II. Technique: Decreased adverse reaction associated factors

  1. Greater depth of injection with longer needle (2.5 cm or 1 inch)
    1. Fewer injection site reactions
  2. Use 23 gauge, 25 mm needle

III. Adverse Effects: Safety

IV. Contraindications

V. Protocol: Vaccinations

  1. Hepatitis B Vaccine (HepB Vaccine)
    1. Dose 1: Birth to age 2 months
    2. Dose 2: Age 1 to 4 months (>1 month after dose 1)
    3. Dose 3: Age 6 to 18 months (>2 months after dose 2)
  2. Hepatitis A Vaccine
    1. Dose 1: Age 12 months
    2. Dose 2: Age 18 months
  3. Diphtheria Tetanus acellular Pertusis (DTaP Vaccine)
    1. Dose 1: Age 2 months
    2. Dose 2: Age 4 months
    3. Dose 3: Age 6 months
    4. Dose 4: Age 12 to 18 months (>6 months after dose 3)
    5. Dose 5: Age 4 to 6 years
    6. Tdap Booster: Age 11 to 12 years
  4. Haemophilus Influenzae type B (Hib Vaccine)
    1. Dose 1: Age 2 months
    2. Dose 2: Age 4 months
    3. Dose 3: Age 6 months
    4. Dose 4: Age 12 to 15 months
  5. Inactivated Polio Vaccine (EIPV)
    1. Dose 1: Age 2 months
    2. Dose 2: Age 4 months
    3. Dose 3: Age 6 to 18 months
    4. Dose 4: Age 4 to 6 years (Dose 4 not needed if third dose given after age 4 years)
  6. Pneumococcal Conjugate Vaccine (PCV, Prevnar)
    1. Dose 1: Age 2 months
    2. Dose 2: Age 4 months
    3. Dose 3: Age 6 months
    4. Dose 4: Age 12 to 15 months
  7. Measles Mumps Rubella Vaccine (MMR)
    1. Dose 1: Age 12 to 15 months
    2. Dose 2: Age 4 to 6 years (by age 12 years)
  8. Varicella Vaccine
    1. Dose 1: Age 12 to 18 months
    2. Dose 2: Age 5 years
  9. Rotavirus Vaccine
    1. Dose 1: Age 2 months
    2. Dose 2: Age 4 months
    3. Dose 3: Age 6 months (not required if Rotarix was used for Dose 1 and 2)
  10. Influenza Vaccine
    1. Annually between age 6 months and 5 years
  11. Meningococcal Conjugate Vaccine (MCV4)
    1. Administer at 11-12 years or
    2. Before age 18 years
  12. Human Papillomavirus Vaccine
    1. Dose 1: Age 11-12 years in boys and girls
    2. Dose 2: 2 months after first dose
    3. Dose 3: 6 months after first dose

VII. Protocol: Special Circumstances

  1. Prematurity: Immunize if over >1000 grams or >27 weeks
    1. Low Incidence of Hepatitis B and Hib reactions
  2. Children with HIV Infection
    1. Inactivated Polio Vaccine (EIPV) in Primary Series (avoid Oral Polio Vaccine)
    2. Influenza Vaccine
    3. Pneumococcus Vaccine at 24 months
    4. Measles-Mumps-RubellaVaccine

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