Recommended Vaccination Schedule

American Academy of Pediatrics
Recommended Vaccination Schedule

December 15, 2009

The Recommended Immunization Schedules for children 0 to 18 years are approved by the Advisory Committee on Immunization Practices (http://www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).

Recommended vs. Required Vaccines: What is the difference between a recommendation and a requirement? When the CDC and its experts decide that a vaccine is safe and useful, they recommend it for use. A requirement is usually enforced by school entry laws, unless a parent claims an exemption.

Dose 1: Birth
Dose 2: Between 1 and 2 months
Dose 3:  Between 6 and 18 months

Diphtheria, Tetanus, Pertussis (DTP/DTaP)

Dose 1:  2 months
Dose 2:  4 months
Dose 3:  6 months
Dose 4:  Between 15 and 18 months
Dose 5:  Between 4 and 6 years
Dose 6: 11 years

Rotovirus  (RV)

Dose 1:  2 months
Dose 2:  4 months
Dose 3:  6 months

H. influenzae type B (Hib)

Dose 1:  2 months
Dose 2:  4 months
Dose 3:  6 months
Dose 4:  Between 12 and 15 months

Pneumococcal (PCV – Prevnar)

Dose 1:  2 months
Dose 2:  4 months
Dose 3:  6 months
Dose 4:  Between 12 and 15 months

Inactivated Poliovirus (IPV)

Dose 1:  2 months
Dose 2:  4 months
Dose 3:  Between 6 and 18 months
Dose 4:  Between 4 and 6 years

Measles, Mumps, Rubella (MMR)

Dose 1:  Between 12 and 15 months
Dose 2:  Between 4 and 6 years

Varicella

Dose 1:  Between 12 and 15 months
Dose 2:  Between 4 and 6 years

Hepatitis A (HepA)

Dose 1 & 2:  Between 12 months and 24 months (6 months apart)

Influenza

Dose 1:  6 months

Subsequent doses: YEARLY

Human Papillomavirus (HPV)

3 Doses: 11 years  (NOT required by Florida law to attend school)

Meningococcal (MCV)

Dose 1: 11 years

Vaccination Distribution from Birth to Age 5/6:

1 vaccine at birth
8 vaccines at 2 months;
7 vaccines at 4 months;
7 vaccines at 6 months
14 vaccines at approximately 12 – 15 months
3 vaccines (annual flu shot) between age 2 and 5
9 vaccines at approximately age 5/6

Note: If the American Academy of Pediatrics Recommended Vaccination Schedule is adhered to, thirty seven (37) of the vaccines are administered before the age of two. Many of the vaccines are typically administered as “vaccine cocktails”, meaning combined or together with other vaccines.

Note: Clinically significant adverse events that follow vaccinations should be reported to the Vaccine Adverse Event Reporting System (VAERS) at 800-822-7967 or at http://www.vaers.hhs.gov

CONTRAINDICATIONS & PRECAUTIONS:
A Contraindication is:

Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine component

A Precaution is:

Moderate or severe acute illness with or without fever

Contraindications and precautions to vaccination dictate circumstances when vaccines should not be administered. A contraindication is a condition in a recipient that increases the risk for a serious adverse reaction. A vaccine should not be administered when a contraindication is present. For example, administering influenza vaccine to a person with an anaphylactic allergy to egg protein could cause serious illness in or death of the recipient.

A contraindication applicable to ALL vaccines is a history of a severe allergic reaction after a previous dose of vaccine or to a vaccine constituent.

Severely immune-compromised persons should NOT receive live vaccines.

Children who experience encephalopathy within 7 days after administration of a previous dose of DTP, DTaP or Tdap should NOT receive further doses of a vaccine that contains pertussis.

Because of the theoretical risk for the fetus, women known to be pregnant should generally NOT receive live-attenuated virus vaccines. The HPV is NOT recommended for pregnant women.

In general vaccinations should be deferred when a precaution is present. The presence of a moderate or severe acute illness with or without fever is a precaution to administration of ALL vaccines. For example, caution should be exercised in vaccinating a child with DTaP who, within 48 hours of receipt of a previous dose of DTP or DTaP, experienced fever of >104°F, had persistent inconsolable crying for 3 or more hours, collapsed or experienced a shock-like state, or had a seizure <3 days after receiving the previous dose of DTP or DTaP.

Delaying pertussis vaccination for infants and children with a history of previous seizures until the child’s neurologic status has been assessed is prudent. Pertussis vaccine should NOT be administered to infants with evolving neurologic conditions until the condition has been stabilized.

SEVERE ALLERGY TO VACCINE COMPONENTS:

Vaccine components can cause allergic reactions among certain recipients. These reactions can be local or systemic and can include mild to severe anaphylaxis or anaphylactic-like responses such as hives, wheezing, swelling of mouth/throat, difficulty breathing, hypotension and shock.

Allergic reactions might be caused by the vaccine antigen, residual animal protein, antimicrobial agents, preservatives, stabilizers or other vaccine components (see package inserts for list of ingredients).

The most common animal protein allergen is egg protein which is found in influenza and yellow fever vaccines (which are prepared using embryonated chicken eggs).

For more information, visit: http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf