pediatrics
February 2011, VOLUME127 /ISSUE 2

Recommended Childhood and Adolescent Immunization Schedules—United States, 2011

  1. Committee on Infectious Diseases

The 2011 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians (schedules have been provided following this article and online as Supplemental Information). These schedules are revised annually to reflect current recommendations for use of vaccines licensed by the US Food and Drug Administration and include the following changes from last year:

  • Guidance for administration of the hepatitis B vaccine series for children who did not receive the recommended birth dose. A minimum age for dose 3 of hepatitis B vaccine has been added to the catch-up schedule, noting that the final (third or fourth) dose in the hepatitis B series should be administered no earlier than 24 weeks of age.

  • Information on the use of the 13-valent pneumococcal conjugate vaccine (PCV13). A PCV series begun with 7-valent PCV (PCV7) should be completed with PCV13. A single supplemental dose of PCV13 is recommended for all children 14 through 59 months of age who have received an age-appropriate series of PCV7. A single supplemental dose of PCV13 is recommended for all children 60 through 71 months of age with underlying medical conditions who have received an age-appropriate series of PCV7. The supplemental dose of PCV13 should be administered at least 8 weeks after the previous dose of PCV7. A single dose of PCV13 may be administered to children 6 through 18 years of age who have functional or anatomic asplenia, HIV infection or other immunocompromising conditions, cochlear implant, or cerebrospinal fluid leak. The pneumococcal polysaccharide vaccine (PPSV) should be administered to children 2 years of age or older with certain underling medical conditions at least 8 weeks after the last dose of PCV. A single revaccination with the PPSV should be administered after 5 years to children with functional or anatomic asplenia or an immunocompromising condition.

  • Guidance for administration of 1 or 2 doses of influenza vaccine on the basis of the child's history of receipt of monovalent 2009 H1N1 vaccine. Administer 2 doses (separated by at least 4 weeks) to children 6 months through 8 years of age who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose. Children 6 months through 8 years of age who received no doses of monovalent 2009 H1N1 vaccine or in whom the dosing schedule is unknown should receive 2 doses of 2010–2011 seasonal influenza vaccine.

  • Guidance regarding a booster dose of quadrivalent meningococcal conjugate vaccine (MCV4). Adolescents should be routinely immunized, preferably at 11 through 12 years, with a booster dose at 16 years of age. Adolescents who receive their first dose at 13 through 15 years of age should receive a booster at 16 through 18 years of age. For people 2 through 54 years of age who are at increased risk of meningococcal disease, a 2-dose primary series should be administered 2 months apart. For information regarding immunization of older adolescents and adults, see the adult immunization schedule at www.cdc.gov/vaccines/recs/provisional/default.htm.

  • Children 7 through 10 years of age who are not fully immunized against pertussis (including those never vaccinated or with unknown pertussis vaccine status) should receive a single dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap). If further doses are needed to fully immunize against tetanus and diphtheria, children 7 through 10 years of age should be vaccinated according to the catch-up schedule. Adolescents 13 through 18 years of age who have not received the Tdap vaccine should receive a dose followed by a tetanus and diphtheria toxoids vaccine (Td) booster dose every 10 years thereafter. The reference regarding a specified time interval between the Td and Tdap vaccines has been removed from the schedule for children 7 through 18 years of age.

  • Guidance for use of Haemophilus influenzae type b vaccine in people 5 years of age and older at increased risk. One dose of Haemophilus influenzae type b vaccine should be considered for people 5 years of age or older who have sickle cell disease, leukemia, or HIV infection or who have had a splenectomy.

  • Guidance for the use of human papillomavirus vaccine (HPV). The quadrivalent vaccine (HPV4) and the bivalent vaccine (HPV2) are recommended for prevention of cervical precancers and cancers in females. HPV4 also is recommended for prevention of genital warts in females. HPV4 may be administered in a 3-dose series to males 9 through 18 years of age to reduce their likelihood of acquiring genital warts.

Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form can be obtained on the Internet at www.vaers.hhs.gov or by calling 800-822-7967. Additional information can be found in the 2009 Red Book1 and at Red Book Online (www.aapredbook.org). Statements from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that contain details of recommendations for individual vaccines, including recommendations for children with high-risk conditions, are available at www.cdc.gov/vaccines/pubs/ACIP-list.htm. Information on new vaccine releases, vaccine supplies, interim recommendations resulting from vaccine shortages, and statements on specific vaccines can be found at www.aapredbook.org/news/vaccstatus.shtml and www.cdc.gov/vaccines/pubs/ACIP-list.htm.

COMMITTEE ON INFECTIOUS DISEASES, 2010–2011

Michael T. Brady, MD, Chairperson

Henry H. Bernstein, DO

Carrie L. Byington, MD

Kathryn M. Edwards, MD

Margaret C. Fisher, MD

Mary P. Glode, MD

Mary Anne Jackson, MD

Harry L. Keyserling, MD

David W. Kimberlin, MD

Yvonne A. Maldonado, MD

Walter A. Orenstein, MD

Gordon E. Schutze, MD

Rodney E. Willoughby, MD

LIAISONS

Robert Bortolussi, MD – Canadian Paediatric Society

Marc A. Fischer, MD – Centers for Disease Control and Prevention

Bruce Gellin, MD – National Vaccine Program Office

Richard L. Gorman, MD – National Institutes of Health

Lucia Lee, MD – Food and Drug Administration

R. Douglas Pratt, MD – Food and Drug Administration

Jennifer S. Read, MD – National Institutes of Health

Jane Seward, MBBS, MPH – Centers for Disease Control and Prevention

Jeffrey R. Starke, MD – American Thoracic Society

Jack Swanson, MD – Committee on Practice Ambulatory Medicine

Tina Q. Tan, MD – Pediatric Infectious Diseases Society

EX OFFICIO

Carol J. Baker, MD – Red Book Associate Editor

Sarah S. Long, MD – Red Book Associate Editor

H. Cody Meissner, MD – Red Book Associate Editor

Larry K. Pickering, MD – Red Book Editor

CONSULTANTS

Lorry G. Rubin, MD

STAFF

Jennifer Frantz, MPH, jfrantz{at}aap.org

Footnotes

  • This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

  • All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

REFERENCE

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