BNF for Children 2011-2012

BNFC 2011–2012 14.1 Active immunity 601Immunisation scheduleVaccines for the childhood immunisation schedule should be obtained from local health organisations or from ImmForm(www.immform.dh.gov.uk)—not to be prescribed on FP10 (HS21 in Northern Ireland; GP10 in Scotland; WP10 in Wales).Preterm birthBabies born preterm should receive all routine immunisations based on their actual date of birth. The risk ofapnoea following vaccination is increased in preterm babies, particularly in those born at or before 28 weekspostmenstrual age. If babies at risk of apnoea are in hospital at the time of their first immunisation, theyshould be monitored for 48 hours after immunisation. If a baby develops apnoea, bradycardia, or desaturationafter the first immunisation, the second immunisation should also be given in hospital with similarmonitoring. Seroconversion may be unreliable in babies born earlier than 28 weeks’ gestation or in babiestreated with corticosteroids for chronic lung disease; consideration should be given to testing for antibodiesagainst Haemophilus influenzae (type b), meningococcal C, and hepatitis B after primary immunisation.When to immunise (for prematureinfants—see noteabove)Neonates at risk onlyVaccine given and dose schedule (for details of dose, see under individual vaccines). BCG VaccineSee section 14.4, BCG Vaccines. Hepatitis B VaccineSee section 14.4, Hepatitis B Vaccine2 months . Diphtheria, Tetanus, Pertussis (Acellular, Component), Poliomyelitis (Inactivated), andHaemophilus Type b Conjugate Vaccine (Adsorbed)First dose. Pneumococcal Polysaccharide Conjugate Vaccine (Adsorbed)First dose3 months . Diphtheria, Tetanus, Pertussis (Acellular, Component), Poliomyelitis (Inactivated), andHaemophilus Type b Conjugate Vaccine (Adsorbed)Second dose. Meningococcal Group C Conjugate VaccineFirst dose4 months . Diphtheria, Tetanus, Pertussis (Acellular, Component), Poliomyelitis (Inactivated), andHaemophilus Type b Conjugate Vaccine (Adsorbed)Third dose. Meningococcal Group C Conjugate VaccineSecond dose. Pneumococcal Polysaccharide Conjugate Vaccine (Adsorbed)Second dose12 –13 months . Measles, Mumps and Rubella Vaccine, Live (MMR)First dose. Pneumococcal Polysaccharide Conjugate Vaccine (Adsorbed)Single booster dose. Haemophilus Type b Conjugate Vaccine and Meningococcal Group C Conjugate VaccineSingle booster doseBetween 3 years and 4months, and 5 years. Adsorbed Diphtheria [low dose], Tetanus, Pertussis (Acellular, Component) and Poliomyelitis(Inactivated) VaccineorAdsorbed Diphtheria, Tetanus, Pertussis (Acellular, Component) and Poliomyelitis(Inactivated) VaccineSingle booster doseNote: Preferably allow interval of at least 3 years after completing primary course. Measles, Mumps and Rubella Vaccine, Live (MMR)Second dose12–13 years (females only) . Human Papilloma Virus Vaccine3 doses; second dose 1–2 months, and third dose 6 months after first dose 113–18 years . Adsorbed Diphtheria [low dose], Tetanus, and Poliomyelitis (Inactivated) VaccineSingle booster doseDuring adult life, women ofchild-bearing age susceptibleto rubella. Measles, Mumps and Rubella Vaccine, Live (MMR)Women of child-bearing age who have not received 2 doses of a rubella-containingvaccine or who do not have a positive antibody test for rubella should be offered rubellaimmunisation (using the MMR vaccine)—exclude pregnancy before immunisation, but seealso section 14.4, Measles, Mumps and Rubella Vaccine1. The two human papilloma virus vaccines are not interchangeable and one vaccine product should be used for the entirecourse; however, Department of Health (November 2008) states for individuals with previous incomplete vaccination withGardasil c , who are eligible for HPV vaccination under the national programme, Cervarix c can be used to complete thevaccination course if necessary; the individual must be informed that Cervarix c does not protect against genital warts.14 Immunological products and vaccines