1.
Hepatitis B vaccine (HepB). (Minimum age: birth)
At
birth:
·
Administer
monovalent HepB to all newborns prior to hospital discharge.
·
If mother
is HBsAg-positive, administer HepB and 0.5 mL of hepatitis B immune
globulin (HBIG) within 12 hours of birth.
·
If
mother's HBsAg status is unknown, administer HepB within 12 hours of
birth. Determine the HBsAg status as soon as possible and if HBsAg-positive,
adminis-ter HBIG (no later than age 1 week).
·
If mother
is HBsAg-negative, the birth dose can only be delayed with physician's
order and mothers' negative HBsAg laboratory report documented in the
infant's medical record.
Following the birth dose:
·
The HepB
series should be completed with either monovalent HepB or a combination
vaccine containing HepB. The second dose should be administered at age
1-2 months. The final dose should be administered at age >_ 24 weeks.
Infants born to HBsAg-positive mothers should be tested for HBsAg and
antibody to HBsAg after completion of 3 or more doses in a licensed HepB
series, at age 9-18 months (generally at the next well-child visit).
4-month dose of HepB:
·
It is
permissible to administer 4 doses of HepB when combination vaccines are
given after the birth dose.
2.
Rotavirus vaccine (Rota).
(Minimum age: 6 weeks)
o
Administer the final dose in the series by 8 months.
3.
Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP).
(Minimum
age: 6 weeks)
-
The fourth dose of DTaP may be administered as early as age 12
months, provided 6 months have elapsed since the third dose.
-
Administer the final dose in the series at age 4-6 years.
4.
Haemophilus influenzae type b conjugate vaccine (Hib).
(Minimum age: 6 weeks)
·
If PRP-OMP
(PedvaxHIB or ComVax`' [Merck]) is administered at ages 2 and 4 months,
a dose at age 6 months is not required.
·
TriHiBit'
(DTaP/Hib) combination products should not be used for primary
immuniza-tion but can be used as boosters following any Hib vaccine in >
12 month olds.
5.
Pneumococcal vaccine.-
(Minimum age: 6 weeks for pneumococcal conjugate vaccine (PCV); 2 years
for pneumococcal polysaccharide vaccine (PPV))
-
Administer PCV to all children less than 5 yr old. Give one
does to ages 24-59 months who are not completely vaccinated.
-
Administer PPV to certain high-risk groups aged >_ 2 years. See MMWR.
2000;49(RR-9):1-35.
6.
Influenza vaccine.
(Minimum age: 6 months for trivalent inactivated influenza vaccine (TIV);
2 years for live, attenuated influenza vaccine (LAIV)
-
All
children aged 6mo -18 yr.
-
For
healthy persons aged 2-49 years, LAIV may be used as an alternative
to TIV .
-
Children receiving TIV should receive 0.25 ml if aged 6-35 months or
0.5 mL if aged >_ 3 years.
-
Children aged < 9 years who are receiving influenza vaccine for the
first time should receive 2 doses
7.
Measles, mumps, and rubella vaccine (MMR).
(Minimum age: 12 months)
8.
Varicella vaccine.
/Minimum age: 12 months)
-
Administer the second dose of varicella vaccine at age 4-6 years.
Varicella vaccine may be administered prior to age 4-6 years,
provided that >_ 3 months have elapsed since the first dose and both
doses are administered at age >_ 12 months. If second dose was
administered >_ 28 days following the first dose, the second dose
does not need to be repeated.
9.
Hepatitis A vaccine (HepA).
(Minimum age: 12 months)
-
HepA
is recommended for all children at 1 year of age (i.e., 12-23
months). The 2 doses in the series should be administered at least
6 months apart.
-
Children not fully vaccinated by age 2 years can be vaccinated at
subsequent visits.
-
HepA
is recommended for certain other groups of children including in
areas where vaccination programs target older children. See MMWR.
2006;55(RR-7):1-23.
10.
Meningococcal polysaccharide vaccine (MPSV4).
(Minimum
age: 2 years)
1.Tetanus and
diphtheria toxoids and acellular pertussis vaccine (Tdap).
(Minimum age:
10 years for Boostrix ' and 11 years for Adacel IT"')
-
Administer
at age 11-12 years for those who have completed the recommended
childhood DTP/DTaP vaccination series and have not received a Td booster
dose.
-
Adolescents 13-18 years who missed the 11-12 year Td/Tdap booster dose
should also receive a single dose of Tdap if they have completed the
recommended childhood DTP/DTaP vaccination series.
-
A 5 yr
interval from the last Td dose is encouraged when Tdap is used as a
booster dose; however, a shorter interval may be used if pertussis
immunity is needed.
2. Human
papillomavirus vaccine (HPV).
(Minimum age: 9 years)
-
Administer
the first dose of the HPV vaccine series to females at age 11-12 years.
-
Administer
the second dose 2 months after the first dose and the third dose 6
months after the first dose.
-
Administer
the HPV vaccine series to females at age 13-18 years if not previously
vaccinated.
3.
Meningococcal vaccine.
(Minimum age: 11 years for meningococcal conjugate vaccine (MCV4); 2 years
for meningococcal polysaccharide vaccine (MPSV4))
-
Administer
MCV4 at age 11-12-years and to previously unvaccinated adolescents at
high school entry (- 15 years of age).
-
Administer
MCV4 to previously unvaccinated college freshmen living in dormitories;
MPSV4 is an acceptable alternative.
-
Vaccination against invasive meningococcal disease is recommended for
children and adolescents aged > 2 years with terminal complement
deficiencies or anatomic or functional asplenia and certain other high
risk groups. See MMWR 2005;54 (RR-7):1-21. Use MPSV4 for children aged
2-10 years and MCV4 or MPSV4 for older children.
-
Now required
for entry into 7th grade.
4.
Pneumococcal polysaccharide vaccine (PPSV).
5. Influenza
vaccine.
(Minimum age: 6 months for trivalent inactivated influenza vaccine (TIV); 5
years for live, attenuated influenza vaccine (LAIV)
-
Influenza
vaccine is recommended annually for children 6mo to 18yr.
-
For
healthy persons aged 5-49 years, LAIV may be used as an alternative to
TIV.
-
Children
aged < 9 years who are receiving influenza vaccine for the first time
should receive 2 doses (separated by >_ 4 weeks for TIV and >_ 6 weeks
for LAIV).
6. Hepatitis A
vaccine (HepA).
(Minimum age: 12 months)
-
The 2
doses in the series should be administered at least 6 months apart.
-
HepA is
recommended for certain other groups of children including in areas
where vaccination programs target older children. See MMWR 2006;
55(RR-7):1-23.
-
This is now
required in Texas to inter Kg and 7th grade.
7. Hepatitis B
vaccine (HepB).
(Minimum age: birth)
8. Inactivated
poliovirus vaccine (IPV).
(Minimum age: 6 weeks)
-
For
children who received an all-IPV or all-oral poliovirus (OPV) series, a
fourth dose is not necessary if third dose was administered at age >_ 4
years.
-
If both
OPV and IPV were administered as part of a series, a total of 4 doses
should be given, regardless of the child's current age.
9. Measles,
mumps, and rubella vaccine (MMR).(Minimum
age: 12 months)
10.Varicella
vaccine.
(Minimum age: 12 months)
-
-Administer 2 doses of varicella vaccine to persons without evidence of
immunity.
-
-Administer 2 doses of varicella vaccine to persons aged <_ 13 years at
least 3 months apart. Do not repeat the second dose, if administered >_
28 days following the first dose.
-
Administer
2 doses of varicella vaccine to persons aged >_ 13 years at least 4
weeks apart.
-
Now 2 doses
are required
in Texas for entry into Kg and 7th grade as of 2009.
Dr. Knapp's personal choices in these vaccine recommendations.
I have adapted the above schedule to help not giving so many shots at one time.
Many are now required for starting Kg and 7th grade in Texas. The
shots below are required.
| Birth |
|
|
|
|
not if
Mom neg test |
|
|
| 2months |
Pentacel
#1 |
|
|
PCV#1 |
|
|
|
| 4months |
Pentacel #2 |
|
|
PCV#2 |
|
|
|
| 6months |
Pentacel #3 |
|
|
PCV#3 |
HepB#1 |
|
|
| 9months |
|
|
|
|
HepB#2 |
|
|
| 12months |
|
|
HepA |
PCV#4 |
HepB#3 |
MMR#1 |
|
| 18months |
DaPT#4 |
HIB |
HepA |
|
|
|
Varicella
1 |
| 4yr |
DaPT #5 |
IPV#4 |
|
|
|
MMR#2 |
Varicella 2 |
| 12yr |
Tdap |
Menatra |
|
HPV
3 over 6 months |
|
or
Varicella 2 here |
A combination of vaccines were released called the Pentacel that contains DaPT, IPV, and HIB all in one shot. So that
will mean fewer needles especially at 2,4,and 6 months. At 2 months
the baby gets two shots: Pentacel and Prevnar(PCV).
I am now recommending not give the HepB vaccine at birth unless the mother
is Positive for the virus. Studies show that the immunity is better in
the teenage years if the vaccine is given at 6 months or later. The
infant is not exposed to the virus except at birth or as an adult. Also as
mothers are coming to us having been vaccinated to HepB, then we need to
wait until their antibodies (that goes through the placenta to the baby)
decrease and not affect the infants vaccination.
Texas is requiring the Tdap, Menatra and a second Varicella (chicken pox) before 7th grade as of Fall 2009. At 12 yr
we give a new Tetanus booster with Pertussis
(Whooping Cough) called a Tdap. This has to be 5 yrs or more past the last tetanus
shot so if you had one at 12-14 yr, then you cannot have one for 5 yr after
that. Also a vaccine called Menatra. This is for Meningiococcal
Meningitis. It is required by most colleges, we have given it for
many years to 12 yr olds, and now required by Texas to enter the 7th grade.
This vaccine is one only and will satisfy requirements getting into college
or the military service. The second Varicella vaccine is required
unless the parent signs a form at school that the child had the chicken pox
illness.
I recommend the Human Papilloma Virus Vaccine (HPV) by 12-13 yr. old
girls and boys.
The virus causes cervical cancer, cancer of the mouth, genital warts,
nodules on the vocal cords, and prostate cancer. The virus
DNA is found in more than 50% of prostate cancer and none in normal
prostates. It is 3 shots over 6 months: one initially, one 2 months
later, and the third 4 months after the second one.
This vaccine does not increase the promiscuity rate. It is safe and I
strongly recommend it. 10% of the population have the virus by 20 yr old,
50% by 26 yr old, and 80% by 50 yr old. Plus you could be a virgin at
30 yr and marry a spouse with the virus.
HepA is now required for Kg. It is recommended for high risk groups
in the teens who have not had it. Especially they need it if they go
to under developed countries with poor sanitation. Or if they go into
health care fields like paramedics, doctors, nurses, etc.
The Rotavirus vaccine I do not recommend at this time. It is a live
virus and also causes diarrhea in some infants. The chances of getting
the virus in the first 2 years is only slightly higher than the incidence of
diarrhea from the vaccine. This vaccine is not required at this time.
If the parent wants it given to the baby, you will have to see the
county clinics for that vaccine. It changes the illness from 12% to
7%. And side effects are 5% or more.
New requirements for Fall 2009 School year in Texas:
- Meningococcal Vaccine*
- Beginning SY 2009-10, 7th grade requirement
- Varicella Vaccine
- Beginning School Year (SY) 2009-10, 2 dose requirement for
kindergarten and 7th grade entry Unless they had disease.
- Tdap Vaccine
- Beginning SY 2009-10, a booster dose requirement for Tdap for
7th grade
- MMR Vaccine
- Beginning SY 2009-10, 2 dose requirement of MMR vaccine for
kindergarten entry
- Hepatitis A Vaccine
- Beginning SY 2009-10, 2 dose requirement for kindergarten entry
statewide
AND NO ...... THE VACCINES DO NOT CAUSE AUTISM!!!
For those parents who have been brainwashed by Dr. Sears.
Please read this article:
Dr Robert Sears, The Vaccine Book: Making the Right
Decision for Your Child.
Dr. Knapp
