INFL

UEN

ZA

MEALES, MUMPS,

RUBELLA

MENINGOCOCCAL

POLYSACCHARIDE

PNEUMOCOCCAL

POLYSACCHARIDE

TETANUS, DIPHTHERIA, PERTUSSIS

VARICELLA

HEPATITIS A

HEPATITIS BHU

MAN

PAP

ILLO

MA

VIRU

S

Anyo

ne st

artin

g at

6mos

10-65 yo without evidence of

immunity

For those at risk

For all susceptible esp. >50yo, for those without

previous vaccine, give PCV13 followed by PPSV23

after 8wks;if 2 nd dose of PPSV23 is required, give 5 yrs

after

Td every 10yrs; TDaP recomm

ended as one-time substitute

dose for persons aged 10-64yo

Recommended for all adults/adolescents

with no evidence of immunity

For all living in areas of high prevalence (eg. Asia)

Universa

l immuniza

tion of all infants,

adolescents, adults

HPV4

& H

PV2

routi

nely

giv

en to

fem

ales

9-1

9yo;

cat

ch u

p

vacc

inati

on: 1

9-45

yo fo

r HPV

4,

19-

55yo

for H

PV2,

HPV

4 al

so g

iven

to m

ales

9-2

6yo

Anap

hylax

is with

a pr

ior d

ose,

mod

erat

e-

seve

re ill

ness

+/- f

ever

, age

<6m

os, a

ctive

Guilla

n Bar

re

synd

rom

e, eg

g alle

rgy

Allergy to a prior dose, allergy to

gelatin/neomycin, pregnancy, those on

large doses of steroids

Allergy to one component, defer

if with moderate-severe illness Allergy to phenol/thimerosal,

moderate-severe illness

+/- fever

Moderate-severe illness +/-fever’ allergy to

thimerosal, allergy to prior dose,

bleeding disorders

Pregnancy, allergy to prior dose,

malignant conditions of bone

marrow/lymphatic system,

1°/acquired immunodeficiency,

on high dose

immunosuppressants/low dose

steroids >2wks

Allergy to a vaccine component, not

given to those highly febrile

Seve

re a

llerg

y to

a

prio

r dos

e

Single

IM d

ose

1x/y

r (F

eb-Ju

ne)

Adolescents/adults:

2 doses

(0,1 mos)

Single dose, revaccinate after 5yrs

Single dose,

revaccinate after 5 yrs

for high risk patient 3 doses: 0,1,6-12mos

Booster every 10yrs

2 doses (0,1 mos)2doses (0,6-12mos)3doses (0

,1,6);accelerated 4

doses (0,7,21days,1

2 mos)

HPV4

(0,2

,6 o

r 0,1

,4)

HPV2

(0,1

,6)

Give

n at

any

trim

este

r

Contraindicated Pregnancy/lactation

not contraindication Given if needed1dose during each

pregnancy at 27-36w

ks

Contraindicated

Given if neededPregnancy/la

ctation

not contra

indicatedIf

foun

d to

be

preg

nant

, rem

aini

ng

dose

s giv

en a

fter d

eliv

ery

Allergy to a va

ccine

component, not

given to th

ose highly

febrile

Indications

Contraindications Dose Pregnancy

Perforated hole

Injectable Vaccine Administration Guidelines for Adolescents & Adults

Vaccine

Storage

Route

Site

Hepatitis A R

IM Deltoid

Hepatitis B R

IM Deltoid

HPV R IM Deltoid

Influenza R

IM Deltoid

MMR R* SC Lateral upper arm

Meningococcal R IM Deltoid

Pneumococcal R SC Lateral upper arm

IM Deltoid

Td/TDaP R

IM Deltoid

Varicella R SC Lateral upper arm

*can freeze lyophlized MMR powder but not diluent

R-refrigerator F-freeze IM-intramuscular SC-subcutaneous

2013 POGS IFW

RECOMMENDATIONS

INFL

UEN

ZA

MEALES, MUMPS,

RUBELLA

MENINGOCOCCAL

POLYSACCHARIDE

PNEUMOCOCCAL

POLYSACCHARIDE

TETANUS, DIPHTHERIA, PERTUSSIS

VARICELLA

HEPATITIS A

HEPATITIS BHU

MAN

PAP

ILLO

MA

VIRU

S

Perso

ns w

ith ch

roni

c illn

esse

s;

women

who

will

be p

regn

ant

durin

g the

influ

enza

seas

on;

healt

h ca

re w

orke

rs; re

siden

ts of

nursi

ng h

omes

or l

ong t

erm

care

facil

ities

; per

sons

likely

to

trans

mit

influ

enza

to p

erso

ns at

high

risk

Persons > 50 y/o; persons

with chronic illnesses;

asplenia;

imm

unocomprom

ised

patients; persons

receiving chemotherapy,

antimetabolites, high

dose long term

corticosteroids; residents

of long term care

facilities

Td: adults including pregnant w

omen w

ith uncertain histories of a

complete prim

ary vaccination series or

whose last vaccination w

as 10 years or m

oreTdap: 10-64 y/o, pregnant

wom

en who have not

received Tdap; health care w

orkers and those in a high risk

pertussis environm

ent

Persons who do not have a

reliable history of varicella

infection, previous

vaccination, or serological

evidence of prior varicella

zoster virus infection;

adolescents and adults who

previously received only

one dose

Persons with clotting disorders or chronic liver disease; men who have

sex with men; illegal drug users; persons with occupational risk;

persons travelling to or working in endemic areas

Persons w

ith >1 se

x partn

er

in the past 6

months; S

TI

clinic c

lients; household

contacts and se

xual partners

of individuals w

ith ch

ronic

Hepatitis B infection; m

en

who have sex with

men;

injection-drug users; perso

ns

in institutions for th

e

disabled; health

care

workers;

HIV infection;

travellers t

o endemic

areas; inmates o

f

correctional fa

cilities

Pers

ons w

ho a

re o

r will

be

sexu

ally

activ

e

Previously unvaccinated

adolescents (prior to high

school entry); students in

dormitories; microbiologists;

military recruits; persons

travelling to or living in

hyperendemic/endemic

areas; asplenia;

complement component

deficiencies

Persons born in or after 1957

without prior proof of immunity or

documentation of one or more

dose; persons with recent

exposure to measles or mumps or

in an outbreak setting; persons

who were previously vaccinated

with killed measles vaccine;

persons who were vaccinated

between 1963-1967; college

students; those in postsecondary

education institutions; health care

workers; international travellers;

women who lack laboratory

evidence of immunity

WHO IS

AT

RISK?

General Principles of Vaccination:

•

Vaccination is ideally universal in coverage.

•

Vaccination is a primary healthcare service.

•

Can be given by any at all healthcare encounters.

General Considerations for Vaccination:

•

Never administer vaccines in buttock

•

Maintain vaccine administration record in patient’s chart including date,

site, and route of administration; manufacturer and lot number of vaccine

•

Simultaneous administration of vaccines is not contraindicated.

•

The presence of a pregnant woman or immunosuppressed person in the

household is not a reason to withhold an indicated vaccine to a family

member .

•

If a live attenuated vaccine is not given simultaneously with another

vaccine, a 4-wk interval should be used between vaccinations.

IMMUNIZATIONS