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Catch Up Vaccines

Catch Up

For patients who have missed their vaccination
Every effort should be made to check with the registry that the child has really missed the vaccination before administering it to the them. If the vaccination is delayed, it is not necessary to re-start the schedule or give additional doses.

Some practical points to note when catching up delayed vaccination.

-	Always check the records that the previous ones were correctly documented.
-	Check the brand and the dose that was previously administered as it may not be recommended to interchange the vaccines.
-	Vaccines can be administered later but not earlier than the recommended dosing interval. Even though it is important to catch up on the delayed vaccination, safety should not be compromised. Check on the compatibility of the vaccine as some of the vaccines can be administered at the same visit but at different sites.
-	The doses of vaccine may differ as the child grows older. Eg. A baby was given the first dose of pneumococcal vaccine at 2 months of age and reappears in your clinic at 1 years old. The child will now need only 2 doses of the pneumococcal vaccine 2 months apart.
-	For overdue vaccination, it is not necessary to restart the schedule regardless of the interval.
-	When more than 1 vaccine is overdue, give the maximum possible at the first visit.
-	Below is a table showing the minimum dosing interval for the commonly used vaccine

Vaccine	Dose 1-2	Dose 2-3	Dose 3-4
DTPa	1 month	1 month	6 months
DTPa - IPV	1 month	1 month	6 months
DTPa - IPV-Hib	1 month	1 month	6 months
MMR	1 month
Hep B	1 month	2 months

Change in National Childhood Immunisation Program Schedule

2^ND dose of Diptheria-Tetanus containing vaccine is now given at Primary 5 instead of Primary 1. Primary 6 children in 2008 (11 to 12 years old) who have already taken the 2^nd dose of Diptheria-Tetanus while they were in Primary 1 should be given the 3^rd booster of Diptheria Tetanua containing vaccine in Primary 6. Other children from Primary 2 to 5 in 2008 should be given the 3^rd booster of the Diptheria-Tetanus containing vaccine when they are in Primary 5.

2^nd dose of MMR is brought forward to Primary 1 from Primary 6. So with effect from January 2008, all students in Primary 1 in 2008 should be given MMR. Any child from Primary 2 to Primary 6 (from 2008 onwards) who have not received the 2^nd dose of MMR should be given the 2^nd dose of MMR.

National Childhood Immunisation Schedule (Before And After Jan 2008)

Age	Schedule Before 2008	New Schedule from Jan 2008	Immunisation Agent
At birth	BCG Hepatitis B-1^st dose	BCG Hepatitis B-1^st dose	BCG against tuberculosis
1 mth	Hepatitis B-2^nd dose	Hepatitis B-2^nd dose
3 mths	DPT/DT - 1^stdose Oral Sabin - 1^stdose	DPT/DT - 1^stdose Oral Sabin - 1^stdose	DPT stand for Diphtheria, Pertussis and tetanus
4 mths	DPT/DT - 2^nd dose Oral Sabin - 2^nd dose	DPT/DT - 2^nd dose Oral Sabin - 2^nd dose	DT stands for Diphtheria & tetanus
5 mths	DPT/DT - 3^rd dose Oral Sabin - 3^rd dose	DPT/DT - 3^rd dose Oral Sabin - 3^rd dose	3^rd dose of DPT and oral sabin maybe given with 3^rd dose of Hepatitis B
5-6 mths	Hepatitis B - 3^rd dose	Hepatitis B - 3^rd dose
1-2 years old	MMR - 1^st dose	MMR - 1^st dose
18 mths	DPT/DT - 1^st booster Oral Sabin - 1^stbooster	DPT/DT - 1^st booster Oral Sabin - 1^stbooster	Sabin is against poliomyelitis
6-7 years old (Pri 1)	DT containing vaccine - 2^nd booster Oral Sabin - 2^nd booster	MMR - 2^nd dose oral Sabin - 2^nd dose
10-11 years old (pri 5)		DT containing vaccine - 2^nd booster Oral Sabin - 3^rd booster
11-12 years old (Pri 6)	DT containing vaccine - 3^rd booster Oral Sabin - 3^rd booster MMR - 2^nd dose

Case example of a child more than 1 yr old without previous vaccination

For children above 12 months old without previous vaccination, first priority is MMR as the diseases pose the greatest immediate risk. Polio and DTaP with Hepatitis B (6-in-1) can be given at the same time as MMR at SEPARATE injection sites. Do not exceed 6 doses of diphtheria and tetanus before 4th birthday as there is a risk of large local reactions.

The information on this website is strictly meant to be used as an educational guide. Parents are advised to consult their family doctor or paediatrician for specific medical advice.