My 4.5 yr old has previously received:
12mths - pnemo (prevnar)
18mth - pnemo (prevnar)
2.5yr - DTaP-IPV-HIB (pentacel)
4.5yr - DTaP-IPV (quadracel)
4.5yr - MMR (merek)
My understanding is that he has:
Completed the pnemo and HIB.
Requires 3 more boosters of DTaP-IPV, 1 more boosters of MMR, 1 Varicella & 1 MenC (canadian protocol)
Is my understanding correct? Also, specifically I would like to understand more about the spacing of the DTaP-IPV. Has the effectiveness decreased because there were 2yrs in between the first and second doses? Also, what would be a good approach for spacing going forward.
sorry to have left you without reply there for so long, I was away in beautiful Spain.
You are correct on the hib and prevenar. The DTaP-IPV spacing is odd, usually you want shots 1 and 2 closer to each other, like a couple of months apart and the third one more than 6 months after the third. However, if you left 6 months between your LO's second DTaP-IPV and the third, it is very likely that he'll be as protected as if he had had the three shots in a "proper" spacing. There is no research on that, however, it is assumed that the body "recalls" all shots and therefore, the third DTaP-IPV should be a good booster, giving him protection for several years (extrapolating from the Swedes who do 3, 5, 12 months and then a preschool booster). So I would suggest you give your LO the third DTaP-IPV 6 months or so after the second and then boost him about 3 or 4 years after that (with TdaP/IPV). His protection between 2.5 years (shot 1) and 4.5 years will have not been great, but you are past that now.
Yes on MMR (one more needed), Varicella and MenC. MMR and Varicella need to be either given on the same day or at least 4 weeks apart for the viruses to stimulate the immune system well. MenC can be given whenever, no minimal spacing to anything needed. So for those shots, it is really when you feel like it. You could for example give the next MMR in a couple of months, the MenC a month or so after that, the Var a month or so after that and the DTaP/IPV when he is 5. Does this make sense? I hope this helps, let us know how you proceed and again, sorry for the slow response...