Immunizations

Recommended Immunization Schedule for the Expanded Program on Immunization, Bahrain

Children
AGE	VACCINE	DOSE
At birth	Bacillus Calmette Guerin (BCG) for newborns born to parents originally from endemic countries.	Single Dose
At birth	Child Hepatitis B for newborns	Birth Dose
2 months	Diphtheria and Tetanus toxoid with Pertussis, Haemophilus Influenzae type b, hepatitis B, Inactivated Polio vaccine (DTaP-Hib-Hep B-IPV) (as Hexavalent)	1^st Dose
	Pneumococcal Conjugate (PCV)	1^st Dose
	Rotavirus vaccine (oral)	1^st Dose
4 months	Diphtheria and Tetanus toxoid with Pertussis, Haemophilus Influenzae type b, hepatitis B and Inactivated Polio vaccine (DTaP-Hib-Hep B-IPV) (as Hexavalent)	2^nd Dose
	Oral Polio Vaccine (OPV)	2^nd Dose
	Pneumococcal Conjugate (PCV)	2^nd Dose
	Rotavirus vaccine (oral)	2^nd Dose
6 months	Diphtheria and Tetanus toxoid with Pertussis, Haemophilus Influenzae type b and hepatitis B vaccine (DTP-Hib-Hep B) (as Pentavalent)	3^rd Dose
6 months	Oral Polio Vaccine (OPV)	3^rd Dose
12 months	Measles, Mumps, Rubella (MMR)	1^st Dose
12 months	Varicella (Chickenpox)	1^st Dose
15 months	Pneumococcal Conjugate (PCV)	Booster
15 months	Child Hepatitis A	1^st Dose
18 months	Measles, Mumps, Rubella (MMR)	2^nd Dose
	Tetravalent (DPT, Hib), or Pentavalent (DTP-Hib-Hep B) according to availability	1^st Booster
	Oral Polio Vaccine (OPV)	1^st Booster
2 years	Meningococcal ACWY-135 Conjugate	Single Dose
2 years	Child Hepatitis A	2^nd Dose
3 years	Varicella (Chickenpox)	2^nd Dose
4-5 years	Diphtheria and Tetanus toxoid with Pertussis vaccine and Inactivated Polio (DTaP-IPV) (as Tetravalent)	2^nd Booster
	Oral Polio Vaccine (OPV)	2^nd Booster
	Measles, Mumps, Rubella (MMR) if no document of 2 valid doses of MMR vaccination previously.	Catch up dose (if not completed)
ADOLESCENTS
13 years	Tetanus, diphtheria toxoid, acellular pertussis vaccine (Tdap)	Booster
12-13 years	Human Papilloma Virus (HPV)	2 doses (minimum interval 6 months apart)
FOR PREVIOUSLY UNIMMUNISED WOMEN AT REPRODUCTIVE AGE GROUP
Tetanus and diphtheria Toxoid (Td)	At first contact Td1	Td1
	At least 4 weeks after Td1	Td2
	At least 6 months after Td2	Td3
	One year after Td3	Td 1^st booster
	One year after Td 1^st booster	Td 2^nd booster
Tdap	One dose of Tdap in the second or third trimester can replace one dose of Td.
ADULT, ELDERLY AND HIGH RISK GROUPS
Pneumococcal Conjugate vaccine (PCV)		Single dose for adult ≥ 50 years and high-risk groups.
Pneumococcal Polysaccharide vaccine		Single dose for adults at age of ≥ 65. Single dose for High-risk, group ≥ 2-64 years. Single revaccination dose after 5 years recommended to at risk groups including (Sickle cell disease/other blood disorders, congenital or acquired asplenia, congenital or acquired immuno-deficiencies, chronic renal failure, nephrotic syndrome, malignancy, leukemia, lymphoma, iatrogenic immunosuppression, solid organ transplant). In addition, certain high-risk people vaccinated when younger than age 65 years will need a second dose 5 years later.
Tetanus, diphtheria toxoid, acellular pertussis vaccine (Tdap)		Single dose to individuals at higher risk of infection and to elderly above 65 years.
Seasonal Influenza		Recommended in every season to certain categories at risk of infection including: Children ≥6 months and ≤ 5 years, Adults/elderly ≥ 50 years, Certain chronic medical conditions including chronic pulmonary diseases, chronic cardiovascular diseases, chronic renal diseases, chronic hepatic diseases, chronic blood disorders, chronic metabolic disorders including diabetes mellitus, chronic neurologic and neurodevelopment conditions, Immune-suppressed individuals by medications or by disease condition). Pregnant women, Health care workers Other categories at risk to be determined by treating physician.
Varicella vaccine		Recommended to at risk groups. Two doses, 3 months apart from 1 -12 years of age and as 2 doses 4 weeks apart for ≥ 13 years of age.
Meningococcal ACWY-135 Conjugate vaccine		Single dose to certain high-risk groups and travelers to Holly places, meningitis belt countries and countries reporting outbreak. Booster dose every 5 years given to certain categories remain at risk of infection such as Anatomical or functional asplenia (including sickle cell disease), persistent complement component deficiency and people with
Haemophilus Influenza type b vaccine (Hib)		Single dose for >5 years of age having any of the following conditions: Anatomical or functional asplenia (including sickle cell disease), post bone marrow transplant and certain cancer after completion of treatment.
HAJIIs
Meningococcal ACWY-135 Conjugate vaccine		Single dose. Booster doses every 5 years recommended for hajj pilgrims and certain categories at risk of infection.
Seasonal Influenza vaccine		Recommended for every season.
OTHER VACCINES
Travelers (according to travel destination)	Yellow Fever	Single dose
	Typhoid fever polysaccharide	Single dose (typhoid polysaccharide is repeated after 3 years if indicated).
	Hepatitis A	2 doses (if not vaccinated previously)
	Meningococcal ACWY-135 Conjugate	Single dose for traveler to certain countries.
	Oral Polio (OPV)/ Inactivated Polio (IPV)	Booster dose for traveler to Polio endemic/ Polio reporting countries.
Post exposure prophylaxis (depend on exposure and risk category)	Rabies	4 doses of vaccine ± RIG (according to wound category and risk estimation)
Individuals at risk of hepatitis (household and sexual contacts of chronic Hepatitis B cases and/or Hepatitis C cases)	Hepatitis B	3 doses (if not vaccinated previously)
	Hepatitis A	2 doses (6 months apart between two doses)
Immune-compromised & and their household contacts	Inactivated Polio Vaccine (IPV)	4-5 doses (as replacement of the OPV in the routine schedule).
*Other vaccines for high risk/ special groups determined by assessment of risk status by treating physician.s

What parents should know about vaccination and diseases targeted by them.

Note:

Parents and caregivers of children are advised to ensure completion of routine vaccination of their children prior to their enrolment in school.
Patients with chronic diseases conditions and other high risk categories are advised to ensure completion of the recommended vaccination.
Travelers are advised to visit their health center enough time prior to their travel to complete the recommended vaccination according to their travel destination.

General vaccine contraindication

The vaccine is contraindicated in case of severe allergic reaction to vaccine component or following a prior dose.
Fitness certificate from treating physician is recommended for immunocompromised and cancer patients.
Moderate to severe illness at the time of vaccination.

Forms

Defaulters Immunization Form
If the student was not present during the immunization session at school, please complete the above form and visit the respective Health Center to get vaccinated.

Glossary

HB	Hepatitis type B Vaccine
HA	Hepatitis type A Vaccine
OPV	Oral Polio Vaccine
IPV	Inactivated Polio Vaccine
Rota Vaccine	Rota Virus Vaccine
Hib	Hemophilus Influenza type B Vaccine
Flue Vaccine	Influenza Vaccine
MMR	Measles, Mumps and Rubella Vaccine
DPT	Diphtheria, Pertussis, Tetanus Vaccine
Td	Tetanus, diphtheria Vaccine (adult)
DTaP	Diphtheria, Tetanus acellular Pertussis Vaccine for children
Tdap	Tetanus, diphtheria, acellular pertuesis vaccine for adolescents and adults
DT	Dipheteria, Tetanus vaccine(Paediatric)
Hexavalent	Combined IPV, DPT, HB, Hib
Pentavalent	Combined DPT, HB, Hib
BCG	Bacillus Calmette-Guerin (vaccine against Tuberculsis)

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Immunizations