IMMUNIZATIO

N
 Specific defenses
Immunity

Active immunity Passive immunity

natural Transfer of maternal

Following clinical infection Antibodies Through placenta

Transfer of maternal
Following subclinical infection
Antibodies Through milk

acquired
Following vaccination Following administration of
Immunoglobulin or antiserum
 IMMUNIZING AGENTS
Immunizing agents

vaccines immunuglobulins antisera

 TYPES OF VACCINES
Live Live Killed Toxoids Cellular fraction Recombinant
vaccine Attenuated Inactivated vaccines vaccines
vaccines vaccines

Small BCG Typhoid Diphtheria Meningococcal Hepatitis B

pox Typhoid oral Cholera Tetanus polysaccharide vaccine
variola Plague Pertussis vaccine
vaccine Pneumococcal
Oral polio Plague
polysaccharide
Yellow fever Rabies vaccine
Measles Salk polio Hepatitis B
Mumps Intra- polypeptide vaccine
Rubella muscular
Intranasal influenza
Japanise
Influenza
encephalitis
Typhus
 CONTRAINDICATION TO
VACCINATION
Absolute Relative Not
Contraindication Contraindication Contraindication

Severe anaphylactic Immunosppresive Mild illness low

shock or allergic therapy (all live grade fever
reaction to previous vaccines) Current antibiotic
vaccine Egg allergy (MMR) therapy
Moderate to severe Recent infectious
illness fever disease exposure
Pregnancy (MMR, Positive PPD
OPV/IPV) Prematurity, except
other wise specified
NATIONAL IMMUNIZATION PROGRAM
(NIP) THE NATIONAL IMMUNIZATION
PROGRAM (NIP) CONSISTS OF THE
FOLLOWING ANTIGENS:

1. BCG vaccine, single dose given at birth

2. Monovalent Hepatitis B vaccine given at birth
3. DPT-Hib-Hep B vaccine, 3 doses given at 6-10-14 weeks of age
4. Oral Polio vaccine (OPV), 3 doses given at 6-10-14 weeks of age, a
single dose of Inactivated Polio vaccine (IPV) is given with the 3rd
dose of OPV at 14 weeks
5. Pneumococcal conjugate vaccine (PCV), 3 doses given at 6-10-14
weeks of age
6. Rotavirus vaccine given at a minimum age of 6 weeks with a
minimum interval of 4 weeks between doses. The last dose should be
administered not later than 32 weeks of age.
7. Measles containing vaccine (either monovalent measles vaccine
or MMR)
8. given at 9 months of age Measles-Mumps-Rubella (MMR) vaccine
given at 12 months of age
NATIONAL IMMUNIZATION PROGRAM
(NIP) THE NATIONAL IMMUNIZATION
PROGRAM (NIP) CONSISTS OF THE
FOLLOWING ANTIGENS:

A school based immunization program to provide

catch-up doses for school children and adolescents has
been established . Measles-Rubella (MR) and Tetanus-
Diphtheria (Td) vaccines are administered to Grade 1
and Grade 7 students enrolled in public schools
Human Papillomavirus (HPV) shall be given to female
children 9-10 years old at health facilities in priority
provinces. Quadrivalent HPV 2 doses are given at 0, 6
months.
BCG
Route: Intradermal (ID) @ Right deltoid or
Buttocks
Age: 1-2 months
Dose: <12 months 0.05 mL
>12 months 0.1 mL
What to expect: Induration, peau-de-
orange appearance (after 3-8 weeks)
BCG
Contraindications: hypersensitivity,
immunosuppression, active tuberculosis,
HIV infected patients
Adverse Reactions: abscess or ulcers at
site, axillary lymphadenopathy
BCG

Healthy infants & Children >2 months,

PPD should be done prior to BCG in the
following conditions:
Suspected congenital TB
Hx of close contact to known or
infectious cases of TB
Clinical findings of TB / CXR suggestive
of TB
5 mm induration is (+) in these individuals
 HEPATITIS B VACCINE
Route: Intramuscular (IM)
Age: 1st 12 hours of life, then 6, 10, & 14 wks
3rd dose: not given earlier than 24 wks
4th dose: preterms <2kg, 1st dose given
at birth
infants: 3rd dose given < 24 wks
Dose: 0.5 mL
 HEPATITIS B VACCINE
Contraindications: hypersensitivity to
yeast
Adverse Reactions: pain at injection site,
local redness, swelling and warmth
HEPATITIS B VACCINE
Given as monovalent vaccine at birth
Subsequent doses given as combination
vaccine (6, 10, 14 wks)
Mother is HBsAg (+): give HBV and
HBIG within 12 hours of life
HBIG: administered not later than 7 days
if not immediately available
DTP
Route: Intramuscular (IM)
Age: 6 wks of age minimum, interval of
4 weeks (6, 10, 14 wks)
If given <4 wks, may not be
effective due to immaturity of
immune response
Dose: 0.5 mL
DTP
Contraindications: hypersensitivity,
documented Arthus reaction prior to
tetanus vaccination
Adverse Reactions: fever, convulsions,
irritability, prolonged crying, localized
redness, pain at injection site, warmth
DTP

Arthus reaction
Type III sensitivity reaction
a local necrotic reaction that occurs when
an antigen is injected into the skin of a
person previously sensitized to it.
The preformed antibody combines with
the injected antigen causing a high local
concentration of immune complexes and
severe tissu damage
Described by French physiologist,
Nicholas Maurice Arthus
COLLINS DICTIONARY OF MEDICINE, 2004-2005
DTP
Pertussis component not recommended
after age 6 because of increased risk of
neuroparalytic reactions
Whole cell pertussis vaccine causes
neuroparalytic reaction
 HAEMOPHILUS INFLUENZA TYPE B
CONJUGATE VACCINE
Route: Intramuscular (IM)
Age: 6 wks of age minimum, interval of 4
weeks (6, 10, 14 wks)
If first dose is given 7-11 mos, 2nd
after 4 wks, & 3rd after 8 wks
Booster dose: 12-15 mos (6 mos
from 3rd dose)
HAEMOPHILUS INFLUENZA TYPE B
CONJUGATE VACCINE
Dose: 0.5 mL
Contraindications: hypersensitivity,
children <6 wks
Adverse reactions: fever 5-12 days after
vaccination, rashes
POLIOVIRUS VACCINE (OPV)
Route: Per Orem (PO)
Age: 6 wks of age minimum, interval of 4
weeks (6, 10, 14 wks)
EPI: administered together with
DTwP,- Hib- Hep B vaccines
Dose: 2-3 drops
POLIOVIRUS VACCINE (OPV)
Contraindications: Immunosuppression
Adverse reactions: Vaccine-associated
paralytic poliomyelitis (1 in 2.6 M cases),
diarrhea, vomiting, fever
POLIOVIRUS VACCINE (IPV)
Route: Intramuscular (IM)
Age: 6 wks of age, minimum interval of
4 weeks (6, 10, 14 wks)
EPI: administered together with DTwP,-
Hib- Hep B vaccines
Final dose: on or after 4th birthday and at
least 6 months from previous dose
POLIOVIRUS VACCINE (IPV)
Dosage: 0.5 mL
Contraindications: hypersensitivity to
neomycin, streptomycin, polymixin B,
acute febrile illness, immunosuppressed
states
Adverse reactions: fever, pain or
tenderness at injection site, swelling
POLIOVIRUS VACCINE (IPV)
For children who are given OPV series:
Single dose of IPV should be given with
the third dose of OPV
The final dose should be on or after the
4th birthday and at least 6 mos from
previous dose
POLIOVIRUS VACCINE (IPV)
IPV is given in these situations:
persons with compromised immunity
household contacts of
immunodeficient individuals
unimmunized adults at future risk of
exposure
individuals refusing OPV immunization
MEASLES VACCINE
Route: Subcutaneous (SC)
Age: 9 months
Dose: 0.5 mL
May be given as early as 6 months in
cases of outbreaks
MEASLES VACCINE
Contraindications: pregnancy,
hypersensitivity to eggs, neomycin,
gelatin, immunosuppression
Adverse reactions: fever 5-12 days after
vaccination, rash
MMR VACCINE
Route: Subcutaneous (SC)
Age: 12 months
2 doses are recommended
2nd dose: 4-6 years, but given earlier
provided the interval between doses is
at least 4 weeks
EPI: 2nd dose is given to public school
students aged 13 yrs old
MMR VACCINE
Dose: 0.5 mL
Contraindications: pregnancy, allergy to
neomycin, immunosuppression
Adverse reactions: pain at injection site,
local redness, warmth, and swelling,
fever
FULLY IMMUNIZED CHILD
VACCINE # of
Doses
at birth /
before
BCG 1
reaching 12
mos
4 wks
DPT 3 doses interval each
dose
4 wks
OPV 3 doses interval each
dose
4 wks
Hepatitis B 3 doses interval each
dose
Measles 1 dose 9-12 mos
ROTAVIRUS VACCINE
Route: Per Orem (PO)
Age: 6 wks of age, minimum interval of 4
weeks
Dose: 2 mL
Monovalent human rotavirus: 2-dose series
Pentavalent human bovine rotavirus: 3-
dose series
Last dose not later than 32 wks
ROTAVIRUS VACCINE
Contraindications: immunosuppression,
hypersensitivity, history of
intussusception
Adverse reactions: fever, diarrhea,
vomiting
INFLUENZA VACCINE
Trivalent influenza vaccine given intramuscularly (IM)
or subcutaneously (SC)
Quadrivalent influenza vaccine given intramuscularly
(IM)
Given at a minimum age of 6 months
The dose of influenza vaccine is 0.25 ml for children 6
months to 35 months and 0.5 ml for children 36
months to 18 years
INFLUENZA VACCINE
Children 6 to 8 years receiving influenza vaccine for
the first time should receive 2 doses separated by at
least 4 weeks. If only one dose was given during the
previous influenza season, give 2 doses of the vaccine
then 1 dose yearly thereafter.
Children aged 9 to 18 years should receive 1 dose of
the vaccine yearly
Annual vaccination should begin in February but may
be given throughout the year.
JAPANESE ENCEPHALITIS
VACCINE (JE)
Given at a minimum age of 9 months

Children 9 months to 17 years of age should receive one

primary dose followed by a booster dose 12-24 months
after the primary dose

Individuals 18 years and older should receive a single

dose only
VARICELLA VACCINE
Route: Subcutaneous (SC)
Age: 12 months
1st dose is given at 12-15 mos
2nd dose given at 4-6 years or earlier
provided the interval between 1st and 2nd
dose is at least 3 months
VARICELLA VACCINE
Dose: 0.5 mL
Contraindications: pregnancy,
hypersensitivity to eggs, neomycin,
gelatin, immunosuppression
Adverse reactions: pain at injection site,
local redness, warmth, and swelling,
fever
PNEUMOCOCCAL VACCINE
Route: Intramuscular (IM)
Age: 6 wks (PCV)/2 yrs (PPV)
Given 3 doses separated by 4-week
intervals
Booster 6 months after 3rd dose
PPV: given for high risk children > 2 yrs
after completing the PCV series
PNEUMOCOCCAL VACCINE
Dose: 0.5 mL
Contraindications: hypersensitivity to
tetanus toxoid
Adverse reactions: fever, irritability,
tenderness, redness, swelling at
injection site
HEPATITIS A

Given intramuscularly

Recommended for all children >12 years

2nd dose: 6-12 months after the 1st dose

SOURCES
Textbook of Pediatrics and Health del Mundo
Textbook of Pediatrics Nelsons 17th edition
European Center for Disease Prevention and Control.
Shortage of acellular pertussis containing vaccines and impact
on immunization programmes in the EU/EEA- 8 October 2015.
Stockholm :ECDC;2105
National Center for immunization and Respiratory Diseases,
US CDC, December 2015 3. PIDSP/PFV/PPS Childhood
Immunization Schedule 2015
THANK YOU.