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SUMMARY TABLE: Immunization of Teens and Pre-teens 2014

(7 to 18 yrs old}

Range of Dose(s) Schedule of Precautions

Vaccine Route of Administration and Contra-indications *
Recommended Age needed Immunization

Severe
allergicreactiontovaccinecompo
nent,
HepBVaccine Previous
lyunvaccinate
d 7-18yrs.old 3 0,1,6months Intramuscula
rly(IM)
moderate tosevereillness

2nddosegiven atleast6monthsfrom Severe

allerg
icreaction
tovaccine
HepAVaccine Prev
iouslyunvacci
nated7-18yrsold 2 Intramuscu
larly(IM)
1stdose component,
moderatetosevereillness

Previous
lyunvacci
nated7-18yrsold 2 4wksintervalbetwee
ndoses Severeallergicreaction
tovacci ne component ,
Subcutaneously
MMR Pregnancy, immunosu ppression, recentreceiptof
2nddosegivenanytimebutatleast (SC) bloodprodu cts, moderatetosevereillness
Incompletely ed7-18yrsold
vaccinat 1
4wksfrom1st dose

Previously
unvaccinated
7-12yrsold 2 Min
imuminterval
betweendosesis3months
Severe allergicreaction
tovaccine
Previous d ~ 13yrsold
lyunvaccinate 2 Minimumintervalbetweendosesisonemonth Subcutaneous
ly compone nt.Pregnancy , lmmunos
uppressi
on,
VaricellaVac
cine recentreceiptof blood products,
modera
teto
(SC)
severe illness
Anytime:
7-12yearsoldat lea.st 3mosfrom1stdose
Incomp 7-18yrsold
letelyvaccinated 1 ~ 13yearsoldatleast4weeks from1stdose

Intramuscu
larly (IM)/ Severeallergic
reactio
ntovacci ne,
moderatetosevere illness,
historyof
Influenza Vaccine 9-18yrsold annually Beginimmunizing in Feb
.
Subcutaneo
usly(SC) Guillain-
Barresyndrome followinga
previousdose

HPV:
Biva
lent HPV Fema
les: 10-18yrsold 3 0, 1and6 months Severeallergic
reactio
ntovaccine,
moderatetosevere illness
QuadrivalentHPV Females: 10-18yrsold 3 0,2and6 months Intramuscularly
(IM) Iffoundtobe pregnantafterstarting
Mal
es:10-18yrsold(forprevention
of immunizationdelayremainingdosesuntil
anogenitalwarts) completionofpregnancy

Fully
immuniz
ed 7-18yrsold 1 Eve
ry10yrs (GiveonedoseTdapinstead
ofdueTd)

Incomp
letelyimmunized7-18yrsold 1-2 OnedoseTdap
andTdforremainingdoses
Severe
allergicreactiontovaccine
,
Td/Tdap Unimmunized7-18yrsold 3 0,1and6 monthswithTdappreferablyas1stdose Intramuscularly
(IM)
Modera te tosevereillness
Fullyimmunized definedas5 doses
of DToPor 4 dosesof DToPif the4th
dosewasadministeredon or ofter
the 4th birthday.

*Reference:
CDCEpidemiology
andPreventionof Vaccine- Preventable
Diseases
, 12thEdition,2012
 Childhood Immunization Schedule 2014
/
...,
AGEIN BIRTH WE EKS MONTH S
II YEARS

0 2 4 6 8 10 12 14 16 18 20 22 8 10 12 14 16 18 20 4 6 8 10 12 14 16 18

BCG
I I (B4G)

L J HepB (H p B)

-
(Hep B* )
~

~
(HepB*)
_.._ -

F
(DTw P- HiB - (HepB* ) HN I
I - -- --
-----...J.- -
Hep B*)
and ot her
... (DTwP* )/ DTaP*
(DTwP*) / DTaP*
l .J
l ~

-
Td•p/(Td)

DTP
comb inatio ns [HiB* ) (HiB*)
l D DTaP
- IPV

IPV/OPV*
lco,v•11
....."".-
I
(OPV* J/IPV ---, I
(HiB* J

n
DTaP - IPV - HiB

r ~
(OPV* J/IPV

RV*
I I
(RV Series*)
J Cl -
-- -~ -
Measles (Measles)

MMR* j j- (MMR*) I
n- l I ~ I MMR
--
IMMR)

PCV*/PP V
~ )
'-
(PCV*)
(PCV* )
- PCV I PCY I
Infl uenza

Varicella

Hep A
---- l f
Varicella

-----
:
.....
,,.
Hep A Series
1 Influ enza Yearly

I
Varicella

HaoA
I _ l l l -
'--
HPV
I I I HPV Series
- ~

~ EPI Vaccines Range of Recommended Age - Catch Up Imm unizat ion - For High Risk Group • Primary do ses are g iven at least 4 wee ks apart
inside box

DISCLAIMER: PHILIPPINEEPIVACCINES: OTHERRECOMMENDEDVACCINES

:
The Childhood Immunization Schedule presents recommendations for immuniza tion for Vaccines in the pink box, enclosed in parenth eses, are vaccines given in the Other Recommended Vaccines are vaccines outside th e pink box. These vaccinesare not
children and adolescents based on the knowledge, experienceand premisescurrent at the Philippine Expanded Program of Immunization (PEPI)of the Department of Health. part of the Philippine EPI but becauseof merit are advocated by the Philippine Pediatric
time of publication. The schedule represents a consensus with which physicians may a t Vaccines in the PEPI include: Society (PPS), Pediatric Infectious Disease Society of th e Philippines (PIDSP), and the
times disagree. No claim is mode for infallibili ty, and the PPS,PIDSPand PFVacknowledge Philippine Foundation for Vaccination (PFV). Other Recommended vaccines include:
· BCG -Measles -PCV
tha t individual circumstances may warrant a decision differi ng from the • OTaP • IPV • Varicella • Influenza
• OTwP-HiB-HepB • MMR · Td
recommendations given here. The recommendations ore not absolute. Physiciansmust • Tdap/Td • MMRV • Hepatit is A • Human Papillomav irus
•O PV • Rotavirus vaccine
regularly update their knowledge about specific vaccines and their use because Vacci ne (HPV)
information about safety and efficacy of vaccines and recommendations relative to their
admini stra tion continue to develop ofter a vaccine is licensed.

VACCINES FOR SPECIAL GROUPS:

Annotations: Theseare the vaccines which are not part of the Philippine EPI or Other
Recommended Vaccinesbut available data support their use in certain
MEASLES VACCINE ROTAVIRUSVACCINE (RV)
Given subcutaneously(SC)at the age of 9 months. Givenper orem. conditionsor in selectedpopulations. Vaccines for Special Groups include:
May be given asearly as6 monthsof age in casesof outbreaksasdeclared Theminimum interval between dosesis 4 weeks. • MeningococcalVaccines
BCG
The monovalent human rotavirus vaccine (RVl) is given as a two-dose · RabiesVaccine
Givenintradermally (ID) by public health officials.
-Typhoid Vaccine
BCGshould be given at the earliest possible age after birth preferably seriesand the pentavalent humanbovine rotavirus vaccine(RVS ) isgiven as • PneumococcalVaccine (PCV/PPV)
within the first 2 monthsofli fe. MEASLES , MUMPS, RUBELLA(MMR) a 3-dose series.
For healthy infants and children> 2 monthswho arenot given BCG at birth, Given subcutaneously(SC) Thefirst doseshould be administeredbeginning at 6 weeksof age and the MENINGOCOCCAL VACCINE
PPD prior to BCG vaccination is not necessary. However, PPD is The minimum age for MMRis 12 months. lastdose should be administerednot laterthan 32weeksof age. Tetravalent meningococcal (ACYW -135) conjugate vaccine (MCV4) given
recommended prior to BCGvaccination if any of the following arepresent: Twodosesof MMRare recommended.Thesecond dose isadministered at If RVl is administered for the first and second dose, a third dose is not intramuscularly (IM), tetravalent meningococcal polysaccharide vaccine
- suspected congenital Tb ages 4-6 years but may be administered at an earlier age provided the recommended. (MPSV4)givensubcutaneously (SC)
- history of close contact to knownor suspected infectious casesof TB interval betweenthe first and second dose isat least4 weeks. Two dosesof MCV4 given 2 monthsapart should be given to children aged
- clinical findingssuggestive ofTB and/or chest <-<aysuggestive ofTB Children below 12 months of age given any measles containing vaccine VARICELLAVACCINE 9 months and above at high risk for invasive disease (persistent
In the presenceof any of these conditions,an induration of > 5 mm is (measles,MR.MMR)should be given 2 additional dosesof MMR.The 1st Given subcutaneously (SC) complement component deficiencies, anatomic/functional asplenia, HIV,
consideredpositive.Thedoseof BCGis 0.05ml for children < 12 monthsof dose is given at age 12-1S months and should be separated by at least4 Two dosesof varicella vaccinearerecommended. travelers to or residents of areas where meningococcal disease is
weeksfrom measlescontaining vaccine. The seconddose is administered The first doseof the vaccine isadministeredfrom age 12 - 1S months. The hyperendemic or epidemic.or belonging to a defined risk group during a
age and 0.1 ml for children> 12months of age.
at age 4-6 years, but may be given at an earlier age provided the interval second doseof the vaccineis administered at~ years or at an earlier age community or instit utional meningococcaloutbreak).
between the 1st and 2nd doseisat least4 weeks. provided the interval between the first and the second dose is at least If MPSV4is used for high-risk indMduals as the first dose, a seconddose
DIPHTHERIAAND TETANUSTOXOIC>S AND ACELWLAR/WHOLE CELL
Children 12 months or older given one dose of any measles containing 3months. using MCV4should be given 2 monthslater.
PERTUSS ISVACCINE(OTaP/DTwP)
vaccine (measles,MR,MMR ) should be given a 2nd dose of MMRvaccine A seconddose of the vaccine is recommended for children, adolescents If the person remains at increasedrisk. an initial booster dose of MCV4
The following DTPcombination vaccinesare availablein the Philippines:
separated by at least4 weeksfrom the 1st measlescontaining vaccine. and adults who previously received only one dose of the vaccine. For should be given 3 yearsafter completing the primary series,with continued
OTwP-Hib
In the Philippine EPI,a second dose of MMR is given to high school children below 13 years, the recommended minimum interval between boostersat S-yearintervals afterthe initial booster dose.
DTaP -IPV Additional boosterdosesof polysaccha ride vaccinesare not recommended.
students (Grade 7-10) enrolled in public schools in selected cities dosesis 3 months.However,if the second dosewasadministered at least 4
DTwP-HepB weeksafterthe first dose,it can be considered asvalid.
and provinces.
DTaP -IPV-Hib TYPHOIDVACCINE
All individuals aged > 13 years and without immunity should receive2
DTwP-HepB-Hib Given intramuscularly (IM)
POLIOVIRUSVACCINE (OPV/IPV) dosesof varicella vaccinegiven at least4 weeksapart.
DTaP-IPV-Hib-HepB Recommended for travellers to areaswhere there is risk of exposure to S.
OPVgiven per orem (PO)
typhi and for outbreak situationsasdeclared by public health officials.
Given at a minimum age of 6 weekswith a minimum interval of 4 weeks. MEASLES, MUMPS, RUBELLA,VARICELLA(MMRV)
DTP A single dose may be given as early as 2 years of age with revaccination
In the Philippine EPlOPV is administered together with DwPT-Hep B -HiB Given subcutaneously (SC)
every2 to 3 yearsif there is continuedexposure to S.typhi
Givenintramuscularly (IM) vaccinesat6, 10and 14weeksofage. Combination MMRV may be given as an alternati ve to separately
Givenat a minimum ageof 6 weekswith a minimum interval of 4 weeks IPVgiven intramuscularly OM) administered MMRand varicella vaccinefor healthy children 12 monthsto RABIESVACCINE
The 4th dose may be givenasearly as 12 monthsof age providedthere isa Given at a minimum age of 6 weeks with a minimum interval of 4 weeks. 12yearsof age. The AntHabies Act of 2007 recommendsroutine rabies ~ure
minimum interval of 6 months from the third dose.The 5th dose may not The final dose in the series should be on or after the 4th birthday and at Theminimum interval between the first and second dose is3 months. prophylaxis (PrEP)for children ages S-14yearsin areaswhere there is high
be given if the 4th dosewasadministered at age4 yearsor older. least 6 monthsfrom the previousdose. If 4 or more doseshavebeen given incidenceof rabiesand animalbites (definedas more than twice the national
Thepertussiscomponent mayeither bean acellular or whole cell formulation. prior to age 4 years, an additional dose should be given at age 4 through HUMAN PAPILLOMAVIRUSVACCINE(HPV) average) .
6years. Given intramuscularly (IM) Thereare2 recommendedregimensfor P~ ure Prophylaxis:
HEPA TITISB VACCINE Primary vaccinationconsistsof a 3-dose series.The minimum age for HPV - lntramuscularregimen:PVRV0.Sml orPCECV 1 ml given on days0, 7,
Givenintramuscularly OM) TETANUSAND DIPHTHERIATOXOID (Td)/ TETANUSAND DIPHTHERIA vaccination is 9 years.Therecommended schedule isasfollows: 21 or 28.
The 1stdoseshould be given within the first 12 hours of life, and may be TOXOID AND ACE.LLULARPERTUSSIS VACCINE(Tdap) • Bivalent HPVat0, 1 and 6 months - lntradermal regimen: PVRVor PCECV0.1 ml given on days0, 7, 21
counted as part of the ~ oseprimary series.Subsequentdosesare given Given intramuscularly (IM) •Quadrivalent HP\!"at 0, 2 and 6 mos or 28.
at least 4 weeksapart,with the 3rd dosepreferably given not earlier than 24 In children who are fully immunized*,Td booster dosesshould be given The minimum interval between the 1st and 2nd dose is at least 1 month A repeat dose should be given if the vaccine is inadvertently
weeksof age. every 10 years.A single dose ofTdap can be given in placeof the dueTd and the minimum interval between the 2nd and 3rd dose is at least 3 givensubcutaneously.
Another doseof hepatiti sBis neededfor the following (to be administered dose, and can be administered regardless of the interval since the last months.The 3rd doseshould be given at least6 monthsafterthe first dose. Rabies vaccineshould never be given in the gluteal areasinceabsorption
not earlierthan 24 weeksof age): tetanusand diphtheria toxoid containing vaccine. 'The quadnvalentHPV con be given to moles 10- 18yearsof age for the isunpredictable.
Children aged 7 through 18 years who are not fully immunizedwith DPT preventionof anogenita/warts. Periodic boosterdosesin the absence of exposure arenot recommended for
• Preterms <2 kgs whose 1st dose wasreceived at birth
vaccine should receiveTdap as the 1st dose in the catch-up series. If the general population.
•Infantsfor whom the 3rd doseis given at age< 24weeks
In the event of subsequent exposures, thosewho havecompleted 3 dosesof
Preterm infantsborn to HBsAg(-) mothers who are medically stablemay additional dosesareneededuse Tdvaccine. INFLUENZAVACCINE
Givenintramuscularly (IM)or subcutaneously (SC) pre- exposure prophylaxis, regardlessof interval between re-exposure and
be given the 1st doseof HBV at 30daysof chronological age regardlessof Children and adolescentsaged 7 through 18 years who have never been
immunized with DPT vaccine should receivethe 3-dose series of tetanus All children from6 monthsto eighteenyearsshould receive influenzavaccine. lastdoseof the vaccine,will requireonly boosterdosesonday0an d 3.
weight, and this can be counted aspart of the 3 dose primary series. Boosterd osesmaybegiven IM{0.5ml PVRVo r 1 mlPCECV)orlD(0.1 ml PVRV
If mother isHBsAg(+), administer HBVand HBIG (0.5mOwithin 12 hoursof and diphtheria containing vaccinesusing the 0-1-6 months schedule. A Children 6 months to 8 yearsreceiving influenzavaccine for the first time
or PCECV).Thereis no needto give rabiesimmune globulin.
life. If HBsAg status is unknown, administer HBVwithin 12 hours of birth single dose ofTdap is given, preferably as the 1st dose. The remaining should receive 2 dosesof the vaccine separated by at least4 weeks. If only
and determine mother's HBsAg as soon as possible. If HBsAg (+) dosesare given asTd. one dose was administered during the previous influenza season, PNEUMOCOCCALVACCINES(PCV/ PPV)
administerHBIG no laterthan 7 daysof age. *Fullyimmunizedis definedas S dosesof DTaP or 4 dosesof DTaPif the 4th administer 2 doses of the vaccine then onedoseyearly thereafter. Given intramuscularly (IM)
In the EPI schedule,HepatitisBisgivenasmonovalent hepatitisBvaccine at dosewasadministered on or afterthe 4th birthday. Child renaged9 to 18 yearsshould receive one doseof vaccine yearly. For Children ;a, 2 years with the following underlying medical conditions
birth then subsequent doses are given at 6, 10, 14 weeks of age as In the Philippine EPi a single dose ofTd is given to high school students Annual vaccination should be given preferably between February to June, such as but not limited to anatomic/functional asplenia, HIV infection or
(Grades 7-10) enrolled in public schoolsin selected citiesand provinces. but may be given throughout the year other immunocompromising condition, chronic lung, heart and renal
combination vaccinescontaining DTwP-Hep B-Hib.
For the fully immunized pregnantadolescent.administer one doseofTdap diseases,cochlear implant, or cerebral spinal fluid leak.
vaccine between the 3rd or late 2nd trimester of pregnancy (after 20 PNEUMOCOCCA LVACCINES(PCV/ PPV) - Children aged24 to 71 months,give one doseof PCVl 3 if threedoses
HAEMOPHILUSINFLUENZAETYPEB CONJUGATEVACCINE(HiB)
weeksgestation). Given intramuscularly (IMJ of any PCVweregiven previously or give two dosesof PCV13 at least
Givenintramuscularly (IM)
Unimmunized pregnant adolescentsshould receive the 3-dose series of The minimum age for pneumococcal conjugate vaccine (PCV)is 6 weeks. 8 weeksapart if lessthan 3 dosesof any PCVwere previously given.
Givenat a minimum ageof 6 weekswith a minimum interval of 4 weeks.
tetanus and diphthteria containing vaccines(Td/Tdap) following a 0-1-6 Primary vaccination of PCVconsistsof 3 doseswith an interval of at least4 - Children aged 6 to 18 yearswith no previous dosesof PCV,give a
If the first dose was given between 7-11 months of age, the 2nd dose
months schedule. Tdap should replace one dose of Td given preferably weeksbetween doses,plus a boosterat 6 monthsafter the 3rd dose. single doseof PCV13.
should be given at least 4 weeks later, and the 3rd dose at least8 weeks
during the 3rd or late 2nd trimester of pregnancy (after 20 weeks Healthy children 2 to S yearsold who have no previous PCVvaccination - Children 2-18yearsold with the aboveconditions shouldreceive PPV
from the 2nd dose. maybegivenonedoseof PCV13or2dosesofPCV10at least 8weeksapart.
gestation). at least 8 weeksafter PCV.
A booster dose should be given between 12-1S months of age,with an Routine use of PCVis not recommended for healthy children aged ;a, A second dose of PPVis recommended S years after the 1st dose of
interval of 6 monthsfrom the 3rd dose. HEPAITTIS A VACCINE Syears. PPV only for those with anatomic / functional asplenia, congenital
One dose of the HiB vaccine should be considered for unimmunized Given intramuscularly (IM) For high risk children 2: 2 years of age, PPV is recommended after immunodeficiency, HIV infection, chronic renal failure or nephrotic
children aged S years or older who havesickle cell disease,leukemia, HIV HepatitisA vaccine is recommendedfor all childrenaged> 12months. completing PCVseries(refer to Vaccinesfor Special Groups). syndrome, malig nancy, solid organ transplantation, and other diseases
infectionor who had splenectomy A second doseof the vaccine isgivenat least6 monthsafter the first dose For healthy children, no additional doses of PPV are needed if PCVseries associated with immunosuppressivedrugs or radiation therapy. No more
is completed. than 2 PPVdosesshould begiven.