Each year, CDC's Advisory Committee on Immunization Practices (ACIP)
reviews the recommended childhood and adolescent immunization schedule to
ensure that it is current with changes in manufacturers' vaccine formulations
and reflects revised recommendations for the use of licensed vaccines, including
those newly licensed. The recommended childhood and adolescent immunization
schedule for January–June 2004 (Figure
1), recommendations, and format have been approved by ACIP, the
American Academy of Family Physicians, and the American Academy of Pediatrics.
A catch-up immunization schedule for children and adolescents who start
late or who are >1 month behind was introduced in 20031 and
remains the same (Table 1). Minimum
ages and minimum intervals between doses are provided for each of the routinely
recommended childhood and adolescent vaccines. The schedule is divided into
two age groups: children aged 4 months–6 years and children/adolescents
aged 7–18 years.
The schedule indicates a change in the recommendation for the minimum
age for the last dose in the hepatitis B vaccination schedule. The last dose
in the vaccination series should not be administered before age 24 weeks (updating
the previous recommendation not to administer the last dose before age 6 months).
The range of recommended ages for the adolescent Td vaccine dose has
been updated to emphasize a preference for vaccinating at ages 11–12
years with ages 13–18 years to serve as a catch-up interval.
Clarification was added to the footnotes regarding the timing of the
final vaccine doses in the series for diphtheria and tetanus toxoids and acellular
pertussis (DTaP) vaccine, Haemophilus influenzae type
b (Hib) conjugate vaccine, and pneumococcal conjugate vaccine (PCV). The final
dose in the DTaP series should be given at age >4 years. The final doses in
the Hib and PCV series should be given at age >12 months.
Healthy children aged 6–23 months are encouraged to receive influenza
vaccine when feasible during the 2003–2004 influenza season. Children
in this age group are at substantially increased risk for influenza-related
hospitalizations.2 ACIP has indicated further
that beginning in fall 2004, children aged 6–23 months will be recommended
to receive annual influenza vaccine. An updated childhood and adolescent immunization
schedule for July–December 2004 will be released to reflect this change.
An intranasally administered, live, attenuated influenza vaccine (LAIV)
was approved for use in the United States in June 2003. For healthy persons
aged 5–49 years, LAIV is an acceptable alternative to the intramuscular
trivalent inactivated influenza vaccine (TIV).3
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 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 2003 Red Book.4 ACIP
statements for each recommended childhood vaccine can be viewed, downloaded,
and printed from CDC's National Immunization Program website 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. In addition, guidance on how to obtain and complete a Vaccine Adverse
Event Reporting System (VAERS) form is available at http://www.vaers.org or by telephone, 800-822-7967.
Recommended Childhood and Adolescent Immunization Schedule—United States, January–June 2004. JAMA. 2004;291(6):685-687. doi:10.1001/jama.291.6.685