Immunization

 

• Infant immunisations

  2 months

  • 5-in-1 DTaP/IPV/Hib – diptheria, tetanus, pertussis, polio, Hib – dose 1.
  • Pneumococcal conjugate vaccine (PCV) dose 1.
  • Rotavirus dose 1. Live, oral virus.
  • MenB dose 1.

  3 months

  • 5-in-1 dose 2.
  • MenC dose 1.
  • Rotavirus dose 2.

  4 months

  • 5-in-1 dose 3.
  • PCV dose 2.
  • MenB dose 2.

  12 months

  • MMR dose 1.
  • MenC dose 2 + Hib dose 4 (combined).
  • MenB dose 3.
  • PCV dose 3.
  • Hepatitis B if they have risk factors.

• Toddler immunisations

  Flu vaccine

  • Annual, live attenuated nasal spray flu vaccine in September/October at age 2-7.
  • Kids with asthma and other chronic diseases like CF will continue to get this through childhood and beyond.
  • Contraindicated in severe egg allergy, immunosuppression (inc. steroids in past 2 weeks), and severe asthma or active wheeze. Alternative form can be given.
  • Postpone in those with heavy nasal congestion.

  3.5 years

  • 4-in-1 DTaP/IPV: dip, tet, pertussis, polio pre-school boost.
  • MMR dose 2.

• Teenager immunisations

  12 years

  HPV:

  • Girls only. Parental consent needed.
  • 2 doses, 6-24 months apart.
  • Gardasil vaccine covers the HPV types which most commonly cause cervical cancer (16 and 18) and genital warts (6 and 11).

  13-18 years

  • 3-in-1 Td/IPV booster: tetanus, diptheria, polio.
  • MenC booster. Likely to be replaced by MenACWY.

• Contraindications to immunisation

  In general, there are very few true contraindications to receiving vaccines. The following are NOT contraindications, but are commonly thought to be:

  • Family history of an adverse reaction
  • Premature baby.
  • Over the recommended age.
  • On antibiotics (except if still febrile, see below) or steroids (except for live vaccines, see below).
  • Atopy

  The following ARE true contraindications:

  • Acute fever.
  • Severe local or generalised reaction to previous dose of same vaccine. Can be given as an inpatient under monitoring.
  • Severe egg allergy for influenza vaccine. Alternative egg-free influenza vaccine should be given. However, MMR is fine in egg allergy as it uses chick embryos, not egg yolk or white.
  • History of intussusception for rotavirus vaccine, as the vaccine increases the risk of recurrence.

  Contraindications to live vaccines (MMR, BCG, oral vaccines, intranasal flu, yellow fever):

  • Pregnancy
  • Immunosuppression, including recent oral steroids (for most vaccines, defined as ≥1 week in the last 3 months). There may be some exceptions to this under specialist guidance.

• Adverse effects of immunisation

  Common:

  • Swelling and discomfort at injection site.
  • Mild fever and malaise.
  • Mild form of disease after MMR.

  Rare but severe:

  • Anaphylaxis
  • Encephalopathy after pertussis vaccine (<1/100,000).