Immunization Resource Guide for School Nurses

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KANSAS

Compliments of:

Adolescent Immunization

Collaborative

Funding provided by:

GIVE IT

A

S

H

O

T!

Immunization

Resource Guide

for School Nurses

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KANSAS

Table of Contents: Kansas

1. Introduction

2. Immunization Guidelines

3. Kansas State and Local Health

Departments

4. State of Kansas Forms, Letters, and Statutes

5. State of Kansas Classroom Handbook of

Communicable Diseases

6. Resources

7. Strategies for Increasing Adolescent

Immunizations

8. Well Child Exams, Pre-Participation Physical

Evaluations, and Recommended/Required

Physical Examinations of Students

9. Insurance and Health Services Information

For the most recent version of this resource guide, visit

www.mchc.net/immunize/index.html

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KANSAS

Immunization Resource Guide

for School Nurses

1. Introduction

T

his Immunization Resource Guide for School Nurses is designed as an adaptable, easy-to-use manual to assist school nurses in improving student immunization rates specifically in the Kansas City Metropolitan Area.

The genesis of this tool began in October 2005. At that time Blue Cross and Blue Shield of Kansas City (BCBSKC) commissioned Primaris, a healthcare consulting firm to assist them in improving the adolescent immunization rates in five Kansas City Metropolitan counties – Clay, Jackson, and Platte in Missouri and Johnson and Wyandotte in Kansas.

Following an environmental scan, BCBSKC hosted a “Learning Exchange” in March 2006 for all local health plans and immunization champions - state, county and local health departments; school nurses; and community coalitions. The

attendees agreed to approach this as a community effort and formed the Adolescent Immunization Collaborative, which expanded to include over 40 representatives from committed organizations. The Adolescent Immunization Collaborative members prioritized tasks and formed three work groups, one of which focused on

schools. This school work group distributed a “Give It a Shot” toolkit to all secondary school nurses in the five-county area and developed this

Immunization Resource Guide for School Nurses.

This guide was developed in response to recommendations by the National Task Force on Confidential Student Health Information, American School Health Association. The recommendations suggest two best practices. The first of these is to establish uniform standards for collecting and recording student health information. The second is to establish standard procedures for requesting needed health information from outside sources and for releasing confidential health information, with parental consent, to outside agencies and individuals.

The Immunization Resource Guide for School Nurses addresses the recommendations and provides sample forms, letters, information on state laws, immunization resources, insurance options, and information on FERPA/HIPAA. For adaptability, it was designed in a three-ring binder format so information can be added that is unique to the user’s school district. It also provides a means to maintain up-to-date information as users can replace individual pages with updated schedules and regulations. This information is also available on-line at www.mchc.net/immunize/index.html.

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KANSAS

Adolescent Immunization Collaborative

School Work Group Team

2007

Pam Harris, RN, BSN, MEd

Kansas City, Kansas Public Schools

Kansas City, Kansas

Samantha Johnson, RN

Kansas City, Missouri Public Schools

Kansas City, Missouri

Shari Motelet, RN, NCSN, BSN, MEd, MS

President, Kansas School Nurse

Organization

Gwendolyn Nickles, MA, RHIT

Blue Cross and Blue Shield of Kansas City

Patricia Oldham, BSN, RN

Kansas City, Missouri School District

Judi Patrick, RN, BS, MLA Ed

Hickman Mills

Sarah Plummer

Primaris

Columbia, Missouri

Danielle Thornton

Unified Government Public

Health Department

Kansas City, Kansas

Steve Winburn

Kansas City Local Investment

Commission (LINC)

2008

Sheila Bey, RN, BSN

School District

Major Stevie Brooks

Kansas City, Missouri School District

Darla Denney RN, BSN, MET

Shawnee Mission School District

Shawnee Mission, Kansas

Teresa Gerard

Blue Cross and Blue

Shield of Kansas City

Joanna L. Johnson, RN

Kansas City, Missouri

School District

Danielle Thornton

Unified Government Public

Health Department

Kansas City, Kansas

Acknowledgements

Funding for the Adolescent

Immunization Collaborative

is provided by:

B

lue Cross and Blue Shield of Kansas City gratefully acknowledges the time and effort of

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KANSAS

2. Immunization Guidelines

Required Immunizations for School Entry – School Year, 2008 – 2009.

Memo, February 2008

Web site: www.kdheks.gov/immunize/schoolinfo.htm

Recommended Immunization Schedules for Persons Aged 0 – 18

United States.

Web site: www.cdc.gov/vaccines/recs/schedules/child-schedules.htm

Recommended Immunization Catch-Up Schedules for Persons Aged 0-18

Web site: www.cdc.gov/vaccines/recs/schedules/child-schedules.htm

KCQIC Physician Consensus Guidelines.

Web site: www.kcqic.org/wp-content/uploads/2007/03/2006%20KCQIC%20

Adolescent%20Immunization%20Guideline.pdf

When Do Children and Teens Need Vaccinations?

Immunization Action Coalition.

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Date:

February 2008

To:

School Personnel

Immunization Providers

From:

Sue Bowden, Director, KDHE Immunization Program

Re:

I

MMUNIZATION

R

EQUIREMENTS

F

OR THE

2008-2009 S

CHOOL

Y

EAR

This communication is to clarify immunization requirements and recommendations for the 2008-2009 school year.

K.A.R. 28-1-20 defines immunizations required for school entry based on the 2003 Advisory Committee on Immunization Practices (ACIP) recommendations.

x Diphtheria, tetanus, pertussis (DTaP): five doses required, with a 10 year booster dose of Td/Tdap x Poliomyelitis (IPV/OPV): four doses required

x Measles, mumps, rubella: two doses required x Hepatitis B: three doses required [*through grade 5]

x Varicella (chickenpox): one dose required [*through grade 5] unless proof of prior varicella disease is provided. Two doses are currently recommended by the ACIP for all ages

*The Hepatitis B and Varicella requirements for schools, as specified in K.A.R.28-1-20, are being phased in due to vaccine funding and availability considerations. Additional grades will be added each school year until students of all ages are included. Details of immunization requirements by age group are listed on the Feb. 2008 version of the Kansas Certificate of Immunization (KCI).

http://www.kdheks.gov/immunize/download/KCI_Form.pdf

In addition to the immunizations required for school entry listed above, the 2008 ACIP recommendations also include the following for school children:

x Haemophilus influenzae type b (Hib): four doses recommended for children less than 5 yrs of age; not required for school entry

x Pneumococcal conjugate (PCV7): four doses recommended for children less than 5 yrs of age; not required for school entry

x Hepatitis A: two doses recommended for all ages; not required for school entry

x Meningococcal (MCV4): one dose recommended for 11-18 years of age; not required for school entry x Human Papillomavirus (HPV): three doses recommended for females >11 years of age; not required

for school entry

x Influenza: yearly vaccination recommended for all ages; not required for school entry

The complete ACIP recommendations can be found at: http://www.cdc.gov/vaccines/pubs/ACIP-list.htm All required/recommended vaccines can reduce the disease burden in school-aged children, helping to assure that students will be in school ready to learn. Completely immunized school aged children are vital in

protecting other more vulnerable populations from the devastating effects of the diseases that immunizations can prevent. Efforts by schools have been central to the success of public health efforts in eliminating vaccine preventable diseases.

IMMUNIZATION PROGRAM

CURTIS STATE OFFICE BUILDING, 1000 SW JACKSON ST., STE. 540, TOPEKA, KS 66612-1368 Voice 785-296-5591 Fax 785-296-6510

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Weekly

March 28, 2008 / 57(12);319

Errata: Vol 57, No. 1

In "

Recommended Immunization Schedules for Persons Aged 0--18 Years---United States, 2008,"

errors

occurred.

On page Q-2, under Figure 1, in footnote 4, Haemophilus influenzae type b conjugate vaccine (Hib), the

second bullet should read:

z

TriHiBit

®

(DTaP/Hib) combination products should not be used for primary immunization but can

be used as boosters after any Hib vaccine in children aged >12 months.

On page Q-4, in the lower section of the Table titled, Catch-up schedule for persons aged 7--18 years, in

row Human Papillomavirus, under column heading Dose 2 to Dose 3, the text should read:

12 weeks (and 24 weeks after the first dose)

Disclaimer

All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to

[email protected]

.

Date last reviewed: 3/26/2008

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

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Morbidity and Mortality Weekly Report

Centers for Disease Control and Prevention 1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A

Department of Health and Human Services

8/1/2008

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5712a6.htm

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Page 2 of 2

Errata: Vol 57, No. 1

8/1/2008

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5712a6.htm

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Weekly

January 5, 2007 / 55(51);Q1-Q4

Recommended Immunization Schedules for

Persons Aged 0--18 Years --- United States, 2007

Please note:

An erratum has been published for this article. To view the erratum, please click

here

.

The Advisory Committee on Immunization Practices (ACIP) periodically reviews the recommended

immunization schedule for persons aged 0--18 years to ensure that the schedule is current with changes

in vaccine formulations and reflects revised recommendations for the use of licensed vaccines, including

those newly licensed.

The changes to the previous childhood and adolescent immunization schedule, published January 2006

(

1

), are as follows:

z

The new rotavirus vaccine (Rota) is recommended in a 3-dose schedule at ages 2, 4, and 6 months.

The first dose should be administered at ages 6 weeks through 12 weeks with subsequent doses

administered at 4--10 week intervals. Rotavirus vaccination should not be initiated for infants aged

>12 weeks and should not be administered after age 32 weeks (

2

).

z

The influenza vaccine is now recommended for all children aged 6--59 months (

3

).

z

Varicella vaccine recommendations are updated. The first dose should be administered at age

12--15 months, and a newly recommended second dose should be administered at age 4--6 years (4).

z

The new human papillomavirus vaccine (HPV) is recommended in a 3-dose schedule with the

second and third doses administered 2 and 6 months after the first dose. Routine vaccination with

HPV is recommended for females aged 11--12 years; the vaccination series can be started in

females as young as age 9 years; and a catch-up vaccination is recommended for females aged

13--26 years who have not been vaccinated previously or who have not completed the full vaccine

series (5).

z

The main change to the format of the schedule is the division of the recommendation into two

schedules: one schedule for persons aged 0--6 years (

Figure 1

) and another for persons aged 7--18

years (

Figure 2

). Special populations are represented with purple bars; the 11--12 years assessment

is emphasized with the bold, capitalized fonts in the title of that column. Rota, HPV, and varicella

vaccines are incorporated in the catch-up immunization schedule (

Table

).

Vaccine Information Statements

The National Childhood Vaccine Injury Act requires that health-care providers provide parents or

patients with copies of Vaccine Information Statements before administering each dose of the vaccines

listed in the schedule. Additional information is available from state health departments and from CDC at

http://www.cdc.gov/nip/publications/vis

.

Detailed recommendations for using vaccines are available from package inserts, ACIP statements on

specific vaccines, and the 2003 Red Book (6). ACIP statements for each recommended childhood vaccine

are available from CDC at

http://www.cdc.gov/nip/publications/acip-list.htm

. In addition, guidance for

obtaining and completing a Vaccine Adverse Event Reporting System form is available at

http://www.vaers.hhs.gov

or by telephone, 800-822-7967.

8/4/2008

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References

1.

CDC. Recommended childhood and adolescent immunization schedule---United States. MMWR

2006;54(52):Q1--Q4.

2.

CDC. Prevention of rotavirus gastroenteritis among infants and children. Recommendations of the

Advisory Committee on Immunization Practices (ACIP). MMWR 2006;55(No. RR-12):1--13.

3.

CDC. Prevention and control of influenza. Recommendations of the Advisory Committee on

Immunization Practices (ACIP). MMWR 2006;55(No. RR-10):1--42.

4. CDC. ACIP provisional recommendations for the prevention of varicella. Available at

http://www.cdc.gov/nip/vaccine/varicella/varicella_acip_recs_prov_june_2006.pdf

.

5. CDC. ACIP provisional recommendations for the use of quadrivalent HPV vaccine. Available at

http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf

.

6. American Academy of Pediatrics. Active and passive immunization. In: Pickering LK, ed. 2003

red book: report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL:

American Academy of Pediatrics; 2003.

The recommended immunization schedules for persons aged 0--18 years and the catch-up immunization schedule for 2007 have been approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians. The standard MMWR footnote format has been modified for publication of this schedule.

Suggested citation: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0--18 years---United States, 2007. MMWR 2006;55(51&52):Q1--Q4.

Figure 1

Page 2 of 6

Recommended Immunization Schedules for Persons Aged 0--18 Years --- United States, 2007

8/4/2008

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Return to top.

Figure 2

8/4/2008

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Return to top.

Table

Page 4 of 6

8/4/2008

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Return to top.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

8/4/2008

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5551a7.htm

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Disclaimer

All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to

[email protected]

.

Date last reviewed: 1/4/2007

HOME | ABOUT MMWR | MMWR SEARCH | DOWNLOADS | RSS | CONTACT POLICY | DISCLAIMER | ACCESSIBILITY

Morbidity and Mortality Weekly Report

Centers for Disease Control and Prevention 1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A

Page 6 of 6

8/4/2008

(15)

Department of Health and Human Services •Centers for Disease Control and Prevention•SAFER • HEATHIER • PEOPLE

TM

The Recommended Immunization Schedules for Persons Aged 0–18 Years are approved by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).

For those who fall behind or start late, see the catch-up schedule

Certain high-risk groups Range of recommended ages

1. Hepatitis B vaccine (HepB). (Minimum age: birth) At birth:

• Administer monovalent HepB to all newborns prior to hospital discharge. • If mother is hepatitis B surface antigen (HBsAg) positive, administer HepB

and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. • If mother’s HBsAg status is unknown, administer HepB within 12 hours

of birth. Determine the HBsAg status as soon as possible and if HBsAg positive, administer HBIG (no later than age 1 week).

• If mother is HBsAg negative, the birth dose can be delayed, in rare cases, with a provider’s order and a copy of the mother’s negative HBsAg laboratory report in the infant’s medical record.

After the birth dose:

• The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1–2 months. The final dose should be administered no earlier than age 24 weeks. Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of at least 3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).

4-month dose:

• It is permissible to administer 4 doses of HepB when combination vaccines are administered after the birth dose. If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.

2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)

• Administer the first dose at age 6–12 weeks. • Do not start the series later than age 12 weeks.

• Administer the final dose in the series by age 32 weeks. Do not administer any dose later than age 32 weeks.

• Data on safety and efficacy outside of these age ranges are insufficient.

3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP).

(Minimum age: 6 weeks)

• The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose.

• Administer the final dose in the series at age 4–6 years.

4. Haemophilus influenzae type b conjugate vaccine (Hib).

(Minimum age: 6 weeks)

• If PRP-OMP (PedvaxHIB®

or ComVax®

[Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.

• TriHIBit® (DTaP/Hib) combination products should not be used for primary immunization but can be used as boosters following any Hib vaccine in children age 12 months or older.

5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate

vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPV])

• Administer one dose of PCV to all healthy children aged 24–59 months having any incomplete schedule.

• Administer PPV to children aged 2 years and older with underlying medical conditions.

6. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza

vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV])

• Administer annually to children aged 6–59 months and to all eligible close contacts of children aged 0–59 months.

• Administer annually to children 5 years of age and older with certain risk factors, to other persons (including household members) in close contact with persons in groups at higher risk, and to any child whose parents request vaccination. • For healthy persons (those who do not have underlying medical conditions

that predispose them to influenza complications) ages 2–49 years, either LAIV or TIV may be used.

• Children receiving TIV should receive 0.25 mL if age 6–35 months or 0.5 mL if age 3 years or older.

• Administer 2 doses (separated by 4 weeks or longer) to children younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season but only received one dose.

7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)

• Administer the second dose of MMR at age 4–6 years. MMR may be administered before age 4–6 years, provided 4 weeks or more have elapsed since the first dose.

8. Varicella vaccine. (Minimum age: 12 months)

• Administer second dose at age 4–6 years; may be administered 3 months or more after first dose.

• Do not repeat second dose if administered 28 days or more after first dose.

9. Hepatitis A vaccine (HepA). (Minimum age: 12 months)

• Administer to all children aged 1 year (i.e., aged 12–23 months). Administer the 2 doses in the series at least 6 months apart.

• Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits. • HepA is recommended for certain other groups of children, including in

areas where vaccination programs target older children.

10. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate vaccine (MCV4) and for meningococcal polysaccharide vaccine (MPSV4))

• Administer MCV4 to children aged 2–10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high-risk groups. MPSV4 is also acceptable.

• Administer MCV4 to persons who received MPSV4 3 or more years previously and remain at increased risk for meningococcal disease.

This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2007, for children aged 0 through 6 years. Additional information is available at www.cdc.gov/vaccines/recs/schedules. Any dose not administered at the recommended age should be administered at any subsequent visit, when indicated and feasible. Additional vaccines may be licensed and recommended during the year. Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not

contraindicated and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the respective Advisory Committee on Immunization Practices statement for detailed recommendations, including for high-risk conditions:

http://www.cdc.gov/vaccines/pubs/ACIP-list.htm. Clinically significant adverse

events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at www.vaers.hhs.gov or by telephone, 800-822-7967.

CS103164

Vaccine

c

Age

` _Birth _month1 _months2 _months4 _months6 _months12 _months15 _months18 _months19–23 _years2–3 _years4–6

Hepatitis B1 HepB footnote1see

Rotavirus2 Rota Rota Rota

Diphtheria, Tetanus, Pertussis3 DTaP DTaP DTaP _footnote3see

Haemophilus influenzae type b4

Hib Hib Hib4

Pneumococcal5 PCV PCV PCV

Inactivated Poliovirus IPV IPV

Influenza6

Measles, Mumps, Rubella7 Varicella8 Hepatitis A9 Meningococcal10 HepB HepB DTaP DTaP Hib IPV IPV MMR Varicella Varicella MMR PCV

HepA (2 doses) HepA Series

MCV4

Influenza (Yearly)

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Department of Health and Human Services • Centers for Disease Control and Prevention

The Recommended Immunization Schedules for Persons Aged 0–18 Years are approved by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).

Recommended Immunization Schedule for Persons Aged 7–18 Years

—UNITED STATES • 2008 For those who fall behind or start late, see the green bars and the catch-up schedule

This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2007, for children aged 7–18 years. Additional information is available at www.cdc.gov/vaccines/recs/schedules. Any dose not administered at the recommended age should be administered at any subsequent visit, when indicated and feasible. Additional vaccines may be licensed and recommended during the year. Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not

contraindicated and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the respective Advisory Committee on Immunization Practices statement for detailed recommendations, including for high risk conditions: http://www.cdc.gov/vaccines/pubs/ACIP-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and com-plete a VAERS form is available at www.vaers.hhs.gov or by telephone, 800-822-7967.

CS103164

1. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). (Minimum age: 10 years for BOOSTRIX®_and

11 years for ADACEL™)

• Administer at age 11–12 years for those who have completed the

recommended childhood DTP/DTaP vaccination series and have not received a tetanus and diphtheria toxoids (Td) booster dose.

• 13–18-year-olds who missed the 11–12 year Tdap or received Td

only are encouraged to receive one dose of Tdap 5 years after the last Td/DTaP dose.

2. Human papillomavirus vaccine (HPV). (Minimum age: 9 years)

• Administer the first dose of the HPV vaccine series to females at age

11–12 years.

• Administer the second dose 2 months after the first dose and the

third dose 6 months after the first dose.

• Administer the HPV vaccine series to females at age 13–18 years if

not previously vaccinated. 3. Meningococcal vaccine.

• Administer MCV4 at age 11–12 years and at age 13–18 years if not

previously vaccinated. MPSV4 is an acceptable alternative.

• Administer MCV4 to previously unvaccinated college freshmen

living in dormitories.

• MCV4 is recommended for children aged 2–10 years with terminal

complement deficiencies or anatomic or functional asplenia and certain other high-risk groups.

• Persons who received MPSV4 3 or more years previously and remain at

increased risk for meningococcal disease should be vaccinated with MCV4. 4. Pneumococcal polysaccharide vaccine (PPV).

• Administer PPV to certain high-risk groups.

5. Influenza vaccine.

• Administer annually to all close contacts of children aged 0–59 months.

• Administer annually to persons with certain risk factors, health-care

workers, and other persons (including household members) in close contact with persons in groups at higher risk.

• Administer 2 doses (separated by 4 weeks or longer) to children younger

than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season but only received one dose. • For healthy nonpregnant persons (those who do not have underlying medical conditions that predispose them to influenza complications) ages 2–49 years, either LAIV or TIV may be used.

6. Hepatitis A vaccine (HepA).

• Administer the 2 doses in the series at least 6 months apart.

• HepA is recommended for certain other groups of children, including

in areas where vaccination programs target older children. 7. Hepatitis B vaccine (HepB).

• Administer the 3-dose series to those who were not previously

vaccinated.

• A 2-dose series of Recombivax HB®_{is licensed for children aged}

11–15 years.

8. Inactivated poliovirus vaccine (IPV).

• For children who received an all-IPV or all-oral poliovirus (OPV) series,

a fourth dose is not necessary if the third dose was administered at age 4 years or older.

• If both OPV and IPV were administered as part of a series, a total of 4

doses should be administered, regardless of the child’s current age. 9. Measles, mumps, and rubella vaccine (MMR).

• If not previously vaccinated, administer 2 doses of MMR during any

visit, with 4 or more weeks between the doses. 10. Varicella vaccine.

• Administer 2 doses of varicella vaccine to persons younger than

13 years of age at least 3 months apart. Do not repeat the second dose if administered 28 or more days following the first dose.

• Administer 2 doses of varicella vaccine to persons aged 13 years or

older at least 4 weeks apart.

Catch-up immunization Range of recommended ages

Vaccine

c

Age

` 7–10 years 11–12 years 13–18 years

Diphtheria, Tetanus, Pertussis1 _{see footnote}₁

Human Papillomavirus2 _{see footnote}₂

Meningococcal3 Pneumococcal4 Influenza5 Hepatitis A6 Hepatitis B7 Inactivated Poliovirus8

Measles, Mumps, Rubella9

Varicella10 Tdap HPV (3 doses) MCV4 HepB Series MMR Series IPV Series Varicella Series PPV Influenza (Yearly) HepA Series MCV4 Certain high-risk groups HPV Series Tdap MCV4

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The table below provides catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child’s age.

for Persons Aged 4 Months–18 Years Who Start Late or Who Are More Than 1 Month Behind

Information about reporting reactions after immunization is available online at http://www.vaers.hhs.gov or by telephone via the 24-hour national toll-free information line 800-822-7967. Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Additional information, including precautions and contraindications for immunization, is available from the National Center for Immunization and Respiratory Diseases at http://www.cdc.gov/vaccines or telephone, 800-CDC-INFO (800-232-4636).

CATCH-UP SCHEDULE FOR PERSONS AGED 4 MONTHS–6 YEARS

Vaccine

Minimum Age for Dose 1

Minimum Interval Between Doses

Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Dose 4 Dose 4 to Dose 5

Hepatitis B1 _Birth _{4 weeks} 8 weeks

(and 16 weeks after first dose)

Rotavirus2 _{6 wks} _{4 weeks} _{4 weeks}

Diphtheria, Tetanus, Pertussis3 _{6 wks} _{4 weeks} _{4 weeks} _{6 months} _{6 months}3

Haemophilus

influenzae type b4 6 wks

4 weeks4

if current age is younger than 12 months

8 weeks (as final dose)4

if current age is 12 months or older and second dose administered at younger than

15 months of age

No further doses needed

if previous dose administered at age 15 months or older

8 weeks (as final dose)

This dose only necessary for children aged 12 months–5 years

who received 3 doses before age 12 months

Pneumococcal5 6 wks

4 weeks

if first dose administered at younger than 12 months of age

if first dose administered at age 12 months or older or current age 24–59 months

for healthy children if first dose administered at age 24 months or older

4 weeks

if current age is younger than 12 months

if current age is 12 months or older

for healthy children if previous dose administered at age 24 months or older

This dose only necessary for children aged 12 months–5 years

who received 3 doses before age 12 months

Inactivated Poliovirus6 _{6 wks} _{4 weeks} _{4 weeks} _{4 weeks}6

Measles, Mumps, Rubella7 _{12 mos} _{4 weeks}

Varicella8 _{12 mos} _{3 months}

Hepatitis A9 _{12 mos} _{6 months}

CATCH-UP SCHEDULE FOR PERSONS AGED 7–18 YEARS Tetanus,Diphtheria/

Tetanus, Diphtheria, Pertussis10

7 yrs10 _{4 weeks}

4 weeks

6 months

if first dose administered at age 12 months or older

6 months

Human Papillomavirus11 _{9 yrs} _{4 weeks}

Hepatitis A9 _{12 mos} _{6 months}

Hepatitis B1 _Birth _{4 weeks} 8 weeks

(and 16 weeks after first dose)

Inactivated Poliovirus6 _{6 wks} _{4 weeks} _{4 weeks} _{4 weeks}6

Measles, Mumps, Rubella7 _{12 mos} _{4 weeks}

Varicella8 _{12 mos}

4 weeks

if first dose administered at age 13 years or older

3 months

if first dose administered at younger than 13 years of age

•

Centers for Disease Control and Prevention

•

Safer • Healthier • People

1. Hepatitis B vaccine (HepB).

• Administer the 3-dose series to those who were not previously vaccinated. • A 2-dose series of Recombivax HB® is licensed for children aged 11–15 years.

2. Rotavirus vaccine (Rota).

• Do not start the series later than age 12 weeks. • Administer the final dose in the series by age 32 weeks. • Do not administer a dose later than age 32 weeks.

• Data on safety and efficacy outside of these age ranges are insufficient.

3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP).

• The fifth dose is not necessary if the fourth dose was administered at age 4 years or older. • DTaP is not indicated for persons aged 7 years or older.

4. _{Haemophilus influenzae type b conjugate vaccine (Hib).}

• Vaccine is not generally recommended for children aged 5 years or older.

• If current age is younger than 12 months and the first 2 doses were PRP-OMP (PedvaxHIB®_or

ComVax®_{[Merck]), the third (and final) dose should be administered at age 12–15 months and}

at least 8 weeks after the second dose.

• If first dose was administered at age 7–11 months, administer 2 doses separated by 4 weeks plus a booster at age 12–15 months.

5. Pneumococcal conjugate vaccine (PCV).

• Administer one dose of PCV to all healthy children aged 24–59 months having any incomplete schedule. • For children with underlying medical conditions, administer 2 doses of PCV at least 8 weeks

apart if previously received less than 3 doses, or 1 dose of PCV if previously received 3 doses.

6. Inactivated poliovirus vaccine (IPV).

• For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not necessary if third dose was administered at age 4 years or older.

• If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age.

• IPV is not routinely recommended for persons aged 18 years and older.

7. Measles, mumps, and rubella vaccine (MMR).

• The second dose of MMR is recommended routinely at age 4–6 years but may be administered earlier if desired.

• If not previously vaccinated, administer 2 doses of MMR during any visit withª4 or more weeks between the doses.

8. Varicella vaccine.

• The second dose of varicella vaccine is recommended routinely at age 4–6 years but may be administered earlier if desired.

• Do not repeat the second dose in persons younger than 13 years of age if administered 28 or more days after the first dose.

9. Hepatitis A vaccine (HepA).

• HepA is recommended for certain groups of children, including in areas where vaccination programs target older children. See MMWR 2006;55(No. RR-7):1–23.

10. Tetanus and diphtheria toxoids vaccine (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap).

• Tdap should be substituted for a single dose of Td in the primary catch-up series or as a booster if age appropriate; use Td for other doses.

• A 5-year interval from the last Td dose is encouraged when Tdap is used as a booster dose. A booster (fourth) dose is needed if any of the previous doses were administered at younger than 12 months of age. Refer to ACIP recommendations for further information.

See MMWR 2006;55(No. RR-3).

11. Human papillomavirus vaccine (HPV).

• Administer the HPV vaccine series to females at age 13–18 years if not previously vaccinated.

CS113897

4 weeks

if first dose administered at age 12-14 months

if first dose administered at 15 months of age or older

12 weeks

(18)

T h is gui d eli n e li st s rec o m m en d ed an d St at e req u ired i m m u n iza ti on s. I n d ivid u al pa ti en t co n si d era ti on an d ad va nces i n m edi ca l s ci en ce m ay s u pe rs ed e o r m o dif y the se r eco m m endat io n . A ppr o v ed by K C QI C 9/ 2 0 0 6

Kan

sa

s C

it

y

Qu

al

it

y

Im

provem

ent C

o

ns

ort

ium

(KCQIC) Prevent

ion Guideline

s

for

Chil

dren Bi

rth to

10

yea

rs

of Ag

e

T h e f o ll o w in g gu id el in e reco mm en ds cl in ic al prev en ti o n f o r C h il d ren 0 t h rough 10 y ears of ag e. A LL C LI N IC V IS ITS , W HETHE R AC U TE , C HR O N IC , O R TRA D IT IO N A L PR EVEN TI VE S ERV IC ES V IS ITS A R E O PPO R TU N IT IE S F O R PRE V E N TI O N

K

ey Co

m

p

onents

•

Devel

o

p

an

d

i

m

p

le

m

en

t syste

m

al

er

t f

o

r p

reven

ti

ve servi

ces:

•

P

erf

or

m

ri

sk

stra

ti

fi

cati

on

and

health assessm

en

t:

•

Assess patients f

or risk f

actors

at periodic inter

vals and

for

id

en

ti

fi

ed

ri

sk

f

a

ctors

•

U

pdat

e r

o

ut

ine

im

m

uni

za

tions at

e

v

er

y oppor

tunit

y

•

Assess patients f

or status of

im

m

unization.

•

P

rovide i

m

unizations

as appropriate

•

P

rovi

d

e s

ervi

ces w

ith

stron

g

evi

d

en

ce of

ef

fecti

v

en

ess

Use E

v

ery op

p

o

rtu

n

ity f

o

r p

reven

ti

on

:

•

P

a

ti

en

t p

resen

ts f

o

r acu

te or ch

ron

ic

m

edic

a

l pr

oble

m

•

P

a

ti

en

t p

resen

ts f

o

r p

re

v

en

ti

ve servi

ce

visits

•

Sc

he

duli

n

g syst

em

init

ia

tive

s se

rv

ice

oppor

tunit

y

At E

v

ery

Visit

Vacci

n

e

B

irth

1 mo

2 mo

4 mo

6 mo

12 mo

15 mo

18 mo

24 mo

4-6

y

rs

9

y

rs

Hep

atitis B

HepB

s

eries

Hep

a

titis A

HepA (2 doses

)

HepA Series

D

ipht

he

ria,

Tetanus, P

ertussis

DTaP

Hae

m

ophilus

Infl

ue

nz

ae

Type

B

Hib

Inactivated

P

o

liovirus

IP

V

IP

V

Measl

es, Mu

m

p

s,

R

ube

lla

MMR

Vari

cel

la*

Va

ric

ella

Va

ric

ella

Hum

a

n

P

a

pillom

avi

ru

s

Vacci

n

a

ti

on

HP

V*

Men

in

gococcal

MPSV

4

P

n

eu

m

o

co

ccal

PCV

Infl

ue

nz

a (

Y

ea

rl

y)

In

fluenz

a Ye

arl

y

Rotavirus

Rota

*I t s h o u ld be no te d th at H P V r eco m m enda tio n i n cl u d es g ir ls 9 y ear s o f ag e. A C IP al so r eco m m ends t h at c h il dr en w h o pr ev io us ly r ec ei v ed o n e d o se sh o u ld re ce iv e a se co n d d o se . www .c d c. gov/ od /oc/ m edi a/ p res sr el/ r0 606 29 -b. ht m A g e f o r initia l d o se R ang e of R ec o m m ende d a g es f o r Foll ow up dos es C atc h up im m uniz ation R ef ere n ces : 2006 C h il d h ood an d A dol es ce n t I m m uni zat ion S ch edu le , C en ter fo r D is eas e C o n trol , N at io n al I m m u n izat io n Prog ram (N IP ) ( w ww .cdc.g ov /n ip/acip ). P E DIA T R IC S Vo l. 117 N o . 1 Jan u ar y 2006, pp . 2 39-240. A m eri can A cade m y o f F a m il y Pract ice (200 6) C li n ical recom m e n d at io n f o r i m m u n izat ions ( w w w .aa fp .org )

(19)

T h is gui d eli n e li st s rec o m m en d ed an d St at e req u ired i m m u n iza ti on s. I n d ivid u al pa ti en t co n si d era ti on an d ad va nces i n m edi ca l s ci en ce m ay s u pe rs ed e o r m o dif y the se r eco m m endat io n . A ppr o v ed by K C QI C 9/ 2 0 0 6

KCQIC Im

m

unization Gu

ideline

s f

o

r Ch

il

dren Bi

rth to

10

yea

rs

o

f A

g

e

T h e f o ll o w in g gu id el in e reco mm en ds cl in ic al prev en ti o n f o r C h il d ren 0 t h rough 10 y ears of ag e. A LL C LI N IC V IS ITS , W HETHE R AC U TE , C HR O N IC , O R TRA D IT IO N A L PR EVEN TI VE S ERV IC ES V IS ITS A R E O PPO R TU N IT IE S F O R PRE V E N TI O N Mis sour i Req u ir ed I m m uniz ations K an sas Re qui red I m m uniz ation s • C h ild C a re an d Pr esch o o l Fa ci li tie s ż By ag e 2 m onths 1 He p B ż By ag e 3 m onths 1 DT aP /D T , 1 Po lio , 1 o r 2 He p B, 1 Hib ż By ag e 5 m onths 2 DT aP /D T , 2 Po lio , 1 o r 2 He p B, 1 or m ore Hi b ż By ag e 7 m onths 3 DT aP /D T , 2 Po lio , 2 o r 3 He p B, 1 or m ore Hib ż By ag e 16 m onths 4 DT aP /D T , 3 Po lio , 1 M M R, 3 Hep B, 1 Var ice ll a, a t l eas t 1 Hib aft er 1 2 m onths of ag e ż By Ag e 60 m onths 4 D T aP /D T , 3 Po lio , 1M MR, 3 Hep B, 1 Var ice ll a • K-12 ż D taP /D TP /D T /Td (4/5 dose s) ż Hepa ti ti is B (3 do ses ) ż M M R Pol io (3 dos es ) ż Pol io (3 o r 4 do ses ) ż V ari ce ll a (1 d o se k inderg art en on ly ) • K-12 ż D T aP ( 4 dos es) ż Pol io (3 t o 4 do ses d epen d ing on sch edul e) ż Hepa ti ti s B (3 Do ses Kin d erg art en throug h 2nd g rad ż V ar ice ll a ( 1 dos e Kind er g arten thro ug h 2 nd g rade) ż M M R (Req ui red for scho ol en try ) CATCH -U P SC H EDULE FO R CH ILDREN AGED 4 M O NT H S TH R O UGH 6 Y EARS Min imu m In ter val Be tw ee n D o ses V a ccine Min. A g e Dose 1 Dose 1 t o 2 Dose 2 t o 3 Dose 3 t o 4 Dose 4 t o 5 D P T /D T aP /D T 6 w k s 4 w eeks 4 w eeks 6 m o n ths 6 m o n ths IP V 6 w k s 4 w eeks 4 w eeks 4 w eeks H ep B Bi rt h 4 w ee ks MMR 12 m o 4 w eeks HP V 9 y rs V ari cel la 12 m o 12 t o 1 5 m o n th s 4 t o 6 y ears of ag e H ib 6 w ks 4 w eek s if f irs t dos e gi v en at <12 m o nt hs 8 w ee k s ( a s f ina l do se ) i f fi rs t dos e g iv e n at 12-14 m ont hs No further dos es needed i f fi rs t dos e gi ve a t a ge > 1 5 m o nt hs 4 w eek s If cu rrent ag e i s <12 m o n th s 8 w ee k s ( a s f ina l do se ) If cu rren t ag e i s > 12 m o n th s a n d s econ d dos e g iv en at ag e < 15 m o nt hs No further dos es n eeded i f prev ious dos e gi ve n a t a ge > 15 m o n ths 8 w eek s T h is dos e on ly n eces sa ry f o r ch ildren ag ed 12 m o n ths – 5 y ears w ho receiv ed 3 dos es bef o re ag e 12 m on ths PC V 6 w k s 4 w eek s if f irs t dos e gi v en at <12 m o n th s a n d cu rren t a g e is < 2 4 m o . 8 w ee k s ( a s f ina l do se ) i f fi rs t dos e gi ve n a t a ge > 12 an d cu rren t a g e is 24-59 m o .No further dos es needed fo r h ealt h y c h ildren i f fi st dos e gi v e at ag e > 24 m o 4 w eek s If cu rrent ag e i s <12 m o n th s 8 w eek s (as f in al dos e) If cu rr en t ag e i s > 12 mo No further dos es needed f o r h eal th y c h il d ren if prev ious dos e g iv e at ag e > 24 m on ths 8 w eek s T h is dos e on ly n eces sa ry f o r ch ildren ag ed 12 m o n ths – 5 y ears w ho receiv ed 3 dos es bef o re ag e 12 m on ths C a tch S ch ed u le for ages 7 ye ars th rou g h 9 years M ini m u m I n terval B etw een Do se s T etan u s, D iph th eri a In acti vated Pol iovi ru s H epa ti ti s B M ea sle s, M u m p s, Rubella Varicella Dos e 1 to 2 4 w eeks 4 w eeks 4 w eeks 4 w eeks 4 w eeks D o se 2 t o 3 6 m o n ths 4 w eeks 8 w eeks (an d 16 w ee k s af ter th e 1 st dos e D o se 3 – B oos te r 6 m o n ths i f 1 st dos e g iv e at < 12 m o n ths an d cu rren t ag e < 11 y ears , Ot h er w is e 5 y ears R efer en ces : 2 006 C hi ld h ood and A d oles c en t I m m u n iza ti on S ch edu le, C ent er for Di se as e C on trol, Na ti on al I m m u ni za ti on Progra m (N IP) ( w w w .cdc.g o v /ni p/a ci p ). P E DI A T R ICS V o l. 11 7 N o . 1 J an u ar y 200 6, p p . 2 39-24 0. A m er ican A ca d em y o f F am ily P ractice ( 2 0 06) Cl in ical r eco m m enda tio n f o r im m un iz at io ns ( w w w .aaf p.o rg )

(20)

T h is gui d eli n e li st s rec o m m en d ed an d St at e req u ired i m m u n iza ti on s. I n d ivid u al pa ti en t co n si d era ti on an d ad va nces i n m edi ca l s ci en ce m ay s u pe rs ed e o r m o dif y the re r eco m m endatio n. A ppr o v ed by K C QI C 20 0 6

KCQIC Preve

ntion

Guide

lines f

o

r Ad

olescent

s Age 11 to

18

T h e f o llo w in g gu idelin e reco mm en ds cl in ica l prev en tio n C h ildren a n d A doles ce n ts 11 to 18 y ears of a g e. A LL CL IN IC VI SI TS , W H E TH E R ACU TE , C H RON IC , O R FOR TR AD IT IO NAL PR E VEN TI VE S ER VI CE VI SI TS ARE OPP O RT UN IT IE S FO R PR E VE N TI ON

K

ey Co

m

p

onents

•

S

y

ste

m

al

ert f

o

r p

reven

ti

ve servi

ces:

•

P

erf

or

m

ri

sk

stra

ti

fi

cation and

health

assessment:

•

Assess patie

n

ts f

or risk

f

a

ctors at periodic

in

terval

s an

d

f

o

r i

d

en

tifi

ed

ri

sk

f

a

ctors

•

U

pdat

e r

o

ut

ine

im

m

uni

za

tions at

e

v

er

y

oppor

tunit

y

•

Assess patients f

or status of

im

m

unization.

•

P

rovide i

m

unizations

as appropriate

•

P

rovi

d

e s

ervi

ces w

ith

stron

g

evi

d

en

ce of

ef

fecti

v

en

ess

Use E

v

ery op

p

o

rtu

n

ity f

o

r

p

reven

ti

on

:

•

P

a

ti

en

t p

resen

ts f

o

r acu

te

or ch

ron

ic

m

ed

ical

problem

•

P

a

ti

en

t p

resen

ts f

o

r

p

reven

ti

ve se

rvi

ce vi

si

ts

•

Sc

he

duli

n

g syst

em

initiative

s se

rv

ic

e

oppor

tunit

y

AT E A CH VIS IT

Reco

mmended childho

od and a

d

ol

escent imm

unizations (2006)

V

a

cci

ne

11-1

2

y

ear

s o

f a

g

e

13-1

4

y

ear

s o

f a

g

e

15

ye

ar

s of

ag

e

16-1

8

y

ear

of

age

H

ep

a

ti

s B

Hep

atit

is

B

Hep

B

Seri

es

Diphther

ia, T

etan

us,

P

ertus

si

s

Td

ap

Td

ap

Mea

sl

es

, Mum

p

s, R

ubell

a

MMR

Va

ri

cell

a

Varice

lla

Varice

lla

Hum

a

n Papillom

avirus

Vaccinat

ion

HPV

M

enin

goc

oc

ca

l

MCV4

Pneum

o

cocc

al

PPV

Influenz

a

Inf

lue

nz

a

Inf

lue

nz

a (Yearly

)

H

ep

a

ti

s A

Hep

A Seri

es

Hep

A Seri

es

*

It should be noted th

at HPV recommend

ation includes g

irls 13 to

26

y

ear

s of a

g

e. Should routinely

be

g

iv

en 11 to 12

y

ears

olds

.

(http://www.cdc.

g

ov/nip/v

accine/hpv/de

fault.htm)

Referen

ces: 2006 Childhood and Adolesc

ent

Im

m

uniz

ation Schedule, Center for

Disease C

ontrol, N

ational

Immuniz

ation Prog

ra

m (N

IP)

(www.cd

c.

g

ov/nip/acip

).

PED

IA

T

R

ICS Vol. 117

No. 1 J

anuar

y

2006, pp.

239-240. Americ

an Ac

ad

em

y

of

Famil

y

Pra

ctice (

2006) C

linical recommen

dation for imm

uniz

ations

(www.a

afp.or

g

)

Recom

m

ended Age Range

Catc

h- u

p

Im

m

uniza

ti

o

n

s

11-1

2

y

ear ol

d A

ss

es

sm

ent

(21)

T h is gui d eli n e li st s rec o m m en d ed an d St at e req u ired i m m u n iza ti on s. I n d ivid u al pa ti en t co n si d era ti on an d ad va nces i n m edi ca l s ci en ce m ay s u pe rs ed e o r m o dif y the re r eco m m endatio n. A ppr o v ed by K C QI C 20 0 6

KCQIC Im

m

unization Gu

ideline f

o

r Ad

o

le

sce

nts

A

g

e 11

t

o

1

8

T h e f o llo w in g gu idelin e reco mm en ds cl in ica l prev en tio n C h ildren a n d A doles ce n ts 11 to 18 y ears of a g e. AL L CL IN IC VI SIT S, W H E TH ER A CU TE, CH RO N IC, O R FO R T R AD IT IO N AL P R EV EN TI VE SE RV IC E V IS IT S AR E O PP O RT U N IT IES FO R P RE V E N TIO N

M

issour

i R

equir

ed

Im

m

uniz

a

tions

K

a

nsas R

equir

ed

I

m

uniz

a

tions

• K-12 ż

4 D

ta

P

/D

T

P

/D

T

/T

d

(4/

5

d

o

ses

)

ż

3

Hepati

tii

s B (3

dos

es)

ż

3 MM

R Po

li

o (

3

d

o

ses

)

ż

3+ P

o

li

o (

3

or 4

do

ses

)

ż

1 V

ar

ice

lla (

k

in

der

g

ar

ten

o

n

ly

)

• K-12 ż

DTaP (three or four

dose

s)

ż

Po

li

o 3

to 4

do

se

s d

epe

nd

ing

on

sc

he

du

le

ż

Hep

at

iti

s B (3

dos

es

)

ż

Varice

lla (2

dose

s)

ż

MMR (2

do

ses

--Requ

ir

ed

fo

r sc

hoo

l en

tr

y)

ż

M

eni

ngo

co

cc

al

col

leg

e r

equ

ir

em

en

t o

r

wa

iv

er

CATCH-UP SCHEDULE FOR CHILDREN AG

ED

1

MONTHS THROUG

H 1

8

YEARS

M

in

imu

m I

n

te

rv

a

l

B

etw

ee

n

D

o

se

s

Do

se

Tet

anus

, Di

pht

h

eri

a

In

act

iv

at

ed

Po

lio

vi

ru

s

Hep

atit

is

B

Measl

es

, Mu

m

p

s,

Rubella

Varice

lla

1 - 2

4 weeks

4 week

s

4 w

eek

s

4 W

eeks

4 W

eeks

2 - 3

6 m

onth

s

4 w

eek

s

8 w

eek

s (a

nd

1

6

w

ee

k

s

after the

fir

st dose

)

3 - Bo

o

ste

r

6 m

onth

s if f

ir

st

d

o

se

gi

ve

n at

age <

12 m

o

nths and

curre

nt age

< 11 y

ears; otherwise

5 y

ears

Refer enc es: 2006 Ch il dho od and Ado les cen t I m m uniz ation Sc hedu le, Ce nte r f o r Disea se Con tro l, Na tio nal I m m uniz ation Prog ram (NI P) ( www.c d c. g o v /ni p /a ci p ). PED IAT R ICS V ol. 11 7 No . 1 Ja nu ary 2006, p p. 239-240. Am erican Ac ad em y of Fam ily Practi ce (2006 ) Cl in ica l r ecom m endation f o r im m uni za ti ons ( www.a af p.o rg

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Catch-up

5

Immunization Action Coalition • 1573 Selby Avenue, Ste. 234 • St. P

aul, MN 55104 • (651) 647-9009 • www

.vaccineinformation.org • www

.immunize.org

Polio

Birth

2 months 4 months 6 months _{12 months}

Influenza DTaP/Tdap 2 1 MCV4 4–6 years 11–12 years 13–18 years

19–23 months _{Please note:}

Some children may need additional v

accines.

T

alk to your healthcare pro

vider

.

Age

When Do Children and Teens Need Vaccinations?

Hib

Haemophilus

influenzae

type b

Diphtheria, tetanus, pertussis

HepB Hepatitis B PCV Pneumococcal conjugate Meningococcal conjugate MMR Measles, mumps, rubella Varicella Chickenpox HepA Hepatitis A www .immunize.org/catg.d/p4050.pdf • Item #P4050 (1/08) Rota _Rotavirus HPV Human papillo-mavirus (1–2 mos)

Technical content reviewed by the Centers for Disease Control and P

revention, January 2008. Catch-up 5,6 Catch-up 5,7 Catch-up 5 (Tdap/Td) 7–10 years 3 (6–59 mos) (gi v en for each influenza season) An y child or teen who w ants to a v oid influenza may be v accinated;

all children with

risk f actors should be _vaccinated. 8 (females only) 6 Tdap 15 months 18 months Catch-up 5 Catch-up 5 (2 doses gi v en

6 mos apart at 12–23 mos)

5

.

If your child’

s v

accinations are delayed or missed entirely

, the y should be gi v en as soon as possible. 6.

All girls and w

omen ages 9 through 26 years should be v

accinated with 3 doses of HPV v

accine, gi v en o v er a 6-month period. 7. If you ha v

e a teenager who is enrolling in colle

ge and planning to li

v

e in a dormitory and hasn’

t

pre

viously been v

accinated against meningococcal disease, the

y should be v accinated no w . 8 .

Children and teens with certain medical conditions should be v

accinated against influenza.

V

accination is also important for close contacts of children younger than age 6 years and others

who are at risk.

T

alk to your healthcare pro

vider

.

1.

Y

our inf

ant may not need a dose of HepB at age 4 months depending on the type of v

accine that

your healthcare pro

vider uses.

2.

Y

our inf

ant may not need a dose of Hib v

accine at age 6 months depending on the type of

vaccine that your healthcare pro

vider uses.

3. If your child is younger than 9 years and is getting v

accinated against influenza for the first time,

he or she should get 2 doses spaced at least 4 weeks apart.

4.

This dose of DT

aP may be gi

v

en as early as 12 months if it has been 6 months since the pre

vious

dose and you think you might not return for more shots by the time your child is age 18 months.

Catch-up 5 Catch-up 5 (6–18 mos) (15–18 mos) (12–15 mos) (6–18 mos) (12–15 mos) (12–15 mos) (12–15 mos) 4 Catch-up 5 Catch-up 5 Catch-up 5 Catch-up 5 (to 5 y ears) Catch-up 5 Catch-up 5 Catch-up 5 (to 5 y ears)

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Immunization Action Coalition • 1573 Selby Avenue, Ste. 234 • St. P

aul, MN 55104 • (651) 647-9009 • www

.vaccineinformation.org • www

.immunize.org

Polio

Al nacer 2 meses 4 meses _{12 meses} Influenza (Gripe) DTaP/Tdap 2 1 MCV4 4 a 6 años 11 a 12 años 13 a 18 años 19 a 23 meses Nota:

Algunos niños pueden necesitar

más

v

acunas. Hable con su profesional de la salud.

Edad

¿Cuándo deben vacunarse los niños y los adolescentes?

Hib

Haemophilus

influenzae

tipo b

Difteria, tétanos, _{tos ferina}

HepB Hepatitis B PCV Neumocócica conjugada Meningocócica conjugada MMR

Sarampión, paperas, rubéola

Varicela HepA Hepatitis A www .immunize.org/catg.d/p4050-01.pdf • Item #P4050-01 Spanish (1/08) Rota _Rotavirus HPV Virus del papiloma humano

(1 a 2 meses) P onerse al día 5,7 P onerse al día 5 (Tdap/Td) 7 a 10 años 3

(6 a 59 meses) (Se pone todas las temporadas

de gripe)

T

odos los niños _{y adolescentes} que quieran evitar la gripe se pueden v

acunar;

todos los niños con f

actores de riesgo se deben v acunar . 8 (sólo mujeres) 6 Tdap 15 meses 18 meses (2 dosis, la 2ª 6 meses después _{de la 1ª, a los 12} a 23 meses)

5.

Si se atrasa con alguna v

acuna, o se le olvida por completo, su hijo debe recibirla lo antes posible.

6. T

odas las niñas y mujeres de 9 a 26 años de edad se deben v

acunar con 3 dosis de la v

acuna HPV

a lo lar

go de un período de 6 meses.

7.

Si tiene un adolescente que v

a a ir a la uni

v

ersidad y tiene planes de vi

vir en una residencia estudiantil,

y no lo v

acunaron antes contra la enfermedad meningocócica, se debe v

acunar ahora.

8

.

Los niños y adolescentes con ciertos problemas médicos se deben v

acunar contra la inﬂuenza (también

conocida como gripe). La v

acuna también es importante para los que tienen contacto cercano con

niños menores de 6 años de edad y otras personas en riesgo. Hable con su profesional de la salud.

1.

Es posible que su bebé no necesite una dosis de la v

acuna HepB a los 4 meses, dependiendo del tipo

de v

acuna que use su profesional de la salud.

2.

Es posible que su bebé no necesite una dosis de la v

acuna Hib a los 6 meses, dependiendo del tipo

de v

acuna que use su profesional de la salud.

3.

Si su hijo tiene menos de 9 años y lo v

an a v

acunar contra la gripe por primera v

ez, le deben dar 2

dosis, la se

gunda al menos 4 semanas después de la primera.

4.

Esta dosis de DT

aP se puede dar incluso a los 12 meses de edad, si pasaron 6 meses desde la dosis

anterior y cree que tal v

ez no vuelv

a para más v

acunas cuando su hijo tenga 18 meses de edad.

(6 a 18 meses) (15 a 18 meses) (12 a 15 meses) (6 a 18 meses) (12 a 15 meses) (12 a 15 meses) (12 a 15 meses) 4 P onerse al día 5

(hasta los 5 años)

Translation by T ranscend, Davis, CA P onerse al día 5,6 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5 P onerse al día 5

(hasta los 5 años)

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