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Notice to Readers: Recommended Childhood Immunization Schedule
--- United States, 2002
Each year, CDC's Advisory Committee on Immunization Practices (ACIP) reviews the recommended
childhood immunization schedule to ensure that it is current with changes in manufacturers' vaccine formulations, has
revised recommendations for the use of licensed vaccines, and has recommendations for newly licensed vaccines. This report
presents the recommended childhood immunization schedule for 2002, which has remained the same in content since January
2001 (1) but has a redesigned format (Figure 1).
The format of the 2002 schedule is based on a design developed by the Minnesota Department of Health
immunization program; the recommendations and format have been approved by ACIP, the American Academy of Family Physicians,
and the American Academy of Pediatrics. The new design highlights the importance of catch-up vaccination, the
preadolescent visit, the preference for administering the first dose of the hepatitis B vaccine series at birth, and three vaccines for selected
at-risk groups. The importance of assessing whether children aged 24 months--18 years require any catch-up vaccination
is
emphasized by the use of hatched bars. The schedule also underscores the visit at age 11--12 years when immunization
status should be reviewed and all necessary vaccines administered.
Hepatitis B Vaccine
The schedule indicates a preference for administering the first dose of hepatitis B vaccine to all newborns soon after
birth and before hospital discharge. Administering the first dose of hepatitis B vaccine soon after birth should minimize the risk
for infection because of errors in maternal hepatitis B surface antigen (HBsAg) testing or reporting, or from exposure to
persons with chronic hepatitis B virus (HBV) infection in the household, and can increase the likelihood of completing the
vaccine series. Only monovalent hepatitis B vaccine can be used for the birth dose. Either monovalent or combination vaccine can
be used to complete the series. Four doses of hepatitis B vaccine, including the birth dose, may be administered if a
combination vaccine is used to complete the series. In addition to receiving hepatitis B immune globulin (HBIG) and the hepatitis
B vaccine series, infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg (anti-HBs) at
age 9--15 months to identify those with chronic HBV infection or those who may require revaccination
(2).
Vaccines for Selected Populations
The area below the dashed line (Figure 1) displays certain vaccines recommended for use in selected populations.
High-risk children aged 24--59 months should receive catch-up pneumococcal conjugate vaccine (PCV) doses, if indicated
(3). Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain high-risk groups
(3). The recommendation to administer annual influenza vaccine to high-risk children also appears on the schedule
(4).
Vaccine Supply
As a result of the vaccine supply shortage, deferral of some doses of tetanus and diphtheria toxoids (Td), diphtheria
and tetanus toxoids and acellular pertussis vaccine (DTaP), and pneumococcal conjugate vaccine (PCV) has been
recommended (5--7); health-care providers should record patients for whom vaccination has been deferred and should contact them once
the supply has been restored.
Vaccine Information Statements
The National Childhood Vaccine Injury Act requires that all health-care providers give parents or patients copies of
Vaccine Information Statements before administering each dose of the vaccines listed in the schedule. Additional information
about Vaccine Information Statements is available from state health departments and at
http://www.cdc.gov/nip/publications/VIS. Detailed recommendations for using vaccines are available from the manufacturers' package inserts, ACIP statements
on specific vaccines, and the 2000 Red Book
(2--4,8). ACIP statements for each recommended childhood vaccine can be
viewed, downloaded, and printed from the CDC National Immunization Program at
http://www.cdc.gov/nip/publications/ACIP-list.htm; instructions on the use of the Vaccine Information Statements are available at
http://www.cdc.gov/nip/publications/VIS/vis-Instructions.pdf.
American Academy of Pediatrics. Active and passive immunization. In: Pickering LK,
ed. 2000 Red Book: Report of the Committee on
Infectious Diseases. 25th ed. Elk Grove Village, Illinois: American Academy of Pediatrics, 2000:1--81.
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Health and Human Services.
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