Vaccine Reference Guide

VACCINE REFERENCE GUIDE

Excerpts from BC-CDC Manual

(Updated FEBRUARY 2017)

Basic Immunization for Children Starting Series at 2 Months of Age……...…………………2

Adults…………………………………………………………………………………………..3

Immunization of the Immunocompromised

Anatomic or functional Asplenia …………………………………………………………..4 - 5

Stem cell Transplant (Adult Worksheet for 18 years & up).……………………………….6 - 7

Section IIA – Immunization Schedules (August 2016)

2.0 ROUTINE SCHEDULES

2.1Schedule A: Basic Immunization for Children Starting Series at 2 Months of Age

The following recommendations will guide the development of the schedule for healthy children and

adolescents, and should be used in combination with the relevant Biological Product pages (see Section

VII-Biological Products). Children with specific health conditions and/or risk factors should be immunized

according to principles outlined in Section III-Immunization of Special Populations.

AGE / VACCINE
2months / DTaP-HB-IPV-Hib (or DTaP-IPV-Hib and HB) A
PCV13
Men-C-CB
RotaC
4months / DTaP-HB-IPV-Hib (or DTaP-IPV-Hib and HB)
PCV13 D
RotaC
6months / DTaP-HB-IPV-Hib (or DTaP-IPV-Hib and HB)
HepatitisA (Aboriginalinfantsonly)
Flu E
Onorafterthe1st
birthday / MMR
Var
PCV13
Men-C-C
18months / DTaP-IPV-Hib
HepatitisA (Aboriginalinfantsonly)
SchoolEntry
Booster(4-6yearsofage) / DTaP-IPV (or TdaP-IPV)
MMRVF
Grade6 / HPV9(2 dose 6 months apart, girlsonly)
Var(not required if 2 does already received)
Grade9 / TdaPG
Men-C-ACYW-135

The primary series of 3 doses of DTaP-containing vaccine should be completed with the same product.
For high risk infants, Men-C-ACYW-135 (Menveo®) should be given in place of Men-C-C and administered at 2, 4 and 12 months of age.
Give 1st dose of rotavirus vaccine no later than 20 weeks less 1 day of age and 2nd dose by 8 months less 1 day.
For high risk infants, an additional dose of PCV13 should be given at 6 months of age, followed by the dose at 12 months of age. High risk children should be given a dose of PPV23 at 2 years of age or older.
Annual influenza immunization is recommended for infants and children during the influenza season with 2 doses in the first year of vaccine receipt for children less than 9 years of age and 1 dose in subsequent years.
Separate MMR and varicella vaccine may be recommended for select special populations, see Section III-Immunization of Special Populations.
If a booster dose of Tdap is given after 10 years of age, the adolescent dose of Tdap given at 14-16 years of age is not needed, and subsequent Td booster doses are recommended every 10 years.

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Section IIA - Immunization Schedules (January 2016)

2.4 Schedule D: Adults Age 18 and Older When Starting or Resuming Immunization

The following vaccines are routinely offered to eligible adults in BC; this schedule should be used in combination with the relevant Biological Product pages (see Section VII-Biological Products). Additional vaccines may be recommended due to risk factors i.e., occupation, travel, lifestyle, health status. Refer to Section III-Immunization of Special Populations.

Vaccine Scheduling Guidelines and Routine Eligibility Criteria

HA •Aboriginal adults 18 years of age only: 2 doses given at 0 and 6 months

HB •Individuals 18 and 19 years of age: 3 doses (0.5 mL each) given at 0, 1 and 6 months

•Individuals 20 years of age and older born in 1980 or later: 3 doses (1.0 mL each) given

at 0, 1, and 6 months

HPV4 •Women born in 1994 or later and high risk males, up to 26 years of age (inclusive): 3

doses given at 0, 2 and 6 months.

Men-C-C •Adults up to 24 years of age (inclusive): 1 dose

MMR •Measles Protection: up to 2 doses of MMR are recommended for all individuals born on

or after January 1, 1970 (1957 for health care workers) who do not have a history of lab

confirmed measles infection, lab evidence of immunity, or documentation of 2 doses of a live measles-containing vaccine at 12 months of age or older and given at least 4 weeks apart.

•Mumps Protection: up to 2 doses of MMR are recommended for all individuals born on

or after January 1, 1970 (1957 for health care workers) who do not have a history of lab

confirmed mumps infection, or documentation of 2 doses of a live mumps-containing vaccine at 12 months of age and older and given at least 4 weeks apart.

•Rubella Protection: one dose of MMR is recommended for all individuals born on or

after January 1, 1957 who have not received 1 dose of a rubella-containing vaccine or who do not have serologic evidence of rubella immunity.

•If 2 doses of MMR vaccine are required, give at least 4 weeks apart.

IPV •Routine primary immunization against poliomyelitis of adults living in Canada is not

considered necessary. Primary immunization with polio vaccine is recommended only

for unimmunized adults who are at higher risk of exposure to wild polioviruses: refer to Section VII-Biological Products, Polio Vaccine.

•3 doses given at: 0 and 1 month, followed by a 3rd dose 6-12 months after the 2nd dose.

•If IPV is indicated, for those also requiring protection against tetanus, diphtheria or

pertussis, combination products can be used (i.e., Tdap-IPV and Td/IPV).

Td/Tdap •Adults receiving a primary immunization series should receive one dose of Tdap (to

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provide protection against pertussis) followed by 2 doses of Td. This serdies should begiven at: 0 and 1 month, followed by a 3rd dose 6-12 months after the 2n dose.

For adults resuming an interrupted immunization series, provide additional doses of

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•

vaccine to ensure that the client has received at least 3 doses of a diphtheria and tetanus

containing vaccine with at least one dose after the 4 h birthday.

Individuals born in 1989 or later who missed their adolescent Tdap booster are eligible

for one dose of Tdap.

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Var •Assess susceptibility. A varicella susceptible person is one without a history of varicella

or herpes zoster after 12 months of age and without a history of age appropriate varicella

immunization. A self-reported history of varicella is adequate for those born before 2004.

•For susceptible adults, do serological testing for immunity first. For information on

serological testing refer to the varicella vaccine page in Section VII-Biological Products.If susceptible give 2 doses of varicella vaccine 6 weeks apart.

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Section III - Immunization of Special Populations (May 2016)

1.5 SPECIFIC CONDITIONS

1.5.1 ANATOMIC OR FUNCTIONAL ASPLENIA

Recommended vaccines for those with anatomic or functional asplenia A B
All routine inactivated vaccines / Immunize according to routine schedule.
Hib vaccine / All individuals 5 years of age and older require one dose regardless of immunization history. C
Meningococcal quadrivalent
conjugate vaccine / Meningococcal quadrivalent conjugate vaccine for
those 2 months of age and older. (This vaccine to
be given in place of meningococcal C conjugate
vaccine in the routine childhood immunization
schedule).
Reinforcement dose(s) are recommended. D
Pneumococcal vaccine / Conjugate and/or polysaccharide vaccine
depending on age.
Requires once only revaccination with
polysaccharide vaccine.
Influenza vaccine / Immunize yearly (all those 6 months of age and
older). Inactivated influenza vaccine should be
used.
MMR vaccineE / Refer to Subsection 1.4 Immunization with Live
Vaccines. Use Referral Form for MMR
Vaccination. F
Varicella vaccine E / Refer to Subsection 1.4 Immunization with Live
Vaccines. Use Referral Form for Varicella
Vaccination. FSeparate doses by 12 weeks.
Rotavirus vaccine / Refer to Subsection 1.4 Immunization with Live
Vaccines. Use Referral Form for Rotavirus
Vaccination.

AFor specific vaccine schedule information, refer to BC Communicable Disease Control Manual,

Chapter 2, Section VII-Biological Products.

BTo maximize vaccine response, vaccine(s) should be given at least 14 days prior to elective

splenectomy, or if not possible 14 or more days post-splenectomy. However, administration of

vaccines within 14 days of splenectomy is not contraindicated. If there is concern that the patient

may not present later for immunization, give vaccine(s) before discharge.

CWith the exception of Hib vaccine, where one dose is recommended regardless of immunization

history, asplenic individuals do not require re-immunization.

DIf individual was previously vaccinated at 7 years of age and older: give 5 years after previous

dose. If individual was previously vaccinated at 6 years of age and under: give 3 years after

previous dose. Re-immunize every 5 years as long as medical condition exists.

EMMR and varicella vaccines are recommended depending on immunization history, age, and

susceptibility. Use separate MMR and varicella vaccines and separate by 4 weeks. MMRV

vaccine is contraindicated in this population.

FIf client had splenectomy following a traumatic injury many years previously and no longer has

a medical specialist, obtain referral for immunization with MMR and varicella vaccines from

client’s family physician, nurse practitioner or the Medical Health Officer.

Unimmunized individuals who have had a splenectomy in the past or who have

functional hyposplenism should be immunized as soon as their condition is identified.

Asplenia or hyposplenism may be congenital, surgical, or functional. A number of

conditions may lead to functional asplenia (e.g., sickle cell anemia, thalassemia major,

essential thrombocytopenia, celiac disease, inflammatory bowel disease, and

rheumatoid arthritis). Individuals with any of these conditions need further investigation

to determine whether their pre-existing condition is compromising their spleen function.

The spleen plays an important role in the body’s immune system, including:

Filtering antigen-antibody complexes and bacteria
Site for immunoglobulin M (IgM) production, antigen presentation to T cellsand memory B cell differentiation
Production site for a peptide that promotes phagocytosis.

An individual with decreased or no spleen function is at increased risk for infection from

a variety of pathogens, particularly those caused by encapsulated polysaccharide

bacteria (e.g., pneumococcal, meningococcal, and Hib bacteria).

Children who have sickle cell disease or have had a splenectomy are at increased risk

for fulminant pneumococcal sepsis associated with high mortality.

Section III - Immunization of Special Populations (January 2017)

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