Iap recent dose schedule and route tabular coloumn form

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IAP immunization schedule 2025 dose route table Indian Academy of Pediatrics

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https://babynama.com/guides/vaccination

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Here is the complete IAP-ACVIP 2025 Immunization Schedule (for children aged 0-18 years) in tabular form, based on the official IAP-ACVIP 2025 recommendations published in Indian Pediatrics (2026):

IAP-ACVIP Recommended Immunization Schedule 2025

(Children aged 0-18 years)

PART A: ROUTINE VACCINES (Birth to 14 Weeks)

Age	Vaccine	Dose	Route	Notes
Birth	BCG	0.05 mL (0.1 mL if >1 month)	Intradermal (left arm)	Given before discharge
Birth	Hepatitis B (1st)	0.5 mL	IM (anterolateral thigh)	Within 24 hours of birth
Birth	OPV-0 (zero dose)	2 drops	Oral	Before discharge
6 weeks	DTwP/DTaP (1st)	0.5 mL	IM	DTwP = free (govt); DTaP = private
6 weeks	IPV (1st)	0.5 mL	IM
6 weeks	Hepatitis B (2nd)	0.5 mL	IM
6 weeks	Hib (1st)	0.5 mL	IM	Part of Pentavalent in UIP
6 weeks	PCV (1st)	0.5 mL	IM	PCV13 or PCV15 or PCV20
6 weeks	Rotavirus (1st)	1.5 mL	Oral	ROTAVAC/ROTARIX/ROTATEQ
10 weeks	DTwP/DTaP (2nd)	0.5 mL	IM
10 weeks	IPV (2nd)	0.5 mL	IM
10 weeks	Hib (2nd)	0.5 mL	IM
10 weeks	PCV (2nd)	0.5 mL	IM
10 weeks	Rotavirus (2nd)	1.5 mL	Oral
14 weeks	DTwP/DTaP (3rd)	0.5 mL	IM
14 weeks	IPV (3rd)	0.5 mL	IM
14 weeks	Hib (3rd)	0.5 mL	IM
14 weeks	PCV (3rd)	0.5 mL	IM
14 weeks	Rotavirus (3rd)	1.5 mL	Oral	ROTAVAC & ROTATEQ = 3 doses; ROTARIX = 2 doses only

PART B: ROUTINE VACCINES (6 Months to 15 Months)

Age	Vaccine	Dose	Route	Notes
6 months	OPV (1st)	2 drops	Oral
6 months	Hepatitis B (3rd)	0.5 mL	IM
6 months	Influenza (1st)	0.5 mL	IM	Annual; trivalent (2025 update - Yamagata lineage extinct)
9 months	OPV (2nd)	2 drops	Oral
9 months	MMR (1st)	0.5 mL	SC
9-12 months	Typhoid Conjugate Vaccine (TCV)	0.5 mL	IM	From 6 months onward; booster at 2 years
12 months	Hepatitis A (1st)	0.5 mL	IM	2-dose schedule; or single-dose live attenuated
15 months	MMR (2nd)	0.5 mL	SC	IAP recommends at 15 months
15 months	Varicella (1st)	0.5 mL	SC
15 months	PCV booster	0.5 mL	IM

PART C: BOOSTER DOSES (15 Months to 6 Years)

Age	Vaccine	Dose	Route	Notes
15-18 months	DTwP/DTaP (1st booster)	0.5 mL	IM
15-18 months	IPV (booster)	0.5 mL	IM
15-18 months	Hib (booster)	0.5 mL	IM
16 months	MR (2nd) under UIP	0.5 mL	SC	Government schedule
18 months	Hepatitis A (2nd)	0.5 mL	IM
2 years	Typhoid booster	0.5 mL	IM or Oral	Oral Vi capsule = 1 capsule on alternate days x 3
4-6 years	DTwP/DTaP (2nd booster)	0.5 mL	IM
4-6 years	OPV (booster)	2 drops	Oral
4-6 years	Varicella (2nd)	0.5 mL	SC
5 years	MMR (3rd)	0.5 mL	SC	Optional; if 2nd dose given before 15 months

PART D: OLDER CHILDREN & ADOLESCENTS (10-18 Years)

Age	Vaccine	Dose	Route	Notes
10-12 years	Tdap	0.5 mL	IM	Tetanus + diphtheria + acellular pertussis booster
9-14 years	HPV (girls)	0.5 mL x 2 doses (0 & 6 months)	IM	2025 UPDATE: Immunocompetent girls 9-15 yrs = single dose; ≥15 yrs = 3 doses
9-15 years	HPV (boys)	0.5 mL	IM	Gardasil-9 approved; Cervavac 4 for 9-26 yrs males
10-15 years	Td booster	0.5 mL	IM	Every 10 years thereafter

PART E: ANNUAL VACCINES

Vaccine	Age	Dose	Route	Notes
Influenza (annual)	6 months onward	0.5 mL (0.25 mL if <3 yrs in some brands)	IM	2025 UPDATE: Trivalent only (quadrivalent discontinued - B/Yamagata extinct)

PART F: NEWER/SPECIAL VACCINES (Table 3 of IAP-ACVIP 2025)

Vaccine	Age	Doses	Route	Notes
Meningococcal (MenACWY)	9 months+	1-2 doses	IM	High-risk / travelers
Meningococcal B	2 months+	2-3 doses	IM	High-risk
Cholera (Shanchol)	≥1 year	2 doses (2 weeks apart)	Oral	Outbreak/travel
Japanese Encephalitis (SA-14-14-2)	9-12 months	2 doses	SC	Endemic areas
Rabies (post-exposure PEP)	Any age	5 doses (days 0,3,7,14,28)	IM	2025 UPDATE: 5-dose IM schedule; + RIG or RMAb for Cat III
RSV - Nirsevimab	Neonates/infants	Single dose (50 mg <5 kg; 100 mg ≥5 kg)	IM	2025 UPDATE: High-risk infants only (not universal yet in India)

KEY 2025 UPDATES (IAP-ACVIP)

Topic	Change
Influenza vaccine	Switch from quadrivalent to trivalent (B/Yamagata lineage extinct)
HPV vaccine	Immunocompetent girls 9-15 yrs = single dose now recommended
RSV Nirsevimab	Recommended for high-risk infants only (not universal)
Rabies PEP	5-dose IM schedule (days 0,3,7,14,28) confirmed; + RIG/RMAb
ROTAVAC 5D	Not yet recommended as booster (DCGI approval pending)

Route abbreviations: IM = Intramuscular | SC = Subcutaneous | ID = Intradermal | Oral = by mouth

Source: IAP-ACVIP Recommended Immunization Schedule 2025, published in Indian Pediatrics (2026). Full PDF available at the official ACVIP document.

Aefi as a 5 mark questiom

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AEFI adverse events following immunization classification WHO 5 marks exam pediatrics

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Here is a complete, exam-ready 5-mark answer on AEFI:

AEFI - Adverse Events Following Immunization

Definition

An AEFI is any untoward medical occurrence which follows immunization and which does not necessarily have a causal relationship with the usage of the vaccine. It may be any unfavourable or unintended sign, abnormal laboratory finding, symptom, or disease temporally associated with immunization. (Park's Preventive & Social Medicine)

Classification (CIOMS/WHO 2012)

Type	Definition	Example
Vaccine product-related reaction	Due to inherent properties of the vaccine	Measles vaccine fever, BCG ulcer
Vaccine quality defect-related reaction	Due to manufacturing/quality defect of vaccine or device	Contaminated vaccine batch
Immunization error-related reaction (formerly "programme error")	Due to inappropriate handling, prescribing, or administration - preventable	Abscess from wrong injection technique
Immunization anxiety-related reaction	Arising from anxiety about immunization	Vasovagal syncope, hyperventilation
Coincidental event	Caused by something other than vaccine/process; temporally associated	Fever due to concurrent infection

Common AEFI by Type and Severity

Minor (Local & Systemic)

Reaction	Vaccine	Management
Local pain, swelling, redness at site	All	Cold compress, analgesic
Fever (38-38.9°C)	All	Paracetamol
Persistent inconsolable crying (>3 hrs)	DTP	Reassurance
Transient rash	MMR, Measles	Self-limiting

Serious AEFI

Reaction	Vaccine	Time after vaccination	Treatment
Anaphylaxis	All	Within 1 hour	IM Adrenaline (1:1000)
Anaphylactoid reaction	All	Within 2 hours	Antihistamines
Hypotonic Hyporesponsive Episode (HHE)	DTP/DTwP	48 hours	Self-limiting; reassure
Encephalopathy	DTP, Measles/MMR	48 hrs (DTP); 7-12 days (MMR)	Supportive care
Vaccine Associated Paralytic Polio (VAPP)	OPV	4-30 days (recipient); 4-75 days (contact)	Supportive care
Toxic Shock Syndrome (TSS)	All	24-48 hours	ICU, antibiotics
Injection site abscess	All	Within 7 days	Surgical drainage
Febrile seizures	Measles/MMR	6-12 days	Anticonvulsants
Thrombocytopenia	MMR	15-35 days	Supportive
Intussusception	Rotavirus	Within days	Surgical/radiological
Brachial neuritis	Tetanus-containing	2-28 days	Analgesics
Lymphadenitis / Disseminated BCG	BCG	1-12 months	INH + Rifampicin

Reportable AEFI - Time Windows

Time after Immunization	Events to Report
Within 24-48 hours	Anaphylaxis, anaphylactoid reaction, HHE, persistent crying >3 hrs, TSS
Within 7 days	Severe local reaction, sepsis, injection site abscess
Within 14 days	Seizures, encephalopathy (6-12 days for MMR; 0-2 days for DTP)
Within 3 months	Acute flaccid paralysis / VAPP
1-12 months (BCG)	Lymphadenitis, disseminated BCG, osteitis

Fainting vs Anaphylaxis - Key Distinction (Exam Favourite)

Feature	Fainting (Vasovagal)	Anaphylaxis
Timing	During/minutes after	Up to a few hours
Skin	Pallor, cold clammy	Urticaria, erythema, swelling
Pulse	Bradycardia	Tachycardia
Response to supine	Relieved	NOT relieved
Treatment	Position change	IM Adrenaline

Management of Serious AEFI

Anaphylaxis - Adrenaline 0.01 mg/kg IM (1:1000) in anterolateral thigh; repeat every 5-15 min if needed; call emergency services
HHE - Reassure parents; usually self-limiting; no specific treatment
Febrile seizures - Paracetamol + diazepam if prolonged
Abscess - Surgical drainage + antibiotics
VAPP - Supportive; replace OPV with IPV

AEFI Surveillance and Reporting

Minor reactions need not be reported
Serious/unexpected reactions must be reported to MO/district health authorities
Cluster AEFI = two or more cases of same event related in time, place, or vaccine administration
Reporting form: AEFI reporting form submitted to state/national level

Key point for 5-marks: Always include - Definition + CIOMS/WHO classification (5 types) + examples of serious AEFI per vaccine + management of anaphylaxis + surveillance/reporting.

(Source: Park's Textbook of Preventive and Social Medicine)

Opv ipv difference

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Here is a complete, exam-ready comparison of OPV vs IPV:

OPV vs IPV - Differences

(Source: Park's Textbook of Preventive & Social Medicine)

Basic Identity

Feature	OPV (Oral Polio Vaccine)	IPV (Inactivated Polio Vaccine)
Developer	Albert Sabin (1957)	Jonas Salk (1955)
Other name	Sabin vaccine	Salk vaccine
Type of virus	Live attenuated (weakened) virus	Killed/inactivated virus
Route	Oral (2 drops on tongue)	Intramuscular injection (or fractional ID)
Serotypes	Types 1 & 3 (current bOPV) - Type 2 withdrawn globally	Types 1, 2, and 3 (trivalent)
Preparation	Grown in monkey kidney or human diploid cell culture	Formalin-inactivated; contains D-antigen units (40:8:32 for types 1,2,3)

Immunity Produced

Feature	OPV	IPV
Humoral immunity	Yes (IgM, IgG serum antibodies)	Yes (IgM, IgG, IgA serum antibodies)
Intestinal/mucosal immunity	Yes - secretory IgA in gut wall	No - does NOT induce local intestinal immunity
Type of immunity	Both local + systemic	Systemic only
Herd immunity	Yes - virus excreted in faeces, spreads to contacts	No - no spread to contacts
Duration of immunity	Possibly lifelong	Long-lasting; boosters every 5-10 years
Onset	Rapid - even single dose gives substantial immunity	Requires full primary series

Schedule (India - IAP 2025)

Feature	OPV	IPV
Birth dose	OPV-0 (zero dose) given before discharge	Not given at birth
Primary series	6, 10, 14 weeks + booster at 15-18 months	6, 10, 14 weeks + booster at 15-18 months
Given with	DPT / Pentavalent simultaneously	DPT / Pentavalent simultaneously
Booster	4-6 years	4-6 years

Storage and Cost

Feature	OPV	IPV
Storage	2-8°C; sensitive to heat; freeze-drying acceptable	2-8°C; freezing must be AVOIDED (reduces potency)
Cost	Relatively inexpensive	More expensive
Cold chain	Required (heat sensitive)	Required (but no freezing)
Administration	No trained personnel needed	Requires trained personnel for injection

Adverse Effects

Feature	OPV	IPV
VAPP (Vaccine Associated Paralytic Polio)	Yes - rare (~1 per 2.5 million doses); type 3 most common mutant	No - cannot cause VAPP
VDPV (Vaccine Derived Poliovirus)	Yes - mutated strains can circulate in under-immunized populations	No
Local reactions	None	Mild - local erythema (0.5-1%), induration (3-11%), tenderness (14-29%)
Serious reactions	Rare VAPP	None serious reported

Contraindications

Feature	OPV	IPV
Immunocompromised	Contraindicated - live virus can cause disease	Safe - preferred in immunocompromised
HIV infection	Use IPV instead	Preferred
Malignancy / corticosteroids	Contraindicated	Safe
Pregnancy	No proven danger; can be given if needed	Safe - preferred
Diarrhoea	Not a contraindication; but dose should be repeated (not counted in series)	Not affected

Advantages and Disadvantages Summary

	OPV	IPV
Advantages	Oral = easy to give; induces gut immunity; provides herd immunity; cheaper; useful in epidemic control; single dose gives good protection	No VAPP risk; safe in immunocompromised; safe in pregnancy; does not mutate
Disadvantages	Risk of VAPP and VDPV; live virus - contraindicated in immunodeficient; heat sensitive; type interference in tropics reduces efficacy	No gut immunity; no herd immunity; more expensive; needs injection

Key Points for Exams

Point	Answer
Which gives gut immunity?	OPV only
Which gives herd immunity?	OPV only
Which causes VAPP?	OPV (especially type 3)
Which is safe in immunocompromised?	IPV
Which was used in India's birth dose?	OPV-0
Why was Type 2 OPV withdrawn?	Wild poliovirus type 2 was eradicated; remaining type 2 in bOPV only caused VDPV
India currently uses	bOPV (types 1 & 3) + IPV together in the schedule
Why IPV added to India's schedule?	To provide immunity against type 2 after withdrawal of OPV type 2, and to reduce VAPP risk

(Park's Textbook of Preventive & Social Medicine; Jawetz Medical Microbiology; Goodman & Gilman's Pharmacology)

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