Philippine EPINayssa Alleyah Marohom Pacote

DOH-PCSHC Intern 2012-2013Pedia-EAMC

Vaccines in the EPI

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

Other Recommended Vaccines

DTaP Hepatitis A HPV IPV Influenza MMRV Pneumococcal Tdap Varicella

Vaccines for Special Groups:

Typhoid Meningococcal Rabies

BCG

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.

DTaP/DTwP 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.

Hepatitis B Vaccine

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.

A 4th dose is needed for the following:

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.

Hib

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.

Measles

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

MMR

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.

OPV

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.

RV

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

Hepatitis A Vaccine

IM Recommended for all children > 12

months. 2nd dose = is given 6 to 12 months

after the 1st dose.

HPV

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.

Influenza

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.

MMRV

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.

PCV/PPV

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

Varicella Vaccine

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.

Td and Tdap

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.

Typhoid

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

Meningococcal Vaccine

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.

Rabies

IM / ID 2 recommended regimens for pre-

exposure 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.

Thank you!