Karen Bardossi

) has announced the release of the 2015 recommended vaccination schedule for children and adolescents aged from birth through 18 years in a recent 

 from the Academy’s Committee on Infectious Diseases.

	For the first time, the updated immunization schedule, along with footnotes and the catch-up vaccination schedule, will appear on the websites of the 

Centers for Disease Control and Prevention

 (CDC) instead of being published in the AAP journal 

. As new vaccines are licensed, the schedule will be updated online. A 

 of the schedule is also available online from the CDC.

	This year’s schedule-which has been approved by the AAP, the CDC’s Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists-includes current recommendations for giving 

 approved by the US Food and Drug Administration as well as some, mostly minor, changes from last year’s schedule.

			A new column has been added at age 2 years through 8 years to emphasize the availability of inactivated 

 and live-attenuated vaccine and highlight the need for 2 doses of influenza vaccine for some children aged 2 through 8 years. A second column has been added for children aged 9 through 10 years to specify when 2 doses of influenza vaccine are no longer necessary.

			A purple bar has been added for children aged 6 months to younger than 12 months who travel outside the United States and need the measles-mumps-rubella vaccine.

			Minor clarifying word changes have been made to the catch-up schedule for the following vaccines: 

; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; hepatitis A and B; polio; meningococcal; measles-mumps-rubella; and varicella.

			Major and minor changes have been made to the footnotes. They include an extensive revision of the footnote for the 3 meningococcal vaccines to clarify appropriate dosing schedules for high-risk infants and children; minor simplifying word changes to the footnotes for diphtheria-tetanus-acellular 

 and pneumococcal conjugate vaccines; and an update of the influenza vaccine footnote to reflect revised contraindications and precautions for the live-attenuated influenza vaccine.

Alternate vaccine schedules are not safer

	The policy statement also directs readers to websites for 

 detailing recommendations for specific vaccines, including guidelines for children with high-risk conditions; 

information on new vaccine releases, vaccine supplies, and interim recommendations related to vaccine shortages

; and instructions for reporting clinically significant adverse events following immunization through the 

Articles

The American Academy of Pediatrics has announced the release of the 2015 recommended vaccination schedule for children and adolescents in a recent policy statement from the Academy’s Committee on Infectious Diseases.

2015 pediatric immunization schedule issued

	Two measles-containing vaccines are unlikely to result in 

 evaluated the effects of 123,200 doses of measles-mumps-rubella-varicella 

 (MMR+V) vaccines (given separately on the same day) in children aged 12 to 23 months from 2000 to 2012 to determine whether MMRV posed more risk that MMR+V.

	Risks for the 7 main study outcomes (anaphylaxis; immune thrombocytopenic purpura; ataxia; arthritis; 

 and encephalitis; acute disseminated encephalomyelitis; and 

) didn’t differ significantly between MMRV and MMR+V, and several of the outcomes were associated with few or no postvaccination events. Researchers didn’t discover any new safety concerns for either vaccine course.

	In line with previous research, the study found that MMRV and MMR+V both slightly increase the risk of fever and 

 in 1-year-old children within 7 to 10 days after vaccination and that MMRV carries a higher risk than MMR+V. Fewer than 1 febrile seizure occurs for every 1000 immunizations.

	The researchers conclude that the study findings provide reassurance that the safety outcomes they evaluated are “extremely rate and unlikely after either vaccine.”

	To get weekly clinical advice for today's pediatrician, 

Two measles-containing vaccines are unlikely to result in adverse effects, a 12-year study has found.

Measles vaccines are safe, study confirms

	Young children are more likely to get a second dose of 

 when their parents receive reminders by text message, a new 

 for initial flu shots in young children, researchers examined whether such reminders would also increase the number of children who received a needed second vaccine dose in a timely manner.

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	Their randomized, controlled trial of 660 families, conducted during the 2012-2013 flu season at 3 community-based pediatric clinics in New York City, divided children aged 6 months to 8 years in need of a second flu shot into 3 groups whose parents received a written 

 with and without vaccine educational information.  

	Children whose parents received educational text messages were significantly more likely to get a second flu shot (72.7%) than children whose parents received conventional text reminders (66.7%) or a written reminder only (57.1%). They also had more timely receipt of the vaccine.

	Parents reported high levels of satisfaction with the text messages and said they would recommend them to other parents. More than 60% said they brought their child for a second vaccine dose mainly or partly because of the messages; 70% said they brought their child for the second dose sooner than they would have without the messages.

	Influenza vaccine coverage in children aged younger than 17 years is low (56.6%), the researchers point out, highlighting the need to find effective ways to increase the vaccination rate. The need is especially pressing in children aged younger than 9 years, who may require 2 doses in a season depending on their previous vaccination status.

	Only 40% to 60% of children who need a second dose get one, and many of them get the second dose after the recommended 28-day follow-up period has elapsed, leaving them incompletely protected.

Young children are more likely to get a second dose of influenza vaccine when their parents receive reminders by text message, a new study reports.

Text reminders increase flu vaccination in kids

	Contrary to current guidelines, children born before 37 weeks’ gestation should be considered at high risk for complications of 

	British researchers reviewed 27 studies with a total of 14,086 children who saw a healthcare provider for 

 or flu-like illness, including 3086 children with underlying medical conditions. They sought to develop an evidence-based definition of children at greatest risk of 

 because existing guidelines “are based on consensus opinion rather than evidence and do not specify risk factors in children.”

	In addition to confirming some known risk factors mentioned in current guidelines (neurologic disorders, 

, immunosuppression, diabetes, age younger than 2 years), the study identified 

 as a strong new risk. Children with flu who had been born prematurely were twice as likely to be admitted to the hospital with 

 as children with no underlying medical conditions.

	More than 1 underlying condition increased the risk. About 20% of children with flu have at least 1 comorbidity, the researchers note, and these conditions raise the risk of flu-related hospital admissions nearly 6 times in children aged between 5 and 14 years. The researchers recommend targeting high-risk groups for intervention, such as 

, to prevent complications and also considering intervention for children with more than 1 risk factor or severe underlying medical problems.

 accompanying the study urges implementation of measures to prevent flu-related complications worldwide before the next pandemic. Such measures include increasing influenza and pneumococcal immunization; vaccinating mothers against flu to protect young infants; and investigating potentially more effective vaccines.

Contrary to current guidelines, children born before 37 weeks’ gestation should be considered at high risk for complications of influenza, a new meta-analysis shows.

Preemies in danger of flu complications

	Infants have borne the brunt of the worst outbreak of 

, in almost 70 years in California, the Centers for Disease Control and Prevention (

. Large numbers of older children and teenagers are also affected.

	Between January 1 and November 26 of this year, 9935 cases of pertussis-or 26 per 100,000 population-were reported in California. Infants aged younger than 1 year had the highest incidence, 174.6 cases per 100,000. Adolescents aged 15 years had the next highest incidence, 137.8 cases per 100,000. Overall, the greatest incidence aside from infants occurred in young persons aged 14 to 16 years. In June, the California Department of Public Health declared a pertussis epidemic in the state.

	Infants aged younger than 1 year, who are most likely to suffer severe complications and die from pertussis, accounted for 275 of the 347 hospitalizations for the disease. Of the hospitalized infants, 214 were aged younger than 4 months. One death was reported, a 5-week-old infant (2 other infants, who had contracted pertussis in 2013, also died).

	Only 17% of mothers of infants who came down with pertussis during this year’s outbreak had been vaccinated during pregnancy, as 

 by the CDC’s Advisory Committee for Immunization Practices (

). The ACIP recommends that pregnant women receive a tetanus-diphtheria-acellular pertussis (

) booster during the third trimester to protect babies until they can begin immunization at 2 months of age. Recent research has found that vaccinated pregnant women pass antibodies to the fetus through the placenta.

	“Strategies to prevent the most severe cases of pertussis, which occur primarily in young infants, should be prioritized,” the CDC emphasizes.

	Among adolescents who contracted pertussis, only 2.2% had never received pertussis vaccine, and 87% had 

received Tdap at least 3 years previously

, probably indicating waning immunity. The effect of acellular pertussis vaccines 

wanes more quickly than earlier whole-cell vaccines

. “It is likely that increased incidence will continue to be observed among this cohort [teenagers] in the absence of a new vaccine or more effective vaccination strategy,” the CDC report notes. 

Infants have borne the brunt of the worst outbreak of pertussis, or whooping cough, in almost 70 years in California, the Centers for Disease Control and Prevention reports.

Pertussis outbreak strikes hard at infants, teens

, the American Academy of Pediatrics (AAP) has expanded its recommendations for giving 

 to high-risk older children and adolescents. 

	The new guidelines recommend a single dose of PCV13 for children aged 6 through 18 years who haven’t received a previous dose and are at highest risk of invasive pneumococcal disease because of immunocompromising conditions (HIV infection; functional or anatomic asplenia, including 

; malignancy; transplant; congenital immunodeficiency), cerebrospinal fluid leaks, or cochlear implants.

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	Children in this group should be given PCV13 whether or not they have received PCV7 or 

 (PPSV23) previously. If they haven’t received PPSV23, which contains 11 serotypes not found in PCV13, they should get a dose at least 8 weeks after the PCV13 dose. If they have received PPSV23, the PCV13 dose should be given at least 8 weeks after the polysaccharide vaccine.

	Recommendations for vaccinating healthy children with PCV13 and PPSV23 remain the same, as do guidelines for immunizing high-risk children aged 6 to 18 years with PPSV23.

In a new policy statement, the American Academy of Pediatrics (AAP) has expanded its recommendations for giving pneumococcal conjugate vaccine to prevent invasive pneumococcal disease caused by Streptococcus pneumoniae to high-risk older children and adolescents.