Immunizations - Introduction

[Also for more information, see In-Depth Report #1: Travel to Developing Countries.]

Childhood Immunization Schedule**
Age	Hepatitis B (Hep-B)*	Chickenpox (Varicella Zoster)	Haemophilus influenzae type (Hib)	Polio (Inactive virus) (IPV)*	Diphtheria, Tetanus, Pertussis (DTaP)*	Measles, Mumps, Rubella (MMR)	Pneumococcal Vaccine (PCV7)	Hepatitis A
Birth	Hep-B immediately after birth. (This is very important when mothers are infected.) No later than two months in children of noninfected mothers. *
Two months	Hep-B some time between one and four months depending on risk. *		Hib	IPV*	DTaP*		PCV7
Four months			Hib	IPV*	DTaP*		PCV7
Six months	Hep-B some time between six and 18 months. *		Hib (Depending on brand. For example, no third dose is required for PedvaxHIB or ComVax.)	IPV* (Advised at some point between six to 18 month.) *	DTaP*		PCV7
12 to 15 months	Hep-B some time between six and 18 months. *	Varies.	Hib (Sometime between 12 and 15 months.)	IPV* (Advised at some point between six to 18 month.) *	DTaP* (Typically between 15 and 18 months. May be given as early as 12 months in high-risk children as long as 6 months have passed since the 3rd dose.)	MMR (Sometimes between 12 and 15 months.)	PCV7
Two years old							PCV7 - 1 dose for children not previously vaccinated.	In children over two years old in selected areas.
Four to Six years				IPV)	DTaP	MMR	PCV7. 1 dose in high-risk children.
11 to 12 years	Hep-B (If vaccinations were previously missed). Two or three doses a few months apart.	Varies. (If previously missed, two doses should be given at least four weeks apart.)			Td	MMR (If vaccinations were previously missed).		In adolescents through age 18 in selected areas.
* A one-shot combination vaccine (Pediarix) has been approved that covers polio, hepatitis B, diphtheria, pertussis, and tetanus (DTaP) and should simplify the immunization process. It would be given as a single injection at 2, 4, and 6 months with booster shots given at 12 to 15 months and 4 to 6 years. **All children aged 6-23 months should receive an annual flu shot. Children older than 2 years of age who have chronic medical conditions should also receive influenza vaccination. The flu shot is not approved for children less than 6 months of age.

SideEffects andAnti-Immunization Groups

Of great concern are anti-immunization organizations and websites, which were formed mostly because of unsubstantiated reports which linkedsmall numbers of serious problems to some vaccines. The following watchdog systems are now in effect to monitorside effects from vaccination:

VAERS (Vaccine Adverse Event Reporting System) is a government service that it registers all adverse events reported after vaccination, including those not related to the vaccine. It is useful for surveillance, but has limitations. For example, it may record the same case more than once. In addition, more serious events that occur after a vaccination are more likely to be reported than later and milder events, and such events are not necessarily linked to the vaccine.
VSD (Vaccine Safety Datalink) is a linked database that analyses the records of over seven million patients. It is more accurate than VAERS, although its information is not as timely.
The CDC has establishedthe national network of Clinical Immunization Safety Assessment (CISA) Centers.It will provide services to physicians to help them evaluate and manage patients who may have had a side effect.