Dosing Schedules and Immunogenicity Criteria – Required Vaccines

Vaccine

Standard Dosing Schedule

Immunogenicity Criteria

Anthrax

Pre-exposure vaccination: 5 doses of Biothrax® 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

1. VAQTA®: 2 doses at 0 and 6-18 months

2.  HAVRIX®: 2 doses at 0 and 6-12 months

3. 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.

 

TWINRIX® accelerated schedule of 4 doses on days 0, 7, and 21 to 30 followed by a booster dose at Month 12.

Japanese Encephalitis

1.  IXIARO®: 2 doses at 0 and 28 days

2.  JE-VAX®: 3 doses at 0, 7 and 30 days

1.  IXIARO®: considered protected 7 days after the 2nd dose

2.  JE-VAX®: considered protected after the 3rd dose

Meningococcal

Laboratory workers routinely exposed to isolates of N. meningitidis should receive a single dose of MenACWY conjugate and a 2 (BEXSERO®) or 3 (TRUMENBA®) dose series of MenB vaccines

1. MenACWY conjugates including MENVEO®, MenHibrix®, and Menactra®. Studies in healthy young adults suggest up to 10 days might be required to achieve protective rSBA titers ≥1:8

2. BEXSERO® >60% composite hSBA responses after 2 doses.

3. TRUMENBA® >80% composite hSBA responses after 3 doses.

·    ≥4-fold increase in hSBA titer deemed protective

For continued exposure, 5-year boosters are recommended for MenACWY and MenB optimal, sustained protection.

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:

1.  If >8 weeks are available before protection needed: administer 3 doses of IPV at least 4 weeks apart

2.  If >8 but <4 weeks are available before protection is needed: administer 2 doses of IPV at least 4 weeks apart

3.  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 increased risk for exposure to poliovirus continues.

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:

1.  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.

2.  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.

Smallpox

(Vaccinia)

A percutaneous dose of ≥2.5 x 105 PFU ACAM2000® 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

1.  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.

2.  Vi capsular polysaccharide:

·        Primary vaccination: 1 dose

·        Booster required every 2 years to maintain immunity. 

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

 

 

 

 

 

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

Yellow Fever

Primary vaccination: 1 dose of YF-Vax®.

·        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 Td® or Tdap®.

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.

* Consult with a UF medical health care provider to confirm appropriate vaccine formulations and immunization schedules.

** A comprehensive list of all FDA licensed vaccines approved for use in the United States, including those required by UF, can be accessed here.


Revised 2/7/2018