Childhood Vaccination Schedule Expanded for 2007

ATLANTA, Jan. 4 -- A more comprehensive vaccination schedule for children and adolescents has been issued by the CDC for 2007.

Jointly released with the American Academy of Pediatrics and the American Academy of Family Physicians, the schedule includes new recommendations for rotavirus, human papilloma virus (HPV), varicella, and influenza.

The new recommendations were divided into two separate schedules by age--birth to six years and seven to 18-because of the increasing number of vaccines developed for adolescents, such as the HPV vaccine.

New to the schedule for 2007 were:

• Three doses of oral rotavirus vaccine at two, four and six months to protect infants against severe diarrhea,
• A second dose of varicella vaccine at age four to six years following the first dose at 12 to 15 months, or a catch-up dose for older children and adults who previously received only one dose, and
• Expansion of the flu vaccine to include children 24 months to five years old and their caregivers and others who come in close contact.

The HPV vaccine Gardasil was approved in June 2006 for females ages nine to 26 for the prevention of cervical cancer, precancerous genital lesions, and genital warts due to HPV types 6, 11, 16 and 18.

The vaccination schedule reflects this with an allowance for HPV vaccination at a minimum age of nine years but a recommendation for girls ages 11 to 12 to get three HPV vaccine doses. After the first dose, the second should follow two months later and the third dose to come at least four months later. Catch-up vaccination is suggested for girls ages 13 to 18 if they were not previously vaccinated.

Overall, vaccination for children from birth to age six years should include diphtheria, tetanus and pertussis (DTaP) as well as hepatitis B, rotavirus, Haemophilus influenzae type b (Hib), pneumococcal vaccine, inactivated poliovirus, influenza vaccine, varicella, hepatitis A, and measles, mumps and rubella (MMR) with meningococcal vaccine for certain high risk groups.

For those ages seven to 18, vaccinations should include immunization against tetanus, diphtheria and pertussis (Tdap), human papilloma virus and meningococcal vaccine (MCV4) with the pneumococcal vaccine (PPV), yearly influenza, and hepatitis A vaccine for certain high risk groups.

Childhood and adolescent immunizations are likely to be a major issue in 2007, said Jay E. Berkelhamer, M.D., of Children's Healthcare of Atlanta, president of the American Academy of Pediatrics.

The big questions, he said, are: "Are we going to do [HPV vaccination] routinely? Is the flu vaccine going to be available in a timely manner?"