1. Rotravirus vaccine: It is true that the
figure with range does not show the range of administration of rotavirus
vaccines . We have deliberately avoided providing a range since it is
of paramount importance to complete the series with RV1 or RV5 within
the stipulated time limit owing to higher incidence of intussusception
if the prescribed age-limit is exceeded. It is not always possible to
display all the information in a single figure or chart. The detailed
information on administration of each of the vaccines shown in the
figure is provided in the footnotes. One should also make note of the
footnote immediately below the figure which reads, "These
recommendations must be read with the footnotes that follow".
2. Hepatitis B vaccine: It is customary to
provide ideal minimum and maximum intervals between different doses of a
vaccine that is employed in more than one dose schedule. This is of
significant importance for those who fall behind or start late, i.e.
for catch-up vaccination. The schedule and duration provided in the IAP
immunization schedule are ideal for immunizing an individual child in
office practice. However, Hepatitis B vaccine is also provided through
mass immunization in Universal Immunization Program (UIP) in a shorter
schedule (i.e. at birth, 6, 10 and 14 weeks) mainly due to
logistic and programmatic reasons. These schedules are also found to be
protective and permitted for use in large scale immunization programs,
particularly in developing countries .
3. HPV vaccine: The most appropriate time slot
recommended for HPV vaccine is indicated in yellow shade in the figure
. As elaborated above, it is not possible to display all the
information in a single figure and the figure must be read with the
footnotes that follow.
4. Changing the needle: The current
recommendation, i.e. "changing needles between drawing vaccine
into the syringe and injecting it into the child is not necessary" is
based on overall general vaccination practice all over the world. In
most instances it is not necessary. The recommendation is also in
concurrence with the guidelines issued by international agencies like
CDC and WHO. However, on certain exceptional occasions when the
clinician thinks the needle may have got blunted due to multiple
punctures/pricks, it can be changed.
1. Vashishtha VM, Choudhury P, Kalra A, Bose A,
Thacker N, Yewale VN, et al. Indian Academy of Pediatrics (IAP)
Recommended immunization schedule for children aged 0 through 18 years -
India, 2014 and updates on immunizations. Indian Pediatr.
2. Hepatitis B vaccines. WHO position paper. Wkly Epidemiol Rec.