Immunization Schedule for Filipino children

1. Immunization Schedule for Filipino children

2. Objectives • To present the 2013 Immunization schedule for Filipino children with focus on • Minimum age for vaccination • Route of vaccination • Recommended schedule for vaccination

4. Philippine EPI BCG Hepatitis B Measles OPV DTwP Hib MMR RV PCV • Other recommended vaccines • are not part of the Philippine EPI but because of merit are advocated by the PPS, PIDSP, PFV DTaP IPV MMRV Td/Tdap Hepatitis A Varicella Influenza HPV • Vaccines for Special Groups Typhoid Meningococcal vaccine PCV/PPV Rabies

5. BCG • Given intradermally (ID) • BCG should be given at the earliest possible age after birth preferably within the first 2 months of life.

7. Hepatitis B Vaccine

8. In the EPI schedule, hepatitis B is given as monovalent hepatitis B vaccine at birth then subsequent doses are given at 6, 10, 14 weeks of age as combination vaccines containing DTwP/Hep B/Hib.

10. DTwP / DTaP

11. Td / Tdap

14. OPV / IPV

16. Hemophilus influenza b vaccine (HiB)

17. Rotavirus Vaccine

18. DOH ADMINISTRATIVE ORDER 2012-0157: Administration of Rotavirus vaccine

20. PCV / PPV

21. PCV (Pneumococcal Conjugate Vaccine)PPV (Pneumococcal Polysaccharide Vaccine) • The minimum age for pneumococcal conjugate vaccine (PCV) is 6 weeks. • Primary vaccination of PCV consists of 3 doses with an interval of at least 4 weeks between doses, plus a booster (at 12-15 mos of age) given 6 months after the 3rd dose. • Healthy children 2 to 5 years old who have no previous PCV vaccination may be given one dose of PCV 13 or 2 doses of PCV 10 at least 8 weeks apart. • Routine use of PCV is not recommended for healthy children aged ≥ 5 years. • For high risk children > 2 years of age, PPV is recommended after completing PCV series (refer to Vaccines for Special Groups). • For healthy children, no additional doses of PPV are needed if PCV series is completed.

22. Influenza Vaccine

23. Influenza vaccine dosing algorithm for children aged 6 months through 8 yearsAdvisory Committee on Immunization Practices United States, 2012-2013 influenza season

25. Measles

26. MMR

28. Varicella Vaccine

29. MMRV

30. Hepatitis A Vaccine

31. Human Papillomavirus Vaccine (HPV)

32. Vaccines for Special Groups • Not part of EPI or recommended vaccines but data support its use in certain conditions or populations

33. TyphoidVaccine

34. Meningococcal Vaccine • Tetravalent meningococcal (ACYW-135) conjugate vaccine (MCV4) given IM • Tetravalent meningococcal polysaccharide vaccine (MPSV4) given SC • Bivalent meningococcal polysaccharide A and C vaccine given IM/SC • Children aged 9 mos & above at high risk for invasive disease (persistent complement component deficiencies, anatomic/functional asplenia, HIV, travelers to or residents of areas where meningococcal disease is hyperendemic or epidemic, or belonging to a defined risk group during a community or institutional meningococcal outbreak,) should receive 2 doses of MCV4 given 2 months apart. • If MPSV4 or bivalent meningococcal polysaccharide A and C vaccine are used for high-risk individuals as the first dose, a second dose using MCV4 should be given 2 months later. • If the person remains at increased risk, an initial booster dose of MCV4 should be given 3 years after completing the primary series, with continued boosters at 5-year intervals after the initial booster dose. • Additional booster doses of MPSV4 or bivalent meningococcal polysaccharide A and C vaccine are not recommended.

35. PNEUMOCOCCAL VACCINES (PCV/PPV) • Given intramuscularly (IM) • For children > 2 years w/ the ff underlying medical conditions such as but not limited to anatomic/functional asplenia, chronic heart or lung disease, chronic renal failure or nephrotic syndrome, DM , cochlear implant, cerebral spinal leak, congenital immunodeficiency, HIV infection, & other immunocompromising condition resulting from disease or treatment of disease. • Children aged 24 to 71 months who were previously given 4 doses of PCV, give one dose of PPV at least 8 weeks after last dose of PCV • Children aged 24 to 71 months who were previously given 3 doses of PCV, give one dose of PCV 13 or if previously given less than 3 doses of PCV, give 2 doses of PCV 13 at least 8 weeks apart. This should be followed by one dose of PPV at least 8 weeks after the last dose of PCV. • Children aged 6 to 18 years with no previous doses or incomplete doses of PCV or previously given PPV, give a single dose of PCV 13, followed by one dose of PPV at least 8 weeks after last dose of PCV 13.

36. PNEUMOCOCCAL VACCINES (PCV/PPV) • A second dose of PPV is recommended 5 years after the first dose of PPV ONLY for those with • anatomic/functional asplenia, congenital immunodeficiency, HIV infection, chronic renal failure or nephrotic syndrome, malignancy, solid organ transplantation, and other diseases associated with immunosuppressive drugs or radiation therapy. No more than 2 PPV doses should be given.

37. Rabies Vaccine • The Anti-rabies Act of 2007 recommends routine rabies pre-exposure prophylaxis (PrEP) for children ages 5-14 years in areas where there is high incidence of rabies and animal bites (defined as more than twice the national average). • There are 2 recommended regimens for Pre-exposure Prophylaxis: • Intramuscular regimen: PVRV 0.5 ml or PCECV 1 ml given on days 0,7, 21 or 28. • Intradermal regimen: PVRV or PCECV 0.1 ml given on days 0, 7, 21 or 28 . • A repeat dose should be given if the vaccine is inadvertently given subcutaneously. • Rabies vaccine should never be given in the gluteal area since absorption is unpredictable. • Periodic booster doses in the absence of exposure are not recommended for the general population. • In the event of subsequent exposures, those who have completed 3 doses of pre-exposure prophylaxis, regardless of interval between re-exposure and last dose of the vaccine, will require only booster doses on day 0 and 3. Booster doses may be given IM (0.5 ml PVRV or 1 ml PCECV) or ID (0.1 ml PVRV or PCECV). There is no need to give rabies immune globulin