 |
Childhood Vaccinations
Content
-
Hepatitis B Vaccine
-
DTaP
Vaccine
-
H.
Influenzae type b (Hib) Vaccine
-
Inactivated Polio (IPV) Vaccine
-
Pneumococcal Conjugate Vaccine
-
Measles,
Mumps, Rubella (MMR) Vaccine
-
Varicella Vaccine
-
Hepatitis A Vaccine
-
Make
Sure Your Child is Protected
-
Immunizations are Safe and Effective
-
Recommended childhood and adolescent immunization
schedule — United States, July-December 2004
-
For Children and Adolescents Who Start Late or Who
Are >1 Month Behind
Immunizations have been
protecting children from serious diseases for more than 50 years!
|
When your child is immunized,
he or she receives a vaccine to prevent a certain disease. Vaccines
usually are given as shots. The vaccine makes your child's body produce
antibodies. These antibodies make him or her immune to this disease
should he or she ever come in contact with it.
|
|
Your child should receive most
of his or her immunizations during the first 2 years of life, starting
at birth. Infants and young children are more a risk of being harmed by
serious diseases. That is why it is important to begin immunization
early. Your child also will need immunizations before starting school.
In addition, he or she will need to receive vaccines as an older child
and teenager.
|
|
Today children receive more
immunizations than in past because now we can protect them from more
serious diseases than ever before. Most vaccines used for routine
childhood immunizations can be given safely at the same time.
|
|
For more information on
immunizations, visit
The National Network for Immunization Information
Top |
Hepatitis B Vaccine
This protects against a virus that may cause
serious liver disease including cancer. Your child needs to receive doses of
hepatitis B vaccine at:
 | Birth to 2 months of age |
| 1 to 4 months of age |
| 6 to 18 months of age |
Any older child or teen who has not received this vaccine can begin the
series of immunizations at any time.
Top
|
DTaP Vaccine
This protects against diphtheria (a
potentially fatal throat and windpipe infection), tetanus (lockjaw), and
pertussis (whooping cough).
Most children should receive this vaccine at ages:
| 2 months |
| 4 months |
| 6 months |
| 15 to 18 months |
| 4 to 6 years |
| 11 to 16 years, Td (tetanus and diphtheria) only. Routine Td
boosters are needed every 10 years after that. |
Top
|
|
H. Influenzae type b (Hib) Vaccine
This protects against Haemophilus influenzae
type b. This bacterium is a major cause of spinal meningitis, pneumonia,
and other serious infections.
Your child should receive:
| two or three doses of the Hib vaccine between 2 and 6 months of
age |
| a booster dose at12 to 15 months |
Your pediatrician can tell you about different types of the Hib
vaccine that are available.
Top
|
Inactivated Polio (IPV)
Vaccine
This protects against polio, which can
cause paralysis or death. This type of polio vaccine is given as a
shot and is recommended for almost everyone. Your child should
receive doses of polio vaccine at ages:
| 2 months |
| 4 months |
| 6 to 18 months |
| 4 to 6 years |
Under certain circumstances your pediatrician may recommend that
your child receive the oral polio vaccine, which is given by mouth.
Top
|
|
Pneumococcal Conjugate Vaccine
This protects against the pneumococcal
bacteria, which can cause meningitis, pneumonia, and serious
infections in the brain, blood stream, and ears.
Your child needs this vaccine at ages:
| 2 months |
| 4 months |
| 6 months |
| 12 to 15 months. |
Some children between the ages of 2 and 5 years also may need
this vaccine.
Top |
|
Measles, Mumps, Rubella (MMR)
Vaccine
This protects against measles, mumps and
rubella (German measles).
Your child needs to receive doses of the MMR vaccine at:
| 12 to 15 months of age |
| 4 to 6 years of age |
Children who do not get the second dose on schedule should
receive it at the earliest opportunity.
Top
|
|
Varicella Vaccine
This protects against chicken pox, which
can cause serious complications such as bacterial skin infections,
pneumonia and infections of the brain.
If your child has not had chicken pox, he child should receive:
| A single dose of the varicella vaccine between the ages of 12
and 18 months. |
| A single dose at the earliest opportunity if he or she is an
older child (but younger than 13 years) and has not been
immunized. |
| Two doses of the vaccine at least 4 weeks apart, if he or she
is older than 13 years of age and has never been immunized. |
Some relevant news articles that you may find interesting are:
|
Top
Hepatitis A Vaccine
Under certain conditions your child may need
the Hepatitis A vaccine:
This protects against a virus that causes liver disease. Hepatitis A
virus can be spread from person to person or through contaminated food
or water. Hepatitis A vaccine may be given to children 2 years of age
and older. If your child needs this vaccine, your pediatrician will
recommend the appropriate immunization schedule for your child.
Top
|
Make Sure Your Child is
Protected
It's important to keep track of your
child's immunizations and make sure that your child receives each
vaccine on time. Children who lag behind on getting their shots are
at risk of getting very sick. They also may spread serious diseases
to other people.
Keep a chart that shows each immunization that your child has
received. Put that chart in a safe place where you can refer to it.
Vaccine doses that are not given at the recommended age should be
given as a “catch-up” immunization at a later time. Ask your
pediatrician if your child’s immunizations are up-to-date.
There are some groups of people who should not receive certain
vaccines. Those groups may include people with certain allergies or
weakened immune systems. Your pediatrician can tell you which
vaccines your child should have.
Top |
|
Immunizations are Safe and Effective
Reactions to vaccines may occur, but they
are usually mild. Severe reactions to vaccines are very rare.
Children are much more likely to be harmed by serious diseases than
by immunizations. Your pediatrician may recommend acetaminophen for
common side effects such as irritability and fever. If you have
questions about possible reactions, call your pediatrician.
Immunizations are one of the most important ways you can protect
your child against serious dis-eases. Much information is available
about immu-nizations. Your pediatrician can tell you the facts. Talk
with your pediatrician about the vaccines your child needs to stay
healthy.
Top
Recommended childhood and adolescent immunization schedule1 — United
States, July-December 2004
 |
1. Indicates
the recommended ages for routine administration of currently
licensed childhood vaccines, as of April 1, 2004, for children
through age 18 years. Any dose not given at the recommended age
should be given at any subsequent visit when indicated and
feasible. Indicates age groups that warrant special effort to
administer those vaccines not given previously. Additional
vaccines may be licensed and recommended during the year. Licensed
combination vaccines may be used whenever any components of the
combination are indicated and the vaccine’s other components are
not contraindicated. Providers should consult the manufacturers'
package inserts for detailed recommendations. Clinically
significant adverse events that follow vaccination should be
reported to the Vaccine Adverse Event Reporting System (VAERS).
Guidance about how to obtain and complete a VAERS form is
available at
http://www.vaers.org/
or by telephone, 1-800-822-7967.
2. Hepatitis B vaccine (HepB). All infants should receive the
first dose of HepB vaccine soon after birth and before hospital
discharge; the first dose may also be given by age 2 months if the
infant’s mother is HBsAg-negative. Only monovalent HepB vaccine
can be used for the birth dose. Monovalent or combination vaccine
containing HepB may be used to complete the series; 4 doses of
vaccine may be administered when a birth dose is given. The second
dose should be given at least 4 weeks after the first dose except
for combination vaccines, which cannot be administered before age
6 weeks. The third dose should be given at least 16 weeks after
the first dose and at least 8 weeks after the second dose. The
last dose in the vaccination series (third or fourth dose) should
not be administered before age 24 weeks. Infants born to HBsAg-positive
mothers should receive HepB vaccine and 0.5 mL hepatitis B immune
globulin (HBIG) within 12 hours of birth at separate sites. The
second dose is recommended at age 1-2 months. The last dose in the
vaccination series should not be administered before age 24 weeks.
These infants should be tested for HBsAg and anti-HBs at 9-15
months of age. Infants born to mothers whose HBsAg status is
unknown should receive the first dose of the HepB vaccine series
within 12 hours of birth. Maternal blood should be drawn as soon
as possible to determine the mother's HBsAg status; if the HBsAg
test is positive, the infant should receive HBIG as soon as
possible (no later than age 1 week). The second dose is
recommended at age 1-2 months. The last dose in the vaccination
series should not be administered before age 24 weeks.
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine
(DTaP). The fourth dose of DTaP may be administered at age 12
months provided that 6 months have elapsed since the third dose
and the child is unlikely to return at age 15-18 months. The final
dose in the series should be given at age >4 years. Tetanus and
diphtheria toxoids (Td) is recommended at age 11-12 years if at
least 5 years have elapsed since the last dose of tetanus and
diphtheria toxoidcontaining vaccine. Subsequent routine Td
boosters are recommended every 10 years.
|
 |
4. Haemophilus
influenzae type b (Hib) conjugate vaccine. Three Hib conjugate
vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB® or
ComVax® [Merck]) is administered at ages 2 and 4 months, a dose at
age 6 months is not required. DTaP/Hib combination products should
not be used for primary vaccination in infants at ages 2, 4, or 6
months but can be used as boosters after any Hib vaccine. The
final dose in the series should be given at age >12 months.
5. Measles, mumps, and rubella vaccine (MMR). The second dose of
MMR is recommended routinely at age 4-6 years but may be
administered during any visit, provided at least 4 weeks have
elapsed since the first dose and both doses are administered
beginning at or after age 12 months. Those who have not received
the second dose previously should complete the schedule by the
visit at age 11-12 years.
6. Varicella vaccine (VAR). Varicella vaccine is recommended at
any visit at or after age 12 months for susceptible children (
i.e., those who lack a reliable history of chickenpox).
Susceptible persons aged >13 years should receive 2 doses given at
least 4 weeks apart.
7. Pneumococcal vaccine. The heptavalent pneumococcal conjugate
vaccine
(PCV) is recommended for all children aged 2-23 months. It is also
recommended for certain children aged 24-59 months. The final dose
in the series should be given at age >12 months. Pneumococcal
polysaccharide vaccine (PPV) is recommended in addition to PCV for
certain high-risk groups. See MMWR 2000;49(No. RR-9):1-35.
8. Influenza vaccine. Influenza vaccine is recommended annually
for children aged >6 months with certain risk factors (including
but not limited to asthma, cardiac disease, sickle cell disease,
HIV, and diabetes), health care workers, and other persons
(including household members) in close contact with persons in
groups at high-risk (see CDC. Prevention and control of influenza:
recommendations of the Advisory Committee on Immunization
Practices (ACIP). MMWR 2004;53[No. RR-] (in press).) and can be
administered to all others wishing to obtain immunity. In
addition, healthy children aged 6-23 months and close contacts of
healthy children aged 0-23 months are recommended to receive
influenza vaccine, because children in this age group are at
substantially increased risk of influenza-related
hospitalizations. For healthy persons aged 5-49 years, the
intranasally administered live, attenuated influenza vaccine (LAIV)
is an acceptable alternative to the intramuscular trivalent
inactivated influenza vaccine (TIV). See MMWR 2003;52(No.
RR-13):1-8. Children receiving TIV should be administered a dosage
appropriate for their age (0.25 mL if 6-35 months or
0.5 mL if >3 years). Children aged <8 years who are receiving
influenza vaccine for the first time should receive 2 doses
(separated by at least 4 weeks for TIV and at least 6 weeks for
LAIV).
9. Hepatitis A vaccine. Hepatitis A vaccine is recommended for
children and adolescents in selected states and regions and for
certain high-risk groups. Consult your local public health
authority and MMWR 1999;48(No.RR-12):1-37. Children and
adolescents in these states, regions, and high-risk groups who
have not been immunized against hepatitis A can begin the
hepatitis A vaccination series during any visit. The two doses in
the series should be administered at least 6 months apart.
|
|
Additional information
about vaccines, including precautions and contraindications for
vaccination and vaccine shortages is available at
http://www.cdc.gov/nip
or from the National Immunization Information Hotline,
800-232-2522 (English) or 800-232-0233 (Spanish). Approved
by the Advisory Committee on Immunization Practices (
http://www.cdc.gov/nip/acip),
the American Academy of Pediatrics (http://www.aap.org),
and the American Academy of Family Physicians (http://www.aafp.org).
For Children and Adolescents Who Start Late or Who Are >1 Month
Behind
The tables below give catch-up schedules and minimum intervals
between doses for children who have delayed immunizations. There is
no need to restart a vaccine series regardless of the time that has
elapsed between doses. Use the chart appropriate for the child’s
age.
Catch-up schedule for children age 4 months through 6 years Minimum
Interval Between Doses
|
 |
|
1. DTaP: The
fifth dose is not necessary if the fourth dose was given after the
fourth birthday.
2. IPV: For children who received an all-IPV or all-oral poliovirus (OPV)
series, a fourth dose is not necessary if third dose was given at age >4
years. If both OPV and IPV were given as part of a series, a total of 4
doses should be given, regardless of the child’s current age.
3. HepB: All children and adolescents who have not been immunized
against hepatitis B should begin the HepB immunization series during any
visit. Providers should make special efforts to immunize children who
were born in, or whose parents were born in, areas of the world where
hepatitis B virus infection is moderately or highly endemic.
4. MMR: The second dose of MMR is recommended routinely at age 4 to 6
years but may be given earlier if desired.
5. Hib: Vaccine is not generally recommended for children age >5 years.
6. Hib: If current age <12 months and the first 2 doses were PRP-OMP (PedvaxHIB
or ComVax [Merck]), the third (and final) dose should be given at age 12
to 15 months and at least 8 weeks after the second dose.
7. PCV: Vaccine is not generally recommended for children age >5 years.
8. Td: For children age 7 to 10 years, the interval between the third
and booster dose is determined by the age when the first dose was given.
For adolescents age 11 to 18 years, the interval is determined by the
age when the third dose was given.
9. IPV: Vaccine is not generally recommended for persons age >18 years.
10. Varicella: Give 2-dose series to all susceptible adolescents age >13
years
Reporting Adverse Reactions
Report adverse reactions to vaccines through the federal Vaccine Adverse
Event Reporting System. For information on reporting reactions following
immunization, please visit
www.vaers.org
or call the
24-hour national toll-free information line (800) 822-7967.
Disease Reporting
Reporting Adverse Reactions Report suspected cases of
vaccine-preventable diseases to your state or local health department.
For additional information about vaccines, including precautions and
contraindications for immunization and vaccine shortages, please visit
the National Immunization Program Web site at
www.cdc.gov/nip
or call the National Immunization Information Hotline at 800-232-2522
(English) or 800-232-0233 (Spanish).
|
