The American Academy of Pediatrics (AAP) has harmonized the Recommended Childhood Immunization Schedule with the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and the American Academy of Family Physicians (AAFP) since January 1995. Since the last schedule was issued in July 1996,1 the following developments with resulting changes in immunization recommendations have occurred:
As of early 1997, the recommendations for polio immunization in the United States have been revised. The complete AAP policy statement for the use of inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV) will be published concurrently or in an upcoming issue of Pediatrics. Each of the following schedules is acceptable by the AAP, the ACIP, and the AAFP: (1)sequential: IPV at 2 and 4 months, OPV at 12 to 18 months, and 4 to 6 years, (2) IPV only: IPV at 2, 4, 12 to 18 months, and 4 to 6 years, (3) OPV only: OPV at 2, 4, 6 to 18 months, and 4 to 6 years. Parents and providers may choose among these schedules. The ACIP recommends the sequential schedule for most children. IPV is the only poliovirus vaccine recommended for immunocompromised persons and their household contacts.
As of December 5, 1996, one acellular pertussis vaccine combined with diphtheria and tetanus toxiods (DTaP) (Tripedia, Connaught Laboratories, Swiftwater, PA) was approved by the Food and Drug Administration (FDA) for use in infants. DTaP is preferred for use at all ages, but whole-cell pertussis vaccines (DTP) are acceptable alternatives. FDA approval of additional DTaP products for use in infants is anticipated before the 1998 schedule is issued next January.
A new combination of DTaP with a conjugate Haemophilus influenzae type b (Hib) vaccine (Tripedia-ActHIB) has been approved only for administration as the fourth dose in the DTaP/DTP series for children 15 months of age and older. As of November 15, 1996, this combination was not approved for use in the primary series in infants.
A new combination product (COMVAX, Merck, West Point, PA) of hepatitis B and Haemophilus influenzae type b (Hib) vaccines has been approved for immunization at 2, 4, and 12 to 15 months of age. This and other Hib-containing vaccines should not be administered to infants younger than 6 weeks. The Hib component administered at earlier ages is not adequately immunogenic and could have an adverse effect on the immune response to subsequent doses of Hib vaccines administered at older ages.
Other new combination products that are licensed by the FDA may be used whenever administration of components of the vaccine are indicated. The package inserts should be consulted for details.
The footnotes for DTaP/DTP, poliovirus, and Hib vaccines have been modified to take into account these recent developments. Other changes have been made in the hepatitis B, measles, and varicella footnotes to clarify recommendations. Of particular note, hepatitis B immunization can begin at any age for children who were not immunized in infancy.
Committee on Infectious Diseases, 1996 to 1997
Neal A. Halsey, MD, Chairperson
Jon S. Abramson, MD
P. Joan Chesney, MD
Margaret C. Fisher, MD
Michael A. Gerber, MD
Donald S. Gromisch, MD
Steve Kohl, MD
S. Michael Marcy, MD
Dennis L. Murray, MD
Gary D. Overturf, MD
Richard J. Whitley, MD
Ram Yogev, MD
Georges Peter, MD
Robert Breiman, MD
National Vaccine Program Office
M. Carolyn Hardegree, MD
Food and Drug Administration
Stephen Hadler, MD
National Immunization Program
Richard F. Jacobs, MD
American Thoracic Society
Noni E. MacDonald, MD
Canadian Paediatric Society
Walter A. Orenstein, MD
National Immunization Program
N. Regina Rabinovich, MD
National Institutes of Allergy and Infectious Diseases
Ben Schwartz, MD
Centers for Disease Control and Prevention
The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
- ↵American Academy of Pediatrics, Committee on Infectious Diseases. Recommended childhood immunization schedule. Pediatrics 1996;98:158–160
- Copyright © 1997 American Academy of Pediatrics