Vaccine schedule
 When Do
Children and Teens Need Vaccinations
Harmonized Childhood and Adolescent Immunization Schedule, 2006
The
Advisory Committee on Immunization Practices (ACIP) periodically
reviews the recommended childhood and adolescent immunization
schedule to ensure that the schedule is current with changes in
vaccine formulations and reflects revised recommendations for the
use of licensed vaccines, including those newly licensed. The
recommendations and format of the childhood and adolescent
immunization schedule and catch-up schedule for January--December
2006 were approved by ACIP, the American Academy of Pediatrics (AAP),
and the American Academy of Family Physicians (AAFP) (Figure
and Table).
The
changes to the previous childhood and adolescent immunization
schedule, published January 2005 (1),
are as follows:
-
The importance of the hepatitis B vaccine (HepB) birth dose has
been emphasized. Vaccination of infants born to hepatitis B
surface antigen (HBsAg)-negative mothers can be delayed in rare
circumstances, but only if a physician's order to withhold the
vaccine and a copy of the mother's original HBsAg-negative
laboratory report are documented in the infant's medical record.
Administering four doses of HepB is permissible (e.g., when
combination vaccines are administered after the birth dose);
however, if monovalent HepB is used, a dose at age 4 months is
not needed. For infants born to HBsAg-positive mothers, testing
for HBsAg and antibody to HBsAg after completion of the vaccine
series should be conducted at age 9--18 months (generally at the
next well-child visit after completion of the vaccine series).
-
A
new tetanus toxoid, reduced diphtheria toxoid, and acellular
pertussis vaccine recommended by ACIP for adolescents (Tdap
adolescent preparation) was approved by the Food and Drug
Administration (FDA) on May 5, 2005, for use in the United
States. Tdap is recommended for adolescents aged 11--12 years
who have completed the recommended childhood diphtheria and
tetanus toxoids and pertussis/diphtheria and tetanus toxoids and
acellular pertusis (DTP/DTaP) vaccination series and have not
received a tetanus and diphtheria toxoids (Td) booster dose.
Adolescents aged 13--18 years who missed the age 11--12-year Td/Tdap
booster dose should also receive a single dose of Tdap if they
have completed the recommended childhood DTP/DTaP vaccination
series. Subsequent Td boosters are recommended every 10 years (2).
-
Meningococcal conjugate vaccine (MCV4), approved by FDA on
January 14, 2005, should be administered to all children at age
11--12 years as well as to unvaccinated adolescents at high
school entry (age 15 years). Other adolescents who wish to
decrease their risk for meningococcal disease may also be
vaccinated. All college freshmen living in dormitories should
also be vaccinated with MCV4 or meningococcal polysaccharide
vaccine (MPSV4). For prevention of invasive meningococcal
disease, vaccination with MPSV4 for children aged 2--10 years
and with MCV4 for older children in certain high-risk groups is
recommended (3).
-
Influenza vaccine is now recommended for children aged >6
months with certain risk factors, which now specifically include
conditions that can compromise respiratory function or handling
of respiratory secretions or that can increase the risk for
aspiration (4).
-
Hepatitis A vaccine is now universally recommended for all
children at age 1 year (12--23 months). The 2 doses in the
series should be administered at least 6 months apart.
-
The catch-up schedule for persons aged 7--18 years has been
changed for Td; Tdap may be substituted for any dose in a
primary catch-up series or as a booster if age appropriate for
Tdap. A 5-year interval from the last Td dose is encouraged when
Tdap is used as a booster dose.
Vaccine Information Statements
The
National Childhood Vaccine Injury Act requires that health-care
providers provide parents or patients with copies of Vaccine
Information Statements before administering each dose of the
vaccines listed in the schedule. Additional information is available
from state health departments and from CDC at
http://www.cdc.gov/nip/publications/vis.
Detailed recommendations for using vaccines are available from
package inserts, ACIP statements on specific vaccines, and the
2003 Red Book (5). ACIP statements for each recommended
childhood vaccine are available at the CDC National Immunization
Program website at
http://www.cdc.gov/nip/publications/acip-list.htm. In addition,
guidance for obtaining and completing a Vaccine Adverse Event
Reporting System form is available at
http://www.vaers.hhs.gov or
by telephone, 800-822-7967.
References
-
CDC. Recommended childhood and adolescent immunization
schedule---United States, 2005. MMWR 2005;53:Q1--Q3.
-
CDC. ACIP recommends adolescent vaccination for tetanus,
diphtheria and pertussis vaccine. Atlanta, GA: US Department of
Health and Human Services, CDC; June 30, 2005. Available at
http://www.cdc.gov/nip/pr/pr_tdap_jun2005.htm.
-
CDC. Prevention and control of meningococcal disease:
recommendations of the Advisory Committee on Immunization
Practices (ACIP). MMWR 2005;54(No. RR-7).
-
CDC. Prevention and control of influenza: recommendations of the
Advisory Committee on Immunization Practices (ACIP). MMWR
2005;54(No. RR-8).
-
American Academy of Pediatrics. Active and passive immunization.
In: Pickering LK, ed. 2003 red book: report of the Committee on
Infectious Diseases. 26th ed. Elk Grove Village, IL: American
Academy of Pediatrics; 2003.
The
Recommended Childhood and Adolescent Immunization Schedule and the
Catch-up Childhood and Adolescent Immunization Schedule have been
approved by the Advisory Committee on Immunization Practices, the
American Academy of Pediatrics, and the American Academy of Family
Physicians. The standard MMWR footnote format has been
modified for publication of this schedule.
Suggested citation: Centers for Disease Control and Prevention.
Recommended childhood and adolescent immunization schedule---United
States, 2006. MMWR 2005;54 (Nos. 51&52):Q1--Q4.
Figure
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