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A New Calendar for Kids' Shots

The experts finally agree on an immunization schedule

For years, federal health officials at the Centers for Disease Control recommended a childhood immunization schedule that was followed in public health clinics, while the American Academy of Pediatrics put out a different one that was used widely by private practitioners. Now the two groups have finally issued a uniform timetable for vaccinating children (see below). The new schedule clears up discrepancies over when to administer oral polio, diphtheria, pertussis, and tetanus (DPT); measles, mumps, and rubella (MMR); and infant hepatitis B vaccines.

Since the late 1980s the number of vaccine doses recommended for children has increased from 9 to 15. What's more, federal health officials recently approved a vaccine for chicken pox. While the chicken pox vaccine has not yet been added to the new uniform immunization schedule, such a move is expected shortly. The vaccine is reported to be only 70 to 90 percent effective in preventing the childhood disease, but in nearly every case, says Food and Drug Administration Commissioner David A. Kessler, "almost all of the vaccinated patients who got chicken pox had a milder form of the disease."

The vaccine is expected to cost physicians approximately $39 per dose and to be administered to children 12 to 15 months old and to people over 13 years old who have not had the disease already.

To promote universal childhood vaccination, the Clinton administration recently persuaded the Congress to pay for immunizing children who are uninsured, poor, or of Native American or Native Alaskan ancestry. As of early 1995, about half the states had elected to make vaccines available free through public health clinics while the other half were working through private physicians and reimbursing them. State Medicaid programs remain responsible for supplying vaccines to children enrolled in Medicaid. For the situation in your state, contact your state health department's immunization program.

Recommended Childhood Immunization Schedule

The Centers for Disease Control and the American Academy of Pediatrics are America's leading authorities on childhood immunization, but, until recently, they disagreed about when children should be immunized. Below is their unified immunization schedule, released in January 1995.

Vaccine First Dose Second Dose Third Dose Fourth Dose Fifth Dose Sixth Dose
Hepatitis B Before 2 mos. 1-4 mos. (1) 6-18 mos. . . .
Diphtheria, Pertussis, Tetanus (DPT) 2 mos. 4 mos. 6 mos. 12-18 mos. (1) 4-6 yrs. (booster) (2) 11-16 yrs.
H. Influenza Type B 2 mos. 4 mos. 6 mos. 12-15 mos. (booster) (3) . .
Polio 2 mos. 4 mos. 6-8 mos. 4-6 yrs. . .
MMR 12-15 mos. 4-6 yrs. or 11-12 yrs. (4) . . . .

NOTES: (1). Allow at least one month after previous dose before administering next. (2). Allow at least five years after previous dose before administering next. (3). Children who get an H. influenza vaccine known as PRP-OMP do not require a dose at 6 months, but still require the booster. (4). Depends on state school requirements.
SOURCE: Centers for Disease Control and the American Academy of Pediatrics, 1995.

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Updated on October 8, 1995