Vaccines Schedules

Adolescents
by Food and Drug Administration (FDA)

(Page 2 of 4)

Recommendations reinstated for pneumococcal conjugate vaccine (PCV7). Prevnar, marketed by Wyeth Vaccines of Sanford, N.C., had production problems that resulted in shortages in 2001 which changed the recommendations for the vaccine from four doses to two doses for healthy children. These shortages were resolved, and in September 2004, the ACIP recommended that health care providers resume the full four-dose vaccination schedule for young children for PCV7: one dose each at 2 months, 4 months, and 6 months of age, and one dose at 12 months to 15 months of age. According to Prevnar's label, the fourth dose should be given at least two months after the third dose. This vaccine can help prevent serious invasive pneumococcal diseases, such as meningitis, pneumonia, and blood infections, all of which can be fatal.

Second dose of chickenpox vaccine. The FDA licensed Varivax (varicella virus vaccine live), the first vaccine for chickenpox, in 1995. Varivax, which is manufactured by Merck & Co., is indicated for people 1 year of age and older.

In June 2006, the ACIP voted to recommend a second dose of chickenpox vaccine for children 4 years to 6 years old to further improve protection against the disease. The first dose of chickenpox vaccine is recommended at ages 12 months to 15 months. Parents should talk with physicians about the best way to catch up. The ACIP also recommended that adolescents and adults who previously received one dose receive a second dose of chickenpox-containing vaccine.

Availability of measles, mumps, rubella, and varicella (MMRV) vaccine. In September 2005, the FDA licensed ProQuad, a combined live, attenuated MMRV vaccine. It is indicated for the simultaneous vaccination against measles, mumps, German measles, and chickenpox among children ages 12 months to 12 years. Manufactured by Merck & Co., the vaccine presents a more convenient way to give MMR and varicella vaccines at the same time.

Expanded hepatitis A vaccination. Hepatitis A is a liver disease caused by the hepatitis A virus. Previous ACIP recommendations called for vaccinations only in states with the highest rates of hepatitis A. The ACIP now recommends that all children in the United States receive hepatitis A vaccine. Children should get the first dose of a two-dose series at ages 1 year to 2 years.

Expanded age range for flu vaccination. Previously, the ACIP recommended that children ages 6 months to 23 months receive an annual flu shot. The latest ACIP recommendations expand this age range and call for children ages 6 months to 5 years to receive the flu vaccine annually. Research has shown that children ages 2 years to 5 years are nearly as likely to require visits to health care providers and emergency rooms for flu as are children 6 months to 23 months. In February 2006, the ACIP also recommended expansion of routine flu vaccination for household contacts, caregivers, and anyone else who spends a significant amount of time with children from birth to 5 years.

For Adolescents

Adolescents 11 to 18 years of age also need to be sure that they are up-to-date with their immunizations. The checkup that takes place near age 11 years is a good time to check on what they need, says Robert Frenck, M.D., professor of pediatrics in the Division of Infectious Diseases at Children's Hospital in Cincinnati.

"At this time, parents should make sure that adolescents have had two doses of the MMR vaccine," Frenck says. "There's also a recommendation to receive a booster dose of Tdap after the eleventh birthday if it's been five years since the last Td dose. And if an adolescent has never had chickenpox and missed the chickenpox vaccine, this would be the time to get it."

Parents should discuss any concerns about booster vaccines with their children's physicians. For example, if a child had a serious reaction to a previous dose of vaccine as a young child, a booster dose in adolescence may not be recommended. Some adolescents with certain health risks may need other vaccines, such as the annual flu vaccine, hepatitis vaccine, or pneumococcal vaccine.

The following vaccines were recently licensed by the FDA and include adolescents in the targeted population.

Approval of a vaccine for human papillomavirus (HPV). In June 2006, the FDA licensed Gardasil to help prevent HPV, the most common sexually transmitted infection in the United States. The vaccine is highly effective against four types of the HPV virus, including two that cause about 70 percent of the cases of cervical cancer in the United States. Manufactured by Merck & Co., Gardasil was licensed in six months under the FDA's priority review process. This vaccine is indicated in girls and women who are ages 9 years to 26 years.

According to the ACIP, three doses of the new vaccine should be routinely given over a six-month period to girls when they are 11 years or 12 years old. But the vaccine can be given to girls as young as 9 years old at the discretion of a health provider, and can be given to women up to age 26.

Approval of vaccines for whooping cough. In May 2005, the FDA licensed two new combination vaccines to prevent tetanus, diphtheria, and whooping cough. One preparation of Tdap, Boostrix, is licensed for use for people 10 years to 18 years of age. The other preparation, Adacel, is licensed for people ages 11 years to 64 years.

In June 2005, the ACIP recommended that adolescents ages 11 years to 18 years be given a single shot of Tdap in place of the tetanus-diphtheria (Td) booster typically given to adolescents. Those who already received a Td booster should get the Tdap five years after having received the Td vaccine. If they live in an area where pertussis is epidemic, the Tdap vaccine can be given two years after having received a Td vaccine.

About the Author

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