Childhood Immunization Schedule Updated for 2002

LEAWOOD, Kan. — The American Academy of Family Physicians has issued the 2002 Recommended Childhood Immunization Schedule. The schedule is developed by representatives of the American Academy of Family Physicians, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the American Academy of Pediatrics. The schedule remains the same, however, the format has changed to include existing recommendations for children at high risk. There are two additional prioritization recommendations that address current vaccine shortages.

The Academy recommends that family physicians not vaccinate children 2 years of age and older against invasive pneumococcal disease (pneumonia) until more of the vaccine is available. However, children 2 to 5 years of age who are at increased risk of developing pneumonia, including those with sickle cell disease, anatomic asplenia, chronic illness, or who are immunosuppressed, should receive the vaccine. Physicians with insufficient vaccine to vaccinate all high-risk pediatric patients should give highest priority to vaccinating all infants less than 12 months old and children aged 1 to 5 years who are at increased risk.

There is a growing shortage of tetanus and diphtheria toxoids and acellular pertussis (DTaP) vaccine. In response to this shortage, the AAFP recommends that family physicians who do not have an adequate supply of DTaP vaccine should vaccinate infants with the initial three doses and defer from administering the fourth dose. If this does not provide enough vaccine to immunize all infants with three doses, then the fifth dose for other children in the practice over 12 months of age can be deferred. It is important that records be kept for all patients who either did not receive the pneumococcal conjugate vaccine or for whom a dose of DTaP was deferred. Vaccine should be given to these patients when it becomes more widely available.

All pregnant women should be screened for hepatitis B. Infants born to hepatitis B-infected mothers should receive hepatitis B vaccine and 0.5mL hepatitis B immune globulin within 12 hours of birth to protect against hepatitis B. The first dose of hepatitis B vaccine should be given at birth unless the mother’s surface antigen status is known to be negative, in which case the range of birth to 2 months is acceptable for vaccinating.