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| IMMUNIZATION
(VACCINATION) |
SCHEDULE:
The schedule
recommended by the Indian Academy of Pediatrics is as follows:
| AGE |
VACCINE |
| Birth-15 days |
BCG,
OPV – zero dose,
Hepatitis B Vaccine – 1 st dose. |
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| 6 weeks-8 weeks |
DPT – 1 st dose,
OPV – 1 st dose,
Hepatitis B Vaccine – 2 nd dose.
Hib vaccine – 1 st dose |
| 10 weeks - 12 weeks |
DPT – 2 nd dose,
OPV – 2 nd dose.
Hib vaccine – 2 nd dose |
| 14 weeks - 16 weeks |
DPT – 3 rd dose,
OPV – 3 rd dose
Hib vaccine – 3 rd dose |
| 6 months - 9 months |
Hepatitis B Vaccine – 3 rd dose
Measles vaccine. |
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| 15 months - 18 months |
MMR (Measles, Mumps, Rubella)
DPT – 1 st Booster dose,
OPV – 1 st Booster dose.
Hib vaccine - Booster |
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| 5 years |
DPT – 2 nd Booster,
OPV – 2 nd Booster. |
| 10 years |
TT (Tetanus Toxoid)–3 rd Booster dose,
Hepatitis B Vaccine – Booster dose. |
| 15 – 16 years |
TT – 4 th Booster dose. |
Other vaccines:
Typhoid vaccine: 2 years and above (Revaccinate after 3-4 years)
Varicella vaccine: Above 1 year
Hepatitis A vaccine: Above 1 year
Note: Though the gap recommended between first 3 OPV – DPT doses is 4 weeks, some recommend that the doses can be given even at intervals of 6-8 weeks.
DISEASES PREVENTED BY VACCINES:
| Vaccine |
Disease Prevented |
| BCG |
Tuberculosis. |
OPV
(Oral Polio Vaccine) |
Poliomyelitis. |
| DPT (Triple Vaccine) |
D: Diphtheria,
P: Pertussis (Whooping Cough),
T: Tetanus. |
| Hepatitis – B Vaccine |
Hepatitis – B |
| Measles Vaccine |
Measles |
| MMR Vaccine |
M: Mumps,
M: Measles,
R: Rubella (German Measles). |
| Hepatitis A vaccine |
Hepatitis A |
| Varicella vaccine |
Chickenpox |
| Hib vaccine |
H.influenza b infection |
| Typhoid vaccine |
Typhoid |
BCG
BCG is given on the left shoulder. Within 3 – 6 weeks (sometimes a few months) of giving BCG a small swelling/ redness appears at the site of injection. The swelling will soften and subsequently rupture discharging pus. This ulcer takes several weeks to heal, leaving behind a scar. The ulcer should be kept dry and cleaned with soap and water. No ointment/cream is required. There may be an associated swelling in the armpit or in some cases on the neck. It is nothing to be worried about, but if the swelling increases more than 1 cm in diameter or becomes red or soft or attached to the overlying skin, consult your doctor. This swelling may persist for months or years. If no reaction or mark is seen at BCG injection site after 3 months, consult your doctor. BCG significantly decreases the risk of tuberculous meningitis (Brain TB) and other widespread forms of tuberculosis.
OPV:
OPV given at the time of birth is called zero polio. Total 5 polio doses are given in the first year of life. Over and above that ‘pulses polio’ doses are administered at least twice a year (usually in winter) to all children below 5 years of age, irrespective of number and time of previous polio doses. Additional doses of polio may be given in a particular area if a case of polio is found in that area.
DPT:
After receiving the DPT injection, swelling and pain at the injection site and fever upto 72 hours is common. Paracetamol is given for 48 – 72 hours after DPT to reduce the severity of the effects. Applying ice wrapped in handkerchief over the injection site helps to reduce swelling and pain to some extent.
Measles:
Measles vaccine is usually without any side effects. However, fever, measles like rash, cough and cold are commonly seen post vaccination. These symptoms do not need any treatment except paracetamol to control the fever.
MMR:
Apart from side effects like those with measles vaccine, mumps like swelling of parotid and other salivary glands may be seen. However these are not the rule.
Typhoid:
Considering the high incidence of typhoid in our country, it would be worthwhile to administer this vaccine. Newer vaccines now available are administered as a single dose injection after two years of age. Boosters are necessary every 3 years. In a child more than 6 years old, an oral (capsule) preparation is available. This is given as a single capsule every alternate day for 3 doses. The oral vaccine also needs to be taken every 3 years for continued protection.
Hib Vaccine:
Hib infection usually leads to invasive disease like meningitis, epiglottitis, pneumonitis, cellulitis, arthritis, septicemia etc. Of the invasive H. influenzae infections in children, 99% are due to type b. For a child less than 6 months, 3 primary doses are necessary. The first dose can be given at 6 weeks along with OPV/DPT and subsequent 2 doses at 4 weeks interval along with subsequent OPV/DPT. One booster will be necessary between 15-18 months of age. For children between 6 months to 12 months: 2 primary doses at 4-8 weeks interval are given followed by a booster at 15-18 months of age. For children between 12-15 months only single primary dose is given followed by a booster at 15-18 months of age. If a child present beyond 15 months till 15 years of age, only one dose is given straight as the booster dose. It is usually not given after 5 years of age
Hepatitis A vaccine
Havirix for pediatric use has two schedules. First is 3 doses of 360 EU at 0, 1 and 6-12 months or 2 doses of 720 EU at 0 and 6 – 12 months. For adults, it is given as 720 EL. U at 0,1 and 6- 12 months or 1440 EU 2 doses at 0 and 6 – 12 months. Vaqta for pediatric use is given as 2 doses of 25 U at 0 and 6- 12 months and for adults 2 doses of 50 U at 0 and 6- 12 months. BIOVAC A is to be given as single dose subcutaneously after 1 year of age.
Varicella vaccine:
It is to be given subcutaneously over left arm or thigh. It is given at 12-15 months of age. It can be given as early as 9 months but the seroresponse is best after first year of life. In children <13 years, only one dose is required. In children> 13 years and adults, 2 doses are given at 6-8 weeks interval. Immuno-compromised patients need 2 doses irrespective of age.
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Last created on 23-02-2001
Last updated on 01-07-2006 |
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