Immunization Schedule

Combination Vaccines

Combination vaccines are necessary and important for the continuing success of our immunization program, especially when more vaccines are added to the already crowded immunization schedule. However, the multiplicity of competing vaccine products, with various overlapping antigen menu and subtle immunologic differences, may be confusing to the busy practitioner. Combining vaccines that target children immunization may expand immunization opportunities and effectiveness. However, offering new choices may not necessarily translate into simpler solutions at the practical level. The combo’s aspects of immunization schedules are not included in this review.

Immunization Schedule - Introduction

The purpose of this review is to revise and update the evolving immunization schedule at the national and global levels. Good vaccination practices begin shortly after birth. The WHO estimated that immunization currently averts an estimated 2 to 3 million deaths every year apart from societal burden & medical costs. For each birth cohort vaccinated in the United States, approximately 20 million illnesses are prevented, along with 40,000 deaths.

The Advisory Committee on Vaccines and Immunization Practices (ACVIP) of the Indian Academy of Pediatrics (IAP) has recently (2014) updated the immunization schedule for children aged 0 through 18 years. This was based on recent evidence for licensed vaccines that are incorporated into our clinical practices in India (Table 1).

Table 1: Recommendation for IAP Immunization - updated 2014 Schedule

One should follow and adhere to the regional health authority & Institutional immunization policy that are principally derived from the Centers for Disease Control and Prevention (CDC &P) and the WHO. The immunization schedules are intermittently revised and updated; these programs are supported by the Global Alliance for Vaccines and Immunization (GAVI) at the global level.

The Advisory Committee on Immunization Practices (ACIP) of the CDC & P, has now updated to reflect the 2016 immunization schedules for the use of vaccines for children and adolescents. The schedules are approved by the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AFP), and the American College of Obstetricians and Gynecologists (ACOG). (Table 2)

Table 2: General Recommendation from ACIP/CDC from Newborn to 18 yrs. of age

Readers are referred to the AAP Web site (http://redbook.solutions.aap.org/SS/Immunization_Schedules.aspx) or the CDC & P Web site (http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html) for the most recent version of the immunization schedule, the full set of footnotes, and the catch-up schedule. This method will ensure that readers have the most current recommendations on the clinical and immunogenicity effects of individual vaccines. Further, the WHO and GAVI support the Combination Vaccines (Combo’s), which are now an integral part of vaccination programs.

Acip 2016 Immunization Schedules And Iap Immunization Schedule 2014

The ACIP 2016 immunization schedules for children and adolescents from birth through 18 years of age include several changes from last year, including updated recommendations for the human papillomavirus (HPV) and meningococcal B vaccines. Both the updated schedules (IAP 2014) and the immunization schedules for 2016 (IAP, ACIP) is summarized in the following two tables:

Table 3: Background summary of Licensed HPV vaccines

Other IAP Recommended Vaccines For High-risk* Children (vaccines Under Special Circumstances)

1-Influenza Vaccine, 2-Meningococcal Vaccine. 3-Japanese Encephalitis Vaccine. 4-Cholera Vaccine. 5-Rabies Vaccine. 6-Yellow Fever Vaccine. 7-Pneumococcal Polysaccharide vaccine (PPSV 23)

Highlights from the IAP updated schedule are shown below:

• Now whole-cell pertussis (wP) vaccines are scheduled for the primary series of infant vaccination.
• Rotavirus vaccine has been revised to 10 & 14 weeks from existing 6 & 10 weeks of age. Only 2 doses of RV1 (Roderick) are recommended at present. If chosen, 3-dose Rota-teq (RV5) should be completed before 32 weeks of age.
• New typhoid conjugated vaccine (tetanus toxoid conjugated Vi TT) and new meningococcal conjugate vaccines have been introduced (TT conjugated VI-TT).
• To use Tdap vaccine during 2nd or 3rd trimester of each pregnancy to protect neonatal tetanus and pertussis during infancy.