Recommendations on IAP
Immunization Time Table for 2012
December 24th, 25th 2011
Meeting of IAPCOI, ITC Maratha, Mumbai
Vipin M. Vashishtha, MD, FIAP
Convener, IAPCOI 2011-13
vipinipsita@gmail.com
• Immunization schedules ought to be dynamic
& adaptable to ongoing epidemiological
changes & rapid developments in vaccine
sciences
Existing IAP Immunization Schedules
IAP recommended vaccines (2011)
I. IAP Immunization Time Table 2011
Footnotes:
• OPV alone if IPV cannot be given
• *# Rotavirus vaccine (2/3 doses depending on the brand at 4-8
weeks interval)
• ** The third dose of Hepatitis B can be given at 6 months
• $ The second dose of MMR vaccine can be given at any time 4-8
weeks after the first dose
• $ $ Varicella (2nd dose may be given any time 3 months after the
1st dose)
• # Typhoid revaccination every 3 years
• & Tdap preferred to Td, followed by repeat Td every 10 years
• ^ Only females, three doses at 0, 1-2 (depending on brands) and 6
months
II. IAP Immunization Schedule for
adolescents
• IAP recommended vaccines for Adolescents
(10 Years to 18 Years)
• IAP Recommendations for Catch up
Immunization in Adolescents
• IAP Recommendations for Adolescent
Immunization in Special Circumstances
• IAP Recommandations for Adolescents
traveller
IAP recommended vaccines for
Adolescents (10 Years to 18 Years)
IAP Recommendations for Catch up
Immunization in Adolescents
IAP Recommendations for Adolescent
Immunization in Special
Circumstances
IAP Recommandations for
Adolescents traveller
What changes are needed?
• Need to have separate schedules
• Need to consolidate footnotes
• Need to revise recommendations pertaining
to individual vaccines
The CDC style timetables:
•
•
•
•
Three schedules
0 through 6 years
7 through 18 years
“Catch-up”
– 4 months through 6 years
– 7 through 18 years
• Each schedule should have separate
footnotes
I. Recommended Immunization Schedule for Persons
Aged 0 Through 6 Years—United States 2011
II. Recommended Immunization Schedule for Persons
Aged 7 Through 18 Years—United States 2011
Changes to Individual vaccine
recommendations:
Hepatitis B vaccine (HepB)
CDC new guidelines for Hep-B
schedule:
• For infants born to HBsAg-positive mothers:
• Administer HepB vaccine + 0.5 mL of
hepatitis B immune globulin (HBIG) within 12
hours of birth.
• These infants should be tested for HBsAg and
antibody to HBsAg 1 to 2 months after
receiving the last dose of the series.
http://www.cdc.gov/vaccines/recs/acip/downloads/mtg-slides-oct11/ChildAdolescent-Immunization.pdf
Hep-B
• If mother’s HBsAg status is unknown:
• Infants weighing ≥ 2000 grams: within 12 hours
of birth administer HepB vaccine
• Infants weighing < 2000 grams: within 12 hours
of birth administer Hep B vacccine + HBIG
• Determine mother’s HBsAg status as soon as
possible and, if HBsAg-positive, administer HBIG
for infants weighing ≥ 2000 grams (no later than
age 1 week).
http://www.cdc.gov/vaccines/recs/acip/downloads/mtg-slides-oct11/ChildAdolescent-Immunization.pdf
Hep-B
• Infants who did not receive a birth dose
should receive 3 doses of a HepB-containing
vaccine starting as soon as feasible
http://www.cdc.gov/vaccines/recs/acip/downloads/mtg-slides-oct11/ChildAdolescent-Immunization.pdf
Hep-B
•
•
•
•
The minimum interval between doses:
1 and dose 2: 4 weeks
Between dose 2 and 3: 8 weeks
The final (3rd or 4th) dose in the HepB series
should be administered no earlier than age
24 weeks, and at least 16 weeks after the 1st
dose.
http://www.cdc.gov/vaccines/recs/acip/downloads/mtg-slides-oct11/ChildAdolescent-Immunization.pdf
Suggested modification:
• IAPCOI schedule:
• Three doses at:
• Birth, 6 weeks, & 6 months
Tdap vaccine:
• CDC recommended use during pregnancy
Hib vaccines:
• Hib vaccine should be considered for
unvaccinated persons aged 5 years or older
who have sickle cell disease, leukemia, or HIV
infection, or who have had a splenectomy.
PCV:
Discussion & Vote: