Primary Series

1. See Also
   1. Adult Immunization
   2. Immunization Status Unknown
2. Technique: Decreased adverse reaction associated factors
   1. Greater depth of injection with longer needle
   2. Use 23 gauge, 25 mm needle
3. Contraindications: Vaccination
   1. True contraindications to vaccination
      1. Anaphylaxis to Vaccine or Vaccine constituent
      2. Current moderate to severe illness
   2. Conditions that do not contraindicate Vaccine
      1. Moderate inflammation at prior Immunization site
      2. Moderate fever following prior vaccination
      3. Current antibiotic usage
      4. Recovering from illness or recent exposure to illness
      5. Prematurity (no change in dosage)
      6. Unvaccinated household contact
      7. Pregnancy of household contact
4. Vaccinations: CDC 2007 recommendations
   1. Hepatitis B Vaccine (HepB Vaccine)
      1. Dose 1: Birth to age 2 months
      2. Dose 2: Age 1 to 4 months (>1 month after dose 1)
      3. Dose 3: Age 6 to 18 months (>2 months after dose 2)
   2. Hepatitis A Vaccine
      1. Dose 1: Age 12 months
      2. Dose 2: Age 18 months
   3. Diphtheria Tetanus acellular Pertusis (DTaP Vaccine)
      1. Dose 1: Age 2 months
      2. Dose 2: Age 4 months
      3. Dose 3: Age 6 months
      4. Dose 4: Age 12 to 18 months (>6 months after dose 3)
      5. Dose 5: Age 4 to 6 years
      6. Tdap Booster: Age 11 to 12 years
   4. HaemophilusInfluenzae type B (Hib Vaccine)
      1. Dose 1: Age 2 months
      2. Dose 2: Age 4 months
      3. Dose 3: Age 6 months
      4. Dose 4: Age 12 to 15 months
   5. Inactivated Polio Vaccine (EIPV)
      1. Dose 1: Age 2 months
      2. Dose 2: Age 4 months
      3. Dose 3: Age 6 to 18 months
      4. Dose 4: Age 4 to 6 years (Dose 4 not needed if third dose given after age 4 years)
   6. Pneumococcal Conjugate Vaccine (PCV, Prevnar)
      1. Dose 1: Age 2 months
      2. Dose 2: Age 4 months
      3. Dose 3: Age 6 months
      4. Dose 4: Age 12 to 15 months
   7. Measles Mumps Rubella Vaccine (MMR)
      1. Dose 1: Age 12 to 15 months
      2. Dose 2: Age 4 to 6 years (by age 12 years)
   8. Varicella Vaccine
      1. Dose 1: Age 12 to 18 months
      2. Dose 2: Age 5 years
   9. Rotavirus Vaccine
      1. Dose 1: Age 2 months
      2. Dose 2: Age 4 months
      3. Dose 3: Age 6 months
   10. Influenza Vaccine
       1. Annually between age 6 months and 5 years
   11. Meningococcal Conjugate Vaccine (MCV4)
       1. Administer at 11-12 years or
       2. Before age 18 years
   12. Human PapillomavirusVaccine
       1. Dose 1: Age 11-12 years
       2. Dose 2: 2 months after first dose
       3. Dose 3: 6 months after first dose
5. Protocol: Vaccination Schedule Example
   1. Well Child Visit at 2 months
      1. Hep B Vaccine (1) with Hib Vaccine (1)
      2. Pneumococcal Conjugate Vaccine (1)
      3. Diphtheria Tetanus Acellular Pertussis Vaccine (1)
      4. Inactivated Polio Vaccine (1)
      5. Rotavirus Vaccine (1)
   2. Well Child Visit at 4 months
      1. Hep B Vaccine (2) with Hib Vaccine (2)
      2. Pneumococcal Conjugate Vaccine (2)
      3. Diphtheria Tetanus Acellular Pertussis Vaccine (2)
      4. Inactivated Polio Vaccine (2)
      5. Rotavirus Vaccine (2)
   3. Well Child Visit at 6 months
      1. Hep B Vaccine (3)
      2. Pneumococcal Conjugate Vaccine (3)
      3. Diphtheria Tetanus Acellular Pertussis Vaccine (3)
      4. Inactivated Polio Vaccine (3)
      5. Rotavirus Vaccine (3)
   4. Well Child Visit at 12 months
      1. Measles Mumps Rubella Vaccine (1)
      2. Varicella Vaccine (1)
      3. Hepatitis A Vaccine (1)
   5. Well Child Visit at 15 months
      1. Pneumococcal Conjugate Vaccine (4)
      2. DTaP Vaccine (4) with Hib Vaccine (3-4)
   6. Well Child Visit at 18 months
      1. Hepatitis A Vaccine (2)
   7. Well Child Visit at 4 to 6 years
      1. Diphtheria Tetanus Acellular Pertussis Vaccine (5)
      2. Inactivated Polio Vaccine (4)
      3. Measles Mumps Rubella Vaccine (2)
      4. Varicella Vaccine (2)
6. Protocol: Special Circumstances
   1. Prematurity: Immunize if over >1000 grams or >27 weeks
      1. Low Incidence of Hepatitis B and Hib reactions
   2. Children with HIV Infection
      1. Use EIPV instead of Oral Polio Vaccine
      2. Influenza Vaccine
      3. Pneumococcus Vaccine at 24 months
      4. Measles-Mumps-RubellaVaccine
7. Resources
   1. CDC ACIP Recommendations
      1. http://www.cdc.gov/nip/publications/acip-list.htm
8. References
   1. Diggle (2000) BMJ 321:931-3