Notice to Readers Recommended Childhood Immunization Schedule -- United States, January-June 1996

In January 1995, the recommended childhood immunization schedule was published in MMWR following issuance by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians (1). This schedule was the first unified schedule developed through a collaborative process among the recommending groups, the pharmaceutical manufacturing industry, and the Food and Drug Administration. This collaborative process should assist in maintaining a common childhood vaccination schedule and enabling further simplification of the schedule. This notice presents the recommended childhood immunization schedule for January-June 1996 (Figure_1 and Figure_1C) to incorporate licensure of varicella zoster virus vaccine (Var) and recommendations for adolescent hepatitis B vaccination.

OPV remains the recommended vaccine for routine polio vaccination in the United States. IPV is recommended for persons with compromised immune systems and their household contacts and is an acceptable alternative for other persons. ACIP is developing recommendations for expanded use of IPV in the United States.

General Changes

Footnotes have been shortened and simplified wherever possible. For detailed information and specific recommendations for administration of vaccines, practitioners should consult the Report of the Committee on Infectious Diseases (Red Book) (2), the vaccine-specific recommendations of the ACIP, and the official manufacturers' package inserts or the Physicians' Desk Reference (PDR) (3).

Date

The schedule is dated January-June 1996, and will be republished in July 1996 to revise or add recommendations and/or to include any changes resulting from licensure of new vaccines. Publishing an updated schedule will permit providers to be certain they are using the most current schedule.

Format Changes

A column has been added to the figure for age 1 month to indicate the second dose of hepatitis B vaccine may be given to infants as early as age 1 month. Shaded bars indicate ages at which adolescents should receive "catch-up" vaccinations if they have not received vaccinations before and, for chickenpox, lack a reliable history of the disease.

Vaccine Recommendations Changes

Hepatitis B, infant. Because of the availability of different formulations of hepatitis B vaccine, doses are presented in micrograms rather than volumes. In addition, the footnote includes recommendations for vaccination of infants born to mothers whose hepatitis B surface antigen status is unknown.

Hepatitis B, adolescent. A bar has been added to indicate that the three-dose series of hepatitis B vaccine should be initiated or completed for adolescents aged 11-12 years who have not previously received three doses of hepatitis B vaccine.

Poliovirus. A footnote has been added to indicate that, although oral poliovirus vaccine (OPV) is recommended for routine vaccination, inactivated poliovirus vaccine (IPV) is indicated for certain persons (i.e., those with a compromised immune system and their household contacts) and continues to be an acceptable alternative for other persons. The schedule for IPV is included in the footnote.

Measles-mumps-rubella vaccine. The footnote has been changed to indicate that although the second dose of measles-mumps-rubella vaccine is routinely administered at age 4-6 years or at age 11-12 years, it may be administered at any visit if at least 1 month has elapsed since receipt of the first dose.

Var. Var was licensed in March 1995 and has been added to the schedule. This vaccine is recommended for all children at age 12-18 months. The footnote indicates that it may be administered to susceptible persons any time after age 12 months, and that it should be given at age 11-12 years to previously unvaccinated persons lacking a reliable history of chickenpox.

References

1. CDC. Recommended childhood immunization schedule -- United States, January 1995. MMWR 1995;43:959-60.

2. American Academy of Pediatrics. Active and passive immunization. In: Peter G, ed. 1994 Red book: report of the Committee on Infectious Diseases. 23rd ed. Elk Grove Village, Illinois: American Academy of Pediatrics, 1994:1-67.

3. Medical Economics Data. Physicians' desk reference. 49th ed. Montvale, New Jersey: Medical Economics Company, Inc., 1995.

Figure_1


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Figure_1C


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