3. VACCINE WHEN TO GIVE MAX.AGE DOSE ROUTE SITE
BCG At birth Till 1 yr
0.1ml (0.05 ml
till 1 mth)
Intra-dermal L. Upper arm
Hepatitis B At birth In 24 hrs 0.5ml I.M.
Anterolateral aspect
of L. Mid thigh
OPV₀ At birth In 1st 15 days 2 drops Oral
OPV₁₂₃ At 6,10, 14w Till 5 yrs 2 drops Oral
Rota virus vaccine 6, 10, 14w Till 1 yr 5 drops Oral
IPV 14w Upto 1 yr 0.5ml i.m.
Anterolateral aspect
of R. mid thigh
Pentavac₁₂₃ 6, 10,14w Till 1 yr 0.5ml I.M.
Anterolateral aspect
of l. Mid thigh
Measles ₁ 9-12 months Till 5 yrs 0.5ml S.C. R. Upper arm
Japanese
encephalitis
9-12 months Till 15 yrs 0.5ml s.c. L. Upper arm
Vitamin A 9 compltd mths Till 5 yrs 1 lakh IU Oral
5. VACCINES WHEN TO GIVE MAX. AGE DOSE ROUTE SITE
DPT booster 16-24 months 7 yrs 0.5 ml I.M.
Anterolateral
aspect of l. Mid
thigh
Measles 2nd 16-24months Till 5 yrs 0.5 ml s.c. R. Upper arm
OPV booster 16-24 months Til 5 yrs 2 drops Oral
Japanese
encephalitis
16-24 months 0.5 ml s.c. L. Upper arm
Vitamin A 2nd -
9th dose
16 months.1
dose every 6 m
Till 5 yrs 2 lakh IU Oral
DPT 2nd booster 5-6 yrs 7yrs 0.5 ml i.m. l. Upper arm
TT 10 & 16 yrs 0.5ml i.m. Upper arm
8. Age Vaccines
18 months Hep-A₂
2 years Booster of typhoid conjugate
4-6 years
DTwP B2/DTaP B₂ , OPV₃ , Varicella 2 ,
MMR₃
10-12 years HPV
9. COMMONLY USED VACCINES
BCG VACCINE
• Dose, Route
• Site
• Adverse reactions
• Contraindication
• Storage
‒ 0.1ml, intradermal
‒ Left upper arm at insertion of deltoid
‒ Local ulceration or discharging sinus, axillary
lymphadenitis, disseminated infection, osteomyelitis.
‒ Cellular immunodeficiency, symptomatic HIV
‒ 2-8°C; sensitive to heat & light; discard unused
vaccine after 4 hr
10. • 2-3w after correct intradermal inj. of potent vaccine, paule develops at
the site .
• Slowly increases in size (diameter=4-8mm in 5w)
• Subside or breaks into shallow ulcer, usually covered by crust.
• Healing: spontaneous, within 6-12w leaving permanent, tiny, round scar of
4-8mm.
• Patient becomes mantoux positive in 8w.
11. POLIOMYELITIS
OPV
• Dose, Route
• Adverse reactions
• Contraindications
• Storage
‒ 2 drops; oral
‒ Vaccine derived polio virus, VAPP
‒ Inherited or acquired immunodeficiency,
symptomatic HIV
‒ 2-8˚C ; sensitive to heat ; use vaccine vial
monitor
12. IPV
• Dose, Route
• Adverse reactions
• Contraindication
• Storage
‒ 0.5ml; i.m. or s.c.
‒ Local pain, swelling
‒ Known allergy
‒ 2-8˚C sensitive to light
13. Diphtheria Toxoid, Tetanus Toxoid & Killed Whole Cell Pertussis or
Acellular Pertussis Vaccine
• Dose , Route
• Site
• Adverse
reactions
• Contraindication
‒ 0.5ml; i.m.
‒ Anterolateral aspect of mid thigh
‒ Local pain, swelling, fever
‒ Progressive neurological disease, anaphylaxis after
previous dose , encephalopathy within 7 days of
previous dose
14. • Precautions
• Storage
‒ Previous dose associated with
(i) fever >40.5˚C within 48hr
(ii) collapse within 48hr
(iii) persistent inconsolable crying for more than 3hr
within 48hr
(iv) seizures within 72hr
‒ 2-8ºC ; sensitive to light
15. MEASLES VACCINE
• Dose, route
• Site
• Adverse reactions
• Contraindications
• Storage
‒ 0.5ml, sc
‒ Right upper arm or anterolateral thigh
‒ Fever, transient macular rash 5-10 days later.
‒ (i) immunosuppressive therapy eg:alkylating
agents, high dose corticosteroids (ii) malignancy
(iii) immunodeficiency eg: advanced HIV (iv)
untreated TB
‒ 2-8°C;sensitive to heat and light; use within 4-6
hrs of reconstitution
16. MMR VACCINE
• Dose, route
• Site
• Adverse reactions
• Contraindications
• Storage
‒ 0.5ml;s.c.
‒ Right upper arm or anterolateral thigh
‒ Fever, transient rash, arthralgia, aseptic meningitis,
lymphadenopathy
‒ (i) immunosuppressive therapy eg: alkylating
agents, high dose corticosteroids (ii) malignancy
(iii) severe immunodeficiency eg: advanced HIV
(iv) untreated TB
‒ 2-8ºC;sensitive to heat and light; use within 4-6 hrs
of reconstitutional
17. HEPATITIS B VACCINE
• Dose, route
• Site
• Schedule
IAP 2012
‒ 0.5ML, i.m.
‒ Anterolateral thigh; avoid gluteal region
‒ At birth, 6 weeks & 6 months; may give 3-4 doses in
an alternative schedule while ensuring that
‒ Doses 1& 2 are ≥4weeks apart
‒ Doses 2&3 are≥8weeks apart
‒ Final dose is at ≥6mo of age &≥16weeks beyond
1st dose
18. • Catch up
• Adverse reactions
• Contraindications
• storage
‒ Complete 3 doses series; 2nd dose is given
≥4weeks & 3rd dose ≥8weeks after previous dose
‒ Local soreness, fever, fatigue
‒ Anaphylaxis after previous dose
‒ 2-8˚c ;do not freeze
19. VARICELLA VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Catch up
‒ 0.5ml s.c.
‒ Anterolateral thigh or upper arm
‒ Not included
‒ 2 doses at 15-18mo & 4-6yr; 2nd dose maybe
given >3mo after 1st dose
‒ Complete 2 dose series with minimum interval of
3mo between the doses
20. • Adverse reactions
• Contraindications
• Storage
‒ Fever , rash, local pain or redness
‒ Anaphylaxis after previous dose, lymphopenia,
immunodeficiency ,during immunosuppressive
therapy
‒ 2-8ºC; protect from light; use within 3omin of
reconstitution.
21. TYPHOID VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
Catch up
• Adverse reactions
• Contraindications
• Storage
‒ 0.5ml, sc or i.m.
‒ Anterolateral thigh
‒ Not included
‒ 1 dose at 2yr ; repeat every 3yr
‒ 1 dose beyond 2yr
‒ Local pain, swelling, redness, fever
‒ Anaphylaxis after previous dose
‒ 2-8˚c ;do not freeze
22. HEPATITIS A VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Catch up
‒ 0.5ml; i.m.
‒ Deltoid
‒ Not included
‒ 2 doses beyond 1yr of age given 6 months apart
‒ Complete 2dose series with interval of ≥6mo;
if≥10 yr old, screen for HAV antibody 1st,
administer vaccine only if seronegative; use adult
vaccine if≥ 13yr old.
23. • Adverse reactions
• Contraindications
• Storage
‒ Local pain, nausea, anorexia, malaise
‒ Anaphylaxis after previous dose
‒ 2-8ºC;protect from light; use within 3omin of
reconstitution.
24. ROTAVIRUS VACCINE
• Dose, route
• Schedule
National program
IAP 2012
‒ RV1: 1ml (lyophilized) or 1.5ml(liquid) ;
RV5: 2ml(liquid);oral
‒ Not included
‒ RV1: 2doses; RV5: 3 doses; at 6-14 weeks ≥ 4weeks
apart; maximum age <15weeks for the 1st dose &
<8mo for the final dose; do not begin schedule
at≥15weeks
25. • Adverse reactions
• Contraindications
• Precaution
• storage
‒ Intussusception
‒ Past history of intussusception; severe
immunodeficiency
‒ Postpone vaccination during ongoing diarrhoea
or moderate illness
‒ 2-8˚c ;do not freeze; protect from light; use
immediately after reconstitution or opening
26. HAEMOPHILUS INFLUENZA B VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Catch up
‒ 0.5 ml; i.m.
‒ Anterolateral thigh
‒ Introduced in some states as pentavalent vaccine with
DPT & hepatitis B
‒ 3 doses at ≥6 weeks given≥ 4 weeks apart; 1 booster at
15-18 mo
‒ At 6-12mo:2doses≥ 8weeks apart with 1 booster at 15-
18 mo; at 12-15mo: 1 dose and 1 booster at 15-18 mo;
15-60 mo:1 dose ; not recommended > 5yr old.
27. • Adverse reactions
• Contraindications
• storage
‒ Fever, rash, local pain or redness
‒ Hypersensitivity to previous dose
‒ 2-8˚c
28. PNEUMOCOCCAL VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
Catch up
‒ 0.5ml s.c./i.m.
‒ Anterolateral thigh
‒ Not included
‒ 3 doses at ≥ 6 weeks given ≥ 4 weeks apart and 1
booster at 15-18 mo;
‒ At 7-11 mo: 2doses ≥ 4 wks apart & one booster
dose at 15-18 mo; 12-23mo; 2 doses ≥ 8 wks
apart; 24-59 mo; one dose; >60 mo: one dose
only if in high risk category.
29. • Adverse reactions
• Contraindications
• storage
‒ fever, local pain, soreness, malaise.
‒ Anaphylaxis after previous dose
‒ 2-8˚C; do not freeze.
30. HPV VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Catch up
• Adverse reactions
• Contraindications
• storage
‒ 0.5ml; i.m.
‒ Upper arm (deltoid)
‒ Not included
‒ Girls 11-12 yr old
‒ HPV4: at 0, 2 & 6 mo;HPV2: 0, 1 & 6 mo
‒ Before initiation of sexual activity
‒ fever, local pain, erythema, swelling.
‒ Anaphylaxis after previous dose
‒ 2-8˚C; protect from light.
31. JAPANESE B ENCEPHALITIS VACCINE
• Dose, route
• Site
• Schedule
National Program
IAP 2012
Catch up
• Adverse reactions
‒ 0.5ml; s.c.
‒ Anterolateral thigh or upper arm
‒ Only in endemic areas; 1 dose at 9 mo.
‒ Only in endemic areas.
‒ 1 dose in susceptible children up to 15 yr old.
‒ Fever, malaise
32. INFLUENZA VACCINES
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Adverse reactions
• Contraindications
• storage
‒ 0.5ml; i.m.
‒ Anterolateral thigh or upper arm
‒ Not included
‒ Only in high risk categories; 1st time vaccination: 2
doses ≥ 4 wks apart if 6 mo-9 yr old and 1 dose if > 9
yr; annual revaccination with 1 dose; best
administered before rainy season
‒ Local pain, redness, anaphylaxis.
‒ Anaphylaxis after previous dose
‒ 2-8˚C; do not freeze.
33. MENINGOCOCCAL VACCINE
• Dose, route
• Site
• Schedule
National program
IAP 2012
• Adverse reactions
• Contraindications
• Storage
‒ 0.5 ml; s.c./i.m.
‒ Anterolateral thigh or upper arm
‒ Not included
‒ Single dose in high risk categories older than 2 yrs;
repeat after 3-5 yrs if required.
‒ Fever, local pain or redness
‒ Anaphylaxis after previous dose
‒ 2-8˚C; protect from light; use within 30 min of
reconstitution
34. Cold chain
• System for storage and transport of vaccines at low temperature from
manufacturer to the actual vaccination site.
• To prevent vaccine failure (sensitive to temperature).
• Potency of the vaccine decreases when exposed to inappropriate
temperatures.
• Heat sensitive vaccine: OPV > Influenza > IPV, MMR > Cholera,
Pentavac, Rotavirus > BCG, HPV > Hep B, Hib
35. Deep freezer:
•Temperature b/w -15° to -25°C.
•Used for storing OPV vaccine and for
freezing ice packs
Ice lined refrigerator:
•Temperature b/w +2° to +8°C.
•2 parts:
•upper part :DPT, TT, HepB, IPV &
pentavalent vaccines
•Lowe part: OPV, BCG, measles, JE