2016 Child and adolescent immunization schedules available

The 2016 recommended vaccine schedule for children aged 0 to 18 years has been approved by the American Academy of Pediatrics (AAP), the Advisory Committee on Immunization Practices of the CDC, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

The full 2016 immunization schedule, footnotes, and catch-up schedule are available on the American Pediatrics website (http://redbook.solutions.aap.org/SS/Immunization_Schedules.aspx) and on the CDC website (http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html). A corresponding policy statement from the AAP’s Committee on Infectious Diseases has been published in Pediatrics.

The new schedule is similar to the 2015 version, with a single, color-coded schedule that covers immunizations from birth to age 18. The recommended ages for immunizations are represented by yellow bars. For children who did not receive a vaccine by the recommended age, the green bars represent recommended catch-up periods. For patient populations at high risk, purple bars represent the recommend age for immunization. A combined green-and-purple bar indicates a catch-up period for high-risk populations. New to the 2016 schedule, a blue bar shows the range of recommended ages during which non–high-risk patients may opt to receive a vaccine. White spaces indicate that a vaccine is not recommended during that time.

The catch-up schedule applies to children aged 4 months or older who started immunizations late or are more than 1 month behind schedule.

The following specific changes were made from the 2015 schedule:

• The sequence of listing of vaccines in the Recommended Immunization Schedule for Persons Aged 0 Through 18 Years has been modified so that routinely recommended vaccines are grouped from the earliest age to older ages of administration. The order of the footnotes has been modified to reflect the new order.
• The split purple-green bar key has been removed from the legend because both colors are defined separately.
• A purple bar representing the range of recommended ages from 5 through 18 years for certain high-risk groups has been added to H influenzae type b.
• The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed, row has been moved to a lower position in the schedule to facilitate vaccine grouping by age.
• The human papillomavirus (HPV) nomenclature has been modified to reflect the new designation (eg, HPV9 is now referred to as 9vHPV).
• The HPV row contains an additional purple bar from age 9 to 10 years to signify that children with a history of sexual abuse are at increased risk of HPV and should be vaccinated.
• Meningococcal B vaccine has been added to the schedule, with a purple bar indicating vaccination at 10 years of age for people at increased risk. A blue bar has been added for people aged 16 through 18 years to indicate that non–high-risk people may be considered for vaccination.
• The pneumococcal polysaccharide bar has been moved to the bottom of the schedule because this vaccine is not routinely indicated for any population.
• Minor, simplifying word changes have been made to the footnotes to address inadvertent administration of a dose of diphtheria-tetanus-acellular pertussis, guidance for inactivated poliovirus vaccine use in children who previously received only the oral polio vaccine before the fourth birthday, clarification of the time interval between doses of HPV vaccine, and a discussion regarding use of meningococcal B vaccines.¹

Reference

1. Committee on Infectious Diseases. Recommended Childhood and Adolescent Immunization Schedule – United States, 2016. Pediatrics. 2016; 137(3). doi:10.1542/peds.2015-4531.