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Vaccine Update 2009

Changes in the recommended immunization schedule, a warning about the growing popularity of an alternative vaccine schedule, and progress with the avian influenza (H5N1) vaccine in children

2009 RECOMMENDED CHILDHOOD AND ADOLESCENT IMMUNIZATION SCHEDULES

The vaccine schedule for children and adolescents is a moving target that requires frequent updates and adjustments. The AAP, the CDC, and the American Academy of Family Physicians have published the 2009 immunization schedules. Two important changes include:

• Influenza vaccine is now recommended for all children ages 6 months through 18 years, close contacts of children through age 4 years, and contacts of high-risk children ages 5 years through 18 years (JW Pediatr Adolesc Med Mar 12 2008).
  
• A second rotavirus vaccine (Rotarix; GlaxoSmithKline Biologicals) has been licensed; the dosing schedules for Rotarix and RotaTeq have been synchronized so that the first dose of either one can be administered at ages 6 weeks through 14 weeks (JW Pediatr Adolesc Med Jul 30 2008).
  

A WARNING ABOUT DR. ROBERT SEARS’S ALTERNATIVE VACCINE SCHEDULE

In a special article in the January issue of Pediatrics, the authors discuss the increasing popularity of a book by Dr. Robert Sears (The Vaccine Book: Making the Right Decision for Your Child) in which he provides alternative vaccine schedules for parents who want to decline, delay, or reduce the number of vaccines. The authors of the special article provide information about the fallacies of the alternative approach and summarize misconceptions of families and physicians who opt for the alternative schedule. All physicians who care for children should read this article to increase their understanding of alternative vaccine schedules and to better inform parents.

AVIAN INFLUENZA (H5N1) VACCINE IN CHILDREN

The same avian influenza (H5N1) vaccine that has been studied in adults has now been examined in children. Twelve healthy children (age range, 9–17 years) were immunized with the H5N1 strain. No serious adverse events occurred. At 21 days after vaccination, 75% of participants had seroconverted. Although the number of patients in this study is small and the vaccine will not be available for some time, this is a good start to solving a vexing issue. Stay tuned!

— Peggy Sue Weintrub, MD

Dr. Weintrub is on the speakers’ bureau for Sanofi and MedImmune (manufacturer of flu vaccines) and for Merck (manufacturer of RotaTeq rotavirus vaccine).

Published in Journal Watch Pediatrics and Adolescent Medicine January 28, 2009

Citation(s):

American Academy of Pediatrics Committee on Infectious Diseases. Recommended childhood and adolescent immunization schedules — United States, 2009. Pediatrics 2009 Jan; 123:189.

• Original article (Subscription may be required)
• Medline abstract (Free)

Offit PA and Moser CA. The problem with Dr Bob’s alternative vaccine schedule. Pediatrics 2009 Jan; 123:e164.

• Original article (Subscription may be required)
• Medline abstract (Free)

Vajo Z et al. Safety and immunogenicity of a prepandemic influenza A (H5N1) vaccine in children. Pediatr Infect Dis J 2008 Dec; 27:1052.

• Medline abstract (Free)

Reader Remarks:

Review and add to remarks on this article

• Critical look at critical artical... and bias
  Michael Wilson, 8 May 2009 11:22 AM EST
  I just researched the article that is critical of Dr. Sears' alternate vaccine schedule. Guess who wrote it? Offit, the... [more]

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