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 2005, the US Centers for Disease Control (CDC) now recommends vaccination against at least eleven diseases. By two years of age, children routinely receive as many as 20 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 <ref name= "WHO">Estimated Incidence/deaths World Health Organization Immunization, Vaccines and Biologicals Year 2000 data (unless noted) (Note: Please choose appropriate disease)</ref>	Incubation<ref name= "WHO"/>	Worldwide Incidence<ref name= "WHO"/>	Worldwide Deaths<ref name= "WHO"/>	U.S. Incidence<ref name= "CDC1">Reported cases/deaths (pdf) CDC "Pink Pages", Year 2002 data </ref>	U.S. Deaths<ref name= "CDC1"/>	UK. Incidence<ref name=UK1>Reported cases/deaths NHS Immunisation Information, Year 2000 data (unless noted)</ref>	UK. Deaths<ref name=UK1/>
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<ref>Call for hepatitis B vaccination BBC News, 16 January, 2003.</ref>	Not reported
Measles	Airborne	10-12 days	30-40,000,000	610,000<ref>See also: Estimated regional measles deaths (with uncertainty bounds) Fact sheet N°286 (2004). The World Health Organization (WHO) and UNICEF. Revised March 2006.</ref>	44	0	77 <ref name="BBC">UK 'in grip of measles outbreak' BBC News. Statistics: 2005. First measles related death in the UK in 14 years</ref>	1 <ref name="BBC"/>
Mumps	Airborne droplets	14-21 days	477,079 (reported)<small/>	N/A	270	1	16,436 <ref>Mumps BBC News, Friday, 13 May, 2005. Statistics: 2004</ref>	0
Pertussis	Airborne droplets	5-10 days	39,000,000	297,000	9,771	18	2 <ref>1999</ref>	2
Polio	Fecal contamination	Hours	1,951 <ref name= "WHO2005">(2005 data) Polio is endemic in only four countries; Nigeria, India, Afghanistan and Pakistan</ref>	<1,000 <ref name= "WHO2005"/>	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 <ref>(year 2000: due to neonatal tetanus from non-sterile delivery and/or umbilical severing tools)</ref>	25	5	6	0
Tuberculosis	Airborne	3 day - 15 weeks	8,000,000	1,600,000	15,056<ref>Reported Tuberculosis in the United States The National Center for HIV, STD, and TB Prevention Statistics: 2002</ref>	784	6,572	373
Varicella	Airborne	2 weeks	Not reported	Not reported	22,841	32	Not reported	Not reported

[edit] Recommended schedules

Image:CDC immunization schedule.png

Image:CDC adult immunization 2006.png

[edit] USA

[edit] Childhood vaccinations

The American Academy of Pediatrics recommends the following four vaccines for teenagers and one for college students:

Varicella (chicken pox) vaccine
Hepatitis B vaccines
Measles-Mumps-Rubella (MMR vaccine)
Tetanus-Diphtheria vaccine
Meningococcus vaccine (college students)

[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 2005, the United Kingdom childhood vaccination schedule uses combination immunisations where available:

Vaccine	2 months	3 months	4 months	12-15 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	.	DTaP/IPV	Td/IPV
Menningitis C	Men C	Men C	Men C	.	.	.
Measles, Mumps, Rubella	.	.	.	MMR	MMR	.

This schedule was amended on 4th 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:<ref>Full immunisation schedule. NHS (September 4, 2006).</ref>

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	.	.
Menningitis C	.	Men C	Men C	MenC	.	.	.
Measles, Mumps, Rubella	.	.	.	.	MMR	MMR	.

Notes:

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 vax 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.<ref>Jane Symons. "National jabs scandal exposed", The Sun, November8, 2006. Retrieved on 2006-11-14.</ref>

[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**<ref>State of the World's Vaccines and Immunizations (pdf) from the World Health Organization (2003 edition)</ref>
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 (such as human papilloma virus or HPV). 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.