New, simpler childhood vaccine schedule
January 29th, 2013
10:29 AM ET

New, simpler childhood vaccine schedule

Pregnant women should receive a whooping cough vaccine in the second half of each pregnancy, according to this year's recommended vaccine schedule for children and adolescents.

In addition, the new schedule - published Monday by the American Academy of Pediatrics (AAP), along with the Centers for Disease Control and Prevention  and the American Academy of Family Physicians - consolidates the schedules into one comprehensive list, covering children from birth through age 18.

That's a change from previous years, when the schedule was separated into two different lists, for ages 0 to 6 and 7 to 18. The new schedule will also include an additional column that highlights which vaccines 4-to-6-year-olds and adolescents need.

The schedule, which is published every February, tells parents and doctors when is the correct time to vaccinate children against the 16 infectious diseases for which vaccines are available, said Dr. Cody Meissner, head of the pediatric infectious disease division at Tufts Medical Center and a consultant for the AAP's Committee on Infectious Diseases. The schedule is updated yearly to reflect any changes based on new research or developments. 

It is now recommended that pregnant adolescents women receive a whooping cough (Tdap) shot in the final half of pregnancy, every time they are pregnant.

"After mom gets the booster dose during pregnancy number one, the immunity peaks and then wanes pretty quickly," explains Meissner. The rational behind this recommendation is to vaccinate women near their time of delivery to boost immunity, which then passes through the placenta and get into the baby - so the baby will have its mother's immunity until it can develop its own.

Whooping cough cases have risen to a 50-year high, the CDC said last year.  "There will be about 20 (whooping cough) deaths for 2013," says Meissner.  Ninety percent of  pertussis deaths occur in the first three months of life, he adds.  That's because children in the first three months  are too young to acquire immunity from their first (inoculation), which doesn't even occur until they are two months old.  So having mom confer immunity to the newborn and having others around the babies, including grandparents, inoculated can protect the unvaccinated child.

Despite assurances that these vaccines are safe, more parents are choosing to delay getting their children vaccinated or not vaccinating them at all.   Just last week, a study in the Journal of the American Medical Association (JAMA) found "undervaccination appears to be an increasing trend."

And two weeks ago, a report from the Institute of Medicine not only found no evidence of major safety concerns when following the recommended vaccine schedules,  it also "confirmed that following the schedule strongly reduces the risk of disease."

Meissner says it's "such a mistake for people not to vaccinate according to the current schedule."  He adds that "a vaccine is not added to the vaccine schedule by FDA, CDC, AAP unless we are absolutely convinced of the benefit of that vaccine and the safety of the vaccine."

Still, some have suggested there are alternate ways to vaccinate children by either spacing out the vaccines or even dropping some.

"There is no "alternate" vaccine schedule," says Dr. Paul Offit, chief of the infectious diseases division at Children's Hospital of Philadelphia, co-inventor of a rotovirus vaccine and author of "Deadly Choices: How the Anti-Vaccine Movement Threatens Us All."  He says about 13% of parents are choosing not to vaccine or delay vaccinating their children and "that's a dangerous thing to do" because the vaccine-preventable diseases can kill.

Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University Medical Center, says "there isn't any doubt, there are increasing exceptions to the ACIP/AAP immunization schedule."

Childhood vaccinations are being ignored for a variety of reasons, he says. "There are those who are vaccine skeptics or parents don't get around to it; parents are forgetful, or children are not able to get vaccine for health reasons and are listed as not receiving vaccine."

This opens the door for the occasional importation of disease, like measles - which is still very much present in other parts of the world, he says. "I find this disquieting because I think there will be more clusters of more spread of forgotten disease."

The 2013 vaccine schedule calls for vaccinating against 16 diseases: Diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type b (can cause meningitis, arthritis, pneumonia), Hepatitis A, Hepatitis B, Human papillomavirus (HPV), Influenza (flu), measles, mumps, rubella (German measles), meningococcal (can cause meningitis, sepsis), pneumococcal (incl. ear infections, pneumonia, meningitis), Poliomyelitis (polio), rotavirus and varicella (chickenpox).

soundoff (31 Responses)
  1. Nancy Sexton, RN, BSN

    I I find the photo misleading and would consider this a "scare tactic". No needle/syringe combination of this size would be used on an infant. And the arm is not the site of choice in infants. I suggest you work harder at finding accurate photos to use in your articles.

    January 29, 2013 at 12:51 | Report abuse | Reply
    • sharron

      I certainly agree. I am a REgistered Nurse and some of the things you see on line and in the papers arae just totally ridiculous.

      January 29, 2013 at 22:03 | Report abuse |
  2. Jeff

    For profit Offit says

    January 29, 2013 at 18:16 | Report abuse | Reply
  3. Julie

    Just last week, a study in the Journal of the American Medical Association (JAMA) found "undervaccination appears to be an increasing trend."
    May I include the other part of that study? That children who were undervaccinated were also healthier?

    January 30, 2013 at 12:12 | Report abuse | Reply
    • Kristin

      Don't have access to the JAMA article. Could you please define "healthier" as reported by the article? Numbers would be helpful.

      February 6, 2013 at 20:44 | Report abuse |
    • Sophia

      From the article:
      "In our matched cohort analysis, children who were undervaccinated for any reason had lower rates of out- patient visits and higher rates of ED encounters and in- patient admissions compared with children who were age- appropriately vaccinated."

      Unvaccinated kids are more likely to be admitted to the hospital or show up at the ER.

      February 17, 2013 at 15:38 | Report abuse |
  4. Renae

    Nice to see that the general public is wising up. Now they want to vaccinate pregnant women? I have yet to meet a chiropractor who vaccinates their children and I have yet to meet one who has lost a child to infectious disease.

    January 31, 2013 at 15:12 | Report abuse | Reply
    • Mitch

      I think it's safe to assume that you "have yet to meet a chiropractor who vaccinates their children " and "have yet to meet one who has lost a child to infectious disease" because chiropractors are not licensed to vaccinate nor treat infectious disease.

      January 31, 2013 at 21:08 | Report abuse |
    • A41us

      Chiropractors are NOT doctors!

      February 1, 2013 at 13:17 | Report abuse |
    • John

      So since YOU have never met anyone who lost a child to an infectious disease, that means that children no longer die of infectious disease? If you ever decide to embrace reality, try reading an actual evidence-based article and not relying on your anecdotes and personal interactions.

      February 4, 2013 at 23:16 | Report abuse |
    • janet

      A few issues to address:
      1. The reason the majority of unvaccinated children do not get infectious diseases is because of a concept called "herd immunity" which in layman's terms means that if most people around you are vaccinated, you are unlikely to get the disease. When that falls below 80%, however, those diseases can re-emerge as is being evidenced across Western countries.

      2. Vaccines are not entirely benign. There are occasional reactions in individuals who are severely immunocompromised or just unlikely (perhaps as Erin can attest to). Those rare side affects are few and far between and not nearly as devastating from a population standpoint as the outcomes associated with the diseases childhood immunizations protect against such as polio and hemophilus. In the USA, we are fortunate enough that we do not know what being "sick" really looks like.

      3. Chiropractor training is entirely separate from MD training. Both require a basic college background in science and both fields study anatomy and so forth. That being said, the average GPA of a chiropractor is typically far below that of a physician and the admission requirements are not as high. A chiropractor is not licensed to prescribe medications. Although they may have some relevance when it comes to musculoskeletal issues, they do NOT have the necessary expertise to make recommendations regarding other areas of health care such as vaccinations.

      February 6, 2013 at 20:04 | Report abuse |
  5. erin

    yes, there is a risk to not vaccinating. there is also a risk TO vaccinating, as i can attest to the last 6 week of pure hell following a routine vaccine given to my 4 year old. enough fear-mongering. when i see the images of the kids in hospital beds on the public health posters on the doctor's wall, i would like to include a picture of my son after he received his MMR to show the other side of the story. until the vaccine information sheet they give you does not include a "vaccine injury" hotline to call, i won't be putting my trust in the doctors.

    February 4, 2013 at 00:04 | Report abuse | Reply
    • Christina

      I'm sorry to hear your child had problems with the vaccine. All vaccines that I have received in the last 5-7 years or my child (2 years old) has received has a vaccine injury number on the sheet. It's usually on the back side or second page of the sheet. You can also find it by calling your doctor or the CDC. It's good to report problems because unless they are reported they can't be accounted for properly by those that focus on keeping good vaccines on the market and pulling bad ones off the market.

      February 7, 2013 at 14:34 | Report abuse |
  6. erin

    oh- chiropractors are not medical doctors, but they are a hell of a lot smarter than most of them!

    February 4, 2013 at 00:04 | Report abuse | Reply
    • A41US

      No they are not. Chiropractors do not go to medical school and have little actual medical knowledge

      February 4, 2013 at 16:53 | Report abuse |
  7. Kathy

    Yes, chiropractors attend medical school, and states except New Jersey require licensed chiropractors to complete continuing education courses on a yearly basis in order to keep their license.

    In 2005, the World Health Organization set guidelines for basic training in Chiropractic. There are three potential educational paths involving full‐time chiropractic education (a) 1 – 4 years of prerequisite training in basic sciences at university level, followed by a 4 year full‐time Doctorate program; DC. (b) A 5 year integrated bachelor degree; BSc (Chiro). (c) A 2 – 3 year Masters program following the completion of a bachelor degree; MSc (Chiro).

    These are basic guidelines; in countries where the practice of chiropractic is well established, the standards are frequently much higher.

    Regardless of the model of education utilized, prospective chiropractors without relevant prior health care education or experience must have 4200 student/teacher contact hours in four years of full‐time education, including a minimum of 1000 hours of supervised clinical training. Health professionals with advanced clinical degrees, such as medical doctors, can meet the educational and clinical requirements to practice as a chiropractor in 2200 hours, which is most commonly done in countries where the profession is in its infancy.

    February 5, 2013 at 01:16 | Report abuse | Reply
    • Really

      Really? Which Medical School do chiropractors attend?

      They do not attend medical school.

      February 7, 2013 at 20:13 | Report abuse |
  8. tina

    I have yet to meet a chiropractor who isn't a quack

    February 5, 2013 at 14:03 | Report abuse | Reply
  9. Alissa

    What the news never mentions is pressuring pregnant women to get the pertussis or flu shot during pregnancy does pose them and the fetus to risks. All you have to go is read the damn package insert and the pharmaceutical company clearly states they do not know whether it poses harm to the fetus. It blows my mind. They don't even want to take responsibility for it. Also, no vaccine is 100% safe, just as no medication is 100% safe. There are some people that have some pretty bad reactions, and sometimes permanent disability. Just visit the VAERS website and see for yourselves. It is a crime if I say so myself!

    February 15, 2013 at 23:04 | Report abuse | Reply
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  11. Diedre Thier

    Chiropractic was founded in 1895 by magnetic healer, D.D. Palmer, in Davenport, Iowa. Chiropractic theory on spinal joint dysfunction and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895...,`:

    Best wishes http://www.healthfitnessbook.com/

    June 16, 2013 at 02:35 | Report abuse | Reply
  12. Amber

    I received the 2009 h1n1 flu vaccine in the fall of 2009. I was very newly pregnant ad misinformed that I absolutely needed the vaccine. My son was born in June 2010. He is 3, almost 3 1/2. He has autistic behaviors (currently waiting on a formal diagnosis), severe speech delays with suspected apraxia of speech, extreme violent behavioral outbursts, self injury, sensory processing disorder (which includes food texture issues), and severe food allergies. I never received a vaccine with my older child or youngest child. Neither one of them exhibit any signs of problems as my son (who is the middle child). Coincidence? I don't know, but with all the cover ups from the CDC and other governmental agencies, I'm really starting to believe that vaccines can and do cause harm for many children.

    November 11, 2013 at 10:45 | Report abuse | Reply
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