health

Immunizations revised to reflect latest research

New schedules for children and adolescents target seven of 11 vaccines that guard against 15 diseases.

By Carolyne Krupa — Posted Feb. 11, 2011

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New guidelines to direct physicians in vaccinating children and adolescents include several revisions spurred by the latest research to ensure proper protection during the first years of life.

The latest immunization schedules include changes or new guidance for seven of 11 vaccines offered to guard children against 15 diseases.

"We could describe this as a busy year. There have been a number of changes," said H. Cody Meissner, MD, a pediatric infectious diseases specialist from Boston and a member of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

The schedules are published in the February issue of Pediatrics. The American Academy of Pediatrics release them annually in cooperation with ACIP and the American Academy of Family Physicians (link).

Recent pertussis outbreaks in several states, including California and Michigan, led the AAP to recommend one dose of the tetanus, diphtheria and pertussis vaccine (Tdap) for 7- to 10-year-olds who aren't adequately immunized. Those who haven't been vaccinated by ages 13-18 should receive a dose of Tdap followed by a tetanus and diphtheria toxoids vaccine booster every 10 years.

For children who didn't receive the recommended dose of hepatitis B vaccine at birth, the AAP recommends that they receive their final dose in the catch-up series after 24 weeks old.

Because the peak ages for meningococcal disease are 16 to 21, a booster dose of quadrivalent meningococcal conjugate vaccine is suggested at age 16.

The schedules include guidance for administering influenza vaccine to children who didn't receive a dose of the 2009 H1N1 vaccine, for Haemophilus influenzae type b vaccine in at-risk children and for 13-valent pneumococcal conjugate vaccine, which replaced the 7-valent PCV.

For human papillomavirus, the AAP advises girls 9 and older be vaccinated with the quadrivalent and bivalent vaccines to protect against cervical cancer. A three-dose series of HPV4 is also recommended for girls and boys ages 9 to 18 to reduce their chances of getting genital warts.

On Jan. 28, ACIP released revised immunization recommendations, including stricter criteria for vaccine storage and a revised list of contraindications and precautions to vaccination (link).

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