Immunization

VACCINE
BREAKTHROUGH
CC HEYWOOD
CC DEPASUCAT
1.4 M children under 5
die of vaccine-
preventable diseases
INTRODUCTION
WHAT ARE VACCINES?
● Biological preparations to
stimulate an individual’s
immune system
● Weakened or killed
pathogens
WHAT DOES A VACCINE DO?
● Prime immune system to recognize and
remember pathogens
● PREVENT spread of infection
● REDUCE severity of illness
● ERADICATE or control deadly diseases
BRIEF HISTORY OF VACCINES Jan 2020 -
SARS-COV 2
Practice of 1900s outbreak
PCECV, and later Dec 2020 -Start
VARIOLATION
rabies for post
SPANISH of vaccine roll-
As protection FLU
from smallpox JENNER exposure out
1796 OUTBREAK
01 02 03 04 05
1400-1700s PASTEUR Y2K

World’s first
People successful 1800s 1945- Influenza
vax
around vaccine 1950s - IPV
the world 1960s - OPV
1974 - EPI
MECHANISM OF VACCINATION
PASSIVE ACTIVE
IMMUNIZATION IMMUNIZATION
Antibody administration from
Stimulates immune system to
a person or an animal to
produce antibodies and cell-
another person to provide
mediated immunity by
temporary protection
immunizing agents.
CLINICAL TRIAL
Pharmaceutical quality and
1 PRECLINICAL non-clinical research
Human pharmacologic studies

2 PHASE 1 in 20-100 healthy volunteers
Therapeutic exploratory studies

3 PHASE 2 in several hundred volunteers
Clinical efficacy and safety

4 PHASE 3 studies in thousands
volunteers
CLINICAL TRIAL

● Animal modelsTherapeutic exploratory studies

3 PHASE 2
● Safety in several hundred volunteers
● Safe dosage

volunteers
CLINICAL TRIAL



volunteers
CLINICAL TRIAL


● Test on HEALTHY human volunteers
● Effectiveness and safeefficacy
Clinical dosageand safety
volunteers
CLINICAL TRIAL



volunteers
CLINICAL TRIAL


● Test on HUNDREDS of HEALTHY

Clinical human
efficacy and safety
4 PHASE 3
volunteers studies in thousands
volunteers and safe dosage
● MEASURES Effectiveness
CLINICAL TRIAL



volunteers
CLINICAL TRIAL
● THOUSANDS ofHuman
healthypharmacologic
volunteers studies
2 PHASE 1
● Compared in 20-100 healthy volunteers
to a placebo


volunteers
HERD IMMUNITY
Vaccines given individually can
provide immunity even to those
who are not vaccinated
TYPES OF VACCINES
LIVE ATTENUATED INACTIVATED COMBINATION

VIRUS VACCINES VACCINES
Derived from live antigens Stimulates immune system to Multiple different antigens of
produce the most effective produce antibodies and cell- an organism mixed as a
immune responses mediated immunity by single product to immunize
immunizing agents. against multiple serotypes
ADVERSE REACTIONS FOLLOWING
VACCINATION
LOCAL SYSTEMIC ANAPHYLACTIC
Derived from live antigens Generalized, includes fever, MOST SEVERE

produce the most effective malaise, myalgia, headache,
immune responses and loss of appetite LEAST FREQUENT
Minimized by good screening
TUBERCULOSIS
EXPANDED PROGRAM
POLIOMYELITIS ON IMMUNIZATION DIPHTHERIA
6 Vaccine preventable
diseases
TETANUS MEASLES
PERTUSSIS
Interventions and Strategies
OVERALL GOAL SPECIFIC GOALS
immunize all
REDUCE morbidity
infants/children
and mortality
among children against the most
against vaccine- common vaccine-
preventable diseases preventable diseases.
Interventions and Strategies
SPECIFIC GOALS SPECIFIC GOALS
● eliminate maternal and

● sustain the polio- neonatal tetanus
free status of the ● Control of diphtheria,
Philippines. pertussis, hepatitis b
and German measles.
● Prevent extra
pulmonary
● eliminate measles tuberculosis among
children.
infection
MANDATES
RA no. 10152
Mandatory Infants and Children Health
Immunization Act of 2011
President Benigno Aquino III
Basic immunization for children under 5

including other types that will be determined by
the Secretary of Health.
● WHO-UNICEF Reaching Every District
(RED)
● Improve immunization and reduce drop
outs
REACHING ● Data analysis for

action
EVERY
● Re-establish outreach
BARANGAY (REB) services
STRATEGY (2004) ● Strengthen links
between community
and service
● Supportive supervision
● Maximizing resources
Strategies
Strengthening Vaccine-
Preventable Disease Status of Implementation
Surveillance
● Critical for ALL health facilities

eradication efforts
● Measles and
have at least one staff
indigenous wild trained on REB
polio
● Adequate vaccines,
needles and
syringes
● What are the included vaccines in this
program?
● BCG ● Available vaccines

● Diphtheria ● Hepatitis A
NATIONAL ● Pertussis ● Varicella
● Influenza
IMMUNIZATION ● Tetanus toxoid ● Pneumococcal
PROGRAM OF THE ● Measles ● Typhoid
PHILIPPINES ● Mumps ● HPV
● Rubella
● Poliovirus
● Hemophilus influenzae
Type B
● Hepatitis B
● Rotavirus
EXPANDED PROGRAM ON IMMUNIZATION
SCHEDULE
BCG
Birth
Hepatitis B
DTwP-Hib-Hep B
OPV 6,10,14 weeks
Pneumococcal
Rotavirus 6 and 10th week
Measles 9 months
MMR 12 months
BCG
Bacillus Calmette - Guerin (BCG) Vaccine
Type of Vaccine ● Live Bacteria

● 1 dose
Number of Doses ● At birth preferably within 2 months of life
Schedule
Dosage ● 0.05ml <12 months and 0.1 ml if ≥ 12 months
● Outer upper arm below deltoid muscle
Injection Site/ Type ● Intradermal
Storage ● Stored between 2-8 C
● Known HIV, TB or other immunodeficiencies
Contraindications ○ Congenital TB, close contact to known or suspected
Adverse Reactions infectious cases, or clinical findings suggestive of TB
● Local abscess, regional lymphadenopathies
Hepatitis B (HepB) Vaccine
● Recombinant DNA
Type of Vaccine ● 2-3 doses
Number of Doses ● At birth for infants ≥ 2kgs within 24 hours of life
● Second dose 1-2 months of age (third dose needed if last dose
Schedule was given at age <24 weeks
Dosage ● 0.5 ml
● Infants: outer mid-thigh; Children and Adults: outer upper arm
Injection Site/ Type ● Intramuscular
Contraindications ● Anaphylactic reaction- extremely rare

● Local tenderness and redness
Adverse Reactions
Disease Agent Reservoir Spread Duration of Risk Factors
Immunity for Infection
post-
infection
Diphtheria Corynebacterium Humans Close Usually crowding
diphtheria respiratory lifelong
contact or
contact with
infectious
material
Pertussis Bordetella Humans Close No concrete crowding

Pertussis respiratory evidence
contact
post-
infection
Tetanus Toxin Soil Spores enter None Untreated
producing Animal the body via wounds
Clostridium intestines open especially
Tetani wounds those
caused by
rusty metal,
and
exposure to
animal feces
Maternal Toxin Human Infection None Lack of

Tetanus producing mother through the clean and
Clostridium umbilical safe delivery
Tetani cord in
newborns
Diphtheria, Tetanus, Pertussis Vaccine (DTP)
Type of Vaccine ● Usually part of the pentavalent vaccine

● 3 dose
Number of Doses At minimum age of 6 weeks with intervals of 4 weeks per dose
●
Schedule (6 weeks, 10 weeks, 14 weeks)
Dosage ● 0.5ml
● Right outer upper thigh
Contraindications ● Anaphylaxis or hypersensitivity after previous dose

● Mild local and systemic reactions are common
Adverse Reactions
post-
infection
Meningitis Haemophilus humans Close Usually Overcrowding

and influenzae type respiratory lifelong leading to
pneumonia b bacterium contact exposure
Haemophilus Influenzae Type B Conjugate Vaccine
Type of Vaccine ●
●
Usually part of the pentavalent vaccine
3 dose
Number of Doses ● At minimum age of 6 weeks with intervals of 4 weeks per dose
(6 weeks, 10 weeks, 14 weeks)
Schedule ● Booster dose- 12-15 months with interval of 6 months from the
third dose
Dosage ● 0.5ml
● Right outer upper thigh
Contraindications ● Anaphylaxis or hypersensitivity after previous dose

● Mild local and systemic reactions are common
Adverse Reactions
Poliovirus Vaccine
● Inactivated Polio Vaccine (IPV)
Type of Vaccine ● 3 doses- primary series
● First booster at 12-18 months with interval of 6 months from
Schedule the third dose of primary series
● Second booster at 4-6 years old (if 4th dose given at 4 years
old or onward no second booster is needed)
Dosage ● 0.5ml
● Intramuscular- or in combination with DPT- containing vaccines
Injection Site/ Type ● Stored between 2-8 C
Storage
Previously unvaccinated ● 3 doses given
○ First two doses 4 weeks apart
at ages 7-11 months ○ Third dose is given after 2 months from the second dose
ideally at or after the first birthday
Poliovirus Vaccine- OPV/ IPV
● National Immunization Program (DOH)
○ Oral Polio Vaccine (OPV)
■ 3 doses; 4 week intervals
■ 6 weeks, 10 weeks, 14 weeks
○ Inactivated Polio Vaccine (IPV)
■ 2 doses
● First dose IPV given together with 3rd dose of OPV
● Second dose at 9 months with measles vaccine
Pneumococcal Conjugate Vaccine
● Pneumococcal Polysaccharide and Pneumococcal Conjugate
Type of Vaccine ● PCV- 3 doses; PPV- 1 dose
● Booster dose 6 months from the third dose of primary series
Schedule
Dosage ● 0.5ml
● Anterolateral (outer) part of the left thigh (vastus lateralis) for infants,
Injection Site/ Type upper arm (deltoid) for adults
Storage ● Intramuscular- or in combination with DPT- containing vaccines
● Stored between 2-8 C
Previously ● 3 doses given
○ First two doses 4 weeks apart
unvaccinated at ages 7- ○ Third dose is given after 2 months from the second dose
11 months ideally at or after the first birthday
Pneumococcal conjugate Vaccine
● PCV 10: 1-5 years old
Previously ○ 2 doses at least 2 months apart
unvaccinated older ● PCV 13: 12-23 months
○ 2 doses at least 2 months apart
children ages 12 ● 2- 5 years old patient give 1 dose
months - 5 years
Rotavirus Vaccine
● Live attenuated virus, oral
Type of Vaccine ● 2 doses (Rotarix- RV1); 3 doses (Rotateq- RV5);
Number of Doses ● RV1- minimum 6 weeks with 4 week interval minimum
● Oral liquid formulation of RV5- 6-12 weeks, with minimum of 4-
Schedule 10 weeks interval; last dose not given beyond 32 weeks old
● Oral freeze-dried formulation of RV5- 2,4,6 months given at
minimum age of 6 weeks with 4 week intervals; last dose
should not be given beyond 12 months of age
Dosage ● 1ml
● Oral
Injection Site/ Type ● Stored between 2-8 C
Storage
● Severe allergic reaction to previous dose, immunodeficiency,
Contraindications history of malformation of the GI tract
Adverse Reactions ● Mild: irritability in patient, ear infection, diarrhea, vomiting,
runny nose; Severe: intussusception
post-
infection
Influenza Virus Humans Close Weak Overcrowding

respiratory immunity leading to
contact and exposure
airborne
droplet
Influenza Vaccine (Trivalent/ Quadrivalent)
Type of Vaccine ●
●
Trivalent and Quadrivalent
Given at a minimum of 6 months age
Number of Doses ● Children 6 months- 8 years receiving first dose should have 2
doses with intervals of 4 weeks
Schedule ● If only one dose given during previous influenza season:
○ 2 doses given followed by 1 dose a year after
● Children 9-18 years
○ 1 dose yearly; usually during February
Dosage ● Dose varies as per manufacturer recommendation
● Trivalent given intramuscularly or subcutaneously; Quadrivalent
Injection Site/ Type given intramuscularly
Contraindications ● Severe allergic reaction to previous dose, moderate to severe

illness, and those with history of Guillain- Barre Syndrome
Adverse Reactions following a previous dose of vaccine
MEASLES
Type of Vaccine ● Live attenuated

● 1 dose
Number of Doses ● At 9 months
Schedule ○ 6 months in case of outbreaks
Dosage ● 0.5ml
● Anterolateral thigh
Injection Site/ Type ● Subcutaneously
● MMR/MR given as substitute for infants below 12 months

If monovalent ○ In these cases→ 2 more MMR vaccines received starting
unavailable at 1 year old
Measles- Mumps- Rubella Vaccine (MMR)
● Live attenuated
Type of Vaccine ● 2 doses
Number of Doses ● At minimum age of 12 months
● Second dose at 4-6 years of age or earlier but with a minimum
Schedule of 4 weeks interval
Dosage ● 0.5ml
● Known allergies, pregnancy, immunodeficiency

Contraindications ● Mild: fever, rash, 5-12 days after immunization
Adverse Reactions ● Severe: thrombocytopenia, anaphylaxis, encephalitis; joint pain
in older women; parotitis with mumps
Measles- Mumps- Rubella- Varicella Vaccine
● Live attenuated
Number of Doses ● At minimum age of 12 months and maximum age 12 years
● Alternative to MMR and Varicella vaccines given separately
Schedule ● Recommended minimum interval between doses is 3 months,
though second dose given 4 weeks from first dose is valid
Dosage ● 0.5ml
Varicella Vaccine
● Live attenuated
Number of Doses ● At minimum age of 12 months
● Second dose given 4-6 years of age but may be given earlier
Schedule with interval of 3 months from first dose
○ (if dose given 4 weeks from first dose still valid)
● Children 13 years or older: dose interval 4 weeks
Dosage ● 0.5ml
Japanese Encephalitis Vaccine
● Live attenuated recombinant vaccine
Type of Vaccine ● 1 dose
Number of Doses ● Given at minimum of 9 months old
● Those 9 months- 17 years receive primary dose followed by
Schedule booster 12-24 months after
● 18 years+ - single dose
Dosage ● 0.5ml
● Outer upper arm
Injection Site/ Type ● Subcutaneous
● Allergy to vaccine, pregnancy, immunodeficient conditions,

Contraindications acute and severe chronic diseases with symptoms of fever.
Adverse Reactions Encephalopathy, or uncontrolled epilepsy
● High fever, injection site reactions, low grade fever, irritability,
nausea, and dizziness.
Hepatitis A Vaccine (HAV)
Type of Vaccine ● Live attenuated Vaccine and Inactivated Hepatitis Vaccine

● 1 dose and 2 doses respectively
Number of Doses ● 18 months minimum and 12 months minimum respectively
Schedule ● Inactivated doses must have minimum interval of 6 months
● Inactivated Hepatitis A vaccine- given intramuscularly
Dosage ● Live attenuated vaccine- given subcutaneously
● Both: severe allergic reaction to vaccine component and

Contraindications moderate to severe illnesses
● Live: immunosuppression, pregnancy and recent receipt of
blood products
Human Papillomavirus Vaccine (HPV)
● Bivalent (2vHPV), Quadrivalent (4vHPV), and Nonavalent
Type of Vaccine (9vHPV)
Number of Doses/ ● Ages:
○ 9-14 years 2 doses recommended (0, 6 months)
Schedule ■ First dose and second dose with 6 month interval
■ If first two dose interval is less than 6 months a
third dose is needed 3 months after second dose
○ 15 years and older: 3 doses (0,2,6 months)
■ First and second dose minimum interval is 1 month
■ Second and third dose interval is 3 months
○ Males 9-18 4vHPV and 9vHPV given to help prevent
anogenital warts and anal cancer
● Outer upper arm below deltoid muscle or anterolateral aspect
Injection Site/ Type of the thigh
Storage ● Intramuscular
● Stored between 2-8 C
VACCINES FOR
SPECIAL
GROUPS/
HIGH RISK
Pneumococcal conjugate Vaccine (PCV)/ Pneumococcal
Polysaccharide Vaccine (PPSV23)
Given How? PCV or PPSV23?
Depends on age and
If possible, PCV doses
indication
should be prior to
PPSV23
Intramuscularly
Schedule Dose
8 week interval Immunocompromised
individuals should
receive both at separate
times
PCV-PPSV23 Vaccination Schedule Indications for Pneumococcal Vaccines
Age: 24 months to 5 years ONE DOSE

● Administer 1 dose PCV if 3 doses given •Chronic heart disease, including congestive heart
previously; give 1 or 2 doses PPSV23 at failure and cardiomyopathies
least 8 weeks after most recent dose of •Chronic lung disease, including chronic obstructive
PCV pulmonary disease, emphysema, and asthma
•Diabetes mellitus, Cerebrospinal fluid leaks,
● Administer 2 doses of PCV 8 weeks apart
Cochlear implant(s), Alcoholism
if unvaccinated or less than 3 doses PCV
•Chronic liver disease
was given precious; give 1 or 2 doses of
PPSV23 at least 8 weeks after most TWO DOSES
recent dose of PCV •Sickle cell disease and other hemoglobinopathies
•Congenital or acquired asplenia, or splenic
Age: 6-18 years dysfunction
● Administer 1 dose of PCV13 if no •HIV infection
precious doses; give 1 or 2 doses of •Chronic renal failure and nephrotic syndrome
PPSV23 at least 8 weeks after the most •Diseases associated with treatment with
recent dose immunosuppressive drugs or radiation therapy
•Congenital or acquired immunodeficiency
•Hodgkin disease
•Solid organ transplant
Anti-rabies Vaccinations
● For immunocompetent individuals given WHO prequalified vaccines (Verorab ® or Rabipur®):

○ Intramuscular(IM) regimen: Purified Vero Cell Rabies vaccine (PVRV) 0.5 ml OR
○ Purified Chick Embryo Cell vaccine (PCECV) 1 ml given on days 0 and 7
○ Intradermal (ID) regimen: PVRV or PCECV 0.1 ml given on days 0 and 7
● For immunocompromised individuals or those given non-WHO prequalified vaccines, give 3 doses on days 0, 7, 21 or
28
● A repeat dose should be given if the vaccine is inadvertently given subcutaneously
● Never give in the gluteal area
● In the event of subsequent exposures:
○ High-risk* individuals who have completed PrEP require booster doses, regardless of the interval between
exposure and last dose of the vaccine.
○ Booster doses may be given through either:
■ 1-visit regimen: 0.1 ml ID (PVRV or PCECV) on each of the 4 sites on day 0
■ 2-visit regimen: 0.1 ml ID (PVRV or PCECV) OR 0.5 ml PVRV or 1.0 ml PCECV IM at 1 site on days 0 and
3
Meningococcal Vaccine
• 0.5 ml Given intramuscularly (IM) or subcutaneously (SC)
• Tetravalent meningococcal conjugate vaccine MCV4-D, MCV4-TT, MCV4-CRM given intramuscularly (IM)
• Tetravalent meningococcal polysaccharide vaccine (MPSV4) given intramuscularly (IM)/subcutaneously (SC)
Indications in :
● Persistent complement component deficiencies
● Anatomic/functional asplenia (including sickle cell disease)
● HIV
● Travelers to or resident of areas where meningococcal disease is hyperendemic or epidemic
Schedule:
● MCV4-D: minimum age is 9 months
● 9-23 months old: 2 doses 3 months apart
● 2 years and above give one dose
○ Except in cases of asplenia, HIV, persistent complement component deficiency where 2 doses given 8 weeks apart
Meningococcal Vaccine
Schedule:
● MCV4-TT: minimum age is 6 weeks
○ 6-12 weeks old: give first 2 doses at least 2 months apart; the 3rd (booster) dose is at age 12 months
○ 12 months of age to adolescence: 1 dose only
● MCV4-CRM: given to children 2 years and above as a single dose
○ Revaccinate with a MCV4 vaccine every 5 years
● RABIES VACCINE MENINGOCOCCAL VACCINES Polysaccharide vaccines (MPSV4)
○ Given to children 2 years and above as a single dose followed by MCV4 as a second dose 2 months after
○ Booster doses of MPSV4 are not recommended.
Haemophilus Influenzae Type B
Conjugate Vaccine
● Given intramuscularly (IM)
● Indications for children with:
○ Chemotherapy recipients, anatomic/functional asplenia including sickle cell disease, HIV infection,
immunoglobulin or early component complement deficiency
● Age 12-59 months:
○ Unimmunized* or with one Hib vaccine dose received before age 12 months, give 2 additional
doses 8 weeks apart
○ With ≥ 2 Hib vaccine doses received before age 12 months., give 1 additional dose
Haemophilus Influenzae Type B
Conjugate Vaccine
● For children ≤ 5 years old who received a Hib vaccine dose(s) during or within 14 days of starting
chemotherapy or radiation treatment, repeat the dose(s) of Hib vaccine at least 3 months after
completion of therapy
● For children who are hematopoietic stem cell transplant recipients, revaccination with 3 doses of Hib
vaccine given 4 weeks apart, starting 6-12 months after transplant, is recommended regardless of
vaccination history.
● Unimmunized and ≥ 15 months of age to undergo elective splenectomy should be given 1 dose of Hib-
containing vaccine at least 14 days before the procedure
● Unimmunized 5-18 years old and with either anatomic or functional asplenia (including sickle cell
disease) or HIV infection, should be given 1 dose of Hib vaccine
Typhoid Vaccine
● Given intramuscularly (IM)

● Given at a minimum age of 2 years old with revaccination every 2—3
years
● Recommended for travelers to areas where there is a risk for exposure
and for outbreak situations as declared by public health authorities
Cholera Vaccine
• Given per orem (PO)
• Given at a minimum age of 12 months as a 2-dose series two weeks apart.
• Recommended for outbreak situations and natural disasters as declared by health
authorities
Hepatitis A Vaccine
Given intramuscularly (IM)

● Administer 2 doses of Hepatitis A vaccine, at least 6 months apart
to unvaccinated individuals who are at increased risk for infection:
○ Travelers to or are working in countries with intermediate or
high endemicity of infection
○ MSMs, Homelessness, Users of injection and non-injection
illicit drugs,
○ Working with HAV infected primates or with HAV in research
laboratories, o With clotting factor disorders, and chronic liver
disease o HIV
Human Papillomavirus Vaccine
Given intramuscularly (IM)
● Give 3 doses of HPV vaccine following the 0, 1-2, and 6 month schedule, regardless
of age at vaccine initiation to the following:
○ Children with history of sexual abuse or assault starting at age 9 years
○ Immunocompromised children
● Pregnancy- not recommended

■ If given during pregnancy, delay the remaining doses until after
pregnancy. Pregnancy testing is not necessary before initiating HPV
vaccination
Adult
Vaccinations
COVID 19 VACCINE
● 0.5 ml, IM, 2 doses, 21 days apart

BNT162b2
(Pfizer/BioNTech)
● 0.5 ml, IM, 2 doses, at least 28 days
mRNA-1273 (Moderna) apart
● 0.5 ml, IM, 2 doses, at least 12 weeks

ChAdOx1 (AstraZeneca) apart
COVID 19 VACCINE
Gam-COVID-Vac (Gamaleya) ● 0.5 ml, IM, 2 doses, 21 days apart
Ad26.COV2.S ● 0.5 ml, IM, single dose
(Janssen/Johnson&Johnson)
● 0.5 ml, IM, 2 doses, at least 28 days

Coronavac (Sinovac) apart
COVID-19 VACCINE
THE CDC RECOMMENDS AGAINST THE USE OF THE FOLLOWING

VACCINES IN YOUNGER CHILDREN:
BNT162b2: <16 years old

ChAdOx1: <18 years old
MYTHS AND FACTS
CAN A COVID-19 VACCINE MAKE ME SICK WITH COVID-19?
No. None of the authorized and recommended COVID-19 vaccines or COVID-19

vaccines currently in development contain the live virus that causes COVID-19. This
means that a COVID-19 vaccine cannot make you sick with COVID-19.
WILL A COVID-19 VACCINE ALTER MY DNA?
No. COVID-19 vaccines do not change or interact with your DNA in any way.There are
currently two types of COVID-19 vaccines that have been authorized for use in the
United States: messenger RNA (mRNA) vaccines and viral vector vaccines.
MYTHS AND FACTS
WILL A VACCINATION PROTECT ME FROM GETTING SICK WITH COVID-19?
Yes. COVID-19 vaccination is like teaching your immune system how to recognize the
virus that causes COVID-19 and how to fight it. As a consequence, this protects you
from getting sick with COVID-19.
IF I'VE ALREADY HAD COVID-19, DO I STILL NEED TO GET VACCINATED?
Yes. It is recommended that you should be vaccinated regardless of whether you

already had COVID-19. Since it is not yet known how long you are protected from
getting sick again after recovering from COVID-19, you should get vaccinated.
INFLUENZA VIRUS
Type of Vaccine ●
●
Inactivated Trivalent or Quadrivalent
Covers AH1N1, AH3N2, 1 Influenza virus
Indications (2 for Quadrivalent), prevailing WHO
recommendation
● May be given to cancer and PLHIV px to
prevent pneumonia associated mortality
Dosage and schedule ●

●
Yearly
IM, deltoid
Injection Site/ Type
Adverse Reactions ●
●
Local
Known anaphylactics, especially previous
Contraindications vaccine components
TETANUS, DIPHTHERIA, PERTUSSIS
Type of Vaccine ● Fixed combinations of tetanus and
diphtheria toxoids, and accellular
Indications pertussis
● Immunity after pediatric dose wanes after
5-10 years
● Given to pregnant women 2 doses with 4
week intervals
Dosage and schedule ● At least the same amount of toxoid in

pediatric doses but a reduced amount of
Injection Site/ Type diphtheria toxoid (20:2 IU)
● Second dose given 4-8 weeks after first
dose
● Third dose after 6-12 months
● IM, deltoid
● Local
MEASLES, MUMPS, RUBELLA
Type of Vaccine ●
●
Inactivated Trivalent or Quadrivalent
Covers AH1N1, AH3N2, 1 Influenza virus
Indications (2 for Quadrivalent), prevailing WHO
recommendation
● May be given to cancer and PLHIV px to
prevent pneumonia associated mortality

●
Yearly
IM, deltoid
●
Local
VARICELLA
Type of Vaccine ● Pneumococcal Polysaccharide Vaccine
(PPSV23) and Pneumococcal Conjugate
Indications Vaccine (PCV13)
● Immunocompetent adults, and elderly
(>60) to prevent pneumococcal
pneumonia

●
2 doses 4 to 8 weeks apart
IM
●
Local
Known anaphylactics
Contraindications
ZOSTER RECOMBINANT (RZV)
Type of Vaccine ●
●
Live attenuated
Adjuvanted recombinant
Indications ● >60 w/o prior history for disease
prevention
● If w/ history, for preventing recurrence

●
Single dose for Live attenuated
Two doses (0.5ml) for recombinant
Injection Site/ Type ● IM, deltoid
● 2-6 months apart
Adverse Reactions ● Local, shivering, and gastrointestinal

symptoms may occur
Contraindications ● Known anaphylactics, especially vaccine
components and neomycin
HUMAN PAPILLOMAVIRUS
Type of Vaccine ●
●
Bivalent, Quadrivalent, Nonavalent
Immunocompetent women given until 26
Indications years old

●
0-1-6 months for bivalent
0-2-6 months for quadrivalent and
Injection Site/ Type nonavalent
● IM, deltoid
●
Local, dizziness
Contraindications vaccine components and yeast
● NO studies on the effect of nonavalent
vaccines on males
HUMAN PAPILLOMAVIRUS
Type of Vaccine
Indications
Dosage and schedule
Adverse Reactions
Contraindications
PNEUMOCOCCAL VACCINE (PCV)
Type of Vaccine ● Pneumococcal Polysaccharide Vaccine
(PPSV23) and Pneumococcal Conjugate
Indications Vaccine (PCV13)
● Immunocompetent adults, and elderly
(>60) to prevent pneumococcal
pneumonia

●
0.5 ml SC or IM
PCV13 as first dose, followed by PPSV23
Injection Site/ Type a year later, no revaccination needed
● >50 yo given PPSV23 may be given PCV
13 at least 1 year later
●
Local
Contraindications vaccine components and yeast
● PPSV23 can be given during pregnancy
HEPATITIS A
Type of Vaccine ● Formalin-inactivated monovalent,
adsorbed aluminum hydroxide as
Indications adjuvant
● Adult immunocompetent, Men having sex
with men, hemophiliacs, contacts of
infected persons, endemic to a region
Dosage and schedule ● 2 doses, 0- (6-12) months, 1440 ELISA

units per ml
Injection Site/ Type ● IM, deltoid
●
Local
● Administer with caution to those with
bleeding disorders
HEPATITIS B
Type of Vaccine ● Monovalent recombinant Hepatitis B or Combined inactivated
Hepatitis A and B
Number of Doses ● 0-1-6 months to confer immunity
● 0-2-6 weeks for High Risk Individuals [ACCELERATED]
Schedule ○ 1 booster dose 1 year after 1st dose if titers are below 10
mIU/ml, after 5 years for healthy individuals
● 0.5ml, IM, Deltoid

Dosage
Adverse Reactions ● Pain, redness, soreness at injection site, and fever

● Hypersensitivity especially to yeast, those with moderate or
Contraindications severe illness
● NO STUDIES on effects to breastfeeding mothers and infants
MENINGOCOCCAL
Type of Vaccine ● Quadrivalent polysaccharide from
serotypes A, C, Y, W-135
Indications ● Routine administration is NOT
recommended in immunocompetent
● 65 and above, travelling to endemic areas

●
0.5 ml, single dose 10 days before travel
2 doses 2 months apart
Injection Site/ Type ● Re-vaccinate with 2 doses ever 5 years
● IM, deltoid
●
Local
HAEMOPHILUS INFLUENZAE B
Type of Vaccine ● Conjugated polysaccharides with: DPT
carrier proteins and N. meningitidis type
Indications B outer membrane protein complex
Dosage and schedule ● Single dose of pediatric vaccine IM

●
Local
Contraindications vaccine components, neomycin, and
gelatin
● PREGNANT WOMEN
VACCINE HESITANCY
TOP 10 GREATEST THREAT TO PUBLIC HEALTH (WHO, 2019)

Delay or rejection of vaccines in spite availability
● Pseudoscience
● False claims
Outcomes of vaccine hesitancy

● Decrease in demand
● Decreased coverage of both childhood and adult vaccination
● Increased vaccine-preventable disease outbreaks and epidemics
VACCINE HESITANCY
TOP 10 GREATEST THREAT TO PUBLIC HEALTH (WHO, 2019)

Delay or rejection of vaccines in spite availability
● Pseudoscience
● False claims
Outcomes of vaccine hesitancy

● Decrease in demand
● Decreased coverage of both childhood and adult vaccination
● Increased vaccine-preventable disease outbreaks and epidemics
VACCINE HESITANCY
HOW TO PREVENT VACCINE OPPOSITION

● STRENGHT OF RECOMMENDATION
● TAILORED COMMUNICATION
● TRANSPARENCY AND ACCURACY
● SUPPORT FROM ACCESIBLE AND RELIABLE INFORMATION
● REINFORCEMENT OF VACCINE RECCOMENDATIONS

Immunization

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Immunization

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VACCINE

1400-1700s PASTEUR Y2K

Human pharmacologic studies

Therapeutic exploratory studies

Clinical efficacy and safety

Human pharmacologic studies

● Animal modelsTherapeutic exploratory studies

Clinical efficacy and safety

Human pharmacologic studies

Therapeutic exploratory studies

Clinical efficacy and safety

Human pharmacologic studies

Therapeutic exploratory studies

Human pharmacologic studies

Therapeutic exploratory studies

Clinical efficacy and safety

Human pharmacologic studies

Therapeutic exploratory studies

● Test on HUNDREDS of HEALTHY

Human pharmacologic studies

Therapeutic exploratory studies

Clinical efficacy and safety

Therapeutic exploratory studies

Clinical efficacy and safety

LIVE ATTENUATED INACTIVATED COMBINATION

LOCAL SYSTEMIC ANAPHYLACTIC

Derived from live antigens Generalized, includes fever, MOST SEVERE

● eliminate maternal and

President Benigno Aquino III

Basic immunization for children under 5

REACHING ● Data analysis for

● Critical for ALL health facilities

● BCG ● Available vaccines

OPV 6,10,14 weeks

Rotavirus 6 and 10th week

Type of Vaccine ● Live Bacteria

Contraindications ● Anaphylactic reaction- extremely rare

Pertussis Bordetella Humans Close No concrete crowding

Maternal Toxin Human Infection None Lack of

Type of Vaccine ● Usually part of the pentavalent vaccine

Contraindications ● Anaphylaxis or hypersensitivity after previous dose

Meningitis Haemophilus humans Close Usually Overcrowding

Contraindications ● Anaphylaxis or hypersensitivity after previous dose

Influenza Virus Humans Close Weak Overcrowding

Contraindications ● Severe allergic reaction to previous dose, moderate to severe

Type of Vaccine ● Live attenuated

● MMR/MR given as substitute for infants below 12 months

● Known allergies, pregnancy, immunodeficiency

● Allergy to vaccine, pregnancy, immunodeficient conditions,

Type of Vaccine ● Live attenuated Vaccine and Inactivated Hepatitis Vaccine

● Both: severe allergic reaction to vaccine component and

Age: 24 months to 5 years ONE DOSE

● For immunocompetent individuals given WHO prequalified vaccines (Verorab ® or Rabipur®):

● Given intramuscularly (IM)

Given intramuscularly (IM)

● Pregnancy- not recommended

● 0.5 ml, IM, 2 doses, 21 days apart

● 0.5 ml, IM, 2 doses, at least 12 weeks

Gam-COVID-Vac (Gamaleya) ● 0.5 ml, IM, 2 doses, 21 days apart

Ad26.COV2.S ● 0.5 ml, IM, single dose

● 0.5 ml, IM, 2 doses, at least 28 days

THE CDC RECOMMENDS AGAINST THE USE OF THE FOLLOWING

BNT162b2: <16 years old