ROUT

VACCINE RANGE OF RECOMMENDED AGE DOSAGE

E
<12 mos old = 0.05mL
BCG 0 - 2 weeks old ID
>12 mos old = 0.1mL
0 - 2 weeks old

as part of Pentavalent vaccine:

1 mo - 2 mos,
<18 yrs old = 0.5mL
HEP B 2 mos 1/2 - 4 mos, IM
>18 yrs old = 1mL
3 mos 1/2 - 1 yr

Catch-up immunization
1 yr - 18 yrs
1 mo1/2 - 2 mos,
2 mos 1/2 - 4 mos,
3 mos 1/2 - 6 mos,
DTwP/DTaP 0.5mL IM
1 yr - 1.5 yrs old (DTaP-IPV-Hib),
4 yrs - 6 yrs (DTaP-IPV),
7 yrs - 18 yrs (Tdap/Td)
1 mo 1/2 - 2 mos,
Hib 2 mos 1/2 - 4 mos, 0.5mL IM
3 mos 1/2 - 6 mos
1 mo1/2 - 2 mos, OPV =
2 mos 1/2 - 4 mos, OPV = 2 drops (0.1mL) PO
OPV/IPV
3 mos 1/2 - 6 mos IPV = 0.5mL IPV =
IPV: 1 yr - 1 yr 1/2, 4 yrs - 6 yrs IM
1 mo1/2 - 2 mos,
2 mos 1/2 - 4 mos,
3 mos 1/2 - 6 mos
PCV 1 yr - 1.25 yrs old 0.5mL IM

Catch-up immunization
1.25 yrs old - 5 yrs
9 mos (measles only),
1 yr - 1.25 yrs, 1.3 - 6 yrs (MMR)
(can be given as early as 6 mos)
MMR 0.5mL SC
Catch-up immunization:
6 yrs - 18 yrs
JEV 9 mos - 18 yrs 0.5mL IM
HPV 9 yrs - 18 yrs 0.5mL IM
Rotarix: 1mL
Rotavirus 1 mo 1/2 - 8 mos PO
Rotateq: 2mL
Influenza Starting 6 mos; annually 0.5mL IM
1 yr - 1.25 yrs, 1.4 yrs - 6 yrs
Varicella 0.5mL SC
Catch-up immunization:
6 yrs - 18 yrs
1 yr - 2 yrs
<18 yrs old = 0.5mL
Hep A IM
Catch-up immunization: >18 yrs old = 1mL
2 yrs - 18 yrs
MCV4-D: minimum age is 9 mos
For 9mos-1 yr 9 mos: give doses 2 months apart
For 2 yrs & above: give 1 dose except in cases of
asplenia, HIV, and persistent complement deficiency
where 2 doses, 8 weeks apart are recommended

MCV4-TT: given to children 1 yr and above as a

Meningococca
single dose 0.5mL IM
l
MCV4-CRM: given to children 2 yrs and above as a
single dose

Revaccinate with a MCV4 vaccine every 5 years as

long as the person remains at increased risk of
infection
IM: 0.5mL Purified Vero Cell
Rabies
Dose 1: as appropriate
1mL Purified Chick Embryo Cell
Rabies Dose 2: 7 days after dose 1 IM/ID
Vaccine
Dose 3: 21 days or 28 days after dose 2
ID: 0.1 mL PVRV or PCECV
Minimum age: 2 yrs old with revaccination every 2-3
yrs
Typhoid 0.5mL IM
Travelers to areas where there is a risk for exposure
and for outbreak situations
Cholera Minimum age: 1 yr PO
LIVE ATTENUATED VACCINES:
- BCG, Cholera, Typhoid, Hep A, JEV, Influenza, MMR, OPV, Smallpox & Yellow fever

KLLED/INACTIVATED VACCINES:
- Hep B, Diphtheria toxoid, Tetanus toxoid, Pertussis, IPV, PCV, Rabies, Cholera, Typhoid, HPV, Influenza,
Meningococcal, Tick-borne encephalitis

WHY CAN’T YOU GIVE ROTAVIRUS VACCINE BEYOND 8 MONTHS OLD?

Because theoretically, there is an increased risk for Intussuception (SAGE Trial)

SYMPTOMS OF VA CCINE REACTIONS (source: seattlechildren.org)

1. Local reactions - shot sites can have swelling, redness & pain. Most often, these symptoms start within 24Hrs of the
shot. They most often lasts 3-5 days, can last up to a week
2. Fever - begin within 24Hrs & lasts 1-2 days
3. Delayed Reactions - with MMR and Varicella vaccine shots, fever & rash can occur. These symptoms start later and
usually begin between 1-4 weeks
4. Anaphylaxis - severe allergic reactions are very rare, but can occur with any vaccine; start within 2Hrs

TIMING AND SPACING OF VACCINES

GENERAL RULE: Inactivated vaccines are generally not affected by circulating antibody to the antigen. Live-attenuated
vaccines may be affected by circulating antibody to the antigen.

SIMULTANEOUS & NONSIMULTANEOUS ADMINISTRATION

GENERAL RULE: All vaccines can be administered at the same visit as all other vaccines

INTERVAL BETWEEN DOSES OF THE SAME VACCINE

Increasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine.
Decreasing the interval between doses of a multi-dose vaccine may interfere with antibody response & protection

CAN YOU GIVE TWO DIFFERENT VACCINES IN THE SAME SITE? (source: cdc website)
Multiple Injections
If multiple vaccines are administered at a single visit, administer each preparation at a different anatomic site. The
location of all injection sites with the corresponding vaccine injected should be documented in each patient’s medical
record. Health-care practices should consider using a vaccination site map so that all persons administering vaccines
routinely use a particular anatomic site for each particular vaccine.

For infants and younger children, if more than 2 vaccines are injected in a single limb, the thigh is the preferred site
because of the greater muscle mass; the injections should be sufficiently separated (separate anatomic sites [i.e. ≥1 inch]
if possible) so that any local reactions can be differentiated. For older children and adults, the deltoid muscle can be used
for more than one intramuscular injection.

If a vaccine and an immune globulin preparation are administered simultaneously (e.g., Td/Tdap and tetanus immune
globulin [TIG], hepatitis B and hepatitis B immunoglobulin [HBIG]), separate limbs should be used for each injection