Recommended Immunization Schedules for Children and Adolescents, 2007 CRISBERT I. CUALTEROS, M.D. http://crisbertcualteros...
2007 Schedule Major Changes <ul><li>The addition of oral live rotavirus vaccine for routine administration to all infants ...
2007 Schedule Major Changes <ul><li>The addition of human papillomavirus vaccine for girls 11-12 years of age, with catch-...
2007 Schedule Major Changes <ul><li>The age range for annual administration of influenza vaccine has been expanded to chil...
Recommended Immunization Schedule for Ages 0-6 years
Hepatitis B vaccine (HepB) <ul><li>1st Dose : At birth </li></ul><ul><ul><li>ALL NEWBORNS  prior to discharge. </li></ul><...
Inactivated Polio Vaccine (IPV) <ul><li>Minimum age:  6 weeks </li></ul><ul><li>Schedule:  age 2,4,6 months with booster a...
Inactivated Polio Vaccine (IPV) <ul><li>Indications: </li></ul><ul><ul><ul><li>Persons with immunocompromised immunity who...
Rotavirus vaccine <ul><li>Minimum age:  6 weeks </li></ul><ul><li>1 st  dose : between  6-12 weeks  of age </li></ul><ul><...
Diphtheria & Tetanus toxoids and Acellular Pertussis vaccine (DTaP) <ul><li>Minimum age:  6 weeks </li></ul><ul><li>Schedu...
Diphtheria & Tetanus toxoids and Acellular Pertussis vaccine (DTaP) <ul><li>Pertussis component- not recommended after the...
Haemophilus influenzae type B (HiB) <ul><li>Minimum age:  6 weeks </li></ul><ul><li>Schedule:  2,4,6 months  with  booster...
Pneumococcal vaccine <ul><li>Minimum age:  </li></ul><ul><ul><ul><li>6 weeks for PCV  (Pneumococcal conjugate vaccine) </l...
Influenza vaccine <ul><li>Minimum age:  </li></ul><ul><ul><ul><li>6 months  for trivalent influenza vaccine  (TIV) </li></...
<ul><li>For healthy persons aged 5-49 years, LAIV may be used as an alternative to TIV </li></ul>
Measles, mumps and rubella vaccine (MMR) <ul><li>Minimum age:  12 months </li></ul><ul><li>Schedule: 12-15 months with boo...
Varicella vaccine <ul><li>Minimum age:  12 months </li></ul><ul><li>Schedule:  12-15 months  with second dose at 4-6 years...
Hepatitis A vaccine (HepA) <ul><li>Minimum age:  12 months </li></ul><ul><li>All children at 1 year of age  (i.e. 12-23 mo...
Meningococcal polysaccharide  vaccine (MPSV4) <ul><li>Minimum age:  2 years </li></ul><ul><li>Administer to children aged ...
Recommended Immunization Schedule for Persons Aged 7-18 years
Tetanus and Diphtheria toxoids and acellular pertussis vaccine (Tdap) <ul><li>Administer at  age 11-12 years  for those wh...
Human Papillomavirus vaccine (HPV) <ul><li>Minimum age:  9 years </li></ul><ul><li>1 st  dose :  females at   11-12 years ...
Meningococcal vaccine <ul><li>Minimum age:  11 years for MCV4; 2 years for MPSV4) </li></ul><ul><li>Administer MCV4 at age...
Pneumococcal polysaccharide  vaccine (PPV) <ul><li>Minimum age: 2 years </li></ul><ul><li>Administer or certain high risk ...
Influenza vaccine <ul><li>Children aged <9 years who are receiving influenza vaccine for the 1 st  time should receive 2 d...
Hepatitis A vaccine <ul><li>2 doses should be given at least 6 months apart </li></ul>
Hepatitis B vaccine (HepB) <ul><li>Administer the  3-dose series  to those who are not previously vaccinated. </li></ul><u...
Inactivated Polio Vaccine (IPV) <ul><li>For children who received an all-IPV or all-OPV series, a fourth dose is not neces...
Measles, Mumps, and Rubella  vaccine (MMR) <ul><li>If not previously vaccinated, administer 2 doses of MMR during any visi...
Varicella vaccine <ul><li>2 doses: </li></ul><ul><ul><li>Persons without evidence of immunity </li></ul></ul><ul><ul><li>P...
addendum
Bacillus-Calmette Guerin vaccine (BCG) <ul><li>Given  anytime after birth </li></ul><ul><li>1 dose : 0.05 mL ID over delto...
Oral Polio Vaccine (OPV) <ul><li>Given at  2,4,6 months   </li></ul><ul><li>Minimum age:  6 weeks </li></ul><ul><li>1 st  ...
Measles Vaccine <ul><li>Live attenuated virus </li></ul><ul><li>Given at  9 months or later ; maybe given as early as 6 mo...
Expanded Program of Immunization for Infants (EPI) 1 9 months 5) Measles vaccine 4 weeks 3 At birth 4) Hepa B vaccine 4 we...
thAnks fOr listEning !
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Recommended Immunization Schedules For Children And Adolescents,

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  • For the evidence based facts and the truth on vaccines I recommend the following: How Vaccines Harm Child Brain Development - Dr Russell Blaylock MD. (Neurosurgeon)
    http://www.youtube.com/watch?v=7QBcMYqlaDs#t=417 88 minutes
    Read 'Dissolving Illusions, disease, vaccines and the forgotten history' by Dr. Suzanne Humphries to learn the truth about the history of disease http://www.dissolvingillusions.com/
    Read my power point 'Exposing the Myth of Vaccination; Essential Information You Need to Know to be Fully Informed' at http://www.slideshare.net/db61/exposing-the-myth-of-vaccination-essential-information-you-need-to-know-to-be-fully-informed-30978670
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Recommended Immunization Schedules For Children And Adolescents,

  1. 1. Recommended Immunization Schedules for Children and Adolescents, 2007 CRISBERT I. CUALTEROS, M.D. http://crisbertcualteros.page.tl
  2. 2. 2007 Schedule Major Changes <ul><li>The addition of oral live rotavirus vaccine for routine administration to all infants at ages 2, 4, and 6 months of age. </li></ul><ul><li>Routine administration of a second dose of varicella vaccine at 4 to 6 years of age. </li></ul>
  3. 3. 2007 Schedule Major Changes <ul><li>The addition of human papillomavirus vaccine for girls 11-12 years of age, with catch-up immunization of girls 13-18 years of age. This vaccine, administered intramuscularly in a 3-dose series at 0,2, and 6 months is expected to prevent most cases of cervical cancer and genital warts. </li></ul>
  4. 4. 2007 Schedule Major Changes <ul><li>The age range for annual administration of influenza vaccine has been expanded to children 6 to 59 months old. Vaccine is also recommended for close contacts of children 0 to 59 months old. </li></ul>
  5. 5. Recommended Immunization Schedule for Ages 0-6 years
  6. 6. Hepatitis B vaccine (HepB) <ul><li>1st Dose : At birth </li></ul><ul><ul><li>ALL NEWBORNS prior to discharge. </li></ul></ul><ul><ul><li>Monovalent hepB </li></ul></ul><ul><li>2nd dose : 1-2 months old </li></ul><ul><li>Final Dose : age ≥ 24 weeks </li></ul><ul><li>Permissible to administer 4 doses of Hepa B when combination vaccines are given after the birth dose. </li></ul><ul><li>>90% efficacy; probably 5 years or longer immunity </li></ul>
  7. 7. Inactivated Polio Vaccine (IPV) <ul><li>Minimum age: 6 weeks </li></ul><ul><li>Schedule: age 2,4,6 months with booster at 4-6 years </li></ul><ul><li>Dose: 0.5ml SQ </li></ul><ul><li>>95% efficacy </li></ul>
  8. 8. Inactivated Polio Vaccine (IPV) <ul><li>Indications: </li></ul><ul><ul><ul><li>Persons with immunocompromised immunity who are unimmunized or partially immunized </li></ul></ul></ul><ul><ul><ul><li>Household contacts of an immunodeficient individual </li></ul></ul></ul><ul><ul><ul><li>Unimmunized adults at future risk of exposure to poliomyelitis who have been partially immunized with OPV or IPV </li></ul></ul></ul><ul><ul><ul><li>Adults at future risks of exposure to poliomyelitis who have had a primary series of IPV </li></ul></ul></ul><ul><ul><ul><li>Individuals refusing OPV immunization </li></ul></ul></ul>
  9. 9. Rotavirus vaccine <ul><li>Minimum age: 6 weeks </li></ul><ul><li>1 st dose : between 6-12 weeks of age </li></ul><ul><ul><ul><li>Do not start the series later than age 12 weeks! </li></ul></ul></ul><ul><li>Schedule: 2,4,6 months </li></ul><ul><li>Final Dose : by 32 weeks of age </li></ul><ul><ul><ul><li>No more than age 32 weeks. </li></ul></ul></ul><ul><li>Insufficient data on safety and efficacy </li></ul>
  10. 10. Diphtheria & Tetanus toxoids and Acellular Pertussis vaccine (DTaP) <ul><li>Minimum age: 6 weeks </li></ul><ul><li>Schedule: 2,4,6 months with booster as early as age 12 months , provided that 6 months have elapsed since the 3 rd dose. </li></ul><ul><li>Dose: 0.5 ml IM </li></ul><ul><li>Administer the final dose in the series at age 4-6 years </li></ul><ul><li>100% efficacy/length of immunity for 10 years except pertussis component </li></ul>
  11. 11. Diphtheria & Tetanus toxoids and Acellular Pertussis vaccine (DTaP) <ul><li>Pertussis component- not recommended after the age of 6 years because of the increased risk for neuroparalytic reactions. </li></ul><ul><li>Subsequent doses are not recommended if the previous dose was followed by reactions such as: </li></ul><ul><ul><ul><li>Collapse </li></ul></ul></ul><ul><ul><ul><li>Shock-like state </li></ul></ul></ul><ul><ul><ul><li>Persistent screaming </li></ul></ul></ul><ul><ul><ul><li>Fever >40.5 C </li></ul></ul></ul><ul><ul><ul><li>Convulsions </li></ul></ul></ul><ul><ul><ul><li>Alterations in level of consciousness or other neurologic sx </li></ul></ul></ul>
  12. 12. Haemophilus influenzae type B (HiB) <ul><li>Minimum age: 6 weeks </li></ul><ul><li>Schedule: 2,4,6 months with booster at 12-15 months old </li></ul><ul><li>Dose: 0.5ml IM </li></ul><ul><li>Possible reaction: pain, redness and/or swelling at injection site in 25%; rarely fever and irritability </li></ul><ul><li>90-100% effective </li></ul>
  13. 13. Pneumococcal vaccine <ul><li>Minimum age: </li></ul><ul><ul><ul><li>6 weeks for PCV (Pneumococcal conjugate vaccine) </li></ul></ul></ul><ul><ul><ul><li>2 years for PPV (Pneumococcal polysaccharide vaccine) </li></ul></ul></ul><ul><li>Administer PCV at ages 24-59 months in certain high-risk groups </li></ul><ul><li>Administer PPV to certain high-risk groups aged ≥ 2 years </li></ul>
  14. 14. Influenza vaccine <ul><li>Minimum age: </li></ul><ul><ul><ul><li>6 months for trivalent influenza vaccine (TIV) </li></ul></ul></ul><ul><ul><ul><li>5 years for live attenuated influenza vaccine (LAIV) </li></ul></ul></ul><ul><li>All children aged 6-59 months and close contacts of all children aged 0-59 months </li></ul><ul><li>Recommended annually for children aged ≥ 59 months with certain risk factors. </li></ul>
  15. 15. <ul><li>For healthy persons aged 5-49 years, LAIV may be used as an alternative to TIV </li></ul>
  16. 16. Measles, mumps and rubella vaccine (MMR) <ul><li>Minimum age: 12 months </li></ul><ul><li>Schedule: 12-15 months with booster at 4-6 years old. </li></ul><ul><li>MMR may be given prior to age 4-6 years, provided that ≥ 4 weeks have elapsed since the first dose and both doses are administered at age ≥ 12 months. </li></ul><ul><li>Dose: 0.5 mL SQ </li></ul><ul><li>>95% efficacy and long-lasting immunity </li></ul>
  17. 17. Varicella vaccine <ul><li>Minimum age: 12 months </li></ul><ul><li>Schedule: 12-15 months with second dose at 4-6 years old. </li></ul><ul><li>The second dose may be administered prior to age 4-6 years, provided that ≥ 3 months have elapsed since the 1 st dose and both doses are administered at age ≥ 12 months. </li></ul><ul><li>Dose: 0.5 ml SC </li></ul><ul><li>Possible reaction: Fever, papulovesicular eruptions in 3% </li></ul><ul><li>Close to 100% efficacy </li></ul>
  18. 18. Hepatitis A vaccine (HepA) <ul><li>Minimum age: 12 months </li></ul><ul><li>All children at 1 year of age (i.e. 12-23 months) </li></ul><ul><li>2 doses should be administered at least 6 months apart. </li></ul><ul><li>Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits. </li></ul>
  19. 19. Meningococcal polysaccharide vaccine (MPSV4) <ul><li>Minimum age: 2 years </li></ul><ul><li>Administer to children aged 2-10 years with terminal complement deficiencies ot anatomic or functional asplenia and certain other high risk groups </li></ul>
  20. 20. Recommended Immunization Schedule for Persons Aged 7-18 years
  21. 21. Tetanus and Diphtheria toxoids and acellular pertussis vaccine (Tdap) <ul><li>Administer at age 11-12 years for those who have completed the recommended childhood DPT/DTaP series and have not received a tetanus & diphteria toxoids vaccine (Td) booster dose </li></ul><ul><li>Adolescents aged 13-18 years who missed the 11-12 year Td/Tdap booster dose should receive a single dose of Tdap if they have completed the recommended childhood DTP/DTaP vaccination series. </li></ul>
  22. 22. Human Papillomavirus vaccine (HPV) <ul><li>Minimum age: 9 years </li></ul><ul><li>1 st dose : females at 11-12 years </li></ul><ul><li>2 nd dose : 2 months after the 1 st dose </li></ul><ul><li>3 rd dose : 6 months after the 2 nd dose </li></ul><ul><li>Administer the HPV vaccine series to females at age 13-18 years if not previously vaccinated. </li></ul>
  23. 23. Meningococcal vaccine <ul><li>Minimum age: 11 years for MCV4; 2 years for MPSV4) </li></ul><ul><li>Administer MCV4 at age 11-12 years and to previously unvaccinated adolescents at high school entry </li></ul><ul><li>Administer MCV4 to previously unvaccinated college freshmen living in dormitories; MPSV4 is an acceptable alternative. </li></ul>
  24. 24. Pneumococcal polysaccharide vaccine (PPV) <ul><li>Minimum age: 2 years </li></ul><ul><li>Administer or certain high risk groups </li></ul>
  25. 25. Influenza vaccine <ul><li>Children aged <9 years who are receiving influenza vaccine for the 1 st time should receive 2 doses </li></ul><ul><ul><ul><li>Separated by ≥ 4 weeks for TIV </li></ul></ul></ul><ul><ul><ul><li>By ≥ 6 weeks by LAIV </li></ul></ul></ul>
  26. 26. Hepatitis A vaccine <ul><li>2 doses should be given at least 6 months apart </li></ul>
  27. 27. Hepatitis B vaccine (HepB) <ul><li>Administer the 3-dose series to those who are not previously vaccinated. </li></ul><ul><li>A 2-dose series of Recombivax HB ® is licensed for children aged 11-15 years </li></ul>
  28. 28. Inactivated Polio Vaccine (IPV) <ul><li>For children who received an all-IPV or all-OPV series, a fourth dose is not necessary if the third dose was administered ≥ 4 years. </li></ul><ul><li>If both IPV and OPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age. </li></ul>
  29. 29. Measles, Mumps, and Rubella vaccine (MMR) <ul><li>If not previously vaccinated, administer 2 doses of MMR during any visit, with ≥ 4 weeks between the doses. </li></ul>
  30. 30. Varicella vaccine <ul><li>2 doses: </li></ul><ul><ul><li>Persons without evidence of immunity </li></ul></ul><ul><ul><li>Persons aged <13 years at least 3 months apart </li></ul></ul><ul><ul><li>Persons aged ≥ 13 years at least 4 weeks apart </li></ul></ul>
  31. 31. addendum
  32. 32. Bacillus-Calmette Guerin vaccine (BCG) <ul><li>Given anytime after birth </li></ul><ul><li>1 dose : 0.05 mL ID over deltoid area </li></ul><ul><li>Booster : school entrants (0.1 mL) </li></ul><ul><li>If given at the earliest possible age protects against the possibility of infection from other family members </li></ul><ul><li>50% efficacy </li></ul><ul><li>Possible reaction: Keloid scar, suppurative regional adenitis; disseminated BCG infection & osteomyelitis in immunocompromised </li></ul>
  33. 33. Oral Polio Vaccine (OPV) <ul><li>Given at 2,4,6 months </li></ul><ul><li>Minimum age: 6 weeks </li></ul><ul><li>1 st booster: 1 year after the primary dose </li></ul><ul><li>2 nd booster: 4-6 years </li></ul><ul><li>Dose: 0.5 ml orally for single dose preparation or 2 drops for multiple dose preparation </li></ul><ul><li>Lifelong immunity with >90% efficacy </li></ul><ul><li>Possible reaction: paralytic polio -extremely rare </li></ul><ul><li>Advantage over IPV: ease of administration and better intestinal immunity conferment </li></ul>
  34. 34. Measles Vaccine <ul><li>Live attenuated virus </li></ul><ul><li>Given at 9 months or later ; maybe given as early as 6 months </li></ul><ul><li>1 dose SQ </li></ul><ul><li>Booster : 2 nd dose given at 15mos. If 1 st dose given below 1 year </li></ul><ul><li>3 rd dose given at 5-12 years as part of MMR </li></ul><ul><li>95% efficacy with at least 12 years of immunity </li></ul><ul><li>Possible reaction: fever and rash 5-10 days after dose </li></ul>
  35. 35. Expanded Program of Immunization for Infants (EPI) 1 9 months 5) Measles vaccine 4 weeks 3 At birth 4) Hepa B vaccine 4 weeks 3 6 weeks 3) OPV 4 weeks 3 6 weeks 2) DPT 1 Birth or anytime after birth 1) BCG Minimum Interval Between Doses Number of Doses Minimum age at 1 st dose Vaccine
  36. 36. thAnks fOr listEning !

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