New Immunization Guidelines for Children Released

< Jan. 06, 2010 > -- All children older than six months should be vaccinated against H1N1 flu, and boys ages 9 to 18 should get the human papillomavirus (HPV) vaccine to protect them from genital warts. These are the new recommendations on childhood and teen immunizations from the American Academy of Pediatrics, the U.S. Centers for Disease Control and Prevention, and the American Academy of Family Physicians.

Guidelines Encourage Combining Vaccines and Offer New HPV Options

The three groups also recommend using combination vaccines whenever possible. This will result in fewer shots, says David W. Kimberlin, M.D., a professor of pediatrics and co-director of pediatric infectious diseases at the University of Alabama at Birmingham. Dr. Kimberlin is a member of the committee that created the new immunization schedules, which were published this week in the January issue of Pediatrics.

"These are life-threatening illness that vaccines prevent, and if you have a combination vaccine that's safe and effective and requires one less stick for your child and one less trip to the doctor, it makes sense to me, as a father, to think about that," says Dr. Kimberlin.

The important guideline revisions include: 

• A recommendation that children older than 6 months receive the H1N1 influenza vaccine.
• A suggestion that boys between ages 9 and 18 get a three-dose series of the HPV 4 vaccine to prevent genital warts.
• The option of a new HPV vaccine, called HPV 2, to protect girls against cervical cancer. Girls should get their first dose of either the new vaccine or HPV 4, which includes protection against genital warts, at age 11 or 12.
• A statement that doctors generally should use combined vaccines rather than separate injections.
• A recommendation to revaccinate children at high risk for meningitis, such as those with immune system disorders. Booster shots aren't recommended for children whose only risk factor is living in a dormitory setting. 
  

Vaccines Carry More Benefit Than Risk

Most parents are following the recommended schedules and protecting their children against what can be life-threatening illnesses, Dr. Kimberlin says. But he notes, "Parents are inundated with misinformation or incomplete information about vaccinations," says Dr. Kimberlin. "And with all the noise out there, people start thinking there might be something to what they're hearing."

Michael Green, M.D., an infectious disease specialist at Children's Hospital of Pittsburgh, agrees. Although most children are vaccinated, he says, "There is a fairly large cohort of kids who don't receive optimal immunizations either for religious reasons, or their parents don't believe in immunizations because of health concerns, such as a fear of autism."

While studies show the measles vaccine doesn't cause autism, the measles virus can cause brain damage or even kill children, according to Dr. Green. Though some parents may think that they don't need to fear these diseases because most U.S. children are vaccinated, an outbreak among unvaccinated children is possible due to international travel.

"People forget that when there used to be measles outbreaks, kids died or ended up with brain damage," says Dr. Green. "The risk-to-benefit ratios with today's vaccines are tremendously slanted to the benefit side. And yet between every one to three months, I see a child with a vaccine-preventable illness."

"The vaccines we have today are the safest vaccines we've ever had," says Dr. Kimberlin. "I hope that parents recognize that it is a matter of life and death, and that they choose to do everything they can to protect their children. Time and time again when immunization rates fall, diseases come back, and then the immunization rates go up again."

Keep Track of Your Child's Vaccinations

Usually, it's up to parents, not doctors, to provide vaccination records to schools and childcare facilities. In most states, parents need to prove that children have up-to-date immunizations in order for them to enter school or childcare.

To help keep your children up-to-date, get an immunization record form from your family doctor or health clinic. Bring the form with you to all medical appointments. Keep it protected in a plastic sleeve or zip lock bag. Ask the doctor to sign and date the form each time your child receives a vaccination.

Also, check to see if your doctor participates in an immunization registry. Such registries are computerized information systems that collect vaccination histories to help with correct and timely immunizations. 

If you don't have a record of your child's immunizations from your doctor, school, or health department, you may need to repeat some of the vaccines or arrange blood tests to help determine if your child has immunity to certain diseases.

Always consult your physician for more information.