CDC. Although there is no exact limit on the number of injections, with a little flexibility, a provider can ensure that the primary series doses are given without administering too many injections at each visit. Rates of antibody clearance after receipt of an IG preparation also might vary. Recommended childhood and adolescent immunization schedules—United States, 2010. Recommended intervals are extrapolated from an estimated half-life of 30 days for passively acquired antibody and an observed interference with the immune response to measles vaccine for 5 months after a dose of 80 mg IgG/kg. Because of the unique schedule for rabies vaccine and the accelerated Twinrix schedule the 4-day guideline does not apply to this vaccine (8, personal communication, Hepatitis A subject matter experts). Recommended immunization schedules for persons aged 0 through 18 years—United States, 2011. Control and prevention of rubella: evaluation and management of suspected outbreaks, rubella in pregnant women, and surveillance for congenital rubella syndrome. In: Pickering L, Baker C, Kimberlin D, Long S, eds. In this group, about one additional febrile seizure occurred among every 2,200 children vaccinated. When administering combination vaccines, the minimum age for administration is the oldest age for any of the individual components. Safety and immunogenicity of heptavalent pneumococcal CRM197 conjugate vaccine in infants and toddlers. Sorry, your blog cannot share posts by email. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). Often there is tingling and severe pruritus at the site of the animal bite. Edsall G, Elliott MW, Peebles TC, Eldred MC. (e) Combination vaccines containing the hepatitis B component are available (see Table 3-2). (a) This table is not intended for determining the correct indications and dosages for using antibody-containing products. 1993;122(2):204-211. ACIP prefers that doses of vaccine in a series come from the same manufacturer; however, if this is not possible or if the manufacturer of doses given previously is unknown, providers should administer the vaccine that they have available. The second dose is given 7 days after the first. The extrapolation is performed by counting months from 80 mg down to (1-3 mg) (e.g. Blood products available in the United States are unlikely to contain a substantial amount of antibody to yellow fever virus. J Pediatr. Licensure of a diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine and guidance for use as a booster dose. If the third dose was administered on or after December 16, 2016, and was administered 12 weeks after the 2nd dose and 5 months after the first dose, it is a valid dose. Vaccination providers should administer vaccines as close to the recommended intervals as possible. Kretsinger K, Broder KR, Cortese MM, et al. (a) Certain experts suggest a 28-day interval between tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and tetravalent meningococcal conjugate vaccine if they are not administered simultaneously. Circulating interferon after measles vaccination. Three doses of the vaccine are given over a one-month period on days zero, seven, and either twenty-one or twenty-eight. Clinical safety evaluation of combination vaccines. Zoster vaccine may be given with antibody-containing blood products. Recommendation of the Advisory Committee on Immunization Practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MenACWY-D) among children aged 9 through 23 months at increased risk for invasive meningococcal disease. (a) Although MMR, DTaP, DT, Td, and Tdap are combination vaccines, they are not included on this list because they are not available in the United States as single-antigen products. Administration at recommended ages and in accordance with recommended intervals between doses of multidose antigens provides optimal protection. Excessive use of tetanus toxoid boosters. Vaccines are generally recommended for members of the youngest age group at risk for experiencing the disease for which vaccine efficacy and safety have been demonstrated. Watson JC, Pearson JA, Markowitz LE, et al. CDC. If either vaccine had been given alone at both time points, the 4-day grace period could be applied to the second dose. Marin M, Broder KR, Temte JL, Snider DE, Seward JF. Any reduction in immunity caused by anti-Rho(D) globulin or other blood products is outweighed by the opportunity to generate immunity. Exposure occurs through the bite of an infected (rabid) animal, typically from a wildlife source such as raccoon, fox, skunk, or bat. For management of a tetanus-prone wound in persons who have received a primary series of tetanus-toxoid–containing vaccine, the minimum interval after a previous dose of any tetanus-containing vaccine is 5 years. Rabies Vaccine Schedule: The pre-exposure schedule for rabies vaccination is 3 doses. Leroy Z, Broder K, Menschik D, Shimabukuro T, Martin D. Febrile seizures after 2010-2011 influenza vaccine in young children, United States: a vaccine safety signal from the vaccine adverse event reporting system. 80 >>> 40 >> >20 >> >10 >>> 5>>>2.5….equal to FIVE intervals) and adding a grace month, so 80 mg values take a “6 month” interval). This is based on immunogenicity studies that showed reduced antibody concentrations for 3 serotypes of pneumococcus (subtypes 4, 6B, and 18C) when PCV7 was administered simultaneously with MenACWY-D. For persons with anatomic or functional asplenia and/or HIV, PCV13 should be administered first and MenACWY-D 4 weeks later. Available data indicate that infants who receive sequential doses of different Hib conjugate, hepatitis B, and hepatitis A vaccines produce a satisfactory antibody response after a complete primary series (74-77). General recommendations on immunization. Yvonnet B, Coursaget P, Deubel V, Diop-Mar I, Digoutte JP, Chiron JP. A slash ( / ) indicates that the products must be mixed or reconstituted by the user. (x) The first dose of rotavirus must be administered at age 6 weeks through 14 weeks and 6 days. Verstraeten T, Jumaan AO, Mullooly JP, et al. Simultaneous administration of PPSV23 and inactivated influenza vaccine is recommended for all persons for whom both vaccines are indicated. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Routine administration of all age-appropriate doses of vaccines simultaneously is recommended for children for whom no specific contraindications exist at the time of the visit (7). CDC studied the health-care visit records of more than 200,000 vaccinated children ages 6 months through 59 months through the Vaccine Safety Datalink Project during the 2010-2011 influenza season. (d) The reason the interval is 6 months (and not 4 months) is that the quantity of 16.5 IgG/kg does not reflect the upper ceiling of the quantity of measles IgG in the product. Recommendations of the Advisory Committee on Immunization Practices (ACIP). (b) In persons with functional or anatomic asplenia, MCV-D and PCV13 should not be administered simultaneously and should be spaced by 4 weeks. There has been concern about simultaneous administration of vaccines containing like conjugates. The majority of children aged 1 year who have received 2 Hib vaccine doses (polyribosylribitol phosphate-meningococcal outer membrane protein [PRP-OMP]) or 3 Hib vaccine doses (PRP-tetanus [PRP-T]) and 3 previous doses of DTaP and PCV13 have protection against Hib, diphtheria, pertussis, tetanus, and pneumococcus, which lasts throughout infancy (2, 32). Many vaccines that stimulate both cell-mediated immunity and neutralizing antibodies (e.g., live, attenuated virus vaccines) can usually induce prolonged immunity, even if antibody titers decline over time (3). What are the symptoms of rabies? The 4-day grace period may be used. Unless the parent or caregiver expresses a preference for MMRV vaccine, MMR and varicella vaccine should be administered for the first dose for children aged 12-47 months (see Contraindications and Precautions) (45). Tse A, Tseng HF, Greene SK, Vellozzi C, Lee GM. (i) HepB-3 should be administered at least 8 weeks after HepB-2 and at least 16 weeks after HepB-1 and should not be administered before age 24 weeks. FDA approval of a Haemophilus b Conjugate Vaccine combined by reconstitution with an acellular pertussis vaccine. Conjugation with a protein carrier improves the effectiveness of polysaccharide vaccines by inducing T-lymphocyte–dependent immunologic function (2). RIG is … Therefore, administering inactivated vaccines and toxoids either simultaneously with or at any interval before or after receipt of an antibody-containing product should not substantially impair development of a protective antibody response (Table 3-4). However, commercial serologic testing might not always be sufficiently sensitive or standardized for detection of vaccine-induced immunity (with the exception of hepatitis B vaccination at 1-2 months after the final dose), and research laboratory testing might not be readily available. Two or more injectable or nasally administered live vaccines not administered on the same day should be separated by at least 4 weeks (Table 3-3), to minimize the potential risk for interference. There is zero grace period. Administration of doses of a multidose vaccine using intervals that are shorter than recommended might be necessary in certain circumstances, such as impending international travel or when a person is behind schedule on vaccinations but needs rapid protection. Prevention of pneumococcal disease among infants and children – use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine – recommendations of the Advisory Committee on Immunization Practices (ACIP). You may even know about the minimum ages or minimum intervals between vaccines, but what happens if your child gets a vaccine just a few days early? There is currently one type of vaccine bait, the Ultra-lite, that is used in Ontario for both fox and raccoon rabies control. The baits are distributed in areas where there is a higher risk for rabies in terrestrial wildlife (i.e. A dash ( – ) between vaccine products indicates that products are supplied in their final form by the manufacturer and do not require mixing or reconstitution by the user. For example, if the first and second doses of Haemophilus influenzae type b (Hib) were administered only 14 days apart, the second dose would be invalid and need to be repeated because the minimum interval from dose 1 to dose 2 is 4 weeks. CDC. Be ready to tell or show what was taken, how much, and when it happened. However, in the absence of a clear serologic correlate of protection for pertussis, the relevance of these immunogenicity data for protection against pertussis is unknown. Tomczyk S, Bennett NM, Stoecker C, et al. Potential advantages of combination vaccines include 1) improved vaccine coverage rates (42), 2) timely vaccination coverage for children who are behind in the schedule (43, 44), 3) reduced shipping and stocking costs, 4) reduced costs for extra health care visits necessitated by deferral of vaccination, and 5) facilitation of additional new vaccines into vaccination programs. If a dog, after having received only 1 dose of rabies vaccine, is subsequently exposed to virulent rabies virus, exposure to the virulent virus then serves as the second, or immunizing, “dose.” Because the onset of signs of rabies is slow (weeks to months) following exposure there is adequate time for a protective, humoral immune response to develop. Lane KS, Chu SY, Santoli JM. In patients recommended to receive both PCV13 and PPSV23, the 2 vaccines should not be administered simultaneously (28). Presented at the 32 meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy, Los Angeles, California, October, 1992, AND Siber GR, Werner BG, Halsey NA, et al. Of those who do not respond to the first dose of the measles component of MMR or varicella vaccine, 97%-99% respond to a second dose (5,6). Interference might occur if administration of an antibody-containing product becomes necessary after administration of MMR or varicella vaccines. Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). Meyerhoff A, Jacobs RJ, Greenberg DP, Yagoda B, Castles CG. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. An additional 4 days should not be added on to this grace period. FDA approval for a combined hepatitis A and B vaccine. Pertussis vaccination: use of acellular pertussis vaccines among infants and young children. Protein conjugates used in Hib conjugate vaccines produced in the United States include tetanus toxoid (in PRP-T) which is also used as a component of DTaP and Tdap vaccines (21). (g) If a fourth dose of DTaP is given on or after the fourth birthday, a fifth dose is not needed if the interval between the third dose and fourth dose is at least 6 months. In: Remington J, Swartz M, eds. Only combination vaccines licensed by FDA should be used (56). The length of time that interference with injectable live-virus vaccine (other than yellow fever) can persist after the antibody-containing product is a function of the amount of antigen-specific antibody contained in the product (68,70). In a study conducted in 2 U.S. health maintenance organizations, the risk for varicella vaccine failure (i.e., varicella disease in a vaccinated person) among persons who received varicella vaccine within 28 days of MMR vaccination was threefold higher than among persons who received varicella vaccine >28 days after MMR vaccination (65). However, if the child is eligible for either IIV or LAIV, and the type of vaccine used for the first dose is not available, either vaccine can be used for the second dose (56). A rabies vaccine (human diploid cell) for human use, Freeze-dried produced by Chengdu Kanghua Biological Products Co.,Ltd is used to prevent human rabies. (f) Contains antibody only to respiratory syncytial virus. Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. Any inactivated vaccine can be administered either simultaneously or at any time before or after a different inactivated vaccine or live vaccine (Table 3-3). day 1 is the day before the day that marks the minimum age or minimum interval for a vaccine. Confirmed rabies has occurred as long as 7 years after exposure, but the reasons for this long latency are unknown.The first signs of illness are nonspecific: fever, anxiety, and malaise. (l) A two-dose schedule of HPV vaccine is recommended for most persons beginning the series between 9 through 14 years of age. During the 2010-2011 influenza season, surveillance systems detected safety signals for febrile seizures in young children following IIV and PCV13 vaccines (25). In persons with anatomic or functional asplenia and/or HIV infection, quadrivalent meningococcal conjugate vaccine (MCV4)-D (MenACWY-D, Menactra) and pneumococcal conjugate vaccine (PCV)13 (PCV13, Prevnar 13) should not be administered simultaneously (27). Examples of such vaccines include DTaP, DT (for children), and Td (for adolescents and adults). Rabies is a rare disease in the United States, but it’s almost always deadly. Rabies testing done at the Connecticut Department of Public Health (DPH) Laboratory allows the DPH to monitor the occurrence of rabies among wild and domestic animals. The 4-day grace period may be used. 30 A special grace period of 2 months, based on expert opinion, can be applied to the minimum age of 15 months when evaluating ecordsr retrospectively, which will … Recommendations of the Advisory Committee on Immunization Practices (ACIP). These vaccines should not be administered to infants aged <6 weeks because of the other vaccine components (i.e., Hib, DTaP, HepA, and IPV). Hib-MenCY can be given as young as 6 weeks for high-risk persons. Cohn AC, MacNeil JR, Clark TA, et al. Considerations should include provider assessment,(c) patient preference, and the potential for adverse events. (u) This dose is not necessary if Bexsero is correctly administered, or if Trumenba is correctly administered to healthy adolescents. While IM administration of pre-exposure rabies vaccine is the gold standard, the WHO considers the ID regimen an acceptable alternative, as it uses less vaccine to produce a comparable degree of protection against rabies. Results are also important to guide the medical management of patients exposed to potentially rabid animals. In more than 90 percent of patients, the onset is within one year of exposure. (n) The minimum age for HPV-3 is based on the baseline minimum age for the first dose (i.e., 9 years) and the minimum interval of 5 months between the first and third dose. Interference of immune globulin with measles and rubella immunization. How the rabies vaccine is given The rabies vaccine is given as injections into your upper arm. It is recommended to space these vaccines by 28 days in a person with anatomic asplenia (47). CDC. The repeat dose should be spaced after … Dogs and cats must be four months old. The safety, immunogenicity, and effectiveness of unlicensed combinations are unknown. Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. With the exception of rabies vaccine, ACIP allows a grace period of 4 days (i.e., vaccine doses administered up to 4 days before the recommended minimum interval or age can be counted as valid). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). Rabies human diploid cell vaccine is used to protect people who have been bitten by animals (post-exposure) or otherwise may be exposed to the rabies virus (pre-exposure). Simultaneous administration of influenza and pneumococcal vaccines. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) and inactivated influenza vaccine (IIV) can be administered simultaneously (21). CDC. However, administering a dose a few days earlier than the minimum interval or age is unlikely to have a substantially negative effect on the immune response to that dose. The price of a combination vaccine might exceed the total price of separate vaccines containing the same antigens. This site uses Akismet to reduce spam. A vaccination provider might not have vaccines available that contain only the antigens needed as indicated by a child’s vaccination history. “3 calendar months” (or fewer) can be converted into weeks per the formula “1 month = 4 weeks”. However, intervals between doses that are longer than recommended typically do not reduce final antibody concentrations, although protection might not be attained until the recommended number of doses has been administered. The immune response to one live-virus vaccine might be impaired if administered within 28 days (i.e., 4 weeks) of another live-virus vaccine (63,64). These live, attenuated vaccines can be administered at any time before or after or simultaneously with an antibody-containing product. Enter your email address to follow Vaxopedia and receive notifications of new posts by email. Pichichero ME, Blatter MM, Reisinger KS, et al. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. If the vaccine is a live vaccine, ensuring that a minimum interval of 28 days has elapsed from the invalid dose is recommended (7). This product contains only antibody to respiratory syncytial virus and does not interfere with the immune response to licensed live or inactivated vaccines. Randomized, cross-over, controlled comparison of two inactivated hepatitis A vaccines. *(a), Before administering a vaccine dose, providers might need to verify that all previous doses were administered after the minimum age and in accordance with minimum intervals (Table 3-1). 2008L03156). Alternatively, although the indicated vaccines might be available, the provider might prefer to use a combination vaccine to reduce the required number of injections. Combination vaccines merge equivalent component vaccines into single products to prevent more than one disease or to protect against multiple strains of infectious agents causing the same disease. Sources: Mason W, Takahashi M, Schneider T. Persisting passively acquired measles antibody following gamma globulin therapy for Kawasaki disease and response to live virus vaccination [Abstract 311]. (z) A special grace period of 2 months, based on expert opinion, can be applied to the minimum interval of 3 months, when evaluating records retrospectively, which results in an acceptable minimum interval of 4 weeks. Saving Lives, Protecting People, Vaccine Recommendations and Guidelines of the ACIP, Spacing of Multiple Doses of the Same Antigen, Spacing of Vaccines and Antibody-Containing Products, Interchangeability of Single-Component Vaccines from Different Manufacturers, www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6549a5.pdf, Clinical Decision Support for Immunization (CDSi), National Center for Immunization and Respiratory Diseases, Comprehensive Recommendations and Guidelines, Preventing and Managing Adverse Reactions, Vaccine Recommendations for Emergency Situations, CDC's International Travelers Yellow Book, Clinical Travel Notices, Updates, and Vaccine Shortages, U.S. Department of Health & Human Services, Healthy adolescents: 16-23 years (+1 month), Persons at increased risk: ≥10 years (+1 month), Persons at increased risk: ≥ 10 years (+ 6 months, Three doses on a schedule of 0, 1, and 6 months, Three-dose series at 2, 4, and 6 months of age, Two doses, the first at 12-15 months, the second at 4-6 years, Fifth dose of DTaP and fourth dose of IPV, Four-dose schedule at 2, 4, 6, and 15-18 months of age, Four-dose schedule at 2, 4, 6, and 12-15 months of age, Fifth dose of DTaP and fourth or fifth dose of IPV, May be administered simultaneously or at any interval between doses, 28 days minimum interval, if not administered simultaneously, Antibody-containing products and inactivated antigen, Can be administered simultaneously at different anatomic sites or at any time interval between doses, Antibody-containing products and live antigen. (c) Hib-MenCY can be used for routine dosing of Hib vaccine but is recommended only for meningococcal vaccination in persons at high-risk of meningococcal disease. It is essential that anyone who has potentially been exposed to rabies virus or Australian bat lyssavirus (ABLV) be protected against these diseases through the appropriate use of rabies vaccine and human rabies immunoglobulin (HRIG). Addressing the challenges to immunization practice with an economic algorithm for vaccine selection. Abbreviations: HIV = human immunodeficiency virus; IG = immune globulin; IgG = immune globulin G; IGIV = intravenous immune globulin; mg IgG/kg = milligrams of immune globulin G per kilogram of body weight; IM = intramuscular; IV = intravenous; RBCs = red blood cells. Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis; HepA = hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; HPV = human papillomavirus; IPV = inactivated poliovirus; LAIV = live, attenuated influenza vaccine; MenACWY = quadrivalent meningococcal conjugate vaccine; MenB = serogroup B meningococcal vaccine; MenB-4C = Bexsero; MenB-FHbp = Trumenba; MMR = measles, mumps, and rubella; MMRV Well-care packages include vaccines to help protect dogs and cats from many common, serious and even fatal diseases. Petralli JK, Merigan TC, Wilbur JR. Action of endogenous interferon against vaccinia infection in children. Limited data are available regarding interference between live vaccines used in the United States. Anyone who has been bitten by an animal, or who otherwise may have been exposed to rabies, should see a doctor immediately. For example, if the first dose of varicella vaccine were inadvertently administered at age 10 months, the repeat dose would be administered no earlier than the child’s first birthday (the minimum age for the first dose). CDC. Administration of extra doses of tetanus toxoid vaccines earlier than the recommended intervals can increase the risk for severe local reactions (21, 34). See package insert for vaccine-specific minimum ages. However, doses administered at ages <12 months should not be counted as part of the series (81). The fourth dose of DTaP is recommended at age 15-18 months but may be administered as early as age 12 months if 6 months have elapsed since the third dose and if there is concern that the child might not return by age 18 months (33). Extra doses of tetanus-toxoid–containing vaccines might be appropriate for certain patients, including for children who previously received DT or Td vaccine and need protection from pertussis (in DTaP or Tdap) or for immigrants with uncertain vaccination histories. You will be subject to the destination website's privacy policy when you follow the link. Plotkin SA. (b) Information on travel vaccines, including typhoid, Japanese encephalitis, and yellow fever. Centers for Disease Control and Prevention. Have Thousands Been Negatively Affected After Getting a COVID-19 Vaccine? The rabies vaccine can protect you from being infected with the virus. [Demonstration of the interchangeability of 2 types of recombinant anti-hepatitis-B vaccine]. Black NA, Parsons A, Kurtz JB, McWhinney N, Lacey A, Mayon-White RT. DOI: 10.1016/S0022-3476(06)80114-9, AND Mason WH, Schneider TL, Takahashi M. Duration of passively acquired measles antibody and response to live virus vaccination allowing gamma globulin therapy for Kawasaki syndrome. FDA licensure of diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant), and poliovirus vaccine combined, (PEDIARIX) for use in infants. Every year, thousands of people around the world die from rabies. Usually, vaccine virus replication and stimulation of immunity occurs 1-2 weeks after vaccination. For a child who needs 2 doses of influenza vaccine (IIV or LAIV), it is preferable to use the same type of vaccine for both doses. The virus is spread to humans through the bite of an infected animal. In the US it is recommended people receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period. (b) (Day 1 is the day before the day that marks the minimum age or minimum interval for a vaccine.) (b) Does not include zoster vaccine. The rabies vaccine is given to people who are at higher risk of coming in contact with rabies — like veterinarians. The incubation period of rabies is usually between three and 12 weeks; in rare cases it can be as short as four days or up to 19 years [30, 31]. When inactivated (i.e., killed) or subunit vaccines (which are often adsorbed to aluminum-salt adjuvants) are administered, the reactogenicity of the vaccine must be considered in balancing the benefits and risks of extra doses (56). Interference of immune globulin with measles and rubella immunization. Administering extra antigens contained in a combination vaccine should be avoided in most situations (56). An evaluation of immune response after a second pneumococcal vaccination administered 1 year after the initial study doses showed that subjects who received PPSV23 as the initial study dose had lower antibody responses after subsequent administration of PCV13 than those who had received PCV13 as the initial dose followed by a dose of PPSV23, regardless of the level of the initial response to PPSV23 (29,30). The vaccine or toxoid and antibody preparation should be administered at different sites using the standard recommended dose. Use of combination vaccines is associated with improved coverage rates. With some exceptions (e.g. If records cannot be located within a reasonable time, these persons should be considered susceptible and started on the age-appropriate vaccination schedule. General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP), Printer friendly version pdf icon[38 pages]. All brands of Hib conjugate, hepatitis B,(d) hepatitis A, rotavirus,(e) and quadrivalent meningococcal conjugate vaccines are interchangeable within their respective series. CDC. CDC. (o) One dose of influenza vaccine per season is recommended for most persons. A 4 day grace period can be added to the absolute minimum age of 18 years when evaluating records retrospectively. Simultaneous or sequential vaccination with Hib and these tetanus-toxoid containing vaccines is recommended when both are indicated (56). Series between 9 through 14 weeks and 6 days a slash ( / ) indicates the... Their products might contain different concentrations of measles antibody in an IG preparation vary. Ontario for both fox and raccoon rabies control - ) should be used in Ontario for both fox and rabies. The bat population the destination website 's privacy policy when you follow the link with a protein carrier improves effectiveness. 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