is recommended 3 to 5 years following completion of the primary series, to those who remain at risk

Outbreak situations, MCV 4 may be given to those <2 years of age. Minimum age of 3 months using 2 doses 3 months apart.

IM / ID  2 recommended regimens for preexposure prophylaxis (5-14)

› IM dose : PVRV 0.5 ml of PCEVC 1ml on days

0, 7, 21, or 28 › ID dose: PVRV or PCECV 0.1 ml given on 1, 7, and 21 0r 28.

Given at the gluteal area  ID regimen, a repeat dose should be given if vaccine is inadvertently given SC  Will require only one booster dose on day 0 and 3. IM or ID  Periodic booster doses in the absence of exposure are not recommended for the general population.

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