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CHILDHOOD IMMUNISATION SCHEDULE from birth to 6 years of age VACCINE Birth 6w - 2m 3 - 4m 5 - 6m 6 - 7m 12m 12 - 15m 18m 19 - 23m 2 - 3yr 4 - 6yr BCG Hep B DTaP/IPV Hi B Rotavirus PneumoC Influenza (2nd dose to be given 1 month later then yearly) MMR Chicken pox Hep A (2 doses) MeningoC VACCINE S VACCINE AND ITS EFFECTS BCG (intradermal) BCG Bacille Calmette - Guerin (live bacterial vaccine from bovine tubercle bacillus) Prevent against Mycobacterium tuberculosis (TB) 1 st dose to be given at birth Check for scar at 3 - 6 months of age if no scar, to revaccinate Hep B (intramuscular) Prevent against hepatitis B infection. 1 st dose at birth, 2 nd and 3 rd dose in combination with DTaP/IPV/Hib + Hep B (Hexa) or given separately at 1mth(2 nd dose) and 5 - 6mths(3 rd dose) DTaP/IPV /HiB (intramuscular) DTaP Diphtheria, tetanus toxoid , acellular pertussis/Inactivated polio /HiB vaccine Prevent against dip htheria, tetanus, pertussis, polio and haemophillus influenza B inf DTaP/IPV - 1 st booster at 18mths and 2 nd booster at 4 - 6 years old HiB conjugate vaccine - Only need 1 st booster at 18mths Rotavirus (oral) Prevent against rotavirus infection 1 st and 2 nd doses to be given 1 - 2mths apart 1 st dose should not be administered after the age of 6mths PneumoC (intramuscular) Prevent against pneumococcal infection PCV(pneumococcal conjugate vaccine) recommended for all children < 5 years old Administer 1 dose of PCV for children >2 years old Influenza (intramuscular) Prevent against common cough/cold viruses Administer 2 doses (separate by at least 4weeks) to children age younger than 9 who are receiving influenza vaccine for the first time then yearly interval MMR (subcutaneous) Prevent against MMR ( measles, mumps and rubella ) infections Minimum age 12mths except in Sabah (at 6mths of age) 2 dose (booster) at age 4 - 6 years old Chicken pox (subcutaneous) Prevent against chicken pox/varicella infection Minimum age 12mths; can be given at the same time with MMR vaccine 2 dose (booster) at age 4 - 6 years old Hep A (intramuscular) Prevent against hepatitis A infection 1 st dose at 19 - 23mths and 2dose to be g iven 6mths apart MeningoC (subcutaneous/ (intramuscular) Prevent against meningococcal infection Minimum age 2 years old Recommended especially for high risk groups eg: complement deficiency, functional or anatomical asplenia (absence of spleen)
VACCINES INFORMATION FOR PARENTS BCG Prevent against tuberculosis (TB) . TB is a contagious disease cause by Mycobacterium tuberculosis that usually enters the lung through inhaling infected sputum droplets from a person with TB. Symptoms include prolong cough, loss of appetite, loss of weight, difficulty in breathing, nigh t sweat and blood stain sputum. The disease gradually damages the lung and may spread to other organs including the brain. BCG vaccine protects children from lung TB ~ 50 - 80% and other form of serious infections such as miliary TB (generalized TB) and TB meningitis (TB of the brain) Hep B Hepatitis B can be transmitted to newborn babies by mothers who are carriers of the virus. Infection may also be transmitted from person to person through contaminated needles, blood products and intimate social or sexual contact. Hepatitis B carriers are 200 times more common to develop chronic liver disease or liver cancer than normal people, though it may take many years. Newborn babies of hepatitis B carrier mother should in addition to 3 doses of hepatitis B vaccination, also receive hepatitis B antibody (immunoglobulin) at birth to increase the protection to the babies. DTaP/IPV/HiB DTaP diph theria, tetanus and pertussis Diphtheria highly contagious bacterial infection in children which may cause high grade fever, swollen neck, thick grayish - white membrane on the tonsils and throat causing difficulty in swallowing, hoarse voice and breathing difficulty which may lead to death if untreated. Three primary doses of DTaP and booster doses are required to effectively prevent the disease. Tetanus Cause by bacteria that are widely prese nt in earth, soiled nails and animal faeces. Tetanus bacteria infect wounds and release toxins into the blood stream. The toxin cause severe painful muscle spasm and convulsion. Three primary doses of DTaP and booster doses are required to effectively p revent the disease. Pregnant mothers who have not previously received tetanus vaccine should receive at least 2 doses of tetanus vaccine to prevent tetanus in themselves and their newborn babies. Pertussis also known as whooping cough is caused by bacte ria that are transmitted through minute droplets from the nose and throat. Symptoms include severe paroxysmal cough (usually persist for 2 - 3 months) which may precipitate vomiting, bleeding around the eyes and small infants may turn blue, develop fits or stop breathing. Severe disease may lead to death from pneumonia or brain damage. Three primary doses of DTaP and booster doses are required to effectively prevent the disease. Polio is highly contagious disease caused by a virus that spread through stools and saliva of an infected person. Polio causes fever, vomiting, loose stools, headache, muscle ache followed by paralysis. Paralysis may be confined to one limb or may affect the entire body. Inactivated polio vaccine (IPV) is very effective in preventing polio and can be given via orally (polio drops) or injection (combined with DTaP). Both routes are effective and fu ll protection is achieved only after 3 or more doses. Haemo phillus influenza B (HiB) is a contagious infection caused by bacteria that spread through respiratory droplets. It may cause infection of the blood stream (bacteraemia), brain infection (meningitis), lung infection (pneumonia) and infection of the voca l cord (epiglottitis). HiB vaccine is very effective in protecting infants against all form of HiB diseases. 3 primary doses + 1 booster dose are needed to prevent the disease.
Rotavirus Rotavirus the commonest virus that causes diarrhea in children. Rotarivus is discharged by the billions from the infected stools of a patient and may contaminate garments, toys, bedding, food and in fact everything that is in contact with the patient. Hence, it is difficult to prevent transmission of the virus despi te strict hygiene. The disease will present as fever, diarrhea, vomiting and abdominal pain which may lead to severe dehydration and can cause death. Rotavirus vaccine is given by mouth and can protect children from rotavirus infection. Two vaccines are available and are equally effective. Rotarix is given as 2 doses (1 - 2 months apart) and Rotateq is given as 3 doses (1 - 2 months apart). The duration of protection is a least 2 years. PneumoC Pneumococcal bacteria that are commonly found in the throat of young children. There are about 100 types of pneumococci, of which about 7 - 15 types are most important. Pneumococcal infection can cause middle ear infection (otitis media), lungs infection (pneumonia), brain infection (meningitis) and blood stream infection (septicaemia). Pneumonia, meningitis and septicaemia are serious life - threatening infections with mortality rate about 30%. There are 2 types of pneumococcal vaccines available and a minimum of 3 doses of vaccines is given to children under 1 year, 2 doses to children between 1 - 2 years and 1 dose to children 2 - 9 years old. Influenza Influenza is a common flu virus of the respiratory tract. It is highly contagious and spread through respiratory droplets. In temperate countries, influenza epidemics occur during the winter months but in tropical countries like Malaysia, influenza occurs throu ghout the year with peak seasons in April to June and October to December. Because of the potential complication in the very young and the elderly, vaccination against influenza is targeted at these age groups. The virus mutates every year and therefore annual vaccinations with new strains are necessary. MMR MMR Measles, mumps and rubella vaccine Measles is a serious and contagious viral infection that is transmitted through droplets from the nose and throat of the infected persons. It causes high fever, sore throat, red eyes, a distressing cough, rashes that started from face/neck and spread to the rest of the body. The child will look miserable, fretful and refuse to eat/drink. Complications such as lung infection (pneumonia), dehydration, eye infection and brain infection (encephalitis) which may lead to permanent brain damage can occur. First dose of MMR vaccine is given a t 1 year of age. To ensure full protection, second dose of vaccine is recommended at age 4 - 6 years old. Mumps is a contagious viral infection that is transmitted through saliva. It causes fever, and painful swelling of the salivary glands on one or b oth sides of the face and neck. About 20% of adult males may develop inflammation of the testes. Occasionally, mumps may cause infertility, nerve deafness and brain inflammation (encephalitis). First dose of MMR vaccine is given at 1 year of age. To e nsure full protection, second dose of vaccine is recommended at age 4 - 6 years old. Rubella is a highly contagious viral infection that is transmitted through droplets from the nose and throat of infected persons. It causes fever, swollen lymph glands of the neck and back of head/ear, joint pain and rashes on the face and body. The infection is most serious if a pregnant mother transmits the infection to her unborn baby. About 90% of babies infected in the first 10 weeks after conception will have ser ious birth abnormalities such as blindness, brain damage, heart defects and progressive deafness. First dose of MMR vaccine is given at 1 year of age. To ensure full protection, second dose of vaccine
is recommended at age 4 - 6 years old. Women must ens ure that they are not pregnant when receiving the vaccine. They should also avoid pregnancy for at least 1 month following vaccination. Chicken pox Chicken pox is a contagious disease caused by a virus that is transmitted through nasal droplets and fluid from vesicles of persons with chicken pox or herpes zoster (shingles) infection. The child may have mild fever, minor cough, red spots and blister s on the body which are very itchy. These spots gradually dry up and scab drop off in 10 - 14 days, usually with minor or no scarring. In a few individuals, keloid may form over the healed pox marks. Although chickenpox is usually mild in children, compli cations such as high fever, secondary skin bacterial infection, dehydration and unsteady gait (cerebellitis) may occur. Chickenpox is more serious in adolescents, adults and pregnant women. Overall death from chickenpox infection is 20 times higher in ad ults than in children. Chicken pox vaccine is effective in preventing and modifying the disease. About 75% of the recipients are fully protected. In the rest, a minor illness occurs in which fewer than 50 spots appear which are less infectious to other people. Children need only one dose and a booster dose is optional. Persons over 12 years of age and adult who have not been previously vaccinated should receive 2 doses of vaccine. Women must ensure that they are not pregnant when receiving the vaccin e. They should also avoid pregnancy for at least 1 month following vaccination. Hep A Hepatitis A is caused by a virus that is spread through food or drinks which have been contaminated by faecal material from an infected person. Undercooked seafood such as oysters, clams and cockles are common sources of infection. It can cause mild fever, severe nausea, vomiting, loss of appetite, lethargy followed by jaundice. The eye, skin and urine become progressively more yellow and the stools may turn pale. The liver is swollen and may cause pain and discomfort in the upper quadrant of the abdomen. The disease usually improves within 4 - 8 weeks. Death from hepatitis A is very uncommon. Hepatitis A vac cine is very effective in protecting against hepatitis A infection and to ensure prolonged protection, two doses 6 months apart are required. MeningoC Meningococcal is a bacteria that is transmitted through person to person spread via infected respiratory droplets. It is initially presents wit subtle symptoms such as fever, irritability, loss of appetite and vomiting. Children older than 5 years of age may complain of headache. In meningococcaemia (invading into the blood stream), the illness may deteriorate dramatically and patient may present with sepsis (cold hand/feet), shock, drowsiness, labored breathing, fits, haemorrhagic rash and impaired consciousness. For children 2 years and older, a single 0.5mls dose of vaccine given by subcutaneous or intramuscular injection provides protection against serotypes A, C,Y,W 135 meningococcal disease.