Vaccines for routine administration

Vaccine Form Dose Route Recommended
site 		Age
BCG Powder 0.05 mL Intra-dermal Right upper arm,
at the deltoid muscle 		Birth
OPV Liquid 2 drops Oral Oral Birth,
6 weeks
RV Liquid 1.5 mL Oral Oral 6, 14,
weeks
Hexavalent
(DTaP-IPV-HB-Hib) 		Liquid
and
Powder 		0.5 mL IM <1 year: lateral
aspect of the left
thigh
≥ 1 year:
left upper arm 		6,10,14
weeks,
18 months
Measles Powder 0.5 mL SC < 1 year: lateral
aspect of the left
thigh
≥ 1 year:
right upper arm 		6, 12
months
PCV Liquid 0.5 mL IM Lateral aspect
of the right thigh 		6, 14
weeks
9 months
Td Liquid 0.5 mL IM Upper arm 5­–7 years,
≥ 12years.

BCG (Bacillus Calmette-guerin)

Z23.2

Protects against TB meningitis and miliary TB in children < 2 years of age.

  • BCG, 0.05 mL of reconstituted intradermal BCG vaccine.
    • Administered into the skin (intradermally) on the right upper arm, overlying insertion of the deltoid.
    • Storage:
      • Fridge: In a vaccine fridge at 2–8°C.
      • Discard opened vial after 6 hours or at end of immunisation session, whichever comes first.
    • Adverse events:
      • Initial reaction to intradermal vaccination is a papule formation that lasts a maximum of 4–6 weeks. This develops into a scar (visible in 40% of vaccinated infants).
      • In 1–10% there is oozing, ulceration and lymphadenopathy after vaccination. This is a usual reaction and not a cause for alarm. Lymphadenopathy < 1.5 cm is not clinically significant.
      • Occasionally the papule becomes a pustule.
      • Complete AEFI notification and refer all cases with significant lymphadenopathy or a draining sinus.
    • Contraindications:
      • Children with known HIV infection should not get BCG vaccination. Do not delay BCG vaccination if HIV status is unknown.
        LoEIII
      • Children > 12 months old should not get BCG vaccination.
      • Newborn infants: if the mother is on TB chemotherapy, the infant should be on chemoprophylaxis or treatment, and receive BCG once treatment is completed.

Hexavalent (DTaP-IPV-HB-Hib) vaccine

Z27.8

(Diphtheria, tetanus, acellular pertussis, inactivated polio, hepatitis B and Haemophilus influenzae type b vaccine).

Protects against diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B infection and invasive infections caused by Haemophilus influenzae type b.

  • Hexavalent (DTaP-IPV-HB-Hib), IM, 0.5 mL.
    • <1 year of age: administer into outer side of left thigh.
    • > 1 year of age: administer into upper left arm.

Hexavalent (DTaP-IPV-HB-Hib) vaccine is a fully liquid combination of diphtheria toxoid, tetanus toxoid, acelluar pertussis vaccine, inactivated polio vaccine, hepatitis B vaccine and Haemophilus influenzae type b vaccine.

  • Storage:
    • Fridge: In a vaccine fridge at 2–8°C.
    • Hexavalent (DTaP-IPV-HB-Hib) vaccine should never be frozen.
  • Adverse events:
    • Irritability.
    • Fever ≥ 38°C and acute illness.
    • Redness and induration at the site of the injection.
  • Contra Indications:
    • Known hypersensitivity to any component of the vaccine or pertussis vaccine (acellular or whole cell pertussis) or a life-threatening reaction after previous administration of the vaccine or a vaccine containing the same substance.

Td (Tetanus and diphtheria vaccine)

Z27.8

Protects against diphtheria and tetanus.

  • Td, IM, 0.5 mL in upper arm.
    • Storage:
      • Fridge: In a vaccine fridge at 2–8°C.
      • Easily damaged by freezing.
      • Keep opened vials, record date of opening, for next session if kept at correct temperature and not contaminated.
      • Record date of reconstitution.
      • Discard after 30 days.
    • Adverse events:
      • Mild fever.
      • Pain.
      • Local swelling occasionally
    • Contraindications:
      • Previous anaphylaxis.
      • Children < 6 years of age should not get Td.

bOPV (Oral polio vaccine)

Z24.0

Protects against polio.

  • bOPV, oral, 2 drops given by mouth.
    • If spat out or vomited, repeat immediately.
    • Not affected by feeding (breast or other).
    • Storage:
      • Fridge: In a vaccine fridge at 2–8°C; or freezer (in pharmacy).
      • Not damaged by freezing.
      • Easily damaged by temperature > 8°C.
      • Record date of opening.
      • Discard after 30 days.
    • Adverse events:
      • May be associated with a flu-like illness and gastroenteritis.
      • Mild fever.
    • Contraindications:
      • Previous anaphylaxis.
      • bOPV is not contraindicated in HIV-infected children but should not be administered to children with primary immune deficiency.

RV (Rotavirus Vaccine)

Z25.8

Protects against gastro-enteritis caused by rotavirus.

  • RV, oral, 1.5 mL given by mouth.
    • Squeeze the entire contents of the tube in the inner cheek.
    • Storage:
      • Fridge: In a vaccine fridge at 2–8°C.
      • Easily damaged by freezing.
      • Protect the vaccine from light.
    • Adverse events:
      • Mild fever.
      • Irritability.
    • Contra-indications:
      • Previous anaphylaxis to rotavirus or any ingredients in the formulation.
      • Do not give Rotavirus vaccine if a child has a history of chronic gastro- intestinal disease or severe diarrhoea including children with any history of uncorrected congenital malformation of the gastrointestinal tract. Refer the child for medical opinion.
      • A history of intussusception (severe abdominal pain, persistent vomiting, bloody stools, abdominal bloating and/or high fever).
      • Rotavirus vaccine should not be given after 24 weeks of age (see Catch-up doses table in Childhood Immunisation Schedule ).

PCV (Pneumococcal Conjugated Vaccine)

Z23.8

Protects against invasive pneumococcal disease (meningitis, septicaemia), pneumonia and otitis media.

  • PCV, IM, 0.5 mL
    • < 1 year of age: administer into outer side of right thigh.
    • > 1 year of age: administer into upper arm in the deltoid muscle.
    • PCV and Hexavalent (DTaP-IPV-HB-Hib) can be administered at the same time, but at different sites.
    • Storage:
      • Fridge: middle shelf at 2–8 °C.
      • Do not freeze as the vaccine is easily damaged by freezing.
      • Do not mix PCV in the same syringe with other vaccines.
      • Shake the vaccine well before use.
    • Contra- indications:
      • Previous anaphylaxis.

Measles

Z24.4

  • Measles vaccine, SC, 0.5 mL.
    • < 1 year of age: administer subcutaneously on lateral aspect of the left thigh.
    • ≥ 1 year of age: administer subcutaneously on right upper arm.
    • The new guideline is to administer the measles vaccine at 6 (range 7-11 months) and 12 months.
    • Do not give the currently available measles vaccine at the same time as other vaccines. If a child requires measles vaccine and other vaccines at the same time, give measles vaccine immediately and schedule visit to receive remaining vaccines 1 month later.
    • Storage:
      • Fridge: In a vaccine fridge at 2–8°C.
      • Discard opened vial after 6 hours or at end of immunisation session (whichever comes first).
    • Adverse events:
      • Burning or stinging at the injection site, fever.
      • Transient morbilliform rash and mild pyrexia up to 30 days after vaccination.
    • Contra-indications:
      • Previous anaphylaxis.
      • Uncontrolled convulsions: consult a doctor.