VACCINES
BCG
• Oldest vaccine
• Danish 1331 strain
• LIVE vaccine- 0.1-0.4 million live viable bacilli per dose.
• Freeze dried powder (lyophilized) in vaccum sealed ,
multidose, amber coloured ampoules or 2ml vials.
• Diluted with : sterile NS or diluent
• Storage :
Lyophilized : 2-80℃ upto 12months
After reconstitution : stored at 2-8℃, protected from light
for 4-6 hrs (If kept for long time –no preservative -TSS)
• Dose: 0.05ml i.d
• Schedule : at birth (in preterms- after 32-36 weeks)
• Site : lateral aspect of left upper arm
• Should raise a wheal of 5mm – verifies correct i.d
administration
• Reaction : papule in 2-3 weeks f/b scar in 6-12 weeks
• 10% do not develop scars
• Adverse events :local reactions – site abscess,
ulceration and suppurative lymphadenitis
• Disseminated BCG disease – in immunodeficient
• Contraindication : allergy.
BCG Lymphadenitis
How to
manage
?
Treatment options: Treatment options:
1. Do nothing, follow 1. Needle aspiration,
up may be multiple
2. ATT: NO 2. Surgical incision and
drainage
DPT
• Diphtheria toxoid : 20-30 Lf (loefflers units)
• Pertussis – whole cell (DTwP) / acellular (DTaP)
• Tetanus toxoid – 5-25 Lf
• LIVE vaccine
• Liquid preparation
• Storage – 2-8 ℃ (SHOULD NEVER BE FROZEN )
• Site: anterolateral aspect of thigh 0.5 ml
• Schedule : now with pentavalent at 6,10,14
weeks and booster at 16-18m and 4-6 yrs
• Adverse events :
Fever ( pertussis component ) , local pain and
swelling – almost half
Hypoxic hyporesponsive episode – 0.06-
0.08/1000
• Contraindications:
• Absolute – anaphylaxis , encephalopathy
within 7 days following DPT
PENTAVALENT
• Addition of :HiB & Hep B
• To provide maximum
vaccines when encountered.
HEXAVALENT VACCINES
• Addition of IPV to
pentavalent vaccine.
• Currently in phase 3
Trials in india.
POLIO VACCINE
• Last case reported in india – 2011.
• LIVE vaccine
• Switch to bivalent from trivalent in april 2016 in india (to
decrease cVDPV2 & VAPP)
• Storage : 2-8 ℃ (till 6 months)-
heat sensitive virus
• Route : oral
• Dose : 2 drops or 0.1 ml orally
• Schedule : 0, 6, 10, 14 weeks
booster- 6-18m
• All children <5 yrs are given
• Develop immunity via – humoral(Ab) and
mucosal (IgA).
• Herd immunity
• Pulse polio program – done during low polio
transmission season – 2 doses – 4-6 weeks
apart– national immunization day
fIPV
• Introduced in march 2017
• Made from WPV strains
• Inactivated with formaldehyde.
• All three strains are present
• Storage : 2-8℃
• Dose : 0.1 ml
• Route: intradermal
• Schedule : 6, 14 weeks & booster-16-24 months
Rotavirus vaccine
preparation brand doses volume Maximum age limit
for first dose
RV1 Rotarix 2 1 ml 15 weeks
RV5 Rotateq 3 2ml
116 E Rotavac 3 0.5ml 1 year
(efficacy-
54%)
Introduced in april 2016
Each dose : 5 drops (0.5ml)
Storage : 2-8℃ (Stored upto 4 hrs after
opening)
Route : oral
Schedule : 6,10,14 weeks
Adverse events : intususception ( post
marketing surveillance by ICMR- no increased
risk – 2020)
PCV
• LIVE conjugated vaccine
• PCV 7/10/13
• Dose: 0.5ml
• Site : anterolateral thigh
right side
• Schedule : 6, 14 weeks
booster at 9 months
• Storage : 2-8℃
TYPHOID VACCINE
• Vi polysaccharide
• Vaccine- purified Vi Ag.
• Not included in the NIS.
• Dose: 0.5ml
• Site: anterolateral aspect
of thigh
• Route : s.c /i.m
• Storage : 2-8 ℃
• Schedule according to IAP: one dose at 2yrs
• Repeat every 3 yrs.
VARICELLA VACCINE
• LIVE vaccine (from oka strain)
• Site : upper arm or anterolateral thigh
• Route: s.c
• Dose: 0.5ml
• Schedule: 2 doses 15-18 months and 4-
6 yrs
• Indications: all children if affordable +
children with chronic cardiac or
pulmonary disease, HIV infection
(CD4>15%), nephrotic syndrome,
household contacts of
immunocompromised patients.
