What to do if we miss a certain vaccine or its dose?
Different vaccines are given at different age levels with different intervals. Please read below if you have missed or delayed certain vaccines from your schedule:
Missed or delayed birth vaccines
birth vaccines are usually given as soon as possible but generally a delay of upto a week is acceptable.
Missed or delayed 6 weeks vaccines
This vaccine visit is very important as it has the first doses of protection against 8 deadly diseases. As a general rule this visit should be made as early as possible after the 6 weeks of age, delaying it to a maximum of 8 weeks if needed.
Missed or delayed 10 weeks vaccine?
If your child has already received the vaccines at 6 weeks, its the same vaccines that are given again to enhance the protective effect of previous ones. In this can we case delay the next dose usually till 6 months of age. If the previous doses due at 6 weeks have not been given , then it should be given as early as possible.
Also Read: Vaccine scheduling in Pakistan
Missed or delayed 14 weeks vaccines
At this vaccine visit we have two different injections.
(1) penta + OPV or Hexa: This injection can be delayed till 9 months of age but the sooner the better.
(2) pneumococcal vaccine: If the second dose of pneumococcal vaccine was given before 6 months of age we need to give 3rd dose before 1 year of age and if 2nd dose was given after 6 months of age we can skip the third dose and give 4th dose between 12-15 months of age.
Missed or delayed FLU vaccines
Flu vaccine is usually offered to high risk population, including but not limited to asthmatics, allergic, having repeated exposure to viruses, kids going to day care centres etc. ,therefore this shot if missed can be matched with any other subsequent vaccine.
Missed or delayed 9 months vaccines
A) Measles vaccines: Usual recommended age range for measles 1 is between 6 to 12 months of age. Infants, living in congested places, with routine interactions with many other kids, should get it as early as possible after 6 months of age. For other infants , who are the only kids at home and living in less congested places and family is following the social distancing, this may be delayed till 1 year of age and in some cases omitted altogether if the child gets MMR vaccine at 1 year.
There is one special scenario in case of measles vaccine. Suppose if someone having measles comes in contact with an unvaccinated child, we still have about 72 hours time to get our child vaccinated.
B) Meningococcal vaccines: This vaccine is given for protection against meningococcal meningitis. Its first dose should not be delayed, however if first dose is already given second dose can be delayed till after 2 years of age.
Missed or delayed One Year vaccines
At one year of age 3 new vaccines are included into child’s vaccines needs and two booster doses of vaccines that have already been given.
New vaccines are Hepatitis A, Chicken pox ( varicella) and MMR. First doses of these three vaccines should be given as early as possible after 1 year of age, so delaying the first doses is never recommended.
If child has already taken dose 1 of hepatitis A , second dose can be given any time between 6 -12 months after dose 1.
If first dose of chicken pox vaccine is already given second dose can be given at least 3 months after dose 1 till school admission of the child.
If first dose of MMR vaccine is already given second dose can be given at least 6 months after dose 1 till school admission of the child.
Booster dose of Pneumococcal vaccine depends upon the timing of last dose already given. If the last dose of PCV was given after 6 months of age, booster dose can be given anywhere between 12-24 months, but 6 months after last dose.
If the last dose of PCV was given before 6 months of age , Booster dose must be given bwteen 12-15 months of age.
DTaP+Hib combination dose 4 is recommended anywhere between 12 to 24 months, but it must be at least 6 months after dose 3 of the same vaccine.
DTaP dose 5 can be given any time between 4 to 5 years of age.
Missed or delayed Typhoid vaccine
Minimum age for first dose of typhoid is 2 years and its protective effect last about 2-3 year and subsequent doses have to be given regularly at 2-3 year intervals
Dr. Salman Ahmad Bajwa
MBBS, RMP, FCPS (Paeds)
Child Growth and Nutrition Expert