Written By: Hanan Khalaf. RPH.

1. What do we mean by immunizing schedules?

These are schedules designed to categorize vaccines that should be given according to vaccine type and age at vaccination.

2. Immunizing schedules are they developed for children only?

No, although primary vaccination should be performed in early childhood, there are different schedules classified according to the age like those for children, adolescents, adults, and according to specific situations like pregnancy, and traveling.

3. What are the diseases covered by childhood vaccination?

Measles, is caused by a virus that is transmitted through the respiratory system causing rash, cough, runny nose, eye irritation, and fever. It can lead to ear infection, pneumonia, seizures, brain damage, and death.Mumps, is caused by a virus that is transmitted through the respiratory system causing fever, headache, and swollen salivary glands. It can lead to deafness, meningitis (infection of the brain), painful swelling of the testicles or ovaries, and, rarely, death.Rubella (German Measles), caused by a virus that is transmitted through secretions from nose or throat, causing rash, mild fever, and arthritis. If acquired during pregnancy can lead to serious birth defects.Poliomyelitis or Polio, a disease caused by a virus and it enters the body through the mouth, sometimes harmless and sometimes can be serious causing paralysis and even death.Pertussis (Whooping Cough), a respiratory disease caused by bacteria that produce uncontrollable, violent coughing. Whooping sound is usually heard when the patient tries to take a breath. It can be very serious in infants.Diphtheria, a serious infection of the throat caused by bacteria that can block the airway and cause severe breathing and swallowing difficulty.Tetanus (Lockjaw), a nerve disease, which can occur at any age, caused by toxin-producing bacteria called Clostridium tetani, through a contaminated woundHaemophilus influenzae type b (Hib disease) a major cause of bacterial meningitis in children who are 5 years of age and less.Hepatitis B, a disease caused by a virus that affects the liver and can lead to a carrier state or other complications on the liver as cirrhosis and hepatocellular carcinoma. Infection is usually acquired through shared needles, unprotected sex with an infected person, infected needle stick while on job, or through delivery if mother is infected. It is one of the viruses that affect the liver others are C (there is no vaccine against it) and A (there is a vaccine against it).Varicella (chickenpox), is a respiratory illness that is caused by Varicella-zoster virus. It spreads via air droplets or through fluid from blisters. It causes rash, itching, fever, and tiredness and can can lead to severe skin infection, scars, pneumonia, brain damage, or death.Pneumococcal is caused by a bacteria called Streptococcus pneumoniae causes bacterial meningitis, blood infection, ear infection, and pneumonia and can be very serious in children < 2years of age. It is transferred by close contactInfluenza (Flu), is caused by Influenza virus which affects the respiratory system and can lead to severe complication and is highly contagious.

4. What is the number of shots needed from each vaccine for children?

Measles, mumps & rubella vaccine (MMR) is a live-attenuated vaccine should be given as 2 doses at 12-15 month of age, 4-6years of age. Second dose, however, can be given any time as long as it is 28 days apart from first one. Usually MMR is started after the immune system is completely developed, i.e. at 1 year of life.Polio vaccine: exists in 2 forms Inactivated polio vaccine (IPV) which is given in the form of shots and Live attenuated oral polio (OPV) given through the mouth. OPV, which is no longer used in USA, is still widely used worldwide and is given as 4 doses at 2, 4, 6, 18 months of age and 4-6 years of age. OPV is contraindicated for children with disturbed immunity instead they should receive IPV. OPV can be given at the same time with other vaccines as DTaP, Hib vaccine, Hepatitis b vaccine.Diphtheria, tetanus & pertussis vaccine (DTaP) 4 doses given at 2, 4, 6, 15-18 months, and 4-6 years of age. It is not indicated for children > 7years of age as pertussis is only recommended for children < 7years of age, Instead Td (tetanus and diphtheria) should be given at 11-12 years of age and then every 10 years as a booster. It can be given combined with other vaccines as Hib vaccine.Hib vaccine 4 doses given at 2, 4, 6, 12-15 months of age. However, dose at 6 months of age might not be needed as it depends on the brand used. It is not needed for children > 5years of age except for individuals with certain health conditions as asplenia (functional or removal by surgery), HIV, sickle cell disease. It can be given combined with other vaccines as DTaP and Hepatitis BHepatitis B vaccine, 3 doses given at birth, then 2months after, and at 6 months of age. It can be given combined with other vaccines as DTaP, Hib vaccine, and OPV.Varicella vaccine, a live-attenuated vaccine should be given as 1 shot at 12-18 months of age. If not vaccinated until the age of 13 years, 2 shots should be given 4-8 weeks apart. It can be given with other vaccines as well.Pneumococcal conjucate vaccine (PCV) is a polysaccharide conjugate vaccine given as 4 shots at 2, 4, 6, and 12-18 months of life. It can also be given for children 2-5 years of age who have certain health conditions as sickle cell anemia, asplenia, HIV, any condition that leads to disturbed immunity. In addition such children can receive Pneumococcal polysaccharide vaccine (PPV) that is indicated for children > 2years of age and adults.
PPV vaccine does not include strains of Pneumococcal pneumonia that is available in PCV.Influenza vaccine: Is an inactivated virus that is given as a single shot during the Month of October or November as flu season usually peaks in February. Children < 9years of age who are getting the vaccine for the first time should receive 2 doses 1 month apart and should be repeated yearly. For full information about Flu vaccine please refer to the following link.
In USA, a live attenuated flu vaccine is also available and is used intra-nasally.

5. Combining multiple vaccines in one shot, does it affect immune system of the child?

Combining more than one vaccine in a single shot is advantageous, indeed. First, it allows giving vaccination as early as possible in the infant's life to give protection early since they are more prone to develop complications if they acquire infections. Second, it is less traumatic for the child and saves money. This practice is supported by the recommendations of the AmericanAcademy of Pediatrics (AAP), and Advisory Committee on Immunization Practices (ACIP) that are based on several studies.

6. What is the best way to find updates in immunization schedules?

Ministry of health in any country is the one responsible for updating immunization schedules. Moreover, it is not necessary that immunization schedules will be the same in all countries but will be very similar in essential immunizations.