{
  "schema_version": 1,
  "kind": "condition",
  "id": "routine-immunisation-catch-up",
  "name": "Routine immunisation and catch-up",
  "category": "chronic",
  "sources": "WHO/UNICEF national immunisation schedule for Egypt, 2025 (WHO Immunization Data portal, WIISE AD_SCHEDULES, who-egypt-immunisation-schedule-2025.txt) · Understanding and Application of CDC Immunization Guidelines - StatPearls (NCBI Bookshelf NBK567723) - https://www.ncbi.nlm.nih.gov/books/NBK567723/ · Immunization - StatPearls (NCBI Bookshelf NBK459331) - https://www.ncbi.nlm.nih.gov/books/NBK459331/ · Routine immunisation and catch-up - disease-level clinical article (routine-immunisation-catch-up-full.txt) · Routine immunisation and catch-up - disease-level clinical article (routine-immunisation-catch-up-clinical.txt)",
  "review_status": "reviewed",
  "verified_against": "Understanding and Application of CDC Immunization Guidelines - StatPearls (NCBI Bookshelf NBK567723) - https://www.ncbi.nlm.nih.gov/books/NBK567723/ · Immunization - StatPearls (NCBI Bookshelf NBK459331) - https://www.ncbi.nlm.nih.gov/books/NBK459331/ · Routine immunisation and catch-up - disease-level clinical article (routine-immunisation-catch-up-full.txt) · Routine immunisation and catch-up - disease-level clinical article (routine-immunisation-catch-up-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1623,
      "generic": "Egypt's national schedule - resume it, do not restart it (Advice & Referral)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Understanding and Application of CDC Immunization Guidelines - StatPearls (NCBI Bookshelf NBK567723) - https://www.ncbi.nlm.nih.gov/books/NBK567723/",
      "rationale": "THE EGYPTIAN SCHEDULE IS THE ONE BELOW, AND IT IS NOT THE AMERICAN ONE. The ages and the vaccine list come from the schedule Egypt reported to WHO through the WHO/UNICEF Joint Reporting Form, for 2025. The catch-up principles, the contraindications and the false contraindications that follow come from the cached CDC and ACIP articles, and are labelled as CDC where the detail is CDC-specific - a rule about resuming rather than restarting a series transfers between countries, an age does not. Where a family's own vaccination card disagrees with either, the card in the family's hand is the record of what the child actually had.",
      "cautions": [
        "EGYPT'S ROUTINE CHILDHOOD SCHEDULE, 2025 - AT BIRTH: BCG, hepatitis B, and the first oral polio dose. 2 MONTHS: pentavalent (diphtheria, whole-cell pertussis, tetanus, Haemophilus influenzae type b and hepatitis B), inactivated polio, oral polio. 4 MONTHS: the same three again. 6 MONTHS: the same three again, plus vitamin A. 9 MONTHS: oral polio. 12 MONTHS: measles-mumps-rubella, oral polio, vitamin A. 18 MONTHS: the DTwP booster, the second measles-mumps-rubella, oral polio, vitamin A. 24 MONTHS: vitamin A.",
        "EGYPT GIVES SEVEN ORAL POLIO DOSES AND THREE INJECTED ONES - oral at birth and at 2, 4, 6, 9, 12 and 18 months, injected at 2, 4 and 6 months. A parent counting doses against an American or European card will find far more polio doses here, and that is correct, not an error.",
        "THE SECOND MEASLES DOSE COMES AT 18 MONTHS IN EGYPT, not at 4 to 6 years as on the CDC schedule. A child of 2 who has had two doses is fully vaccinated for measles here.",
        "SCHOOL-AGE DOSES - meningococcal A and C polysaccharide at 4, 6, 12 and 15 years, and tetanus-diphtheria at 7 years and again at 9 years, given through the schools.",
        "WOMEN OF CHILDBEARING AGE - a five-dose tetanus toxoid series: at first contact, then 1 month later, then 6 months after that, then one dose a year later and a fifth a year after that.",
        "AFTER AN ANIMAL BITE OR SCRATCH - rabies vaccine is given on the day of presentation and then 3, 7, 14 and 28 days later. The schedule counts from the first dose, so a missed day is made up rather than started again.",
        "IF PERTUSSIS VACCINE CAUSED AN ADVERSE EVENT LAST TIME, Egypt's schedule substitutes plain diphtheria-tetanus plus separate Haemophilus influenzae type b vaccine at 2, 4, 6 and 18 months, rather than dropping the protection altogether.",
        "HEPATITIS B FOR AN UNVACCINATED ADULT - health and care workers and other high-risk groups get three doses: at first contact, 1 month later, and 6 months after the first.",
        "TRAVEL AND SEASONAL - influenza from 6 months of age, and for adults, health workers, pregnant women and people with chronic conditions; yellow fever as a single lifelong dose for travel to endemic areas; cholera in two doses two weeks apart, and meningococcal ACYW, for travel to countries where those are a risk.",
        "WHAT THIS SCHEDULE IS AND IS NOT - it is what Egypt reported to WHO for 2025, not a Ministry of Health circular, and it lists which vaccines are given at which ages rather than the volume in the syringe. Local practice and supply can differ, and the family's own card is the record of what was actually given.",
        "WHY IT IS WORTH THE VISIT AT ALL - no other public health measure does as much, as safely, to bring down how often infectious disease occurs, how much of it is about, and how much illness and death it causes. Nor is anything else in preventive medicine better value for the money spent.",
        "A LATE CHILD IS CAUGHT UP, NOT STARTED AGAIN - the CDC catch-up rules quoted here all resume a series rather than repeat it. For example \"The fifth dose is unnecessary for catch-up immunization if the fourth dose is given at more than 4 years of age and at least 6 months after the third dose.\" and for Hib at \"15- 59 months - 1 dose\". Doses already given count; the interval since the last one is what governs the next.",
        "AGE CAN CLOSE A CATCH-UP DOWN ALTOGETHER - a healthy child over 5 years old who never had Haemophilus influenzae vaccine is not offered a catch-up course; past 60 months, with no risk factor in the background, Hib is simply not given. Some missed doses are not made up later, which is worth knowing before an anxious parent is sold a course.",
        "THE PERTUSSIS PRODUCT CHANGES WITH AGE - past 7 years of age DTaP is no longer recommended, and Tdap becomes the preferred product from then on. A child over 7 who was never vaccinated needs 3 doses of Tdap: the first 2 separated by 4 weeks, then 6 months before the third.",
        "HEPATITIS A IS THE ONE MOST OFTEN LEFT OUT - anyone unvaccinated should have the 2-dose hepatitis A course, the doses 6 months apart, and the catch-up is recommended for every unvaccinated person from age 2 up to 18. Relevant in Cairo, where exposure is common.",
        "THE REAL CONTRAINDICATIONS ARE FEW - a true contraindication to a vaccine is uncommon, and for the great majority of people vaccines are safe. The main one is an allergy that is already known, either to the vaccine itself or to something in it. Everything else on a parent's list usually is not one.",
        "LIVE VACCINES ARE THE ONES THAT NEED THINKING ABOUT - a severely immunocompromised person should NOT be given a live vaccine as a rule, because the vaccine strain can itself cause infection in them. A pregnant woman should AVOID live vaccines too, unless the threat is immediate and serious - exposure in a polio outbreak, for instance - since a live vaccine can reach the fetus. The article names two more specifically: severe combined immunodeficiency, and intussusception in the past. That second one is the rotavirus question to ask before the first dose.",
        "A SNUFFLY CHILD STILL GETS VACCINATED - the article's caution is narrower than most parents assume. It applies to a child who is acutely ill at a moderate or a severe level, with or without a temperature. The reason is diagnostic: a fever afterwards then cannot be told apart from the illness the child already had, and that muddle makes the child harder to manage. Moderate to severe illness defers the visit. A mild cold, a runny nose, or a course of antibiotics does not.",
        "WHAT TO WARN THE FAMILY WILL HAPPEN - after most vaccines there is a small chance of feeling unwell: fever, tiredness, aching muscles. That is the immune system answering the antigen that was given, and it lasts a day or 2. At the injection site expect redness and swelling, and the muscle around it may be sore. Saying this in advance prevents the next dose being refused.",
        "CATCH-UP IS NOT ONLY A CHILDHOOD JOB - the WHO position widens immunisation well past childhood: to older adults and to adults generally, to adolescents, to pregnant women, and to the people who staff the health service. It presses for three things alongside that - doses caught up, booster programmes, and vaccination records that can be trusted. An unvaccinated adolescent or adult in front of you is also a catch-up opportunity.",
        "IF THE CHILD IS IMMUNOSUPPRESSED, TRANSPLANTED, OR ASPLENIC, ASK RATHER THAN GUESS - the article carries special schedules. Before a planned splenectomy, 1 dose of Hib vaccine is given, ideally 14 days ahead of the operation, whatever the child has had before. After a stem cell transplant, 3 doses of Hib are given 4 weeks apart, starting 6 months from the transplant, and again whatever the child has had before. These children are managed with their specialist, not from a primary-care card."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "routine-immunisation-catch-up"
    }
  ]
}