Immunizations

 

Birth:

Hep B #1

2 months:

Hep B #2

DTaP #1

Hib #1

IPV #1

PCV #1

4 months:

DTaP #2

Hib #2

IPV #2

PCV #2

 

6 months:

Hep B #3

DTaP #3

Hib #3 (if required)

IPV #3

PCV #3

influenza

12 months:

Hib #4

MMR #1

Varicella

PCV #4

 

15-18 months:

DTaP #4

 

2 years:

PPV (pneumococcal)

Hep A

4-6 years:

IPV #4

DTaP #5

MMR #2

11-12 years:

Td booster

 

Hepatitis B:

Administration: 3 shots give at birth, 2-4 months, and 6-18 months

Type of vaccine: recombinant of Hep B surface antigen

Notable Side Effects: fever, local reaction; not SIDS or MS

Fun Facts: if mother is HBsAg +, give Hep B immunoglobulin at birth in a separate location than the Hep B vaccination. Test infant for HbsAg and anti-HBs at age 9-15 months.

 

Diphtheria:

Administration: 3 primary doses at 2 months, 4 months and 6 months (given with tetanus and pertussis -- DTaP). 2 booster doses at 12-18 months and 4-6 years (DTaP). Booster at age 11 and every ten years thereafter (given with tetanus only -- dT).

Type of vaccine: denatured toxoid protein

Notable Side Effects:

Fun Facts: immunization creates antibodies against the exotoxin to block the cardiac and neurologic effects but does not protect against the organism itself

 

Tetanus:

Administration: 3 primary doses at 2 months, 4 months and 6 months (given with diphtheria and pertussis -- DTaP). 2 booster doses at 12-18 months and 4-6 years (DTaP). Booster at age 11 and every ten years thereafter (given with diphtheria only -- dT).

Type of vaccine: denatured toxoid protein

Notable Side Effects: soreness in injection site, Guillain-Barre and brachial neuritis occur rarely.

Fun Facts: immunization creates antibodies against the exotoxin to block effects but does not protect against the organism itself

 

Pertussis:

Administration: 3 primary doses at 2 months, 4 months and 6 months (given with diphtheria and tetanus -- DTaP). 2 booster doses at 12-18 months and 4-6 years (DTaP).

Type of vaccine: acellular – just antigenic proteins

Notable Side Effects: fevers, prolonged crying, hypotonic-hyporesponsive episodes, and seizures have occurred, but are much rarer now that the whole cell preparation is not used.

Fun Facts: the whole cell version caused more serious side effects and thus is not used now

 

Polio: (IPV)

Administration: 4 doses at 2, 4, 6-15 months and at 4-6 years.

Type of vaccine: denatured proteins from the three variants of polio

Notable Side Effects:

Fun Facts: injection (used in the US) has no risk of paralytic poliomyelitis but does not protect against gut infections; oral vaccine (attenuated virus – one that evolved to be less dangerous) is still used in areas with endemic polio

 

Haemophilus influenza Type b: (Hib)

Administration: 2 or 3 primary doses at 2, 4 and (if necessary given brand used) 6 months; 1 booster given at 12-15 months

Type of vaccine: conjugate – the capsular polysaccharide polyribosylribitol phosphate (the virulence factor) is joined to a protein that will excite the infant’s immune system; brands differ by what immunogenic protein is used

Notable Side Effects:

Fun Facts: don’t give to infants younger than 6 weeks or else they may become tolerant – quite contrary to the goal of vaccination

 

Measles, Mumps, Rubella: (MMR)

Administration: 1 primary dose at age 12-15 months; 1 booster at 4-6 years

Type of vaccine: attenuated versions of all three viri

Notable Side Effects: transient rash and thrombocytopenia, unproven rare association with encephalitis, rare reports of orchitis/paroditis from mumps and arthritis/arthalgias from rubella, association with autism have been conclusively disproved

Fun Facts: previous version of measles vaccine used killed virus that could lead to atypical measles when exposed to wild-type

 

Varicella:

Administration: single does for 12 years or younger, two doses if 13 or older

Type of vaccine: attenuated virus

Notable Side Effects: localized varicella rash is possible

Fun Facts: “breakthrough” chicken pox is possible but course is much less severe than in unimmunized patients

 

Pneumococcal: (PCV, PPV)

Administration: PCV given in 4 doses – 2, 4, 6 and 12-15 months

Type of vaccine: PCV is conjugate of capsular polysaccharides of seven strains

Notable Side Effects: febrile seizures

Fun Facts: number of doses in series decreases if given later in life: only 3 if first given after 7 months, and 2 if first given after 12 months. After age 2, the nonconjugated pneumococcal vaccine (PPV – 23 viral variants) can be given as a single shot.

 

Hepatitis A:

Administration: primary dose after age 2 followed by booster within 6-12 months

Type of vaccine: killed virus

Notable Side Effects:

Fun Facts: only required in some states with higher levels of Hep A (not Ohio)

 

Influenza:

Administration: two doses separated by one month if <9 years of age; must be given yearly; recommended for those age 6-23 months, >50 years, immunosuppressed, at risk for pulmonary infections, health care workers

Type of vaccine: purified surface antigens of the three most likely flu bugs of the year, as determined by the CDC

Notable Side Effects: Guillain-Barre – seen only in adults

Fun Facts: nasal spray is available but only approved for use in age 5-49

 

 

Commercial names and combination vaccines:

RecombivaxHB: Hepatitis B

Engerix-B: Hepatitis B

Comvax: Hepatitis B and H. flu Type B

Twinrix: Hepatitis A and Hepatitis B

Pediarix: DTaP, Hepatitis B and inactivated polio (IPV)

Tripedia: DTaP

Infanrix: DTaP

Daptacel: DTaP

Prevnar: conjugated pneumococcal (heptavalent)

Pneumovax 23: nonconjugated pneumococcal (23 valent)

Varivax: varicella

FluMist: influenza nasal spray

 

Attenuated live virus vaccines that are not to be given to immunocompromised or pregnant patients: MMR, varicella