2009 Kids, Teens Immunization Schedules Released

The 2009 immunization schedules for children (1-page PDF; About PDFs) and adolescents (1-page PDF; About PDFs) increase the number of children recommended to receive annual influenza vaccination by about 30 million. That's according to the CDC, which released the schedules Jan. 6 in conjunction with the AAFP and the American Academy of Pediatrics.

The new schedules call for children ages 6 months to 18 years to receive annual influenza immunization. The previous recommendation was to vaccinate children ages 6-59 months against the flu.

Jonathan Temte, M.D., Ph.D., associate professor in the department of family medicine at the University of Wisconsin, Madison, and a member of the CDC's Advisory Committee on Immunization Practices, or ACIP, said about 70 children die each year in the United States from influenza infection.

"Most of these deaths occur in unvaccinated children," he said.

Last February, ACIP recommended that all children ages 6 months to 18 years be vaccinated each year against seasonal influenza beginning no later than the 2009-10 flu season.

Temte said increasing immunity levels within that younger population should decrease the spread of influenza overall.

"In general, children are the real engines of acute viral respiratory infections," he said. "If the transmission is reduced in this group, the resulting effects across the wider population can be very significant. Once we achieve moderate to high levels of immunization in children, we are likely to see profound effects in other ages."

Temte said that although the expanded ACIP recommendation isn't scheduled to be fully implemented until the 2009-10 flu season, physicians should continue immunizing children, other at-risk groups and all people interested in reducing their risk for influenza.

Delaying full implementation of the recommendation until fall 2009 is intended to allow physicians and other vaccine providers time to plan for vaccination of this expanded patient group, the CDC said on its Web site.

The 2009 adolescent immunization schedule includes an additional clarification related to influenza vaccine: that children younger than age 9 years who are receiving the vaccine for the first time -- or who were vaccinated for the first time during the previous season but only received one dose -- should receive two doses at least four weeks apart.
Meanwhile, the recommendations pertaining to vaccination against rotavirus infection changed the maximum ages for vaccination. The maximum age at which the first dose should be given is 14 weeks and six days (Editor's note: This information correlates with an erratum published in the Jan. 9 MMWR), and the oldest age at which any dose may be given is 8 months. If GlaxoSmithKline's liquid rotavirus vaccine, Rotarix, is administered at ages 2 and 4 months, a dose at 6 months is not needed.

Finally, human papillomavirus vaccination recommendations are clarified in the child and adolescent immunization catch-up schedule (1-page PDF; About PDFs).
There should be an interval of no less than six months between the first and last dose.

The 2009 adult immunization schedule is expected to be released on Jan. 9.