A measles-mumps-rubella-varicella combination vaccine (MMRV) is now available and can cut down on the number of injections needed to complete child vaccination recommendations. It will also stimulate more discussion about the potential advantages of a second varicella dose for children under age 13 years, which is currently not recommended.
The TABLE summarizes these new vaccine recommendations by age group. The complete immunization schedule for children and adults can be located on the CDC Web site.4,5 These schedules can be printed and placed in clinic setting to assist physicians and staff to competently fulfill one their most important public health functions, insuring the full immunization of their patient populations.
TABLE
Recent immunization recommendations by age group
| INFANTS AND CHILDREN |
| Hepatitis B vaccine (HepB) as monovalent HepB before discharge from the hospital unless order otherwise by a physicians and the mother is documented to be hepatitis B surface antigen negative. |
| Universal, routine vaccination with hepatitis A vaccine between age 1 to 2 years with 2 doses 6 months apart. |
| ADOLESCENTS |
| Tdap at age 11 to 12 years. |
| Tdap at age 13 to 18 years if the last Td was administered >5 years previously and no previous Tdap administered. In special circumstances the interval from the last Td can be less than 5 years. |
| Wellness visit at age 11 to 12 years to administer both Tdap and meningococcal vaccines. |
| ADULTS |
| Tdap to replace the next scheduled Td booster, one time only. |
| Tdap as single dose for adults caring for children less than age 6 months. |
| PREGNANT WOMEN |
| Screen for varicella immunity in those without proof of immunity. Immunize postpartum those nonimmune. |
| Tdap either during preconception period or immediately postpartum, if no Tdap previously received. |
CORRESPONDENCE
Doug Campos-Outcalt, MD, MPA, 4001 North Third Street #415, Phoenix, AZ 85012. E-mail: dougco@u.arizona.edu