IAC Express #574

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IAC EXPRESS: Extra Edition

Immunization news from the Immunization Action Coalition

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Issue Number 574 January 6, 2006

CONTENTS OF THIS ISSUE

1. CDC, AAP, and AAFP release the Recommended Childhood and

Adolescent Immunization Schedule for 2006

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(1 of 1)

January 6, 2006

CDC, AAP, AND AAFP RELEASE THE RECOMMENDED CHILDHOOD AND ADOLESCENT

IMMUNIZATION SCHEDULE FOR 2006

CDC, AAP, and AAFP have endorsed and released the Recommended

Childhood and Adolescent Immunization Schedule--United States,

2006. On January 6, CDC published the schedule as an MMWR

QuickGuide; a portion of the text is reprinted below.

Additional materials. AAP published an article about the 2006

schedule in the January 2006 issue of the journal Pediatrics. The

AAFP website posted information and a 2-page version of the 2006

schedule. CDC issued a press release about the schedule. Links to

the Pediatrics article, the AAFP information and 2-page schedule,

and the CDC press release are given at the end of this IAC Express

issue.

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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).

The changes to the previous childhood and adolescent immunization

schedule, published January 2005, 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 pertussis (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.

* 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.

* Influenza vaccine is now recommended for children aged 6 months

[and older] 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.

* 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 healthcare

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. 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.

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To access a web-text (HTML) version of the complete MMWR article,

go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5451-Immunizationa1.htm

To access a ready-to-print (PDF) version of the MMWR QuickGuide, go

to: http://www.cdc.gov/mmwr/pdf/wk/mm5451-Immunization.pdf

ADDITIONAL MATERIAL

AAP. In the January 2006 issue of Pediatrics, AAP published

Recommended Childhood and Adolescent Immunization Schedule--United

States, 2006 as a policy statement from its Committee on Infectious

Diseases.

To access a ready-to-print (PDF) version of the article, go to:

http://pediatrics.aappublications.org/cgi/reprint/117/1/239

To access a web-text (HTML) version of it, go to:

http://pediatrics.aappublications.org/cgi/content/full/117/1/239

AAFP. AAFP recently posted a brief page of information about the

2006 schedule, as well as a link to a two-page version of the

schedule.

To access the page of material, go to:

http://www.aafp.org/x7666.xml

To access a ready-to-print (PDF) version of a two-page 2006

schedule, go to:

http://www.aafp.org/PreBuilt/immunization_child2006_engl.pdf

CDC. On January 5, CDC issued a press release, " Recommended

Childhood and Adolescent Immunization Schedule--United States,

2006. "

To access the press release, go to:

http://www.cdc.gov/od/oc/media/pressrel/r060105a.htm

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Editor: Deborah L. Wexler, MD (deborah@...)

Managing Editor: Dale (dale@...)

Editorial Assistant: Janelle Tangonan (janelle@...)

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This publication is supported in part by Grant No. U66/CCU524042

from the National Immunization Program, CDC, and Grant No.

U50/CCU523259 from the Division of Viral Hepatitis, CDC. Its

contents are solely the responsibility of IAC and do not necessarily

represent the official views of CDC.

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