Contents Chapter Topic Page Neonatology Respiratory Cardiology

1.1.6 Typhoid: a) Vi polysaccharide vaccine : Single dose. Seroconversion in >
90% of vaccines and confers 60 – 80% protection commencing within 14
days from vaccination. Boosters every 3 years. Immunogenicity < 2 years
of age has not been established.
b)Oral typhoid vaccine(Ty21a vaccine)* (three doses two days apart) and
whole cell typhoid vaccines are also available.
Category B
1.2 Other Vaccines available in Malaysia but not yet in KKM’s program:
1.2.1 Varicella zoster * 70 – 90 % effectiveness.
From 12 months to 12 years: single dose.
> 12 years old : 2 doses at least 28 days apart.
Two vaccines are currently available in Malaysia:
-Varivax (MSD)
-Varilrix (GSK)
Children who have not had chicken pox by 12 years of age are
encouraged to receive the vaccine as the illness is more severe in
older age groups.
Considered for children with asymptomatic or mildly symptomatic
HIV infection; two doses with a 3 month interval are recommended.
Children with leukaemia & are in remission for at least 1 year, &
have > 700/ml circulating lymphocytes may receive vaccination
under supervision of the attending paediatrician
1.2.2 Hepatitis A : 3 doses. Dose 1 and 2 at 2 - 4 weeks apart then Dose 3 at 6
– 12 months later. Adults need 2 doses 6 – 12 months apart.
Seroconversion rate almost 100%. Booster every 10 years. Approved for
children > 1-2 years of age
Missed second dose: If a child misses the second dose at 2 – 4 weeks
then:
If > 1 month and < 5 months from 1st dose just give the second
dose.
If > 5 months have elapsed from 1st dose repeat whole course.
1.2.3 Influenza: Indications and recommended vaccine will vary between
countries. Unprimed individuals will require a second dose 4 to 6 weeks
after the first dose. Yearly revaccination with the latest recommended
vaccine composition by WHO is required in countries at risk, e.g.
temperate climate
Recommendations:
chronic decompensated disorders of respiratory or cardiovascular
systems : e.g. cyanotic heart diseases, chronic lung diseases
HIV infection. In advanced disease, vaccination may not induce
protective antibody levels.
* Live-vaccines – usually only one dose is required to produce long term immunity (except
Yellow Fever for travel purposes (vaccination may be obtained at IMR & respective state health
departments. An International Certificate of Vaccination will be issued, valid for 10 years
commencing from 10 days after vaccination) and oral poliovirus vaccine which contains 3
different components and more doses are required to ensure an adequate response to each
component).