Indian Academy of Pediatrics recommends their members to prescribe additional vaccines to their child patients depending upon the availability at the vaccines and the affordability of the patents. However, it is mandatory to administer all the UIP vaccines as a priority.
The basic objective of immunization program of any country is the reduction of mortality, prolonged sequelae, disability and morbidity in order of priority against diseases that can be prevented by vaccines. Therefore, the vaccination schedule of a country should be mainly based on epidemiological profile of the diseases that leads to significant mortality, disability and morbidity. Additional important factors that need consideration are the logistics and operational feasibility, availability and the cost effectiveness of the vaccine. At this time, sufficient data are available to justify the inclusion of six diseases currently being covered under National Immunization Schedule. However in view of enough new data on various diseases and availability of several vaccines, Indian Academy of Pediatrics recommends their members to use other vaccines to their clients depending upon the availability and affordability of the vaccines. However, it is mandatory to administer all the vaccines under National programme as a priority.
The IAP after detailed deliberations in the meeting of the Committee on Immunization formulated a policy on different vaccines to be administered to the children under their care. There is now sufficient epidemiological data to suggest that Hepatitis B vaccine to be given to the children starting at birth for prevention of perinatal transmission followed by two more doses at 6 and 14 weeks. If the birth dose is missed, the vaccine can be given at 6, 10 & 14 weeks. Sufficient available data suggests that 3 doses given at 1 month interval produces long lasting immunity. IAP also recommends inclusion of MMR, Typhoid and Haemophilus Influenzae b in the time table. However, in view of the mild nature of chickenpox and hepatitis A, these two are recommended as additional vaccines. If adolescents do not suffer from chickenpox by 12 years of age, varicella vaccine should be administered.
IAP Immunization Time Table
| Vaccine | Age Recommended |
|---|---|
| BCG | Birth - 2 weeks |
| OPV | Birth, 6, 10, 14 weeks 15 - 18 months, 5 years |
| DPT | 6 weeks, 10 weeks, 14 weeks 16 - 18 months, 5 years |
| Hepatitis B | Birth, 6 weeks, 14 weeks / 6 weeks, 10 weeks, 14 weeks |
| Hib Conjugate | 6 weeks, 10 weeks, 14 weeks 16 - 18 months |
| Measles | 9 months plus |
| MMR | 15 months |
| Typhoid | Above 2 years |
| 2 doses of TT | Pregnant Women |
Additional Vaccines
Varicella* 1 year onwards
Hepatitis A** 2 years onwards
Note
- To prevent perinatal transmission, birth dose of Hepatitis B vaccine within 12 hours is essential. BCG, OPV and Hepatitis B vaccines, when missed at birth can be started at the completion of 6 weeks.
- Combined DPTwc / Hepatitis B / Hib vaccines can be given at 6, 10, 14 weeks.
- In addition to ‘Routine OPV doses’, the recommended ‘Pulse OPV doses’ are also mandatory during PPI campaigns.
- For Typhoid* immunization, earliest age recommended : whole cell vaccine at 6 months, Vi antigen at 2 years and Oral Ty21a vaccine at 6 years. Revaccination every 3 years.
- Apart from the earliest age indicated, MMR, Typhoid, Varicella and Hepatitis A can be given at any age, relevant to local epidemiology.
- Td (Tetanus / diphtheria toxoid) should be preferred to TT (Tetanus toxoid) where available.
- Varicella** and Hepatitis A** are additional vaccines as recommended by Indian Academy of Pediatrics.
