IMMUNIZATIO

N

Specific defenses
Immunity

Active immunity Passive immunity

natural Transfer of maternal
Following clinical infection Antibodies Through placenta

Transfer of maternal
Following subclinical infection
Antibodies Through milk

acquired
Following vaccination Following administration of
Immunoglobulin or antiserum

IMMUNIZING AGENTS Immunizing agents vaccines immunuglobulins antisera .

polypeptide vaccine •Rubella muscular •Intranasal influenza •Japanise Influenza encephalitis •Typhus . TYPES OF VACCINES Live Live Killed Toxoids Cellular fraction Recombinant vaccine Attenuated Inactivated vaccines vaccines vaccines vaccines •Small •BCG •Typhoid •Diphtheria •Meningococcal •Hepatitis B pox •Typhoid oral •Cholera •Tetanus polysaccharide vaccine variola •Plague •Pertussis vaccine vaccine •Pneumococcal •Oral polio •Plague polysaccharide •Yellow fever •Rabies vaccine •Measles •Salk polio •Hepatitis B •Mumps •Intra.

except other wise specified . •Positive PPD OPV/IPV) •Prematurity. CONTRAINDICATION TO VACCINATION Absolute Relative Not Contraindication Contraindication Contraindication •Severe anaphylactic •Immunosppresive •Mild illness ± low shock or allergic therapy (all live grade fever reaction to previous vaccines) •Current antibiotic vaccine •Egg allergy (MMR) therapy •Moderate to severe •Recent infectious illness ±fever disease exposure •Pregnancy (MMR.

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The last dose should be administered not later than 32 weeks of age. a single dose of Inactivated Polio vaccine (IPV) is given with the 3rd dose of OPV at 14 weeks 5. Oral Polio vaccine (OPV). Rotavirus vaccine given at a minimum age of 6 weeks with a minimum interval of 4 weeks between doses. BCG vaccine. 3 doses given at 6-10-14 weeks of age. 7. DPT-Hib-Hep B vaccine. Monovalent Hepatitis B vaccine given at birth 3. Pneumococcal conjugate vaccine (PCV). given at 9 months of age Measles-Mumps-Rubella (MMR) vaccine given at 12 months of age . Measles –containing vaccine (either monovalent measles vaccine or MMR) 8. 3 doses given at 6-10-14 weeks of age 6.NATIONAL IMMUNIZATION PROGRAM (NIP) THE NATIONAL IMMUNIZATION PROGRAM (NIP) CONSISTS OF THE FOLLOWING ANTIGENS: 1. single dose given at birth 2. 3 doses given at 6-10-14 weeks of age 4.

Measles-Rubella (MR) and Tetanus- Diphtheria (Td) vaccines are administered to Grade 1 and Grade 7 students enrolled in public schools Human Papillomavirus (HPV) shall be given to female children 9-10 years old at health facilities in priority provinces. 6 months. Quadrivalent HPV 2 doses are given at 0. .NATIONAL IMMUNIZATION PROGRAM (NIP) THE NATIONAL IMMUNIZATION PROGRAM (NIP) CONSISTS OF THE FOLLOWING ANTIGENS: A school based immunization program to provide catch-up doses for school children and adolescents has been established .

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05 mL >12 months – 0. peau-de- orange appearance (after 3-8 weeks) .1 mL •What to expect: Induration.BCG •Route: Intradermal (ID) @ Right deltoid or Buttocks •Age: 1-2 months •Dose: <12 months – 0.

HIV infected patients •Adverse Reactions: abscess or ulcers at site. immunosuppression. axillary lymphadenopathy . active tuberculosis.BCG •Contraindications: hypersensitivity.

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PPD should be done prior to BCG in the following conditions: • Suspected congenital TB • Hx of close contact to known or infectious cases of TB • Clinical findings of TB / CXR suggestive of TB •5 mm induration is (+) in these individuals .BCG •Healthy infants & Children >2 months.

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HEPATITIS B VACCINE •Route: Intramuscular (IM) •Age: 1st 12 hours of life. 1st dose given at birth infants: 3rd dose given < 24 wks •Dose: 0.5 mL . & 14 wks 3rd dose: not given earlier than 24 wks 4th dose: preterms <2kg. 10. then 6.

swelling and warmth . HEPATITIS B VACCINE •Contraindications: hypersensitivity to yeast •Adverse Reactions: pain at injection site. local redness.

HEPATITIS B VACCINE •Given as monovalent vaccine at birth •Subsequent doses given as combination vaccine (6. 14 wks) •Mother is HBsAg (+): give HBV and HBIG within 12 hours of life •HBIG: administered not later than 7 days if not immediately available . 10.

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DTP •Route: Intramuscular (IM) •Age: 6 wks of age minimum. 14 wks) If given <4 wks.5 mL . 10. may not be effective due to immaturity of immune response •Dose: 0. interval of 4 weeks (6.

DTP •Contraindications: hypersensitivity. pain at injection site. documented Arthus reaction prior to tetanus vaccination •Adverse Reactions: fever. localized redness. prolonged crying. irritability. warmth . convulsions.

2004-2005 . Nicholas Maurice Arthus COLLINS DICTIONARY OF MEDICINE.  The preformed antibody combines with the injected antigen causing a high local concentration of immune complexes and severe tissu damage  Described by French physiologist.DTP •Arthus reaction  Type III sensitivity reaction  a local necrotic reaction that occurs when an antigen is injected into the skin of a person previously sensitized to it.

DTP •Pertussis component not recommended after age 6 because of increased risk of neuroparalytic reactions •Whole cell pertussis vaccine causes neuroparalytic reaction .

interval of 4 weeks (6. 14 wks) If first dose is given 7-11 mos. & 3rd after 8 wks Booster dose: 12-15 mos (6 mos from 3rd dose) . 10. 2nd after 4 wks. HAEMOPHILUS INFLUENZA TYPE B CONJUGATE VACCINE •Route: Intramuscular (IM) •Age: 6 wks of age minimum.

HAEMOPHILUS INFLUENZA TYPE B CONJUGATE VACCINE •Dose: 0. rashes . children <6 wks •Adverse reactions: fever 5-12 days after vaccination.5 mL •Contraindications: hypersensitivity.

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10. interval of 4 weeks (6. 14 wks) EPI: administered together with DTwP.POLIOVIRUS VACCINE (OPV) •Route: Per Orem (PO) •Age: 6 wks of age minimum. Hib..Hep B vaccines •Dose: 2-3 drops .

6 M cases). diarrhea. vomiting. fever .POLIOVIRUS VACCINE (OPV) •Contraindications: Immunosuppression •Adverse reactions: Vaccine-associated paralytic poliomyelitis (1 in 2.

14 wks) •EPI: administered together with DTwP. minimum interval of 4 weeks (6. 10.- Hib.Hep B vaccines •Final dose: on or after 4th birthday and at least 6 months from previous dose .POLIOVIRUS VACCINE (IPV) •Route: Intramuscular (IM) •Age: 6 wks of age.

acute febrile illness. streptomycin. polymixin B. pain or tenderness at injection site. immunosuppressed states •Adverse reactions: fever.POLIOVIRUS VACCINE (IPV) •Dosage: 0.5 mL •Contraindications: hypersensitivity to neomycin. swelling .

POLIOVIRUS VACCINE (IPV) •For children who are given OPV series: Single dose of IPV should be given with the third dose of OPV •The final dose should be on or after the 4th birthday and at least 6 mos from previous dose .

POLIOVIRUS VACCINE (IPV) •IPV is given in these situations:  persons with compromised immunity  household contacts of immunodeficient individuals  unimmunized adults at future risk of exposure  individuals refusing OPV immunization .

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MEASLES VACCINE •Route: Subcutaneous (SC) •Age: 9 months •Dose: 0.5 mL •May be given as early as 6 months in cases of outbreaks .

MEASLES VACCINE •Contraindications: pregnancy. rash . gelatin. neomycin. hypersensitivity to eggs. immunosuppression •Adverse reactions: fever 5-12 days after vaccination.

but given earlier provided the interval between doses is at least 4 weeks •EPI: 2nd dose is given to public school students aged 13 yrs old .MMR VACCINE •Route: Subcutaneous (SC) •Age: 12 months •2 doses are recommended •2nd dose: 4-6 years.

MMR VACCINE
•Dose: 0.5 mL
•Contraindications: pregnancy, allergy to
neomycin, immunosuppression
•Adverse reactions: pain at injection site,
local redness, warmth, and swelling,
fever

FULLY IMMUNIZED CHILD
VACCINE # of
Doses
at birth /
before
BCG 1
reaching 12
mos
4 wks
DPT 3 doses interval each
dose
4 wks
OPV 3 doses interval each
dose
4 wks
Hepatitis B 3 doses interval each
dose
Measles 1 dose 9-12 mos

ROTAVIRUS VACCINE •Route: Per Orem (PO) •Age: 6 wks of age. minimum interval of 4 weeks •Dose: 2 mL •Monovalent human rotavirus: 2-dose series •Pentavalent human bovine rotavirus: 3- dose series •Last dose not later than 32 wks .

ROTAVIRUS VACCINE •Contraindications: immunosuppression. vomiting . history of intussusception •Adverse reactions: fever. hypersensitivity. diarrhea.

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5 ml for children 36 months to 18 years .25 ml for children 6 months to 35 months and 0.INFLUENZA VACCINE •Trivalent influenza vaccine given intramuscularly (IM) or subcutaneously (SC) •Quadrivalent influenza vaccine given intramuscularly (IM) •Given at a minimum age of 6 months •The dose of influenza vaccine is 0.

If only one dose was given during the previous influenza season. give 2 doses of the vaccine then 1 dose yearly thereafter.INFLUENZA VACCINE •Children 6 to 8 years receiving influenza vaccine for the first time should receive 2 doses separated by at least 4 weeks. . •Children aged 9 to 18 years should receive 1 dose of the vaccine yearly •Annual vaccination should begin in February but may be given throughout the year.

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JAPANESE ENCEPHALITIS VACCINE (JE) Given at a minimum age of 9 months Children 9 months to 17 years of age should receive one primary dose followed by a booster dose 12-24 months after the primary dose Individuals 18 years and older should receive a single dose only .

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VARICELLA VACCINE •Route: Subcutaneous (SC) •Age: 12 months •1st dose is given at 12-15 mos •2nd dose given at 4-6 years or earlier provided the interval between 1st and 2nd dose is at least 3 months .

hypersensitivity to eggs. immunosuppression •Adverse reactions: pain at injection site.5 mL •Contraindications: pregnancy. fever . gelatin. neomycin.VARICELLA VACCINE •Dose: 0. local redness. and swelling. warmth.

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PNEUMOCOCCAL VACCINE •Route: Intramuscular (IM) •Age: 6 wks (PCV)/2 yrs (PPV) •Given 3 doses separated by 4-week intervals •Booster 6 months after 3rd dose •PPV: given for high risk children > 2 yrs after completing the PCV series .

irritability.5 mL •Contraindications: hypersensitivity to tetanus toxoid •Adverse reactions: fever. swelling at injection site .PNEUMOCOCCAL VACCINE •Dose: 0. redness. tenderness.

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HEPATITIS A ● Given intramuscularly ● Recommended for all children >12 years ● 2nd dose: 6-12 months after the 1st dose .

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8 October 2015.2105 National Center for immunization and Respiratory Diseases. December 2015 3. PIDSP/PFV/PPS Childhood Immunization Schedule 2015 .SOURCES Textbook of Pediatrics and Health – del Mundo Textbook of Pediatrics – Nelson’s 17th edition European Center for Disease Prevention and Control. US CDC. Shortage of acellular pertussis containing vaccines and impact on immunization programmes in the EU/EEA. Stockholm :ECDC.

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