Issue Number
292 January
22, 2002
CONTENTS OF THIS ISSUE
- CDC publishes Notice
to Readers on 2002 Childhood Immunization
Schedule
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January 22, 2002
CDC PUBLISHES NOTICE TO READERS ON 2002 CHILDHOOD
IMMUNIZATION SCHEDULE
On January 18, 2002, the Centers for Disease Control and
Prevention (CDC) published "Notice to
Readers: Recommended Childhood Immunization
Schedule--United States, 2002" in the Morbidity
and Mortality Weekly Report (MMWR). (Last
week IAC EXPRESS reported on the release of the Schedule
by the American Academy of Pediatrics in the journal
Pediatrics.)
The Recommended Childhood Immunization Schedule also is
referred to commonly as "the
harmonized schedule" because it reflects the
unified, or harmonized, conclusions of three
medical groups as described in the Notice.
The complete text of the Notice, excluding references,
reads as follows:
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Each year, CDC's Advisory Committee on Immunization
Practices (ACIP) reviews the recommended
childhood immunization schedule to ensure that it
is current with changes in manufacturers' vaccine
formulations, has revised recommendations
for the use of licensed vaccines, and has
recommendations for newly licensed vaccines. This
report presents the recommended childhood
immunization schedule for 2002, which has remained
the same in content since January 2001 but has
a redesigned format (Figure 1).
The format of the 2002 schedule is based on a design
developed by the Minnesota Department of
Health immunization program; the recommendations
and format have been approved by ACIP, the
American Academy of Family Physicians [AAFP],
and the American Academy of Pediatrics [AAP].
The new design highlights the importance of catch-up
vaccination, the preadolescent visit, the
preference for administering the first dose of the
hepatitis B vaccine series at birth, and three
vaccines for selected at-risk
groups. The importance of assessing whether children aged
24 months-18 years require any catch-up
vaccination is emphasized by the use of hatched
bars. The schedule also underscores the visit at
age 11-12 years when immunization status should be
reviewed and all necessary
vaccines administered.
HEPATITIS B VACCINE
The schedule indicates a preference for administering the
first dose of hepatitis B vaccine to all
newborns soon after birth and before hospital
discharge. Administering the first dose of
hepatitis B vaccine soon after birth
should minimize the risk for infection because of errors
in maternal hepatitis B surface antigen (HBsAg)
testing or reporting, or from exposure to persons
with chronic hepatitis B
virus (HBV) infection in the household, and can
increase the likelihood of completing the vaccine
series. Only monovalent hepatitis B vaccine can be used
for the birth dose. Either monovalent or
combination vaccine can be used to complete
the series. Four doses of hepatitis B vaccine,
including the birth dose, may be
administered if a combination vaccine is used to complete
the series. In addition to receiving
hepatitis B immune globulin (HBIG) and the
hepatitis B vaccine series, infants
born to HBsAg-positive mothers should be tested
for HBsAg and antibody to HBsAg (anti-HBs) at age
9-15 months to identify those with chronic
HBV infection or those who may require
revaccination.
VACCINES FOR SELECTED POPULATIONS
The area below the dashed line (Figure 1) displays certain
vaccines recommended for use in selected
populations. High-risk children aged 24-59
months should receive catch-up pneumococcal
conjugate vaccine (PCV) doses, if
indicated. Pneumococcal polysaccharide vaccine (PPV)
is recommended in addition to PCV for
certain high-risk groups. The recommendation to
administer annual influenza
vaccine to high-risk children also appears on
the schedule.
VACCINE SUPPLY
As a result of the vaccine supply shortage, deferral of
some doses of tetanus and diphtheria toxoids
(Td), diphtheria and tetanus toxoids and
acellular pertussis vaccine (DTaP), and
pneumococcal conjugate vaccine (PCV)
has been recommended; health-care providers should
record patients for whom vaccination has
been deferred and should contact them once the
supply has been restored.
VACCINE INFORMATION STATEMENTS
The National Childhood Vaccine Injury Act requires that all health-care
providers give parents or patients copies of
Vaccine Information Statements before administering each dose of the
vaccines listed in the schedule. Additional
information about Vaccine Information Statements
is available from state health departments and at
http://www.cdc.gov/nip/publications/VIS. Detailed recommendations
for using vaccines are available from the manufacturers' package
inserts, ACIP statements on specific vaccines, and
the 2000 Red Book. ACIP statements for each recommended childhood vaccine
can be viewed, downloaded, and printed from the
CDC National Immunization Program at
http://www.cdc.gov/nip/publications/ACIP-list.htm; instructions on
the use of the Vaccine Information Statements are
available at
http://www.cdc.gov/nip/publications/VIS/vis-Instructions.pdf.
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To obtain the complete text of this Notice to Readers and the Schedule
online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5102a4.htm
The footnotes in the Schedule in the Notice to Readers are
printed across the page and are somewhat
difficult to read. A two-column format for the Schedule's footnotes was
adopted by ACIP, AAP, and AAFP in the final
version below.
To view or print the two-column 2002 Recommended Childhood Immunization
Schedule, go to:
http://www.cdc.gov/nip/recs/child-schedule.PDF
HAVE A HARMONIOUS WEEK!
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