p2010
4
• Vaccinate all children age 0 through 18yrs. • Vaccinate all newborns with monovalent vaccine prior to hospital discharge. Give dose #2 at age 1–2m and the final dose at age 6–18m (the last dose in the infant series should not be given earlier than age 24wks). After the birth dose, the series may be completed using 2 doses of single-antigen vaccine or up to 3 doses of Com- vax (ages 2m, 4m, 12–15m) or Pediarix (ages 2m, 4m, 6m), which may result in giving a total of 4 doses of hepatitis B vaccine. • If mother is HBsAg-positive: give the newborn HBIG + dose #1 within 12hrs of birth; complete series at age 6m or, if using Comvax, at age 12–15m. • If mother’s HBsAg status is unknown: give the newborn dose #1 within 12hrs of birth. If low birth weight (less than 2000 grams), also give HBIG within 12hrs. If the mother is subsequently found to be HBsAg positive, give the infant HBIG ASAP and within 7d of birth and follow HepB immunization schedule for infants born to HBsAg-positive mothers. • Give to children at ages 2m, 4m, 6m, 15–18m, 4–6yrs. • May give dose #1 as early as age 6wks. • May give #4 as early as age 12m if 6m have elapsed since #3. • Do not give DTaP/DT to children age 7yrs and older. • If possible, use the same DTaP product for all doses. • Give Tdap to all children and teens age 11–18yrs (starting at age 11–12yrs) who have not received previous Tdap; then boost every 10yrs with Td. • Tdap should be given regardless of interval since previous Td. • Make special efforts to give Tdap to children and teens who are 1) in contact with infants younger than age 12m and 2) healthcare workers with direct patient contact. •In pregnancy, when indicated, give Td or Tdap in 2nd or 3rd trimester. If not administered during pregnancy, give Tdap in immediate postpartum period (if not previously vaccinated). • Give to children at ages 2m, 4m, 6–18m, 4–6yrs. • May give dose #1 as early as age 6wks. • Not routinely recommended for U.S. residents age 18yrs and older (except certain travelers). Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years) (Page 1 of 4) Schedule for routine vaccination and other guidelines (any vaccine can be given with another) • Do not restart series, no matter how long since previous dose. • 3-dose series can be started at any age. • Minimum intervals between doses: 4wks between #1 and #2, 8wks between #2 and #3, and at least 16wks between #1 and #3 (e.g., 0-, 2-, 4m; 0-, 1-, 4m). • #2 and #3 may be given 4wks after previous dose. • #4 may be given 6m after #3. • If #4 is given before 4th birthday, wait at least 6m for #5 (age 4–6yrs). • If #4 is given after 4th birthday, #5 is not needed. • Children as young as age 7yrs and teens who are unvaccinated or behind schedule should complete a primary Td series (spaced at 0, 1–2m, and 6–12m intervals); substitute a 1-time Tdap for any dose in the series, preferably as dose #1. • The final dose should be given on or after the 4th birthday and at least 6m from the previous dose. • If dose #3 is given after 4th birthday, dose #4 is not needed if dose #3 is given at least 6m after dose #2. Contraindication Previous anaphylaxis to this vaccine or to any of its components. Precaution Moderate or severe acute illness. Contraindications • Previous anaphylaxis to this vaccine or to any of its components. • For DTaP/Tdap only: encephalopathy not attributable to an identifi- able cause, within 7d after DTP/DTaP. Precautions • Moderate or severe acute illness. • History of arthus reaction following a prior dose of tetanus-toxoid- containing vaccine. • Guillain-Barré syndrome (GBS) within 6wks after previous dose of tetanus-toxoid-containing vaccine. • For DTaP only: Any of these events following a previous dose of DTP/DTaP: 1) temperature of 105°F (40.5°C) or higher within 48hrs; 2) continuous crying for 3hrs or more within 48hrs; 3) collapse or shock-like state within 48hrs; 4) seizure within 3d. • For DTaP/Tdap only: Progressive or unstable neurologic disorder, uncontrolled seizures, or progressive encephalopathy. Note: Tdap may be given to pregnant women at the provider’s discretion. Contraindication Previous anaphylaxis to this vaccine or to any of its components. Precautions • Moderate or severe acute illness. • Pregnancy. Schedule for catch-up vaccination and related issues Contraindications and precautions (mild illness is not a contraindication) www.immunize.org/catg.d/p2010.pdf • Item #P2010 (5/11) *This document was adapted from the recommendations of the Advisory Committee on Immunization Practices (ACIP). To obtain copies of the recommendations, call the CDC-INFO Contact Center at (800) 232-4636; visit CDC’s website at www.cdc.gov/vaccines/pubs/ACIP-list.htm; or visit the Immunization Action Coalition (IAC) website at www.immunize.org/acip. This table is revised periodically. Visit IAC’s website at www.immunize.org/childrules to make sure you have the most current version. Technical content reviewed by the Centers for Disease Control and Prevention, May 2011. Immunization Action Coalition • 1573 Selby Avenue • Saint Paul, MN 55104 • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org • [email protected] Special Notes on Hepatitis B Vaccine (HepB) Dosing of HepB: Monovalent vaccine brands are interchangeable. For people age 0 through 19yrs, give 0.5 mL of either Engerix-B or Recombivax HB. Alternative dosing schedule for unvaccinated adolescents age 11 through 15yrs: Give 2 doses Recombivax HB 1.0 mL (adult formulation) spaced 4–6m apart. (Engerix-B is not licensed for a 2-dose schedule.) For preterm infants: Consult ACIP hepatitis B recommendations (MMWR 2005; 54 [RR-16]).* Hepatitis B (HepB) Give IM DTaP, DT (Diphtheria, tetanus, acellular pertussis) Give IM Td, Tdap (Tetanus, diphtheria, acellular pertussis) Give IM Polio (IPV) Give SC or IM Vaccine name and route
Transcript of p2010
•Vaccinateallchildrenage0through18yrs.•Vaccinateallnewbornswithmonovalentvaccinepriortohospital
discharge.Givedose#2atage1–2mandthefinaldoseatage6–18m(thelastdoseintheinfantseriesshouldnotbegivenearlierthanage24wks).Afterthebirthdose,theseriesmaybecompletedusing2dosesofsingle-antigenvaccineorupto3dosesofCom-vax(ages2m,4m,12–15m)orPediarix(ages2m,4m,6m),whichmayresultingivingatotalof4dosesofhepatitisBvaccine.
•If mother is HBsAg-positive:givethenewbornHBIG+dose#1within12hrsofbirth;completeseriesatage6mor,ifusingComvax,atage12–15m.
•If mother’s HBsAg status is unknown:givethenewborndose#1within12hrsofbirth.Iflowbirthweight(lessthan2000grams),alsogiveHBIGwithin12hrs.IfthemotherissubsequentlyfoundtobeHBsAgpositive,givetheinfantHBIGASAPandwithin7dofbirthandfollowHepBimmunizationscheduleforinfantsborntoHBsAg-positivemothers.
•Givetochildrenatages2m,4m,6m,15–18m,4–6yrs.•Maygivedose#1asearlyasage6wks.•Maygive#4asearlyasage12mif6mhaveelapsedsince#3.•DonotgiveDTaP/DTtochildrenage7yrsandolder.•Ifpossible,usethesameDTaPproductforalldoses.
•GiveTdaptoallchildrenandteensage11–18yrs(startingatage11–12yrs)whohavenotreceivedpreviousTdap;thenboostevery10yrswithTd.
•TdapshouldbegivenregardlessofintervalsincepreviousTd.•MakespecialeffortstogiveTdaptochildrenandteenswhoare
1)incontactwithinfantsyoungerthanage12mand2)healthcareworkerswithdirectpatientcontact.
•Inpregnancy,whenindicated,giveTdorTdapin2ndor3rdtrimester.Ifnotadministeredduringpregnancy,giveTdapinimmediatepostpartumperiod(ifnotpreviouslyvaccinated).
•Givetochildrenatages2m,4m,6–18m,4–6yrs.•Maygivedose#1asearlyasage6wks.•NotroutinelyrecommendedforU.S.residentsage18yrsand
older(exceptcertaintravelers).
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years) (Page 1 of 4)
Schedule for routine vaccination and other guidelines (anyvaccinecanbegivenwithanother)
•Donotrestartseries,nomatterhowlongsincepreviousdose.
•3-doseseriescanbestartedatanyage.•Minimumintervalsbetweendoses:
4wksbetween#1and#2,8wksbetween#2and#3,andatleast16wksbetween#1and#3(e.g.,0-,2-,4m;0-,1-,4m).
•#2and#3maybegiven4wksafterpreviousdose.
•#4maybegiven6mafter#3.•If#4isgivenbefore4thbirthday,wait
atleast6mfor#5(age4–6yrs).•If#4isgivenafter4thbirthday,#5is
notneeded.
•Childrenasyoungasage7yrsandteenswhoareunvaccinatedorbehindscheduleshouldcompleteaprimaryTdseries(spacedat0,1–2m,and6–12mintervals);substitutea1-timeTdapforanydoseintheseries,preferablyasdose#1.
•Thefinaldoseshouldbegivenonorafterthe4thbirthdayandatleast6mfromthepreviousdose.
•Ifdose#3isgivenafter4thbirthday,dose#4isnotneededifdose#3isgivenatleast6mafterdose#2.
Contraindication Previousanaphylaxistothisvaccineortoanyofitscomponents.Precaution Moderateorsevereacuteillness.
Contraindications•Previousanaphylaxistothisvaccineortoanyofitscomponents.•ForDTaP/Tdaponly:encephalopathynotattributabletoanidentifi-
ablecause,within7dafterDTP/DTaP.Precautions •Moderateorsevereacuteillness.•Historyofarthusreactionfollowingapriordoseoftetanus-toxoid-
containingvaccine.•Guillain-Barrésyndrome(GBS)within6wksafterpreviousdoseof
tetanus-toxoid-containingvaccine.•ForDTaPonly:Anyoftheseeventsfollowingapreviousdoseof
DTP/DTaP:1)temperatureof105°F(40.5°C)orhigherwithin48hrs;2)continuouscryingfor3hrsormorewithin48hrs;3)collapseorshock-likestatewithin48hrs;4)seizurewithin3d.
•ForDTaP/Tdaponly:Progressiveorunstableneurologicdisorder,uncontrolledseizures,orprogressiveencephalopathy.
Note:Tdapmaybegiventopregnantwomenattheprovider’sdiscretion.
ContraindicationPreviousanaphylaxistothisvaccineortoanyofitscomponents.Precautions•Moderateorsevereacuteillness.•Pregnancy.
Schedule for catch-up vaccination and related issues
Contraindications and precautions (mildillnessisnotacontraindication)
www.immunize.org/catg.d/p2010.pdf•Item #P2010 (5/11)
*ThisdocumentwasadaptedfromtherecommendationsoftheAdvisoryCommitteeonImmunizationPractices(ACIP).Toobtaincopiesoftherecommendations,calltheCDC-INFOContactCenterat(800)232-4636;visitCDC’swebsiteatwww.cdc.gov/vaccines/pubs/ACIP-list.htm;orvisitthe
ImmunizationActionCoalition (IAC)website atwww.immunize.org/acip. This table is revisedperiodically.VisitIAC’swebsiteatwww.immunize.org/childrulestomakesureyouhavethemostcurrentversion.
Technical content reviewed by the Centers for Disease Control and Prevention, May 2011.
Immunization Action Coalition • 1573 Selby Avenue • Saint Paul, MN 55104 • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org • [email protected]
Special Notes on Hepatitis B Vaccine (HepB)Dosing of HepB: Monovalentvaccinebrandsareinterchangeable.Forpeopleage0through19yrs,give0.5mL
ofeitherEngerix-BorRecombivaxHB.Alternative dosing schedule for unvaccinated adolescents age 11 through 15yrs: Give2dosesRecombivax
HB1.0mL(adultformulation)spaced4–6mapart.(Engerix-Bisnotlicensedfora2-doseschedule.)For preterm infants:ConsultACIPhepatitisBrecommendations(MMWR2005;54[RR-16]).*
Hepatitis B(HepB)
Give IM
DTaP, DT(Diphtheria,
tetanus,acellularpertussis)
Give IM
Td, Tdap(Tetanus,
diphtheria,acellularpertussis)
Give IM
Polio(IPV)
Give SC or IM
Vaccine nameand route
•Ifyoungerthanage13yrs,spacedose#1and#2atleast3mapart.Ifage13yrsorolder,spaceatleast4wksapart.
•Mayuseaspostexposurepro-phylaxisifgivenwithin5d.
•IfVarandeitherMMR,LAIV,and/oryellowfevervaccinearenotgivenonthesameday,spacethematleast28dapart.
•IfMMRandeitherVar,LAIV,and/oryellowfevervaccinearenotgivenonthesameday,spacethematleast28dapart.
•WhenusingMMRforbothdoses,minimumintervalis4wks.
•WhenusingMMRVforbothdoses,minimumintervalis3m.
•Within72hrsofmeaslesexpo-sure,give1doseofMMRaspostexposureprophylaxistosusceptiblehealthychildrenage12mandolder.
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years) (Page 2 of 4)
Contraindications•Previousanaphylaxistothisvaccine,toanyofitscomponents,ortoeggs.•ForLAIVonly:ageyoungerthan2yrs;pregnancy;chronicpulmonary(includingasthma),
cardiovascular(excepthypertension),renal,hepatic,neurological/neuromuscular,hematologic,ormetabolic(includingdiabetes)disorders;immunosuppression(includingthatcausedbymedicationsorHIV);forchildrenandteensages6mthrough18yrs,currentlong-termaspirintherapy;forchildrenage2through4yrs,wheezingorasthmawithinthepast12m,perhealthcareproviderstatement.
Precautions•Moderateorsevereacuteillness.•HistoryofGuillain-Barrésyndrome(GBS)within6wksofapreviousinfluenzavaccination.•ForLAIVonly:Receiptofspecificantivirals(i.e.,amantadine,rimantadine,zanamivir,oroseltamivir)48hrsbeforevaccination.Avoiduseoftheseantiviraldrugsfor14daftervaccination.
Contraindications•Previousanaphylaxistothisvaccineortoanyofitscomponents.•Pregnancyorpossibilityofpregnancywithin4wks.•Childrenonhigh-doseimmunosuppressivetherapyorwhoareimmunocompromisedbecauseof
malignancyandprimaryoracquiredcellularimmunodeficiency,includingHIV/AIDS(althoughvaccinationmaybeconsideredifCD4+T-lymphocytepercentagesareeither15%orgreaterinchildrenages1through8yrsor200cells/µLorgreaterinchildrenage9yrsandolder).
Precautions•Moderateorsevereacuteillness.•Ifblood,plasma,and/orimmuneglobulin(IGorVZIG)weregiveninpast11m,seeACIPstatement
General Recommendations on Immunization*regardingtimetowaitbeforevaccinating.•Receiptofspecificantivirals(i.e.,acyclovir,famciclovir,orvalacyclovir)24hrsbeforevaccination,if
possible;delayresumptionoftheseantiviraldrugsfor14daftervaccination.•ForMMRVonly,personalorfamily(i.e.,siblingorparent)historyofseizures.Note:Forpatientswithhumoralimmunodeficiencyorleukemia,seeACIPrecommendations*.
Contraindications•Previousanaphylaxistothisvaccineortoanyofitscomponents.•Pregnancyorpossibilityofpregnancywithin4wks.•Severeimmunodeficiency(e.g.,hematologicandsolidtumors;receivingchemotherapy;congenital
immunodeficiency;long-termimmunosuppressivetherapy,orseverelysymptomaticHIV).Note:HIVinfectionisNOTacontraindicationtoMMRforchildrenwhoarenotseverelyimmunocompromised(consultACIPMMRrecommendations[MMWR1998;47[RR-8]fordetails*).
Precautions•Moderateorsevereacuteillness.•Ifblood,plasma,orimmuneglobulingiveninpast11m,seeACIPstatementGeneral Recommendations
on Immunization*regardingtimetowaitbeforevaccinating.•Historyofthrombocytopeniaorthrombocytopenicpurpura.•ForMMRVonly,personalorfamily(i.e.,siblingorparent)historyofseizures.•Needfortuberculinskintesting(TST).IfTSTneeded,giveTSTbeforeoronsamedayasMMR,or
giveTST4wksfollowingMMR.
Contraindications and precautions(mildillnessisnotacontraindication)
Schedule for catch-up vaccination and related issues
•Givedose#1atage12–15m.•Givedose#2atage4–6yrs.Dose#2
ofVarorMMRVmaybegivenearlierifatleast3msincedose#1.
•Givea2nddosetoallolderchildrenandadolescentswithhistoryofonly1dose.
•MMRVmaybeusedinchildrenage12mthrough12yrs(seenotebelow).
•Givedose#1atage12–15m.•Givedose#2atage4–6yrs.Dose#2
maybegivenearlierifatleast4wkssincedose#1.ForMMRV:dose#2maybegivenearlierifatleast3msincedose#1.
•Givea2nddosetoallolderchildrenandteenswithhistoryofonly1dose.
•MMRVmaybeusedinchildrenage12mthrough12yrs(seenoteabove).
Schedule for routine vaccination and other guidelines
(anyvaccinecanbegivenwithanother)
Influenza
Trivalentinactivatedinfluenzavaccine(TIV)
Give IM
Liveattenuatedinfluenzavaccine(LAIV)
Give intranasally
Varicella(Var)
(Chickenpox)
Give SC
MMR(Measles,mumps,rubella)
Give SC
Vaccine nameand route
•Vaccinateallchildrenandteensage6mthrough18yrs.•LAIVmaybegiventohealthy,non-pregnantpeopleage2–49yrs.•Give2dosestofirst-timevaccineesage6mthrough8yrs,spaced4wks
apart.•ForTIV,give0.25mLdosetochildrenage6–35mand0.5mLdoseif
age3yrsandolder.•IfLAIVandeitherMMR,Var,and/oryellowfevervaccinearenotgiven
onthesameday,spacethematleast28dapart.
5/11
Note:ForthefirstdoseofMMRandvaricellagivenatage12–47mos,eitherMMRandVarorMMRVmaybeused.UnlesstheparentorcaregiverexpressesapreferenceforMMRV,CDCrecommendsthatMMRandVarshouldbegivenforthefirstdoseinthisagegroup.
All Hib vaccines:•If#1wasgivenat12–14m,giveboosterin8wks.•Giveonly1dosetounvaccinatedchildrenages15through59m.ActHib:•#2and#3maybegiven4wksafterpreviousdose.•If#1wasgivenatage7–11m,only3dosesareneeded;#2is
given4–8wksafter#1,thenboostatage12–15m(waitatleast8wksafterdose#2).
PedvaxHIB and Comvax:•#2maybegiven4wksafterdose#1.
•Forminimumintervals,see3rdbulletatleft.•Forage7–11m:Ifhistoryof0doses,give2dosesofPCV13,
8wksapart,witha3rddoseatage12–15m;ifhistoryof1or2doses,give1doseofPCV13witha2nddoseatage12–15m,atleast8wkslater.
•Forage12–23m:Ifunvaccinatedorhistoryof1dosebeforeage12m,give2dosesofPCV138wksapart;ifhistoryof1doseatorafterage12mor2or3dosesbeforeage12m,give1doseofPCV13atleast8wksaftermostrecentdose;ifhistoryof4dosesofPCV7orotherage-appropriatecompletePCV7schedule,give1supplementaldoseofPCV13atleast8wksafterthemostrecentdose.
•Forage24–59mandhealthy:Ifunvaccinatedoranyincompletescheduleorif4dosesofPCV7oranyotherage-appropriatecom-pletePCV7schedule,give1supplementaldoseofPCV13atleast8wksafterthemostrecentdose.
•Forage24–71mandathighrisk**:Ifunvaccinatedoranyincom-pletescheduleof1or2doses,give2dosesofPCV13,1atleast8wksafterthemostrecentdoseandanotherdoseatleast8wkslater;ifanyincompleteseriesof3doses,orif4dosesofPCV7oranyotherage-appropriatecompletePCV7schedule,give1supple-mentaldoseofPCV13atleast8wksafterthemostrecentPCV7dose.
•Forchildrenages6through18yrswithfunctionaloranatomicasplenia(includingsicklecelldisease),HIVinfectionorotherimmunocompromisingcondition,cochlearimplant,orCSFleak,considergiving1doseofPCV13regardlessofprevioushistoryofPCV7orPPSV.
•ActHib(PRP-T):giveatage2m,4m,6m,12–15m(boosterdose).•PedvaxHIBorComvax(containingPRP-OMP):giveatage2m,4m,
12–15m(boosterdose).•Dose#1ofHibvaccineshouldnotbegivenearlierthanage6wks.•Thelastdose(boosterdose)isgivennoearlierthanage12manda
minimumof8wksafterthepreviousdose.•Hibvaccinesareinterchangeable;however,ifdifferentbrandsof
Hibvaccinesareadministeredfordose#1anddose#2,atotalof3dosesarenecessarytocompletetheprimaryseriesininfants.
•AnyHibvaccinemaybeusedfortheboosterdose.•Hibisnotroutinelygiventochildrenage5yrsandolder.•HiberixisapprovedONLYfortheboosterdoseatage15mthrough4yrs.
Assoonasfeasible,replaceexistingstockofPCV7withPCV13.•Giveatages2m,4m,6m,12–15m.•Dose#1maybegivenasearlyasage6wks.•WhenchildrenarebehindonPCVschedule,minimumintervalfor
dosesgiventochildrenyoungerthanage12mis4wks;fordosesgivenat12mandolder,itis8wks.
•Give1dosetounvaccinatedhealthychildrenage24–59m.•Forhigh-risk**childrenages24–71m:Give2dosesatleast8wks
apartiftheypreviouslyreceivedfewerthan3doses;give1doseatleast8wksafterthemostrecentdoseiftheypreviouslyreceived3doses.
•PCV13isnotroutinelygiventohealthychildrenage5yrsandolder.
•Give1doseatleast8wksafterfinaldoseofPCVtohigh-riskchil-drenage2yrsandolder.
•Forchildrenwhohaveanimmunocompromisingconditionorhavesicklecelldiseaseorfunctionaloranatomicasplenia,givea2nddoseofPPSV5yrsafterpreviousPPSV(consultACIPPPSVrec-ommendationsatwww.cdc.gov/vaccines/pubs/ACIP-list.htm*).
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years) (Page 3 of 4)
Vaccine nameand route
Schedule for catch-up vaccination and related issues
Schedule for routine vaccination and other guidelines (anyvaccinecanbegivenwithanother)
Contraindications and precautions(mildillnessisnotacontraindication)
Contraindications•Previousanaphylaxistothisvaccine
ortoanyofitscomponents.•Ageyoungerthan6wks.Precaution Moderateorsevereacuteillness.
ContraindicationPreviousanaphylaxistoaPCVvaccine,toanyofitscomponents,ortoanydiphtheriatoxoid-containingvaccine.PrecautionModerateorsevereacuteillness.
ContraindicationPreviousanaphylaxistothisvaccineortoanyofitscomponents.Precaution Moderateorsevereacuteillness.
Hib(Haemophilus
influenzaetypeb)
Give IM
Pneumococcal conjugate(PCV13)
Give IM
Pneumococcal polysaccharide
(PPSV)
Give IM or SC
**High-risk: Thosewithsicklecelldisease;anatomicorfunctionalasplenia;chroniccardiac,pulmonary,orrenaldisease;diabetes;cerebrospinalfluidleaks;HIVinfection;immunosuppression;diseasesassociatedwithimmunosup-pressiveand/orradiationtherapy;orwhohaveorwillhaveacochlearimplant.
5/11
Summary of Recommendations for Child/Teen Immunization (Ages birth through 18 years) (Page 4 of 4)
Rotavirus(RV)
Give orally
Hepatitis A(HepA)
Give IM
Meningococcal conjugate,
quadrivalent(MCV4)Give IM
Meningococcal polysaccharide
(MPSV4)Give SC
Human papillomavirus
(HPV)(HPV2,Cervarix)(HPV4,Gardasil)
Give IM
•Rotarix(RV1):giveatage2m,4m.•RotaTeq(RV5):giveatage2m,4m,6m.•Maygivedose#1asearlyasage6wks.•Givefinaldosenolaterthanage8m0days.
•Give2dosesspaced6maparttoallchildrenatage1yr(12–23m).•Vaccinateallpreviouslyunvaccinatedchildrenandadolescentsage2yrs
andolderwho-WanttobeprotectedfromHAVinfection.-Liveinareaswherevaccinationprogramstargetolderchildren.-TravelanywhereexceptU.S.,W.Europe,N.Zealand,Australia,Canada,
orJapan.-Havechronicliverdisease,clottingfactordisorder,orareadolescent
maleswhohavesexwithothermales.-Areusersofillicitdrugs(injectableornon-injectable).-Anticipateclosepersonalcontactwithaninternationaladopteefroma
countryofhighorintermediateendemicityduringthefirst60daysfol-lowingtheadoptee’sarrivalintheU.S.
•GiveMCV4#1routinelyatage11through12yrsandaboosterdoseatage16yrs.
•GiveMCV4toallunvaccinatedteensages13through18yrs;ifvaccinatedatage13–15yrs,giveboosterdoseatage16–18yrs.
•Give1initialdosetounvaccinatedincomingcollegestudentsages19–21yrs;giveboosterdosetoincomingstudentswhoreceivedthemostrecentdosewhenyoungerthanage16yrs.Considersamevaccinationstrategyforexistingcollegestudentsages19–21yrs.
•Vaccinateallchildrenage2yrsandolderwhohaveanyofthefollowingriskfactors:-Anatomicorfunctionalasplenia,orpersistentcomplementcomponent
deficiency;give2doses,separatedby8wks.-Traveltoorresideincountriesinwhichmeningococcaldiseaseishyper-
endemicorepidemic(e.g.,the“meningitisbelt”ofSub-SaharanAfrica).Note:UseMPSV4ONLYifthereisapermanentcontraindicationorprecautiontoMCV4.
•Give3-doseseriestogirlsatage11–12yrsona0,1–2,6mschedule.(Maybegivenasearlyasage9yrs.)
•Givea3-doseseriestoalloldergirlsandwomen(throughage26yrs)whowerenotpreviouslyvaccinated.
•ConsidergivingHPV4tomalesage9through26yrstoreducetheirlikeli-hoodofacquiringgenitalwarts.
•Donotbeginseriesininfantsolderthanage14wks6days.
•Intervalsbetweendosesmaybeasshortas4wks.
•Ifpriorvaccinationincludeduseofdifferentorunknownbrand(s),atotalof3dosesshouldbegiven.
•Minimumintervalbetweendosesis6m.•Childrenwhoarenotfullyvaccinated
byage2yrscanbevaccinatedatsubse-quentvisits.
•Considerroutinevaccinationofchildrenage2yrsandolderinareaswithnoexistingprogram.
•Give1doseaspostexposureprophylaxistoincompletelyvaccinatedchildrenage12mandolderwhohaverecently(duringthepast2wks)beenexposedtohepatitisAvirus.
•IfpreviouslyvaccinatedwithMPSV4orMCV4andriskofmeningococ-caldiseasepersists,revaccinatewithMCV4in3yrs(iffirstdosegivenatage2through6yrs)orin5yrs(ifpreviousdosegivenatage7yrsorolder).Then,giveadditionalboosterdosesevery5yrsifriskcontinues.
•WhenadministeringMCV4tochildrenwithHIVinfection,give2initialdoses,separatedby8wks.
Minimumintervalsbetweendoses:4wksbetween#1and#2;12wksbetween#2and#3.Overall,theremustbeatleast24wksbetweendoses#1and#3.Ifpos-sible,usethesamevaccineproductforalldoses.
Contraindications•Previousanaphylaxistothisvaccineortoanyofitscom-ponents.Ifallergytolatex,useRV5.•Diagnosisofseverecombinedimmunodeficiency(SCID).Precautions•Moderateorsevereacuteillness.•AlteredimmunocompetenceotherthanSCID.•Chronicgastrointestinaldisease.•Historyofintussusception.•Spinabifidaorbladderexstrophy.
ContraindicationPreviousanaphylaxistothisvaccineortoanyofitscompo-nents.Precautions•Moderateorsevereacuteillness.•Pregnancy.
ContraindicationPreviousanaphylaxistothisvaccineortoanyofitscompo-nents.Precautions•Moderateorsevereacuteillness.
ContraindicationPreviousanaphylaxistothisvaccineortoanyofitscompo-nents.Precautions•Moderateorsevereacuteillness.•Pregnancy.
Schedule for catch-up vaccination and related issues
Schedule for routine vaccination and other guidelines (anyvaccinecanbegivenwithanother)
Vaccine nameand route
5/11
Contraindications and precautions(mildillnessisnotacontraindication)
