An Update:
Recommended Immunization Schedules
Birth to Age 18

Ellen Link, MD, Department of Pediatrics, Iowa Children's Hospital
Teresa Thornton, RNC, Iowa Department of Public Health
 

In the last few years several new vaccines have been added to the list of recommended immunization for infants, children and adolescents. As a result it has been necessary to update the recommended schedule. The revised schedules are provided here (see links below) for your convenience, as well as the rationale for the recently added vaccines.

The Advisory Committee on Immunization Practices (ACIP) periodically reviews the recommended immunization schedule for persons age 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. 

Changes in the new, 2007 childhood and adolescent immunization schedule include:

• Rotavirus vaccine.  The recommended administration of the new rotavirus vaccine, RotaTeq, is a 3-dose schedule at ages 2, 4, and 6 months.  Children should be given the first dose between the ages of 6-12 weeks. Subsequent doses should be administered at 4-10 week intervals.

• Varicella vaccine. Varicella vaccine recommendations have been updated.  Children should receive the first dose at age 12-15 months. A newly recommended second dose should be administered at age 4-6 years.

• Human papillomavirus vaccine (HPV). The new human papillomavirus vaccine is recommended in a 3-dose schedule for girls. The first dose of the series may be administered to girls as young as 9 years old, with routine vaccination recommended for girls between the ages of 11-12 years. The second and third doses should be given 2 months and 6 months after the first. Catch-up vaccination is recommended for females age 13-26 years who have not been vaccinated previously or who have not completed the full series.

Two schedules. This year, the schedule of recommended immunizations has been broken into two schedules:

• Immunizations for children from birth through 6 years

• Immunizations for children from 7-18 years

A schedule for catch-up immunizations for children from age 4 months through 18 years is also available. This schedule can be used with children who are beginning immunizations late, or are more than a month behind on immunization.

These schedules have been approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.

Vaccine updates

Hepatitis A. All children should receive hepatitis A vaccine, beginning at 1-2 years of age, as part of the routine childhood schedule (MMWR, May 19, 2006).

Influenza. Routine vaccination for influenza is now recommended for all children age 6 months through 5 years of age.  Vaccination is also recommended for household contacts and out-of-home caregivers of all children through 5 years of age.

Pertussis. In the spring of 2005, for the first time in history, vaccines became available to protect teenagers and adults against whooping cough. Two new vaccines, for tetanus, diphtheria and pertussis (Tdap), were licensed and recommended. Adolescents 11-18 years old should receive a single dose of Tdap instead of Td, preferably at 11-12 years of age. All adults through 64 years of age, and especially adults who anticipate close contact with infants less than a year old – such as parents, child care providers, and health care professionals -- should be immunized with a single booster dose of Tdap.

Immunization Resources

• ACIP Immunization Recommendations and Schedules, 2007

• ACIP Vaccine Information Statements for childhood vaccines

• EPSDT Care for Kids Provider Web Site

• Guillain-Barre syndrome

• Human papillomavirus-virus (HPV)

• Influenza Fact Sheet

• Influenza Outbreak Guidelines

• Iowa’s Immunization Registry Information System (IRIS)

• Meningitis

• Rotavirus

• Thimersol (mercury)

• Vaccines and the diseases they prevent

Use IRIS to Monitor
Immunization Status

IRIS, Iowa’s Immunization Registry Information System, helps Iowa health care providers and families by consolidating immunization information into one reliable source. IRIS saves money by ensuring that children get only the vaccines they need. In addition, IRIS improves office efficiency by reducing the time needed to gather and review immunization records.

Learn more about IRIS

 http://www.idph.state.ia.us/adper/iris.asp

IRIS Help Desk, 800-374-3958