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2014 immunization schedule now available.

FROM PEDIATRICS

The 2014 childhood and adolescent immunization schedule has been approved, with additions that include the use of one of the meningococcal conjugate vaccines (Menveo) in certain groups of high-risk infants and a list of the groups of people at increased risk of hepatitis A.

The schedule is in the February issue of Pediatrics (2014;133:357-63).

Guidance on the use of Menveo (Meningococcal Groups A, C, W-135, and Y Oligosaccharide Diphtheria CRM197 conjugate vaccine) for certain groups of infants at increased risk of disease starting at age 2 months has been added to the meningococcal vaccine footnote. This is based on the Food and Drug Administration licensure of Menveo for use starting at age 2 months in August 2013. Some of the high-risk categories are anatomic or functional asplenia, including sickle cell disease; children with persistent complement component deficiency; and those who travel to or live in an area hyperendemic for meningococcal disease.

This is the first time that a meningococcal vaccine has been available for use starting at age 2 months, Dr. H. Cody Meissner, professor of pediatrics at Tufts University, Boston, said in an interview.

The hepatitis A vaccine footnote now provides a list of groups at increased risk for hepatitis A. While these groups are well recognized, "it was useful to itemize these groups in the foomote," noted Dr. Meissner, a member of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices work group on the harmonized immunization schedule.

The list includes people traveling to or working in countries where there is a high or intermediate endemicity of infection; men having sex with men; people with clotting factor disorders; people with chronic liver disease; users of injection and non-injection illicit drugs; and personal contacts --such as household contacts or regular babysitters--of international adoptees during the first 2 months of arrival in the United States "from a country with high or intermediate endemicity."

The footnote on the tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine states that a dose of the vaccine is recommended for each pregnancy--preferably during week 27 through week 36 of gestation. Last year, the American Academy of Pediatrics agreed that this vaccine should be given to a pregnant woman, but it withheld the recommendation to vaccinate during every pregnancy until more data became available, Dr. Meissner said. "Additional data now indicate the safety and efficacy of administration of Tdap each time a woman becomes pregnant." This will protect most infants during the first 2 months of life when pertussis can be most severe and until they receive their first DTaP dose at 2 months, he noted.

Other changes include clarification of the intervals between doses in the human papillomavirus (HPV) vaccines footnote to avoid misunderstanding of the schedule, said Dr. Meissner, chief of pediatric infectious disease at the Floating Hospital for Children at Tufts Medical Center.

The footnote for pneumococcal vaccines provides clarification about the recommendations for PCV13 (Prevnar 13) and PPSV23 in children and adolescents, "which have been stratified according to age and according to degree of risk," he added.

The footnote on Haemophilus influenzae type b (Hib) conjugate vaccine specifies who should receive the vaccine if immunocompromised.

This is the second year that recommendations and footnotes for ages 018 years are included in one schedule, as opposed to previous years with separate schedules and footnotes for 0-7 years and 8-18 years.

The 2014 schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

Dr. Meissner said he has no relevant financial disclosures.

emechcatie@frontlinemedcom.com
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Author:Mechcatie, Elizabeth
Publication:Pediatric News
Date:Feb 1, 2014
Words:609
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