Routine Childhood Vaccination

• The aim is to ensure that all target age groups complete their immunization schedule as above
• Age for vaccinations: Give each vaccine at the recommended age or if this is not possible, at first contact with the child after this age
• BCG vaccination
  • Give this as early as possible in life, preferably at birth
  • Do NOT give BCG vaccine to any child with clinical signs and symptoms of immunosuppression, e.g. AIDS
• Use each vaccine with its corresponding pre-cooled diluent from the same manufacturer
• Polio 0 vaccination (= ‘zero dose’): This is a primer dose of oral polio vaccine (OPV), which should be given ideally at birth but otherwise in the first 2 weeks of life
• DPT-HepB-Hib vaccine
  • Is a combination of DPT vaccine + hepatitis B vaccine (HepB) + haemophilus influenzae type b (Hib) vaccine
  • Minimum interval between each of the doses is 4 weeks
• Measles vaccination
  • Normally given at 9 months of age or first contact after this age
  • Can also be given to any unimmunised child of 6-9 months old who has been exposed to measles patients. Children vaccinated in this way must have the vaccination repeated at 9 months of age
• Vaccination of sick children
  • Admit and treat any child who is severely ill, and vaccinate at the time of discharge
  • Minor illness is not a contraindication to vaccination

Storage and transport

• At health units, vaccines should be stored between +2°C to +8°C
• At the district and central vaccine stores (static units) where freezers exist, polio and measles vaccines may be stored for prolonged periods at -20°C
• Do not freeze DPT-HepB-Hib, PCV, IPV, HPV and TT vaccines
• Never freeze the diluents for BCG and measles vaccines
• Use conditioned ice packs and sponge method for transport
• Carefully follow recommended procedures to maintain the cold chain for all vaccines, e.g.:
  • Ensure continuous supply of power/gas
  • Record fridge temperature twice daily (morning and evening, including weekends/public holidays)
  • Use sponge method during each immunization session

Reconstitution and administration

• Never use the diluents provided for vaccines to mix other injectable medicines
• Never use water for injection as a diluent for vaccine reconstitution
• Do not vaccinate in direct sunlight (always carry out immunization in a building or under a shade)
• Record every vaccination in the child register and on a tally sheet until child has completed all the antigens
• Use the child register and child health card for tracking drop outs
• A child who received any immunization dose during national immunization campaigns should still get the routine vaccination dose
• Never use any vaccine:
  • After its expiry date
  • When the vaccine vial monitor (VVM) has changed to discard point (stage 3 and 4)
  • If there has been contamination, or contamination is suspected in open vials
  • If the vial labels are lost
  • DPT-HepB-Hib, HebB, PCV, IPV, HPV, TT that have been frozen

Common side effects of vaccines and patient advice