Dosing Schedules and Immunogenicity Criteria – Required Vaccines

 

Vaccine Dosing Schedule Immunogenicity Criteria
 Anthrax Pre-exposure vaccination: 5 doses at 0, 4 weeks, 6 months, 12 months and 18 months.
Boosters are required annually to maintain immunity.
 Individual is considered “protected” 3 weeks after the 3rd dose (given at 6 months).
Hepatitis A  VAQTA®: 2 doses at 0 and 6-18 months
HAVRIX®: 2 doses at 0 and 6-12 months
TWINRIX® (combined HepA and HepB): 3 doses given at 0,1,6 months
In clinical trials, protective levels of antibodies seen in 94-100% of vaccinated persons ≥18 years 1 month after the 1st dose of any of the 3 HepA vaccines.
Japanese Encephalitis  IXIARO®: 2 doses at 0 and 28 days
JE-VAX®: 3 doses at 0, 7 and 30 days
IXIARO®: considered protected 7 days after the 2nd dose
JE-VAX®: considered protected after the 3rd dose
Meningiococcal  Laboratory workers routinely exposed to isolates of N. meningitidis should receive a single dose of MenACWY vaccine. No immunogenicity data available.
Polio  3 doses; two doses of IPV should be administered at intervals of 4-8 weeks; a 3rd doses should be administered 6-12 months after the 2nd dose. 

Individuals are considered protected after the complete 3-dose series. If 3 doses of IPV cannot be administered within the recommended intervals before protection is needed, the following alternatives are recommended:

  • If >8 weeks are available before protection needed: administer 3 doses of IPV at least 4 weeks apart
  • If >8 but <4 weeks are available before protection is needed: administer 2 doses of IPV at least 4 weeks apart
  • If <4 weeks are available before protection is needed: a single dose of IPV is recommended.

Remaining doses should be administered later, at the recommended intervals, if person remains at increased risk for exposure to poliovirus.

Rabies  Primary vaccination: 3 doses given at 0, 7 and 21 (or 28) days

The minimum acceptable antibody level a person must have to be considered protected is complete virus neutralization at a 1:5 serum dilution by the rapid fluorescent focus inhibition test (RFFIT).

Serum testing requirements

  • Persons at continuous risk (including those working with rabies virus in a research laboratory or vaccine production facility) must have their serum tested every 6 months.
  • Persons at frequent risk (including those performing rabies diagnostic testing, veterinarians and veterinary staff and persons who frequently handle bats, regardless of location) must have their serum tested every 2 years.

For both groups- if the serum titer falls below the minimum acceptable antibody level (outlined above), a single booster of vaccine should be administered.

 Vaccinia (smallpox)

Recipients of standard potency vaccinia vaccine (Dryvax) receive controlled percutaneous doses (~2.5 x 105 PFU) of relatively low pathogenicity vaccinia virus.

Re-vaccination is required every 10 years.

Clinically, persons are considered fully protected after a successful response is demonstrated at the site of vaccination (vesiculo-papular response; scab resolved between Day 21 and Day 28 after vaccination).
 Typhoid

Ty21a (oral, live-attenuated):

Primary vaccination: 4 doses; one capsule every other day for a week (day 1, day 3, day 5 and day 7)
Boosters required every 5 years to maintain immunity.

Vi capsular polysaccharide:

Primary vaccination: 1 dose
Booster required every 2 years to maintain immunity.

Ty21a (oral, live-attenuated): individuals are considered protected one week after the final dose.

 

 

 

Vi capsular polysaccharide (inactivated): individuals are considered protected two weeks after receiving the vaccine.

 

Yellow Fever

Primary vaccination: 1 dose

Booster vaccinations are required every 10 years to maintain immunity.

Most studies indicate that >99% of vaccinated persons develop YFV neutralizing antibodies by 28 days after vaccination.
Tetanus

Primary vaccination: 1 dose

Booster vaccinations are required every 10 years to maintain immunity.

In clinical trials, the seroprotective rate for tetanus was 100% with the Tdap vaccine and 99.5% with the Td vaccine in adults aged 18-64 one month after vaccination.
Influenza A single dose of the seasonal influenza vaccine. Dependent on yearly vaccine makeup, age group, and several other factors.

Original February 17, 2014