VACCINES

BACILLE CALMETTE-GUERIN (BCG) VACCINE

Type : Live bacterial, lyophilized

Composition : Bovine strain Danish – 1331 (BCG strain)
Diluent—Normal saline
Schedule as per EPI- Primary : At birth, if not given upper age limit less than or equal to 1 yr.
Booster : Not required*

Administration:
Dose : 0.05 ml for < 1 month, 0.1 ml for > 1 month*
Route : Strictly intradermal(If the vaccine is given subcutaneously, it may cause suppurative
lymphadenitis)
Site : Upper left arm just above the insertion of deltoid.
Normal reaction- Two to three weeks after vaccination, a papule develops at the site of
administration. The papule increases in size up to 4 to 8 mm and breaks into a shallow ulcer
after five weeks. The ulcer heals leaving behind a tiny, round, permanent scar after 6 to 12
weeks.
Unwanted reaction : Prolonged ulceration, local abscess, sinus, lymphadenitis.
Contraindications :
Symptomatic HIV infection, Immunodeficiency, Pregnancy, Generalize eczema*
Special precautions:
 Correct intra-dermal injection to be given
 Unused reconstituted vaccine is discarded after 4 hour or at the end of session whichever
come earlier.(for this kindly mention the time of vial reconstitution on vial with permanent
marker)
 Protect the vaccine from direct exposure to sunlight
Storage : 2 to 8 °C
Protective value : 0 to 80 percent
Availability : Freeze-dried powder form along with diluents—Normal saline
Vial of 10 /20 doses (1 ml = 1 mg).
 ORAL POLIO VACCINE (OPV)

Type : live attenuated (Magnesium chloride is used as a stabilizer)

Schedule :
 Primary : At birth, 6 week, 10 week and 14 week of age
 Booster : 1st dose at 16-24 month with DPT
2nd dose at 5th year with DT
 Supplementary : Given in all pulse polio and national immunization days
regardless of previous doses
Administration
Dose : 2 drops (each drop of 0.05 ml)
Route : Oral
Unwanted reaction : Almost nil
Contraindications: Symptomatic HIV infection, immunodeficiency (in
immunodeficiency,Inactivated po-liovirus vaccine (IPV) is preferred)
Storage : 2 to 8 °C, may be frozen for long duration
Protective value : Lifetime
Availability : 2 ml (20 dose) vial with dropper.
 MEASLES VACCINE

Type : Live attenuated, Freeze-dried

Composition : 1000 TCD 50 Edmonston-Zagreb (EZ) strain per 0.5 ml
Schedule : First dose: At 9th month
Second Dose: 16-18 months
Administration
Dose : 0.5 ml
Route : Subcutaneous
Site : Upper arm
Unwanted reaction : Mild fever and rash (5–12 day), Rarely toxic shock
syndrome (TSS), encephalitis, anaphylaxis
Contraindications : Severe reaction to previous dose, pregnancy, untreated
active TB, immune disorder
(symptomatic HIV)
Special precautions : Reconstituted vaccine should be used in the same day
Storage : 2 to 8 °C, may be frozen during long storage
Protective value : Lifetime
Availability : Vial with powder and separate diluent (distilled water).
 MEASLES–MUMPS–RUBELLA (MMR)

Type : Live attenuated viral, trivalent

Composition :
 Measles: 1000 TCID 50 EZ strain HDC cultured
 Mumps: 5000 TCID 50 Jeryl Lynn (JL) strain chick embryo fibroblast culture
 Rubella: 1000 TCID 50 Wistar RA 27/3 HDC cultured strain
Schedule
Primary : 9 month (15 to 18 month is optimal age)
Booster : Not given
Administration
Dose : 0.5 ml
Route : Subcutaneous
Site : Outer mid thigh or upper arm
Unwanted reaction : Fever and rashes , Rarely febrile convulsions. Aseptic
meningitis, SSPE—Subacute sclerosing pan encephalitis
Contraindications: Untreated TB , immunodeficiency, pregnancy
Special precautions : Strictly subcutaneous route
Storage : 2 to 8 °C may be frozen in long storage
Protective value : Durable, high efficacy
Availability : Powder form with diluent (distilled water).
 TETANUS TOXOID VACCINE (TT)

Type : Toxoid monovalent, inactivated toxin

Composition : Tetanus toxoid: 5 Lf Adsorbed to aluminium phosphate (PTAP)
Schedule
Routine : Apart from DTP, 2 doses of TT given at 10th year and 16th year
Previously unimmunized—5 doses given
1st dose on elected day, next doses on 4th week, 6th month, 1st year and 5th year.
Later, every 10 year
Pregnancy— 2 doses in first pregnancy , 4 to 6 week apart
1 dose in second pregnancy, if within 3 year
Administration
Dose : 0.5 ml
Route : Intramuscular (IM)
Site : Outer upper arm
Unwanted reaction : Mild local reactions
Unnecessary excessive doses may cause hyperimmunization syndrome
Contraindications :
H/o previous allergy ,Acute and severe infections, Outbreak of polio
Special precautions : Unnecessary excessive doses are avoided
Storage : 2 to 8 °C, never freeze. Withstands up to 37 ºC
Protective value : 20 year (after 5 dose schedule)
Availability : Liquid in vials/ampoule
 HEPATITIS-B (HEP-B) VACCINE

Type : Monovalent antigen, subunit genetically engineered Plasma derived

vaccine (PDV)
Composition : 20 micrograms of 22 nm surface antigen particles (HBsAg) per ml
Schedule Primary : 3 doses at 0, 1 and 6 month
Booster : Every 5 year
Administration
Dose : 0.5 ml for children < 10 year, 1 ml for > 10 year
Route : Intramuscular (IM)
Site : Outer mid thigh/Outer upper arm
Unwanted reaction : Negligible, one of the safest vaccine Rarely local redness
and fever
Contraindications : Hypersensitivity to previous dose.
Special precautions :
 Not administered to gluteal region, as the response is poor
 Immunosuppressed needs large dose
 In Neonates born to HBsAg carrier mother, Hepatitis B immunoglobulin
(HBIG) is given prior to vaccination
Storage : 2 to 8 °C, never freeze
Protective value : Over 95 percent for 5 year
Helps in preventing mother to child and child to child transmission
Availability : Cloudy liquid in single/multi dose vials often as prefilled auto-
disable (AD)
 RABIES—CELL CULTURED VACCINE (PCEC)

Type : 1. Cell cultured—Human diploid cell cultured vaccine

2. Non-human propagated in primary chick fibroblast cell
culture, lyophilized
Composition:
Inactivated rabies virus, flury low-egg-passage (LEP) strain 2.5 IU/dose
Schedule
Primary : 0, 3, 7, 14, 28 day; Started as soon as possible after exposure
Booster : 90 day (Category III bites)
Administration
Dose : 1 or 0.5 ml (containing 2.5 IU) Dose independent of age, sex and weight
Route : Intramuscular
Site : Deltoid region
Unwanted reaction : Local redness, Fever,Rarely immune complex disease for
booster dose
Contraindications : Nil
Special precautions :
 To be used immediately after reconstitution
 Diluent is added slowly along the side of the wall of the vial
 Not to be injected to the gluteal region, as the immunogenicity is poor
Storage : 2 to 8 ºC, should not be freezed
Protective value : 15 day to 3 month
Availability : Ampoule with sterile water and syringe
 CHICKEN POX (VARICELLA)

Type : Live attenuated lyophilized

Composition : OKA strain of Varicella zoster (VZ) virus
Schedule
Primary : Single dose up to 1 year, 2 doses > 1 year at eight week interval
Booster : Not applicable
Administration
Dose : 0.5 ml
Route : Subcutaneous
Site : Outer aspect of upper arm
Unwanted reaction : Mild local reactions Fever and rash within 4 week
Contraindications :
Neomycin hypersensitivity, Pregnancy, immunodeficiency, Symptomatic HIV
Special precautions :
 Salicylates should not be used for 6 week after vaccination
 Pregnancy is postponed for 3 month after vaccine
 Not mixed with other vaccine in same syringe
 Used within 30 minute of reconstitution
Storage : -15 ºC
Protective value : For 10–20 year
Availability : Freeze-dried form
 PENTAVALENT

Type : Pentavalent, freeze-dried

Composition :Diphtheria, tetanus, pertussis, hepatitis B, haemophilus influenza B
Schedule : Primary : 6, 10, 14 week of age (before 6 year of age)
Administration
Dose : 0.5 ml
Route : Intramuscular
Site : Outer mid thigh
Unwanted reaction : Localinflammation ,Mild fever
Contraindications : Severe reaction to previous dose
Special precautions : Not given at birth and after 6 year,
Storage : 2 to 8 °C

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 GARDASIL(HPV VACCINE)

Type : Gardasil HPV Vaccine (Recombinant Human Papillomavirus

Quadrivalent Vaccine) is a vaccine synthesized using recombinant technology.

Composition : contains purified inactive proteins from HPV types 6, 11, 16,
and 18. The proteins in Gardasil are structural, virus-like proteins (VLP) that
resemble the HPV virus.
Schedule : The first dose is administered at the patient's convenience, the
second dose two months after the first dose, and the third dose six months after
the first dose.
Administration
Dose : 0.5 ml single-dose vial and pre-filled syringe
Route : Intramuscular
Unwanted reaction : Localinflammation ,Mild fever
Contraindications : Severe reaction to previous dose

Storage : 2 to 8 °C and should be protected from light and not frozen.

VACCINE VIAL MONITOR (VVM) STAGES