Immunization Schedule Updated for Children and Teens

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News Author: Laurie Barclay, MD
CME Author: Hien T. Nghiem, MD

Disclosures

Release Date: January 9, 2007Valid for credit through January 9, 2008

Credits Available

Physicians – maximum of 0.25 AMA PRA Category 1 Credit(s) for physicians;
Family Physicians – up to 0.25 AAFP Prescribed credit(s) for physicians;
Nurses – 0.25 nursing contact hours (0.25 contact hours are in the area of pharmacology)


January 9, 2006 — The American Academy of Pediatrics, the Advisory Committee on Immunization Practices (ACIP), and the American Family of Physicians have updated the immunization schedule for children and teens. The revised guidelines appear in the January 5 issue of the Morbidity & Mortality Weekly Report.

Recommended Immunization Schedules for Persons Aged 0 to 18 Years — United States, 2007

“The Advisory Committee on Immunization Practices (ACIP) periodically reviews the recommended immunization schedule for persons aged 0 – 18 years 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 ACIP authors write.

The new guidelines recommend the following changes from the previous childhood and adolescent immunization schedule, published in January 2006:

  • The new rotavirus vaccine (Rota, Merck & Co) should be given in a 3-dose schedule at ages 2, 4, and 6 months. The first dose should be administered from ages 6 weeks through 12 weeks, and subsequent doses should be given at 4- to 10-week intervals. Rotavirus vaccination should not be started in infants older than 12 weeks and should not be given after age 32 weeks.
  • All children aged 6 to 59 months should receive the influenza vaccine.
  • According to the updated recommendations for varicella vaccine, the first dose should be given at age 12 to 15 months, and a newly recommended second dose should be given at age 4 to 6 years.
  • The new human papillomavirus (HPV) vaccine should be given in a 3-dose schedule, with the second and third doses given 2 and 6 months after the first dose. Girls aged 11 to 12 years should be routinely vaccinated with HPV vaccine, but this vaccination series can be started in girls as young as age 9 years. A catch-up vaccination is recommended for females aged 13 to 26 years who have not been vaccinated previously or who have not completed the full vaccine series.
  • The new guidelines divide the recommendations into 2 schedules: 1 for children aged 0 to 6 years, and another for persons aged 7 to 18 years. Purple bars indicate special populations, and bold, capitalized fonts in the title highlight the 11- to 12-year evaluation. The catch-up immunization schedule incorporates the rotavirus, HPV, and varicella vaccines.

“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,” the authors write. “Detailed recommendations for using vaccines are available from package inserts, ACIP statements on specific vaccines, and the 2003 Red Book.”

Individual ACIP statements for each recommended childhood vaccine are also available from the US Centers for Disease Control and Prevention, and guidance for obtaining and completing a Vaccine Adverse Event Reporting System form is available from the Department of Human Health Services.

The ACIP, the American Academy of Pediatrics, and the American Academy of Family Physicians have approved the recommended immunization schedules for persons aged 0 to 18 years and the catch-up immunization schedule for 2007.

MMWR Morb Mortal Wkly Rep. 2007;55:Q1-Q4.

Clinical Context

Recommendations for childhood and adolescent immunizations for 2007 have been reviewed and released by the ACIP. The main change to the format of the schedule is the division of the recommendation into 2 schedules: 1 for persons aged 0 to 6 years and another for persons aged 7 to 18 years.

In this report, it discloses the changes to the previous childhood and adolescent immunization schedule published in January 2006.

Study Highlights

  • The new rotavirus vaccine is recommended in a 3-dose schedule at ages 2, 4, and 6 months.
  • The first dose should be administered at ages 6 weeks through 12 weeks with subsequent doses administered at 4- to 10-week intervals.
  • Rotavirus vaccination should not be initiated for infants older than 12 weeks and should not be administered after age 32 weeks.
  • The influenza vaccine is now recommended for all children aged 6 to 59 months.
  • Varicella vaccine recommendations are updated. The first dose should be administered at age 12 to 15 months, and a newly recommended second dose should be administered at age 4 to 6 years.
  • The new HPV vaccine is recommended in a 3-dose schedule, with the second and third doses administered 2 and 6 months after the first dose.
  • Routine vaccination with HPV vaccine is recommended for girls aged 11 and 12 years; the vaccination series can be started in girls as young as age 9 years, and a catch-up vaccination is recommended for females aged 13 to 26 years who have not been vaccinated previously or who have not completed the full vaccine series.
  • Rotavirus, HPV, and varicella vaccines are incorporated in the catch-up immunization schedule.

Pearls for Practice

  • In the 2007 ACIP vaccination guidelines for children and adolescents, changes to the previous guidelines include the extension of the influenza vaccine to all children aged 6 to 59 months, the second dose of varicella at age 4 to 6 years, and the introduction of the rotavirus and HPV vaccines.
  • The new vaccinations include the 3-dose rotavirus vaccine at ages 2, 4, and 6 months and the 3-dose HPV vaccine, with the second and third doses administered 2 and 6 months after the first dose.


 

1. According to the 2007 ACIP immunization schedule, all of the following are changes to the 2006 guidelines, except:  (Required for credit)

 

2. According to the 2007 ACIP immunization schedule, which of the following statements is not correct regarding the updated vaccine information?  (Required for credit)
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