Immunization Schedule

Immunization Basics - Shield Up, Little Champs!

• Vaccine Types: Live attenuated (BCG, OPV, Measles, MMR, Varicella, Yellow Fever), Killed/Inactivated (IPV, Rabies, Influenza, Pertussis), Toxoids (TT, Diphtheria), Subunit/Recombinant/Conjugate (Hep B, Hib, Pneumococcal, HPV).
• Cold Chain: System for storing & transporting vaccines at recommended temperatures.
  • Most heat sensitive: OPV (📌 Polio melts first!).
  • Freeze sensitive: DPT, TT, Hep B, IPV, Pneumococcal.
• Administration: Correct route, site, dose, schedule critical. Check VVM.

⭐ Cold chain temperature: +2°C to +8°C in Ice Lined Refrigerator (ILR). Deep freezer: -15°C to -25°C for OPV & Measles. Vaccines sensitive to heat: OPV, Measles, BCG, Yellow Fever. Vaccines sensitive to cold (freezing): DPT, TT, Hep B, IPV, Pentavalent, PCV, Rotavirus liquid.

NIS: First Year Feats - Tiny Jabs, Mighty Guards

• At Birth:
  • BCG (ID, LUA), OPV-0 (Oral), Hep B-Birth (IM, AL Thigh; within 24 hrs)
• 6 Weeks: (Min 4 wks interval for next doses)
  • OPV-1, RVV-1 (Oral)
  • Pentavalent-1, PCV-1 (IM, AL Thigh)
  • fIPV-1 (fractional ID, RUA)
• 10 Weeks:
  • OPV-2, RVV-2 (Oral)
  • Pentavalent-2 (IM, AL Thigh)
• 14 Weeks:
  • OPV-3, RVV-3 (Oral)
  • Pentavalent-3, PCV-2 (IM, AL Thigh)
  • fIPV-2 (fractional ID, RUA)
• 9-12 Months:
  • MR-1 (SC, RUA)
  • JE-1 (SC, LUA; endemic areas)
  • PCV Booster (IM, AL Thigh)

⭐ Pentavalent: Diphtheria, Pertussis, Tetanus (DPT), Hep B, Hib. Route: IM, Site: AL Thigh. Common Routes: BCG (ID, LUA), OPV/Rota (Oral), HepB/Penta/PCV (IM, AL Thigh), fIPV (ID, RUA), MR/JE (SC, RUA/LUA).

NIS: Toddler & School Shields - Boosters & Big Kid Vax

• Toddlers (16-24 Months):
  • DPT Booster 1 (IM): Diphtheria, Pertussis, Tetanus.
  • OPV Booster (Oral): Polio.
  • MR/MMR - 2nd dose (SC): Measles, Rubella (Mumps if MMR).
  • JE - 2nd dose (SC): Japanese Encephalitis (endemic areas).
  • Vitamin A (Oral): 2 lakh IU (2nd dose); then q6mo up to 5 yrs.
• School Entry (5-6 Years):
  • DPT Booster 2 (IM).
• Adolescents:
  • Td vaccine (IM) at 10 years.
  • Td vaccine (IM) at 16 years.

⭐ Td (Tetanus & adult Diphtheria) vaccine has reduced diphtheria antigen content compared to DPT, minimizing reactogenicity in older individuals.

Special Groups & Hiccups - Vax Variations & Watchouts

• Preterm: Full dose, chronological age. BCG if >2kg. Hep B at birth (HBsAg+ mother).
• Immunocompromised (HIV):
  • Live vaccines (MMR, Varicella) C/I if severe immunosuppression (CD4 <15%).
  • BCG C/I in HIV-infected infants.
• AEFI: Minor (paracetamol); Severe (rare) - Anaphylaxis (Adrenaline 0.01mg/kg).
• VVM: Discard if inner square darker. Cold chain: +2°C to +8°C.

⭐ Live vaccines (e.g., MMR, Varicella) are C/I in severe immunodeficiency (HIV with CD4 <15% or low age-specific counts).

High‑Yield Points - ⚡ Biggest Takeaways

• Birth doses: BCG, OPV-0, Hepatitis B-0.
• Primary series (6, 10, 14 wks): Pentavalent, OPV, Rotavirus.
• IPV: Two fractional doses at 6 & 14 weeks.
• PCV: 6, 14 weeks, with booster at 9-12 months.
• MR vaccine: 1st dose at 9-12 months, 2nd dose at 16-24 months.
• DPT & OPV boosters: At 16-24 months and 5-6 years.
• Td vaccine: Replaces TT at 10 & 16 years.