0 | BCG OPV0 Hep-B1 |
6wk | DTwP1/DTaP1 IPV1 (or bOPV1 and ID-fIPV1) Hep-B2 Hib1 Rotavirus 1 PCV1 |
10wk | DTwP2 Hepatitis B3 IPV2 (or bOPV2) Hib2 Rotavirus 2 PCV2 |
14wk | DTwP3 Hepatitis B4* IPV3 (or bOPV3 and ID-fIPV2) Hib3 Rotavirus 3 PCV3 |
6mo | Influenza TCV |
9mo | MMR1/MR |
12mo | Hep A1 |
15mo | MMR2 Varicella 1 PCV booster |
16- 18mo | DTwP B1/DTaP B1 IPVB1 (or bOPV B1) Hib B1 |
18mo | Hep A2, Varicella 2 |
4-6yr | DTwP B2/DTaP B2 IPV B2 MMRV or MMR3 +
|
9-12yr | Tdap/Td HPV |
Live attenuated | Killed |
BCG Oral Polio Measles MMR Chicken Pox Hepatitis A | Inactivated Diphtheria toxoid Tetanus toxoid Killed Whole cell pertussis Subunits Hib Hepatitis A, B Typhoid Meningococcal Influenza |
Rules:
Missed immunization- |
No restarting, No additional doses. |
Inactivated vaccines- |
Can give 2/more inactivated vaccines simultaneously / any interval c live vaccine. |
Live vaccines- |
should be given simultaneously / at-least 4 weeks apart. |
If a dose missed, subsequent immunization in next visit should be done for- |
DPT IPV Hib PCV Hepatitis-A,B HPV MMR Rota (follow upper age limit of last dose) |
schedule | @birth earliest opportunity | ✓ | |
Unvaccinated and TST/IGRA -ve (child to adulthood ) | High TB & Leprosy burden | ✓ | |
Moving to high burden area | ✓ | ||
Occupational hazard | ✓ | ||
pregnant | ✘ | ||
lactation | ✓ | ||
HIV+ Child | ART | ✓ | ✓ |
Immunologically stable (CD4>25% @5yrs age) | ✓ | ||
Mother HIV status unknown | ✓ | ||
Mother HIV+ | Child HIV status | ± | ✓ |
Clinical evidence in child | ✘ | ||
Mother PTB+ & Infant is asymptomatic | Preventive Rx completed | ✓ | ✓ |
Remains asymptomatic | ✓ | ||
Immunological evidence | ✘ | ||
HIV | ✘ | ||
Catchup | 0, 1mo, 6mo | ||||||
Workers | 0, 1mo, 6mo | ||||||
Hep B+ mother | |||||||
Ideal | HB-Ig | Ideally- within 12hr Atleast-by 7days Efficacy after 2days is ? | |||||
Vaccine | 0, 1mo, 6mo | ||||||
HB-Ig not available | Vaccine | 0, 1mo, 2mo b/w 9mo-12mo (HBsAg & anti HBsAg Ab b/w 9mo-15mo) | |||||
Preterm infants | |||||||
>2kg | like term babies | ||||||
<2kg | |||||||
HBsAg-mother | 1st dose- 30days age 2nd 3rd dose- like term baby schedule | ||||||
HBsAg+ Mother | HB-Ig & Vaccine @birth 4dose vaccine schedule starting from 4-6wks age | ||||||
Post exposure prophylaxis | |||||||
Vaccine | Response | HBsAg+ | HBsAg- | HBsAg ? Risk | |||
High | Low | ||||||
✘ | ✘ | HBIg HepB | HepB | HBIg HepB | HepB | ||
✓ | ✓ | - | - | - | - | ||
3doses | ✘ | HBIg HepB | - | HBIg HepB | HepB | ||
6 | ✘ | HBIg-2 | - | HBIg-2 | - | ||
3 | ? | antiHBs >10mIU/ml-Rx as responder <10- Rx as non responder | |||||
Catchup | |||||
Last dose >4yrs | No 2nd booster | ||||
<7 yrs | DTwP/DTaP 0,1mo,6mo | ||||
>7yrs | Tdap, Td, Td 0,1mo,6mo | ||||
Tetanus in wounds | |||||
Clean wound | Other wounds | ||||
Unknown unimmunised <3 doses Immunodeficient | Catchup | TIG | Catchup | TIG | |
≥3 doses
| <5yr | - | - | - | - |
>5yr | - | - | Td/Tdap | - | |
>10yr | Td/Tdap | - | Td/Tdap | - | |
Pregnancy | |||||
Unimmunised | Tdap/Td 2 doses 1 month apart at time of 1st ANC Tdap in every pregnancy (27-36wks) | ||||
Immunized | Tdap every pregnancy(27-36wks) | ||||
Catchup | Recommended upto 5yrs age | |
Primary | Booster | |
6-12mo | 2 ( 1months apart) | 1 (after 8wks of 2nd primary) |
12-15mo | 1 | 1 (@18mo) |
>15mo | 1 | - |
Catchup | Recommended upto 5 yrs of age | |
PCV 10 | PCV 13 | |
7-11mo | 2P+1B | 2P+1B |
(2P: 4wk apart & B: @2nd yr) | ||
12-23mo | 2P | 2P |
(8wks apart) | ||
24-59mo | 2P | 1P |
High risk group
| ||
PCV | ||
4doses | 1 PPSV 23 | After 2 yrs age After 8wks of last PCV |
3doses | 1 PCV 10/13 | |
<3doses | 2 PCV 10/13 | 8 wks apart |
0(6-18yr) | 1 PCV 10/13 | |
>5yrs Asplenia Immunocompromised | Additional 1 PPSV dose No more than 2 PPSV in life time. | |
Live vaccine (@ government centre only) SA 14-14-2 | 1st dose | @9mo along c MR/MMR |
2nd dose | @16-18mo along c DTP | |
JEEV (SA 14-14-2) inactivated | 1 - 2.11 yrs | 0.25ml 2 doses 4 weeks apart |
≥3 yrs | 0.5ml 2 doses 4 weeks apart | |
JENVAC Kolar strain inactivated | ≥ 1 yr | 0.5ml 2 doses 4 weeks apart |