What Vaccine to Give and When – Immunization Vaccination Schedule

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Let’s start with one statistics- Immunisation saves 2 to 3 million lives every year. However, there are still about 1.5 million lives which can be saved with Immunization at the right time. World Immunization Week is celebrated in last week of April every year and this year (2017) it’s between 24th April and 30th April.

The theme for this year’s World Immunisation Week is #VaccinesWork. We will be coming up with a follow-up blog on that. But let’s find out more about Immunisation and how it can help save your child from several diseases

World Immunization Week
Immunization is now reaching most of the population of the world. Image Source: WHO Website

What is Immunisation?

By definition, Immunisation is the action of making a person or animal immune to infection, typically by inoculation. Immunisation uses the body’s natural defence mechanism – the immune response – to build resistance to specific infections.

Immunization Vaccination Schedule
Vaccines Work. Source: WHO

What diseases can be prevented by Immunization?

There are nine major diseases which can be prevented by routine childhood immunization – Diphtheria

  • Whooping Cough is prevented using 3 doses of Diphtheria-Tetanus-Pertussis (DTP3) Vaccine Giving this vaccine protects against infectious diseases which can cause serious illness, disability or even fatal
  • Measles – A highly contagious disease caused by a virus, which usually results in a high fever and rash, and can lead to blindness, encephalitis or death
  • Mumps – Can be confused by non-experts as Measles and this too is a highly contagious virus which causes painful swelling at the side of the face under the ears, fever, headache and muscle aches. It can lead to viral meningitis.
  • Polio – India is declared polio free but this has been one of the most dangerous diseases as it can lead to irreversible paralysis. It has been stopped in all but three countries in the world – Afghanistan, Pakistan and Nigeria.
  • Rubella –is usually mild in children, but infection during early pregnancy may cause fetal death or congenital rubella syndrome, which can lead to defects of the brain, heart, eyes and ears.
  • Tetanus – Caused by a bacterium which grows in the absence of oxygen, for example in dirty wounds or in the umbilical cord if it is not kept clean
  • Haemophilus Influenzae type b (Hib). It causes Meningitis and Pneumonia
  • Hepatitis B is a viral infection that attacks the liver

 Vaccination above the diseases mentioned above are a must. However, there are several other diseases which can be prevented with vaccinations. We are giving a schedule of vaccinations/ Immunization Schedule recommended by Indian Academy of Paediatrics Association.

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Immunization Vaccination Schedule

Age (completed weeks/months/years) Vaccines

Comments

Birth
  • BCG
  • OPV 0
  • Hep-B 1
Administer these vaccines to all newborns before hospital discharge
6 weeks  

 

 

  • DTwP 1
  • IPV 1
  • Hep-B 2
  • Hib 1
  • Rotavirus 1
    PCV 1
 DTP:

  • DTaP vaccine/combinations should preferably be avoided for the primary series
  • DTaP vaccine/combinations should be preferred in  certain specific circumstances/conditions only
  • No need of repeating/giving additional doses of whole-cell pertussis (wP) vaccine to a child who has earlier completed their primary schedule with acellular pertussis (aP) vaccine-containing products

Polio:

  • All doses of IPV may be replaced with OPV if administration of the former is unfeasible
  • Additional doses of OPV on all supplementary immunization activities (SIAs)
  • Two doses of IPV instead of 3 for primary series if started at 8 weeks, and 8 weeks interval between the doses
  • No child should leave the facility without polio immunization (IPV or OPV), if indicated by the schedule
  • See footnotes under figure titled IAP recommended immunization schedule (with range) for recommendations on intradermal IPV

Rotavirus:

  • 2 doses of RV1 and 3 doses of RV5 & RV 116E
  • RV1 should be employed in 10 & 14 week schedule, 10 & 14 week schedule of RV1 is found to be more immunogenic than 6 & 10 week schedule
10 weeks

 

  • DTwP 2
  • IPV 2
  • Hib 2
  • Rotavirus 2 PCV 2
Rotavirus:

If RV1 is chosen, the first dose should be given at 10 weeks

14 weeks
  • DTwP 3
  • IPV 3
  • Hib 3
  • Rotavirus 3
  • PCV 3
Rotavirus:

  • Only 2 doses of RV1 are recommended.
  • If RV1 is chosen, the 2nd dose should be given at 14 weeks
6 months

 

  • OPV 1
  • Hep-B 3

 

 Hepatitis-B: The final (3rd or 4th ) dose in the HepB vaccine series should be administered no earlier than age 24 weeks and at least 16 weeks after the first dose.
9 months

 

  • OPV 2
  • MMR-1
 MMR:

  • Measles-containing vaccine ideally should not be administered before completing 270 days or 9 months of life;
  • The 2nd dose must follow in 2nd year of life;
  • No need to give stand-alone measles vaccine
9-12 months

 

 

  • Typhoid Conjugate Vaccine

 

 

  • Currently, two typhoid conjugate vaccines, Typbar-TCV® and PedaTyph® available in Indian market; either can be used
  • An interval of at least 4 weeks with the MMR vaccine should be maintained while administering this vaccine
12 months

 

  • Hep-A 1
Hepatitis A:

  • Single dose for live attenuated H2-strain Hep-A vaccine
  • Two doses for all inactivated Hep-A vaccines are recommended
15 months
  • MMR 2
  • Varicella 1
  • PCV booster
 MMR:

The 2nd dose must follow in 2nd year of life

However, it can be given at anytime 4-8 weeks after the 1st dose

Varicella: The risk of breakthrough varicella is lower if given 15 months onwards

16 to 18 months

 

  • DTwP B1/ DTaP B1
  • IPV B1
  • Hib B1

 

 

The first booster (4thth dose) may be administered as early as age 12 months, provided at least 6 months have elapsed since the third dose.

DTP:

  • 1st  &  2nd boosters should preferably be of DTwP
  • Considering a higher reactogenicity of DTwP, DTaP can be considered for the boosters
18 months
  • Hep-A 2
  • Hepatitis A: 2nd dose for inactivated vaccines only
2 years

 

  • Booster of Typhoid Conjugate Vaccine

 

 

  • A booster dose of Typhoid conjugate vaccine (TCV), if primary dose is given at 9-12 months
  • A dose of Typhoid Vi-polysaccharide (Vi-PS) vaccine can be given if conjugate vaccine is not available or feasible;
  • Revaccination every 3 years with Vi-polysaccharide vaccine
  • Typhoid conjugate vaccine should be preferred over Vi- PS vaccine
4  to 6 years  

  • DTwP B2/DTaP B2
  • OPV 3
  • Varicella 2
  • MMR 3
Varicella: the 2nd dose can be given at anytime 3 months after the 1st dose.

MMR: the 3rd dose is recommended at 4-6 years of age.

10 to 12 years
  • Tdap/Td
  • HPV
 Tdap: is preferred to Td followed by Td every 10 years

HPV:

  • Only 2 doses of either of the two HPV vaccines for adolescent/preadolescent girls aged 9-14 years;
  • For girls 15 years and older, and immunocompromised individuals 3 doses are recommended
  • For two-dose schedule, the minimum interval between doses should be 6 months.
  • For 3 dose schedule, the doses can be administered at 0, 1-2 (depending on brand) and 6 months

Source of Data: http://www.indianpediatrics.net/oct2014/785.pdf

Important Links –
Vaccination TIPs …
How Do Vaccines Help My Child?
Swine Flu Vaccines
Monitor your toddler’s growth using Child Growth Charts
General Diet Plan
Personalized Diet Plan
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