Main Changes to the Vaccination Schedule Recommended by the Japan Pediatric Society January 12, 2014

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1 Main Changes to the Vaccination Schedule Recommended by the Japan Pediatric Society January, 04 ) 3-valent Pneumococcal conjugate vaccine (PCV3) The description of catch-up schedule for PCV3 has been revised and added. ) Hepatitis B virus (HBV) vaccine The vaccination schedule for the prevention of mother-to-child transmission of HBV has been changed from, 3, 5 months after birth to at birth,, 6 months after birth (currently, the package insert has been under the revision).

2 9 yrs 8 yrs 7 yrs 6 yrs 5 yrs 4 yrs 3 yrs yrs 5 mos 4 mos 3 mos mos 6 wks Grade 6 Vaccination Schedule Recommended by the Japan Pediatric Society January, 04 Japan Pediatric Society Infancy Early childhood School age Vaccines Type 6-8 mos 9- mos -5 mos 6-7 mos 8-3 mos 0 yrs Haemophilus influenzae type b (Hib) Pneumococcal conjugate (PCV3) Hepatitis B (HBV) (footnote 3) Rotavirus Tetanus, Poliovirus (DPT-IPV) Tetanus (DPT) (footnote 7) Poliovirus (IPV) (footnote 8) BCG Measles, Rubella (MR) Varicella Mumps Japanese encephalitis (footnote ) 3 4(footnote ) 3 4 (footnote ) 3 3(footnote 4) (footnote 5) 3 (footnote 6) 3 4(footnote 7) 3 4(footnote 7) (up to 7.5 yrs) (up to 7.5 yrs) 3 4(footnote 7) (up to 7.5 yrs) (footnote 0) (footnote 9) (footnote ) 3 (up to 7.5 yrs) Influenza Every year (e.g. October, November) From 3 yrs 4 9- yrs Diphtheria, Tetatus (DT) yrs Human papillomavirus (HPV) (footnote ) yrs Junior High Grade 3 (footnote 3) Junior High Grade -High School Year Recommended age range for routine vaccinations Recommended age range for voluntary vaccinations Period possible for routine vaccinations Period possible for voluntary vaccinations Not stated in package insert but recommended by the Japan Pediatric Society

3 Vaccination Schedule Recommended by the Japan Pediatric Society Perspective of the Japan Pediatric Society, Precautions Routine Vaccination Voluntary Vaccination Vaccines Type Standard Age of Vaccination and Vaccination Schedule Perspective of the Japan Pediatrics Society Precautions Haemophilus influenzae type b (Hib) Pneumococcal conjugate (PCV3) Should be a 3-8 wks interval between --3 Between 3-4 interval of 7-3 mos Should be an interval of 7 days between --3 Between 3-4 an interval of 60 days, and administered when the child is yr - yr 3 mos old Hepatitis B (HBV) An interval of 4 wks between -, 0-4 wks between -3 Rotavirus Diphtheria, Pertussis, Tetanus, Poliovirus (DPT-IPV) Vaccination possible from 6 wks after birth. : recommended between 8 wks and under 5 wks RV vaccine (Rotarix ): For- a total of doses with an interval of 4 wks. For RV5 vaccine (RotaTeq ): --3: a total of 3 doses with 4 wks between doses Interval of 0-56 days between --3 (footnote 6), 6 mos between 3-4. Generally, during -8 mos after 3 Diphtheria, Pertussis, Tetanus (DPT) Poliovirus (IPV) Leave an interval of 0 days between --3 (footnote 7), 6 months between 3-4. Generally, during -8 mos after 3 BCG Measles, Rubella (MR) Varicella Mumps Administered under mos of age, generally administered during the period from 5 mos to <8 mos : year - < yrs : 5 yrs - <7 yrs (footnote 9) year before entering elementary school (footnote ) 4: can obtain satisfactory immunity if administered from mos For 3-4: interval of over 7 mos and administered after child is yr old (footnote ) A supplemental dose of PCV3 is recommended for children <6 yrs who completed appropriate numbers of PCV7 by the Immunization Law, apart from 8 wks from the last PCV7. (footnote 3) Based on vaccination schedule (at, 3, 5 mos after birth) by the former program of the prevention of mother-to-child transmission of HBV. Further investigation is necessary for appropriate timing of vaccination. (footnote 4) to prevent mother-to-child transmission of unvaccinated child Whenever possible, administered simultaneously with DPT Early vaccination required in areas where incidence of tuberculosis is high : yr (footnote 0) To ensure vaccination efficacy, doses are necessary. : early vaccination after the age of, : leave 3 mo interval and administered before reaching age if possible : yr (footnote 0) to ensure vaccination efficacy, doses necessary. : early vaccination after the age of : simultaneous administration with nd dose of MR ( 5 yrs - <7 yrs, year before entering elementary school is recommended) If first dose administered between 7 mos and mos: After - an interval of 7 mos then 3 If first dose administered between yr and 4 yrs: only If first dose administered between 7 mos- mos: After, vaccination, an interval of 60 days and after yr of age, followed by catch-up vaccination 3 If first dose administered between yr-3 mos:, with 60 days interval If first dose administered between yrs-4 yrs: only (footnote 3) Vaccination schedule by the prevention of mother-to-child transmission of HBV is at birth, and 6 mos after birth. (Currently, the package insert has been under revision.) (footnote 5) Total doses, to be completed within 4 th wk of age (footnote 6) Total 3 doses, 3 to be completed within 3 nd wk of age 4 doses for persons with no previous vaccination of DPT, IPV and OPV (oral poliovirus vaccine) (footnote 8) In cases where DPT and IPV are administered separately. (footnote 8) In cases where DPT and IPV are administered separately, refer to vaccination schedule at for persons who did not complete vaccination but was administered OPV vaccine and/or IPV prior to August 3, 0.

4 Vaccines Type Standard Age of Vaccination and Vaccination Schedule Perspective of the Japan Pediatrics Society Precautions Japanese encephalitis (footnote ),: 3 yrs, leave a 6-8 days interval between - 3: 4 yrs 4: 9 yrs (grade 3-4 elementary school ) For general routine vaccinations, first dose administered from 6 mos to under 90 mos (7.5 yrs), and second dose at age 9 to under 3 yrs. Due to the assertive recommendation to refrain from administration in May 005, special target persons (those born between April, 995 and April, 007) are subjects for routine vaccination while under 0 yrs. For details, refer to the Ministry of Health homepage (Japanese encephalitis) Influenza Leave an interval of 4 wks between (-4 wks) <3 yrs: doses, 3 yrs: or doses Single dose: 6 mos - <3 yrs: 0.5 ml; 3 yrs: 0.5 ml Diphtheria, Tetanus (DT) Human papillomavirus (HPV) : At yrs until reaching yrs Transition to DPT necessary due to increasing patients with pertussis Age -6 (footnote 3) Grade 6 to high school year HPV vaccine (Cervarix ): mo between -, leave 6 mos between -3 HPV4 vaccine (Gardasil ): mos between -, leave 6 mos between -3 According to the Immunization Law, yrs, <3 yrs Vaccine given as intramuscular injection (upper arm, deltoid area) (footnote ) HPV vaccine can be administered from 0 yrs, HPV4 vaccine 9 yrs (footnote 3) Note the difference in the interval required for routine vaccination between the vaccines. HPV vaccine: -.5 mos between -; 5- mos between -3; HPV4 vaccine: mo or more between -, 6 mos between -3 January, 04, Japan Pediatric Society

5 Vaccination Checklist Name: Date of Birth: (dd/mm/yyyy) Vaccines Type Dose Dose Dose 3 Dose 4 Haemophilus influenzae type b (Hib) Pneumococcal conjugate (PCV7) Hepatitis B (HBV) Rotavirus Tetanus, Poliovirus (DPT-IPV) Tetanus (DPT) BCG Poliovirus ( doses for, 4 doses for ) Measles, Rubella (MR) Varicella Mumps Japanese encephalitis Dose final for RV vaccine (Rotarix) Influenza (Annual vaccination recommended, refer to nd sheet) Diphtheria, Tetanus (DT) Human papillomavirus (HPV) Routine vaccinations Dose 3 final for RV5 vaccine (RotaTeq) Voluntary vaccinations January, 04, Japan Pediatric Society Routine vaccinations Voluntary vaccinations

6 Influenza Vaccination Checklist Name: Date of Birth: (dd/mm/yyyy) Age Dose Dose Age Dose Dose 6- mos yr yrs 3 yrs 4 yrs 5 yrs 6 yrs 7 yrs 8 yrs 9 yrs 0 yrs yrs yrs 3 yrs 4 yrs 5 yrs January, 04, Japan Pediatrics Society

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