Vaccination schedule

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Over the past two decades, the recommended vaccination schedule in the United States and elsewhere has grown rapidly and become more complicated as many new vaccines have been developed and marketed. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or 'wild' pathogen.

In 1900, the smallpox vaccine was the only one administered to children. By the 1960s, children routinely received five vaccines, for protection against (diphtheria, pertussis, tetanus, polio, and smallpox), and as many as eight shots by two years of age. As of 2007, the US Centers for Disease Control (CDC) now recommends vaccination against at least sixteen diseases. By two years of age, children routinely receive as many as 24 vaccine injections, and might receive up to five shots during one visit to the doctor. The use of combination vaccine products means that, as of 2006, the United Kingdom immunisation programme consists of just 11 injections by the age of two years and a further 3 injections by the time of leaving school.

1 Diseases and vaccines
2 Recommended schedules
3 What lies ahead
4 Footnotes
5 External links

[edit] Diseases and vaccines

**Characteristics of diseases vaccinated against in most vaccine schedules**
Disease	Transmission ^[1]	Incubation^[1]	Worldwide Incidence^[1]	Worldwide Deaths^[1]	U.S. Incidence^[2]	U.S. Deaths^[2]	UK. Incidence^[3]	UK. Deaths^[3]
Diphtheria	Saliva	1-4 days	30,000	3,000	1	0	0	0
Haemophilus influenzae	By airborne droplet	1-4 days	2-3,000,000	450,000 (mostly children)	1,743	7	30	0
Hepatitis B	Exchange of bodily fluids	6 weeks- 6 months	5,700,00 (acute)	521,000	7,996	7	600^[4]	Not reported
Measles	Airborne	10-12 days	30-40,000,000	610,000^[5]	44	0	77 ^[6]	1 ^[6]
Mumps	Airborne droplets	14-21 days	477,079 (reported)	N/A	270	1	16,436 ^[7]	0
Pertussis	Airborne droplets	5-10 days	39,000,000	297,000	9,771	18	2 ^[8]	2
Polio	Fecal contamination	Hours	1,951 ^[9]	<1,000 ^[9]	0	0	0	0
Rubella	Airborne droplets	5-7 days	Not reported	631,571 (most CRS)	18	(1 CRS)	0	0
Tetanus	Penetrating injury, blood contamination,	3-10 days	18,781	200,000 ^[10]	25	5	6	0
Tuberculosis	Airborne	3 day - 15 weeks	8,000,000	1,600,000	15,056^[11]	784	6,572	373
Varicella	Airborne	2 weeks	Not reported	Not reported	22,841	32	Not reported	Not reported

[edit] Recommended schedules

US childhood vaccination schedule^[12]

The 2005 adult immunization schedule recommended by the CDC ^[13]

The World Health Organization monitors vaccination schedules across the world, noting what vaccines are included in each country's programme, the coverage rates achieved and various auditing measures.^[14]

[edit] USA

[edit] Childhood vaccinations

The CDC recommends the following vaccines for children aged 0-6:

Diphtheria-Tetanus-Pertussis vaccine
Hepatitis A vaccine
Hepatitis B vaccine
HiB vaccine
Influenza vaccine
Measles-Mumps-Rubella (MMR vaccine)
Polio (inactivated vaccine)
Pneumococcal vaccine
Rotavirus vaccine
Varicella (chicken pox) vaccine

for children aged 11-12:

HPV vaccine
Meningococcus vaccine

[edit] Adult vaccinations

The 2005 adult immunization schedule recommended by the CDC for adults aged 18 and over is as follows:

Tetanus-Diphtheria Vaccine (all adults, every 10 years)
Hepatitis B Vaccine (adults at risk)
Measles-Mumps-Rubella (MMR) Vaccine (susceptible adults)
Varicella (chickenpox) Vaccine (susceptible adults)
Vaccines for travelers

Vaccines recommended for those age 50 and older:

Influenza (flu) Vaccine

Vaccines needed for those age 65 and older

Pneumococcal Vaccine

Vaccines recommended for healthcare workers:

Hepatitis B Vaccine
Influenza Vaccine (annually)
Measles-Mumps-Rubella (MMR) Vaccine
Varicella (chickenpox) Vaccine

[edit] Vaccine Information Statements

In the US, the National Childhood Vaccine Injury Act requires all health-care providers to provide parents or patients with copies of Vaccine Information Statements before administering vaccines.

[edit] UK

[edit] Childhood vaccinations

As of September 2006, the United Kingdom childhood vaccination schedule uses combination immunisations where available:

Vaccine	2 months	3 months	4 months	12 months	13 months	3-5 years (Pre-School)	School Leaving (13-18yrs)
Diphtheria, Tetanus, Pertussis, Inactivated Polio Vaccine, Haemophilus influenzae (Hib)	DTaP/IPV/Hib	DTaP/IPV/Hib	DTaP/IPV/Hib	Hib	.	DTaP/IPV	Td/IPV
Pneumococcal conjugate vaccine	PCV	.	PCV	.	PCV	.	.
Meningitis C	.	Men C	Men C	MenC	.	.	.
Measles, Mumps, Rubella	.	.	.	.	MMR	MMR	.

Notes: This schedule was amended on 4 September 2006 with the introduction of pneumococcal vaccine for babies, adjustment of the spacing of the MenC immunisations and an additional Hib booster at 12 months of age. A limited catch-up programme is now in place for pneumococcal vaccination. ^[15]

Tuberculosis BCG vaccination is no longer part of a universal programme delivered through schools, but is targeted for those who are at greatest risk, and badgers.
Hepatitis B vaccination is sometimes offered to high risk cases.

[edit] 2006 release of childhood vaccination records

According to a 2006 report, there have been "50 to 60 per cent more vaccines recorded as being administered as would be expected." The report acknowledges that entries may have been duplicated, although speculation has raised that some NHS doctors may have deliberately overstated the number of shots given to youngsters in order to claim bonuses.^[16]

[edit] Adult & High-Risk vaccinations

The five scheduled childhood tetanus vaccinations are thought to generally confer lifelong immunity; thus, no routine booster doses are given in adulthood. Those adults at risk of contaminated cuts (e.g., gardeners) may have booster tetanus vaccination every ten years.
Pneumococcal and Flu vaccinations are recommended routinely for those over 65 and also for both children and adults in special risk categories:
- Serious breathing problems
- Serious heart conditions
- Severe kidney problems
- Long term liver disease
- Diabetes requiring medication
- Immunosuppression due to disease or treatment (e.g., chemotherapy or radiation therapy, long-term steroid use, and problems with the spleen (asplenia), either because the spleen has been removed or does not work properly, for example, sickle cell anemia)

[edit] Developing countries

**Childhood vaccination schedule for infants in developing countries**^[17]
Vaccine	Age at immunization	Notes
BCG	Birth
Polio	6, 10 and 14 weeks	At birth, in endemic countries
Diphtheria, Tetanus, Pertussis	6, 10 and 14 weeks
Hepatitis B	6, 10 and 14 weeks	Vaccine not widely available.
Haemophilus influenzae	6, 10 and 14 weeks	Vaccine not widely available.
Yellow Fever	9 months	In countries where Yellow Fever poses a risk.
Measles	9 months	A second vaccination should be provided.

[edit] What lies ahead

Many vaccinations are currently being evaluated for inclusion into the recommended vaccination schedule. Some of these combine up to five vaccinations into a single preparation, thus decreasing the number of individual vaccinations necessary. Others attempt to prevent diseases which currently do not have available vaccines. In addition, attempts to shield pharmaceutical companies which manufacture vaccines from liability are currently ongoing in the US and elsewhere, including numerous legislative initiatives in the United States Congress. Senator Richard Burr (R-North Carolina) has introduced the most far reaching legislation, known as Biodefense and Pandemic Vaccine and Drug Development Act of 2005, that would further shield drug makers from vaccine injury liability, while streamlining vaccine approval processes to allow new vaccines to reach markets sooner, particularly in the event of a serious public health threat.

According to Dr. Thomas Saari, spokesperson for the American Academy of Pediatrics, "We project over the next ten years that we'll add one to two new vaccines a year." Dr. Andrew Wakefield has said, "The next few years are likely to see the introduction of ever greater numbers of vaccines and the possibility of using combination vaccines containing up to 16 different infectious diseases, is already being discussed in the US."

Often, immunity conferred by vaccination is life-long. However, immunity to some illnesses, such as pertussis fades over time and aging naturally increases susceptibility to disease.

Although the benefits far outway the concequences, many parents are choosing to not immunize their children. This has the potential for an outbreak of disease that could be catastrophic to our children and young adults.