Appendix B: The Chief Public Health Officer's Report on the State of Public Health in Canada, 2009 – Routine immunization schedule for infants and children
Appendix B: Routine Immunization Schedule for Infants and Children
Figure B.1 Routine immunization schedule for infants and children footnote 53.
Symbols with brackets around them imply that these doses may not be required, depending upon the age of the child or adult. Refer to the relevant chapter for that vaccine for further details.
Diphtheria, tetanus, acellular pertussis and inactivated polio virus vaccine (DTaP-IPV): DTaP-IPV(± Hib) vaccine is the preferred vaccine for all doses in the vaccination series, including completion of the series in children who have received one or more doses of DPT (whole cell) vaccine (e.g. recent immigrants). The four- to six-year dose can be omitted if the fourth dose was given after the fourth birthday.
Haemophilus influenzae type b conjugate vaccine (Hib): the Hib schedule shown is for the Haemophilus b capsular polysaccharide - polyribosylribitol phosphate (PRP) conjugated to tetanus toxoid (PRP-T). For catch up, the number of doses depends on the age at which the schedule is begun. Not usually required past the age of five.
Measles, mumps and rubella vaccine (MMR): a second dose of MMR is recommended for children at least one month after the first dose for the purpose of better measles protection. For convenience, options include giving it with the next scheduled vaccination at 18 months of age or at school entry (four to six years of age) (depending on the provincial/territorial policy) or at any intervening age that is practical. In the catch-up schedule, the first dose should not be given until the child is ≥ 12 months old.
Varicella vaccine (Var): children aged 12 months to 12 years should receive one dose of varicella vaccine.
Hepatitis B vaccine (HB): hepatitis B vaccine can be routinely given to infants or pre-adolescents, depending on the provincial/territorial policy. For infants born to chronic carrier mothers, the first dose should be given at birth (with hepatitis B immunoglobulin), otherwise the first dose can be given at two months of age to fit more conveniently with other routine infant immunization visits. The second dose should be administered at least one month after the first dose, and the third at least two months after the second dose, but these may fit more conveniently into the four- and six-month immunization visits.
Pneumococcal conjugate vaccine - 7-valent (Pneu-C-7): recommended for all children under two years of age. The recommended schedule depends on the age of the child when vaccination is begun.
Meningococcal C conjugate vaccine (Men-C): recommended for children under the age of five, adolescents and young adults. The recommended schedule depends on the age of the individual and the conjugate vaccine used. At least one dose in the primary infant series should be given after five months of age. If the provincial/territorial policy is to give Men-C to persons ≥ 12 months of age, one dose is sufficient.
Influenza vaccine (Inf): recommended for all children 6 to 23 months of age and all persons ≥ 65 years of age. Previously unvaccinated children < nine years of age require two doses of the current season's vaccine with an interval of at least four weeks. The second dose within the same season is not required if the child received one or more doses of Influenza vaccine during the previous Influenza season.
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