2013 Immunization Update

New immunization recommendations come out every February. They’re released to assist parents and clinicians in keeping all children up to date and protected from life-threatening infections. The update reflects new science and discoveries, while improving the schedule of vaccines due to outbreaks of infection or improved understandings of how to protect children better amidst a potential resurgence.
This is relevant to every parent: every year the rules for what-children-need-which-shots-when can change. Just when we think all of our children are “up to date,” new science evolves that potentially changes their immunization status. For example, read about new information published this year for the Tdap shot–how & why our children’s immunity fades.
We have to do our best to avoid making false promises to children about “not needing a shot” when they go in to see the doctor.  Just when we do, we find our child is due for a necessary booster or missed vaccine. Commonly, children are missing the last shot in a series of immunizations (for example, to protect children and teens from HPV, they need 3 total shots or children haven’t had the second chicken pox shot). In my opinion, the promises broken break trust with our children and amp fear around going to the doctor. Much of the anguish around shots is the anticipation of them. So an update…
2013 Immunization Recommendations And Reminders:

• This 2013 immunization recommendations have been simplified into one chart for all children from birth to age 18 (used to be 2 charts). It details  the timing for shots and the necessary intervals between doses for all children. The detailed footnote section explains rationale for all the rules. In my opinion the 2013 schedule is easier to read and easier to understand.
• Tdap for every pregnant woman, every pregnancy: the biggest change to the schedule is the recommendation that all pregnant women get a Tdap shot (protecting against tetanus-diphtheria-pertussis or “whooping cough”) in the 2nd half of each and every pregnancy. This recommendation was made due to surges in whooping cough infections, epidemics, and a 50-year high in positive cases. Because whooping cough is most risky to newborns we want pregnant women protected. Ninety percent of those who die from whooping cough are infants. The strategy to vaccinate during every pregnancy takes into count how quickly protection from the vaccine fades after we get it. And the reality the vaccine isn’t 100% effective. About 80% of those who get it are protected. The best way to protect us all is to have all children and adults up to date on their Tdap.
• New recommendations have been issued for children with immune deficiencies and high-risk conditions (i.e. asplenia). See final footnote for details.
• A reminder that both boys and girls are recommended to have the 3-shot series against HPV starting at age 11. Many parents are very surprised when I tell them this during the visit. See footnote # 12.
• Flu shots are recommended for all children age 6 months to age 18 years. Every year your child needs a flu shot or nasal spray, ideally during the late fall. It’s not to late for flu shots now but it’s better for children to be protected prior to the flu season start.
• A few rules for catch-up shots have been updated and simplified. The “catch-up” schedule is for children behind on immunizations or missing specific shots. See Figure 2.

These CDC charts are designed for parents as an Easy-to-Read Immunization Schedule For Babies and Young Children and an  Easy-to-Read Immunization Schedule For Children & Teens 7-18 Years.

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