Each year in January, the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) get together and publish a new immunization schedule for children.
Sometimes this new immunization schedule means extra shots for kids, like the last few years when they introduced recommendations for a booster chicken pox shot and for teens to get the Gardasil and Menactra vaccines.
Not this year, though. The 2008 Childhood Immunization Schedule mainly addresses children who are behind in their immunizations or who are in certain high risk groups. It also formalizes the use of Flumist (the nasal spray flu vaccine) for children who are two years of age or older.
Prevnar
Prevnar protects against certain strains of the Streptococcus pneumoniae bacteria, which can cause bacterial meningitis, blood infections, ear infections and pneumonia.
Infants typically receive three doses of Prevnar when they are two, four, and six months old and then get a booster dose when they are 12 to 15 months old. The 2008 Childhood Immunization Schedule now states that children with an "incomplete schedule" should get one dose of Prevnar when they are between 24 and 59 months old. Since the number of doses of Prevnar a child gets depends on how old they are when they started the series, the term "incomplete schedule" can be confusing. For example, if your child got his first dose of Prevnar when he was seven months old, he would get two doses eight weeks apart and then a booster dose when he was 12 to 15 months old. Even though he only received three doses altogether, his Prevnar immunization schedule would still be complete.
Previously, it was only recommended that high risk children, including those with immune system problems, get a dose of Prevnar after they were two years old. Now even healthy children should get it if they haven't had it already.
The 2008 Immunization Schedule also states that children over age two should get a dose of the pneumococcal polysaccharide vaccine (PPV) if they have certain underlying medication conditions that put them at risk for infections from the Streptococcus pneumoniae bacteria. This usually includes children with long-term health problems (heart disease, lung disease, sickle cell disease, etc.), immune system problems (AIDS, organ transplant, damaged spleen, etc.), or if they are taking medications that could lower their resistance to infections (long-term steroids, radiation therapy, other cancer treatments, etc.).
FluMist
FluMist, the nasal spray flu vaccine, is now available for healthy children as young as two years of age. This is good news for kids who don't want a flu shot each year.
Menactra
Menactra is the meningococcal conjugate vaccine that has been given to teens for a few years now. While an older vaccine was still used for younger children, the 2008 Childhood Immunization Schedule now recommends that Menactra be given to certain high risk children who are at least two years old. These high risk children include those traveling to countries where there are high rates of meningococcal disease, children with terminal complement component deficiencies, and those children with a damaged or absent sleen.
Catch-up Schedules
The 2008 Childhood Immunization Schedule also makes some minor changes to the Td and Tdap (tetanus shots) catch-up schedule and modified the appearance for the catch-up schedule for the hepatitis B and Haemophilus influenzae type b conjugate vaccines.
Sources:
Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0--18 years---United States, 2008. MMWR 2007;56(51&52):Q1--Q4.
Pneumococcal Vaccine Information Statement.
