Vaccines for infants and children

Vaccine recommendations for infants and children 2008 Recommended Childhood and Adolescent Immunization Schedule (pdf) Catch-up schedule (pdf) Online immunization scheduler for parents

In 1983, The Advisory Committee on Immunization Practices (ACIP) published the first immunization schedule for children. At that time, the immunization schedule was relatively simple. During the 1990s, the childhood schedule became more complex as new immunizations became available. Over the past decade, the addition of new vaccines, such as varicella, pneumococcal conjugate and rotavirus vaccines, and changes to existing vaccines, such as polio, has made it increasingly more difficulty for providers and parents to stay abreast of childhood immunization recommendations.

Beginning in 1995, the ACIP, the American Academy of Pediatrics and the American Academy of Family Physicians began publishing an annual childhood immunization schedule, which is occasionally revised mid-year.

The 2007 Recommended Childhood and Adolescent Immunization Schedule contained several important changes from the previous year. The importance of the birth dose of hepatitis B was emphasized, and the use of combination vaccines containing hepatitis B was clarified. The new acellular pertussis vaccine (Tdap) and meningococcal vaccine (MCV4) for adolescents were added. Recommendations for childhood influenza vaccine were broadened, and the age for beginning hepatitis A vaccine was decreased to 12 months.

A catch-up schedule (pdf) is provided for children who have been delayed in receiving their immunizations.

Parents can view an immunization schedule based on their child’s birth date on the Centers for Disease Control and Prevention website, which also provides an online immunization scheduler for parents.

Using the Recommended Childhood and Adolescent Immunization Schedule in daily practice can be tricky. Fortunately, the Immunization Action Coalition provides a helpful summary of the current immunization recommendations. This document, the Summary for Childhood Immunization Rules (pdf), is updated yearly.

In an effort to improve immunization coverage levels in the state of New Mexico, the New Mexico Clinical Prevention Initiative Childhood Immunizations Workgroup derived an ACIP-compatible schedule called Done By One. The DBO schedule emphasizes immunizing children based on minimum intervals and eliminates the long-acceptable windows during which some immunizations are given. For example, the third doses of IPV and hepatitis B are given at 6 months of age. The fourth doses of DTaP, Hib and PCV7 are recommended at 12 months of age. When using this schedule providers must ensure that six months have elapsed between the third and fourth doses of DTaP. Although some providers may have less choice when vaccines are administered and children will receive more vaccines at their one-year visit, widespread use of the DBO schedule has dramatically improved New Mexico’s immunization coverage level. In 2004, 83.5 percent of children had received 4 DTaP, 3 Polio, 1 MMR, 3 Hib and 3 HepB vaccines, compared to 75.2 percent in 2003.

To stay abreast of new recommendations and to promote timely immunization of children, providers should post copies of the current year’s immunization schedule in workstation areas and in patient exam rooms. The updated schedules are usually published in Morbidity and Mortality Weekly Report (MMWR) and Pediatrics  in January every year.