Table : Routine Childhood Immunization Schedule Infants And Children
- For children at-risk due to underlying medical conditions, refer to Table 4 for additional recommendations for immunization.
- = dose may not be required depending upon age of child or vaccine used or both . mos = months. yrs = years. P/T = provincial and territorial.
- Refer to Timing of vaccine administration and Vaccine administration practices in Part 1 regarding administration of multiple injections.
- Refer to vaccine-specific chapters in Part 4 for additional information.
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What Are The Possible Side Effects Of Pcv And Ppsv Vaccines
Kids may have redness, tenderness, or swelling where the shot was given. A child also might have a fever after getting the shot. There is a very small chance of an allergic reaction with any vaccine.
The pneumococcal vaccines contain only a small piece of the germ and so cannot cause pneumococcal disease.
What To Know About The Pneumococcal Vaccine
Who needs it: The CDC recommends one pneumococcal vaccine for adults 19 to 64 with certain risk factors . If you work around chronically ill people say, in a hospital or nursing home you should get the vaccine, even if you’re healthy. People 65 and older can discuss with their health care provider whether they should get PCV13 if they haven’t previously received a dose. A dose of PPSV23 is recommended for those 65 and older, regardless of previous inoculations with pneumococcal vaccines.
How often: Space immunizations out. You should receive a dose of the pneumococcal conjugate vaccine , then, a year later, a dose of pneumococcal polysaccharide vaccine . People with any of the risk factors should get one dose of PCV13 and PPSV23 before age 65, separated by eight weeks.
Why you need it: Pneumococcal disease, which can cause pneumonia, kills around 3,000 people a year. Young children and those over 65 have the highest incidence of serious illness, and older adults are more likely to die from it.
Editors note: This article was published on Oct. 26, 2020. It was updated in September 2021 with new information.
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Pregnancy Or An Immuno
Some vaccines are, in general, not medically appropriate during pregnancy. These vaccines will likely be marked as contraindicated on Form I-693 if the applicant was pregnant at the time of the medical examination.
The civil surgeon may annotate in the remarks section that the applicant did not receive one or more vaccines because of a contraindication that is based on pregnancy or a condition other than pregnancy. The reason for the contraindication may be annotated by the civil surgeon on the Form I-693 however, if it is omitted, the officer does not need to issue a Request for Evidence solely for that omission as long as the contraindication is marked in the vaccine chart.
An officer should also never issue an RFE for additional vaccines if the applicant is no longer pregnant at the time of the adjudication of the adjustment of status. As long as the vaccination assessment was properly completed by the civil surgeon at the time of the examination, the vaccination assessment can be accepted. In other words, if a woman did not receive certain required vaccines because she was pregnant at the time of the medical examination, and the contraindication box is marked by the civil surgeon, the applicant is not required to get those vaccines later at the time of the adjudication.
Likewise, some vaccines are not medically appropriate for applicants who have an immuno-compromised condition and may be marked by the civil surgeon as contraindicated.
Who Should Get Pneumococcal Vaccines

CDC recommends pneumococcal vaccination for all children younger than 2 years old and all adults 65 years or older. In certain situations, older children and other adults should also get pneumococcal vaccines. Below is more information about who should and should not get each type of pneumococcal vaccine.
Talk to your or your childs doctor about what is best for your specific situation.
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Immunisation Against Pneumococcal Disease For Babies And Children
The immunisation schedule for babies involves a course of a primary vaccine that reduces the risk of infection with 13 strains of pneumococcal bacteria.
A second type of vaccine that reduces the risk of infection with 23 strains of pneumococcal bacteria is given as a booster dose to children from four years of age if they:
- have a medical condition putting them at high risk of pneumococcal disease, or
- were born prematurely before 28 weeks gestation.
Protection for babies and children against pneumococcal disease is available under the National Immunisation Program Schedule. In Victoria, immunisation against pneumococcal disease is free of charge for:
Who Should Have The Pneumococcal Vaccine
Anyone can get a pneumococcal infection. But some people are at higher risk of serious illness, so it’s recommended they’re given the pneumococcal vaccination on the NHS.
These include:
- babies
- adults aged 65 or over
- children and adults with certain long-term health conditions, such as a serious heart or kidney condition
Babies are offered 2 doses of pneumococcal vaccine, at 12 weeks and at 1 year of age.
People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab.
If you have a long-term health condition you may only need a single, one-off pneumococcal vaccination, or a vaccination every 5 years, depending on your underlying health problem.
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Vaccines For Children Program
The Vaccines for Children Program provides vaccines to children whose parents or guardians may not be able to afford them. A child is eligible if they are younger than 19 years old and meets one of the following requirements:
- Medicaid-eligible
- American Indian or Alaska Native
- Underinsured
If your child is VFC-eligible, ask if your doctor is a VFC provider. For help in finding a VFC provider near you, contact your state or local health departments VFC Program Coordinator or call CDC at 1-800-CDC-INFO .
Who Needs One Or Two Pneumonia Vaccines
There are two pneumococcal vaccines, each working in a different way to maximize protection. PPSV23 protects against 23 strains of pneumococcal bacteria. Those 23 strains are about 90- to 95-plus percent of the strains that cause pneumonia in humans, Poland explains. PCV13, on the other hand, is a conjugate vaccine that protects against 13 strains of pneumococcal bacteria. PCV13 induces immunologic memory, he says. Your body will remember that it has encountered an antigen 20 years from now and develop antibodies to fight it off.
In order to get the best protection against all strains of bacteria that cause pneumonia, the CDC has long recommended that everyone 65 or older receive both vaccines: PCV13 , followed by the pneumococcal polysaccharide vaccine at a later visit. But the agency is now saying that PCV13 may not be necessary for healthy people 65 and older, suggesting that the decision be left up to patients and their physicians as to whether that extra skin prick is appropriate.
“Anyone who reaches the age of 65 and is in any way immunocompromised or has any of the listed indications for pneumococcal vaccine because they’re in a high-risk group for example, if they have diabetes, heart disease or lung disease, or are a smoker should continue to get both vaccines, says Schaffner.
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Who Should Not Get The Pneumococcal Polysaccharide Vaccine
Speak with your health care provider if you have had a life-threatening reaction to a previous dose of pneumococcal vaccine, or any component of the vaccine.
Children under 2 years of age should not receive the pneumococcal polysaccharide vaccine because it is not effective in young children. These children receive the pneumococcal conjugate vaccine starting at 2 months of age.
There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns speak with your health care provider.
Why Vaccination Is Important For Adults
Vaccination isn’t just for children. Vaccines are safe and protect you and those around you from vaccine-preventable diseases.
As we get older, the protection we had from previous vaccination can decrease for some diseases. Getting another dose can increase our immunity to provide the best protection. Some adults may have missed one or more of their vaccines. They may need to catch up and get these vaccines now.
There are also diseases that are more common in adults, even healthy adults. This is why additional vaccines are needed as we get older.
- babies
- people with certain medical conditions, such as those who have weakened immunity
This is known as community immunity or herd immunity.
Check if your vaccines are up to date. Talk to your health care provider to see what you need to be fully protected.
Learn more about:
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People Who Should Receive The Pneumococcal Vaccine
A number of medical conditions put people at higher risk of pneumococcal disease and people with these conditions require immunisation.
You should speak with your doctor about whether you are at risk.
Pneumococcal immunisation is required for people who have:
- no spleen or have a spleen with poor function
- a weakened immune system includes people with immune deficiency, HIV infection, people receiving chemotherapy or radiotherapy, people who have received a transplant or people with a genetic immune deficiency
- leakage of fluid from around the spine and brain
- cochlear implants
It is also required for people who:
- smoke
- use alcohol to a harmful degree
- were born prematurely .
G Exception For Certain Adopted Children

Some children are not subject to the vaccination requirement if all of the following conditions are met:
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The child is 10 years of age or younger
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The child is classified as an orphan or a Hague Convention adoptee and
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The child is seeking an immigrant visa as an immediate relative.
For the child to benefit from this exception, the adopting parent must sign an affidavit prior to the immigrant visa issuance, affirming that the child will receive the required vaccination within 30 days of admission to the United States or at the earliest time that is medically appropriate. However, noncompliance with the vaccination requirements following the child’s admission to the United States is not a ground for removal.
The Department of State has developed a standard affidavit form, Affidavit Concerning Exemption from Immigrant Vaccination Requirements for a Foreign Adopted Child , to ensure that adopting parents are aware of the possibility of an exception from the vaccination requirements and of their obligation to ensure that the child is vaccinated following admission. The completed form must be submitted to the consulate as part of the immigrant visa application.
When the adoptive or prospective adoptive parent cannot sign the affidavit in good faith because of religious or moral objections to vaccinations, the child will require a waiver.
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Concerns About Immunisation Side Effects
If the side effect following immunisation is unexpected, persistent or severe or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety service.
It is also important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.
Concurrent Administration Of Vaccines
Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
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Blanket Waiver Due To Nationwide Vaccination Shortage
USCIS will grant a blanket waiver only in the case of a vaccination shortage if CDC recommends that USCIS should do so based on CDCs assessment that there is a nationwide shortage.
An officer may only grant a blanket waiver for a vaccine based on a vaccination shortage if the following circumstances are met:
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CDC declares that there is a nationwide vaccination shortage, and issues the appropriate statement on its website for civil surgeons
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USCIS issues the appropriate statement on uscis.gov and
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The civil surgeon annotates the medical examination form in compliance with any additional requirements specified by CDC or USCIS.
The grant of this blanket waiver does not differ from the grant of other blanket waivers.
The Different Types Of Pneumococcal Vaccine
The type of pneumococcal vaccine you’re given depends on your age and health. There are 2 types.
Pneumococcal conjugate vaccine is used to vaccinate children under 2 years old as part of the NHS vaccination schedule. It’s known by the brand name Prevenar 13.
Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards. The PPV vaccine is not very effective in children under the age of 2.
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Everything You Need To Know About The Pneumonia Vaccine
During the winter months, many people think that they have a nasty cold or flu, but it turns out to be pneumonia an illness that can be life threatening in certain people. A vaccine can help lower your chance of contracting pneumonia. While the pneumonia vaccine does not prevent all cases of pneumonia, it reduces the severity of the disease.
That is especially important for older adults and if you have certain medical conditions that put you at greater risk for complications.
Now is the time to talk to your doctor about your risks and if you need a vaccine to protect you against pneumonia.
Niharika Juwarkar, MD, Internal Medicine with Firelands Physician Group, answers your most frequently asked questions about pneumonia and the risks.
What is pneumonia?
Pneumonia is a respiratory lung infection that is often mistaken for the flu. Your lungs become filled with fluid or pus that results in inflammation. Symptoms are very similar to the flu, but pneumonia can last for weeks and result in very serious complications.
While pneumonia can be caused by bacteria, viruses or fungi, most cases are due to a specific bacteria called streptococcus pneumoniae, more commonly known as pneumococcal pneumonia. This form can be treated with antibiotics. Your doctor can test to see what form of pneumonia you have. Treatment depends on the type of pneumonia you have and the severity of your symptoms. But, the best defense is vaccination.
Who is most at risk for pneumonia?
Adults At High Risk Of Ipd
Adults with immunocompromising conditions resulting in high risk of IPD, except HSCT, should receive 1 dose of Pneu-C-13 vaccine followed at least 8 weeks later by 1 dose of Pneu-P-23 vaccine, if not previously received. The dose of Pneu-C-13 vaccine should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Immunocompetent adults with conditions or lifestyle factors resulting in high risk of IPD should receive 1 dose of Pneu-P-23 vaccine, if not previously received. One dose of Pneu-P-23 vaccine is also recommended for all adults who are residents of long-term care facilities and should be considered for individuals who use illicit drugs.
Some experts also suggest a dose of Pneu-C-13 vaccine, followed by Pneu-P-23 vaccine, for immunocompetent adults with conditions resulting in high risk of IPD as this may theoretically improve antibody response and immunologic memory. However, Pneu-P-23 vaccine is the vaccine of choice for these individuals, and if only one vaccine can be provided, it should be Pneu-P-23 vaccine, because of the greater number of serotypes included in the vaccine.
Adults at highest risk of IPD should also receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization.
Table 4 – provides recommended schedules for adult immunization with pneumococcal vaccines.
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Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. Review of pneumococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present, as persons with sickle cell disease are at risk of serious pneumococcal infections. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.
Vaccines For Adults 60 Years Of Age And Older

Some vaccine preventable disease are more common with age, as our immune system may not respond as well as we get older. This puts us at a greater risk for certain diseases, including:
- flu
- pneumococcal disease
The flu is more likely to cause severe illness and even death in older adults.
It’s also important to make sure routine vaccines are up to date for diseases such as:
- diphtheria
- whooping cough
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