Each year, the Advisory Committee on Immunization Practices (ACIP) publishes immunization schedules for persons aged 0 through 18 years. For 2011, most of the changes from 2010 are in the footnotes, with only small changes to the grid itself.
Among the new items:
▸ Hepatitis B vaccine. Guidance has been added to the hepatitis B vaccine schedule for children who did not receive the recommended birth dose. They should receive three doses on a schedule of 0, 1, and 6 months, with the final dose in the series administered no earlier than age 24 weeks.
▸ 13-Valent pneumococcal conjugate vaccine. Information on use of the new 13-valent pneumococcal conjugate vaccine (PCV13) has been added. Prevnar-13 was licensed in February 2010 and recommended by ACIP to replace the old 7-valent version for routine childhood immunization. Children who began the series with PCV7 should receive the rest of the doses in the series as PCV13.
Children aged 14–59 months and those aged 60–71 months with underlying medical conditions who received the entire age-appropriate series of PCV7 should receive one supplemental dose of PCV13. That dose should be given at least 8 weeks after the previous PCV7 dose.
▸ Influenza vaccine. Guidance has been added for administration of one or two doses of seasonal influenza vaccine based upon the child's history of monovalent 2009 H1N1 vaccination. Two doses – separated by at least 4 weeks – should be given to children aged 6 months through 8 years who are receiving seasonal influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but received only one dose.
Children aged 6 months through 8 years who received no doses of monovalent 2009 H1N1 vaccine should receive two doses of 2010–2011 seasonal influenza vaccine, which contains H1N1.
▸ Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. Use of Tdap among children aged 7–10 years who are incompletely vaccinated against pertussis – either never vaccinated or with unknown status – is now addressed, with a recommendation that those children receive a single dose of Tdap. Reference to a specified interval between tetanus and between tetanus and diphtheria toxoids (Td) and Tdap vaccination has been removed, so Tdap can be administered without regard for the interval since the last dose of Td (or T).
▸ Meningococcal conjugate vaccine, quadrivalent (MCV4). For MCV4, recommendations for a routine two-dose schedule have been added for certain individuals at high risk of meningococcal disease, including children aged 2–10 years with persistent complement-component deficiency and anatomic or functional asplenia (who should also receive one dose every 5 years thereafter) and those with HIV infection.
A new recommendation for a booster dose of MCV4 at age 16 years also has been added.
▸ Human papillomavirus vaccine (HPV) and Haemophilus influenzae type b (Hib). Footnote sections on use of the HPV vaccine and use of the Hib vaccine in persons aged 5 years and older in the catch-up schedule have been condensed.
Detailed recommendations for using vaccines are available from ACIP statements (available at www.cdc.gov/vaccines/pubs/acip-list.htmwww.vaers.hhs.gov)