The Complete Childhood Vaccination Schedule: A Clinical Reference for Pediatric Outpatient Clinics

Why Vaccination Documentation Matters

Missed doses, incorrect intervals, and inadequate documentation are the primary causes of vaccine-preventable disease in adequately resourced settings. A pediatric clinic's vaccination record is not just a legal document — it is the primary tool for ensuring no child slips through the immunisation gap.

Standard Childhood Schedule (Age 0–18 Months)

At Birth

• BCG (bacille Calmette-Guérin): 1 dose intradermally, left upper arm. Protects against severe TB (miliary, meningeal).

• Hepatitis B: 1st dose, within 24 hours of birth.

6 Weeks

• DTP-HepB-Hib (pentavalent): 1st dose. Diphtheria, tetanus, pertussis, Hepatitis B, Haemophilus influenzae type b.

• OPV/IPV: 1st dose (oral or inactivated polio vaccine per national schedule).

• PCV-13 (pneumococcal conjugate): 1st dose — critical for preventing pneumococcal meningitis and pneumonia.

• Rotavirus (oral): 1st dose. Must be given before 15 weeks; 1st dose must never be given after 15 weeks.

10 Weeks

• DTP-HepB-Hib: 2nd dose.

• OPV/IPV: 2nd dose.

• PCV-13: 2nd dose.

• Rotavirus: 2nd dose.

14 Weeks

• DTP-HepB-Hib: 3rd dose.

• OPV/IPV: 3rd dose.

• PCV-13: 3rd dose.

• Rotavirus: 3rd dose (if using Rotarix, only 2 doses are needed).

6 Months

• Hepatitis B: 3rd dose (if not using pentavalent containing HepB).

• Influenza (where recommended): 1st dose; repeat annually.

9 Months

• MMR (measles, mumps, rubella): 1st dose.

• Yellow Fever: 1 dose (in endemic regions or per national schedule).

• Meningococcal A conjugate (where endemic): 1 dose.

12 Months

• PCV-13 booster: 4th dose (or 3+1 schedule depending on primary series timing).

• Varicella: 1st dose.

15–18 Months

• DTP booster: 1st booster.

• OPV/IPV booster: 1st booster.

• MMR: 2nd dose.

• Varicella: 2nd dose.

Catch-Up Vaccination

For children presenting late (unvaccinated or incompletely vaccinated), the minimum intervals between doses should be respected:

• DTP: minimum 4 weeks between primary doses.

• MMR: minimum 4 weeks between doses.

• Varicella: minimum 3 months between doses (< 13 years); 4 weeks if ≥ 13 years.

Rotavirus catch-up is NOT recommended after 8 months of age due to the theoretical intussusception risk with first-dose administration at older ages.

Key Contraindications

• Live vaccines (MMR, Varicella, Rotavirus, BCG): contraindicated in primary immunodeficiency, HIV/AIDS with low CD4 count, and patients on high-dose systemic corticosteroids or immunosuppressive therapy.

• DTP: history of anaphylaxis to a previous dose or encephalopathy within 7 days of a previous DTP dose are absolute contraindications. Febrile seizures within 3 days of a previous dose is a precaution, not an absolute contraindication.

• Egg allergy: no longer a contraindication to MMR (Jeryl Lynn strain); influenza vaccine requires caution.

Documenting in ClinIT

ClinIT's pediatric module includes a vaccine tracker that cross-references each entered vaccine against the national schedule and flags overdue doses on the visit dashboard. Vaccine lot numbers, administration site, and administering staff are recorded per dose. The immunisation record is printable as a certificate and shareable with schools or travel authorities.