Page 1193 - Basic _ Clinical Pharmacology ( PDFDrive )

Appendix: Vaccines, Immune Globulins, & Other Complex Biologic Products 1179

TABLE A–2 Recommended routine childhood immunization schedule.

Age Immunization Comments
Birth to 2 months Hepatitis B vaccine (HBV) Infants born to seronegative mothers: Administration should begin prior
to hospital discharge, with the second dose administered at least 4 weeks
after the first dose.
Infants born to seropositive mothers: Should receive the first dose within
12 hours of birth (with hepatitis B immune globulin), the second dose at
1–2 months of age, and the third dose at 6–18 months of age.
2 months Diphtheria and tetanus toxoids and acellular
pertussis vaccine (DTaP), inactivated poliovirus
vaccine (IPV), Haemophilus influenzae type
1
b conjugate vaccine (Hib), pneumococcal
conjugate vaccine (PCV), rotavirus vaccine (RV) 2
1–2 months HBV The second dose should be given at least 4 weeks after the first dose.
1
4 months DTaP, Hib, IPV, PCV, RV 2
1
6 months DTaP, Hib, PCV, RV 2 The third dose of RV is only necessary if RV-5 is used for one or two of the
first two doses.
6–18 months HBV, IPV, influenza The third dose of HBV should be given at least 16 weeks after the first dose
and at least 8 weeks after the second dose, but not before age 24 weeks.
Influenza vaccine should be administered annually to children aged
6 months to 18 years. Live attenuated influenza vaccine cannot be
administered until age 2 years.
1
12–15 months Measles-mumps-rubella vaccine (MMR), Hib, The first dose of MMR may be administered at 6–11 months before depar-
PCV, varicella vaccine ture from the USA for international travel. These infants should receive two
additional doses at the usual interval. Children ≥12 months of age should
receive a second dose at least 4 weeks after the first dose before departure
from the USA for international travel.
15–18 months DTaP DTaP may be given as early as age 12 months if there has been at least
6 months since the third dose.
12–23 months Hepatitis A vaccine Two doses ≥6 months apart.
4–6 years DTaP IPV, MMR, varicella vaccine The second dose of MMR should be routinely administered at age
4–6 years but may be given during any visit if at least 4 weeks have elapsed
since administration of the first dose.
11–12 years Tetanus, diphtheria, pertussis (Tdap) vaccine, Three doses of HPV should be administered to females at 0, 1–2, and
3
human papillomavirus vaccine (HPV), 6 months (may be started as early as age 9 years). HPV4 or HPV9 may be
meningococcal conjugate vaccine (MCV) administered to males aged 9–18 years to reduce the likelihood of devel-
oping genital warts. Administer one dose of Tdap to pregnant adolescents
during each pregnancy at 27–36 weeks of gestation. A booster dose of
MCV should be given at age 16 years.
1
Three Hib conjugate vaccines are available for use: (1) oligosaccharide conjugate Hib vaccine (HbOC), (2) polyribosylribitol phosphate-tetanus toxoid conjugate (PRP-T), and
(3) Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) (PRP-OMP). Children immunized with PRP-OMP at 2 and 4 months of age do not require
a dose at 6 months of age. PRP-T should only be used for the booster dose in children aged 12–15 months.
2 Two RV vaccines are available for use: (1) RV-1 (Rotarix) monovalent live, oral, human attenuated rotavirus vaccine is approved for a two-dose series, and (2) RV-5 (RotaTeq) pentavalent
live, oral, human-bovine reassortant rotavirus vaccine is approved for a three-dose series.
3 Three HPV vaccines are available for use: (1) quadrivalent vaccine (HPV4) and (2) 9-valent vaccine (HPV9) for the prevention of cervical, vaginal, and vulvar cancers (in females)
and genital warts (in males and females), and (3) bivalent vaccine (HPV2) for the prevention of cervical cancers in females.
Adapted from MMWR Morb Mortal Wkly Rep 2013;62(Suppl 1).

hypersensitivity reactions to immune globulin that may limit is not available and administration of the specific antibody is
therapy. Conventional immune globulin contains aggregates of deemed essential, desensitization can be carried out.
IgG; it will cause severe reactions if given intravenously. However, Antibodies derived from human serum not only avoid the risk
if the passively administered antibodies are derived from animal of hypersensitivity reactions but also have a much longer half-life
sera, hypersensitivity reactions ranging from anaphylaxis to serum in humans (about 23 days for IgG antibodies) than those from
sickness may occur. Highly purified immunoglobulins, especially animal sources (5–7 days or less). Consequently, much smaller
from rodents or lagomorphs, are the least likely to cause reactions. doses of human antibody can be administered to provide thera-
To avoid anaphylactic reactions, tests for hypersensitivity to the peutic concentrations for several weeks. These advantages point to
animal serum must be performed. If an alternative preparation the desirability of using human antibodies for passive protection