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Childhood Immunization Schedule

Alberta Health Services Childhood Immunization Schedule: Why we immunize Diphtheria** toxin Bacteria colonize upper respiratory epithelium & secrete exotoxin that enters local cells Sore throat, low grade fever, lymphadenopathy, stridor or wheeze, gray pseudomembrane in the airway ↑ Mortality from CNS, respiratory & cardiac disease Tetanus** toxin Pertussis** metabolites Polio virus Haemophilus influenzae type B Hepatitis B virus Streptococcus pneumoniae Rotavirus Neisseria meningitidis Measles** virus Mumps virus Rubella virus Varicella zoster virus** Human papillomavirus (HPV) Spores enter contaminated wounds & bacteria produce tetanospasmin to invade central nervous system (CNS) Muscle rigidity spasms, hyperreflexia, autonomic dysfunction, laryngeal spasms ↑ Mortality from respiratory obstruction & failure Bacteria attach to ciliated respiratory epithelial cells & release toxins Prolonged paroxysmal cough, inspiratory “whoop” sound, emesis, apnea, cyanosis, leukocytosis ↑ Risk of pneumonia, seizures & encephalopathy Virus invades oropharynx/GI tract & replicates in lymphoid tissue before hematogenous spread to motor neurons ↑ Risk of paralytic poliomyelitis & respiratory failure Bacteria colonize the nasopharynx & invade the bloodstream & CNS Virus invades hepatocytes via specific receptors & replicates within liver cells Bacteria colonize the nasopharynx & may invade the lungs, bloodstream, or meninges Virus invades mature enterocytes in the small intestine Bacteria colonize the nasopharynx & enter the bloodstream to cross the blood–brain barrier Virus invades respiratory epithelium & spreads to regional lymphoid tissue & bloodstream Virus infects upper respiratory tract (URT) & disseminates via viremia to salivary glands & other organs Virus invades URT & enters the bloodstream & regional lymphoid tissue Virus infects URT & lymphoid tissue before invading neural tissue Virus infects anogenital & oropharyngeal basal layer epithelium tissue Influenza virus Virus invades upper & lower respiratory epithelium Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)** Viral invasion of mucous membranes & may invade extrapulmonary tissues Legend: Muscle weakness, asymmetric reduction in tone, quadriplegia Fever, fatigue, shortness of breath, nausea, emesis, headache, stiff neck, altered mental status, otitis media** Fatigue, anorexia, nausea, jaundice, arthralgia, right upper quadrant pain Otitis media**, sinusitis, pneumonia**, meningitis**, bacteremia Gastroenteritis with emesis, fever, diarrhea, malaise & dehydration Fever, headache, neck stiffness, altered level of consciousness, purpuric rash Koplik spots, conjunctivitis, fever, rhinorrhea, cough, diarrhea, otitis media, pneumonia Parotitis, headache, fever, malaise, sensorineural hearing loss, orchitis, mastitis, oophoritis, pancreatitis Fever, lymphadenopathy, rash, congenital anomalies such as hearing loss, cataracts & cardiac defects ↑ Mortality from meningitis, pneumonia & sepsis ↑ Risk of cirrhosis, hepatic malignancy, & liver failure ↑ Mortality from respiratory, CNS & cardiac dysfunction ↑ Mortality from hypovolemic shock & CNS infection ↑ Mortality from sepsis, multiorgan failure & necrosis ↑ Mortality from pneumonia & encephalitis ↑ Mortality from meningitis & encephalitis ↑ Mortality from congenital rubella Vesicular & pruritic rash, fever, malaise, pneumonia, encephalitis, cellulitis ↑ Morbidity from necrotizing fasciitis, CNS, soft tissue & respiratory infections Often asymptomatic, or may present with painless anogenital warts ↑ Risk of anogenital & head & neck malignancy Fever, cough, myalgia, malaise, cough, headache, emesis, diarrhea, abdominal pain, febrile seizures ↑ Mortality from widespread multiorgan infection Fever, cough, fatigue, shortness of breath, anosmia, ageusia, pneumonia, multiorgan dysfunction ↑ Mortality from respiratory distress & multiorgan failure DTaP-IPV-Hib-HB vaccine Given at 2, 4 & 6 months old Protects against diphtheria, Tetanus, Pertussis, Polio, Haemophilus influenzae type B, & Hepatitis B DTaP-IPV-Hib vaccine Given at 18 months old Protects against diphtheria, Tetanus, Pertussis, Polio, & Haemophilus influenzae type B Pneumococcal conjugate vaccine Given at 2, 4 & 12 months old (additional 4th dose given at 6 months if at ↑ risk of invasive pneumococcal disease) Authors: McKayla Kirkpatrick, Stacey Holbrook Reviewers: Merry Faye Graff, Emily J. Doucette, Charissa Chen, Amanda Ang, Danielle Nelson* * MD at time of publication Tdap-IPV vaccine Given at 4 years old Tdap vaccine Given in Grade 9 Protects against diphtheria, Tetanus, Pertussis, & Polio Protects against diphtheria, Tetanus, & Pertussis HB vaccine Given in Grade 6 Protects against Hepatitis B virus Protects against Streptococcus pneumoniae Rotavirus vaccine Given at 2 & 4 months old Protects against rotavirus Meningococcal conjugate (MenconC) Given at 4 & 12 months old MenC-ACYW (Meningococcal type A, C, Y, W-135) in Grade 9 Protects against Neisseria meningitidis MMR-Var vaccine (e.g., Priorix-Tetra) Given at 12 & 18 months old Protects against measles, mumps, rubella & varicella Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications HPV vaccine Given in Grade 6 (2-3 doses over 6 months) Seasonal influenza vaccine Given annually starting at 6 months or older COVID-19 vaccine Given at 6 months or older Published Aug 19, 2015; updated Dec 31, 2025 on www.thecalgaryguide.com Protects against HPV Protects against influenza viruses predicted to circulate each fall & winter Protects against SARS-CoV2