By Philip R. Fischer, MD, DTM&H
Professor of Pediatrics, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN; Department of Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
SYNOPSIS: In February, the annually updated immunization schedule for children in the United States was released by several professional organizations. Key updates involve the inclusion of the PCV-15 vaccine and COVID vaccines, as well as new comments about other vaccines.
SOURCE: Centers for Disease Control and Prevention. Child and Adolescent Immunization Schedule by Age. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
Each year, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), in conjunction with the American Academy of Pediatrics’ Committee on Infectious Diseases and several other professional organizations, updates, prepares, endorses, and publicizes recommended immunization schedules for children and adolescents in the United States. The new schedule, in physician-friendly and family-friendly formats, is available at https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Several updates for the 2023 schedules are highlighted here.
What Is the Same?
Much of the vaccine schedule is as before. Hepatitis B vaccination starts at birth. At 2 months of age, routine immunizations include: rotavirus, diphtheria, tetanus, pertussis, Haemophilus influenzae type b, and polio. For children traveling internationally to areas where measles and/or hepatitis A are more common, relevant vaccines can be given at 6 months of age. Routine measles, mumps, rubella, varicella, and hepatitis A vaccines are given at 12 months of age. Seasonal influenza vaccines can be given at or after 6 months of age.
Depending on which type of ACYW meningococcal vaccine is used, international travelers and children with some risky medical conditions can be vaccinated as early as 2 months of age. Human papillomavirus vaccine usually is given at or after age 11 years but can be given at 9 years of age in special situations. Meningococcal B vaccine is given after 10 years of age.
Pneumococcus
The routine series of pneumococcal vaccination is given at 2, 4, 6, and 12-15 months of age. Now, the new 15-valent pneumococcal vaccine may be used instead of the previously used 13-valent vaccine. Children with special health conditions (congenital heart disease, heart failure, severe asthma, diabetes, cochlear implant, or cerebrospinal fluid leak) also should be given a 23-valent pneumococcal polysaccharide vaccine (PPSV) eight or more weeks after completing the initial four-dose series. Children with hemoglobinopathy or immunosuppression should receive all those doses as well as a second PPSV dose five years after the first.
COVID-19
Who could have imagined how rapidly vaccine science would advance! Children 6 months of age or older should now begin the primary COVID-19 vaccine series. The CDC website provides dosing details for each of the vaccines commonly used in the United States (two vs. three dose primary series based on age, which specific vaccine is used, and whether the child is immunocompromised).
Dengue
A three-dose series of vaccines for dengue fever now is recommended for children aged 9-16 years who live in endemic areas (yes, there are some U.S. territories endemic for dengue) who have had laboratory confirmation of a previous dengue infection. Dengue vaccine is not recommended for travelers to endemic areas.
