COMMENTARY

Vaccine Update: Child and Adolescent Immunization Schedule, 2016

William T. Basco, Jr., MD, MS

Disclosures

February 01, 2016

Recommended Childhood and Adolescent Immunization Schedule—United States, 2016

Committee on Infectious Diseases, American Academy of Pediatrics
Pediatrics. 2016;137:e20154531

Summary of New Recommendations

On February 2, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), along with the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG), released the 2016 recommended childhood and adolescent immunization schedule. Unlike previous years', this year's childhood vaccine schedule does not have many changes, but like last year, there are many changes to the recommendation documents provided by the CDC.

Like last year, the graphical charts that clinicians are used to seeing will be provided online only. This will ensure that physicians and other providers access only the most up-to-date versions of the charts. Pocket-sized printable copies are also available, and free laminated copies can be ordered from the CDC by following a link on the same page. Links to mobile applications for smartphones are also available. Simplified format versions are also available for parents, in both English and Spanish.

The format of the charts has been changed again with respect to how vaccines are grouped visually, and colored bars indicate the level of the recommendation for each vaccine. For example, yellow bars indicate the ranges of recommended vaccines for all children, whereas green bars indicate ranges of recommended ages for catch-up vaccines; purple bars indicate recommended age ranges for vaccines indicated only for high-risk groups.

There has been a slight change to the nomenclature used for the human papilloma virus (HPV) vaccines. The number of strains in each vaccine appears first, as in "9vHPV" instead of "HPV-9."

Once again, the online charts include decision tools to help clinicians determine the need for vaccines, using catch-up schedules that differ according to the age of the child. For example, for Haemophilus influenzae type B vaccine, only one dose is indicated if the child receives the vaccine after age 15 months.

Two vaccine-specific changes are worth mentioning. First, providers may notice that the pneumococcal polysaccharide vaccine has been heavily deemphasized in the charts because it is not routinely indicated for any population. Second, vaccination against meningococcus serogroup B has been added, with purple bars showing that high-risk patients (see next paragraph) ages 10 and older should receive the vaccine, along with special notations (indicated by blue bars) showing ages at which non–high-risk patients may receive the vaccine.

That leads me to finish up with some information pertinent to meningitis serogroup B (MenB) vaccines that I provided in a recent viewpoint. MenB vaccines are recommended only for persons aged 10 years or older who are at increased risk for serogroup B disease (persistent complement component deficiencies, anatomic or functional asplenia, microbiologists working with Neisseria meningitidis, and individuals at risk during an outbreak of serogroup B disease). MenB vaccines may be given to all persons aged 16-23 years, but the vaccines are not expressly recommended. The ideal age for administering MenB vaccines is 16-18 years; the vaccine may be given with other vaccines but preferably at a separate anatomical site. The vaccine is not generally recommended (but may be given if warranted by risk) for pregnant and lactating women, mainly owing to a lack of data.

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