This message is from Dr. Susan M. Lett, Medical Director, MDPH Immunization Program. Please share this advisory with all pertinent colleagues and staff within your practice or institution.
The 2018 Immunization Schedule for those 0-18 years has been published. The changes in the schedule are discussed in the MMWR from February 9, 2018 (attachment 1) and are outlined below. The MMWR can be found at: https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6705e2-H.pdf. The figures, footnotes, and tables of the schedule (attachment 2) are published on the CDC immunization schedule website at: http://www.cdc.gov/vaccines/schedules/index.html. This site provides readers electronic access to the most current version of the schedules and footnotes on the CDC website.
Changes to the 2018 immunization schedule for children and adolescents from birth through 18 years of age are outlined below:
- The schedule footnotes are presented in a new simplified and standardized format. The goal was to remove unnecessary text while preserving all pertinent information and maintaining clarity. This was accomplished by a transition from complete sentences to bullets, removal of unnecessary or redundant language, and formatting changes.
- MenHibrix (Hib-MenCY) vaccine has been removed from the schedule because its manufacture had been discontinued in the United States and all available doses have expired.
Medical Conditions (Figure 3)
- The HIV column provides a reference providing additional information regarding HIV laboratory parameters and use of live vaccines.
- Within the pneumococcal row, stippling was added to heart disease/chronic lung disease, chronic liver disease, and diabetes columns to clarify that in some situations children with these conditions may be recommended to receive an additional dose of vaccine.
Hepatitis B Vaccine
- Hepatitis B (HepB) vaccine is recommended for all medically stable infants >2,000 grams born to HBsAg-negative mothers within 24 hours of birth.
- Infants who are <2,000 grams born to HBsAg-negative mothers should receive 1 dose of HepB vaccine at chronologic age 1 month or at hospital discharge.
- Includes guidance about use of a 3rd dose of mumps-containing vaccine during outbreaks. Persons >12 months of age who previously received <2 doses of mumps-containing vaccine and are identified by public health authorities to be at risk during a mumps outbreak should receive a dose of mumps-containing vaccine.
- The poliovirus vaccine footnote was revised to include updated guidance for persons who received oral polio vaccine as part of their vaccination series.
- The inactivated poliovirus rows of the catch-up schedule have been edited to clarify the catch-up recommendations for children 4 years of age and older.
- The meningococcal vaccine footnote has been edited to create separate footnotes for MenACWY and MenB vaccines.
- The maximum ages for the first and last doses of the rotavirus series have been added to the rotavirus vaccine row of the catch-up schedule for clarity.
- The influenza vaccine footnote has been updated to indicate that LAIV should not be used during the 2017–2018 influenza season. A reference link to the 2017-2018 season influenza recommendations has been added.
An additional helpful resource is the AAP policy statement Recommended Childhood and Adolescent Immunization Schedule — United States, 2018, which is available at http://pediatrics.aappublications.org/content/pediatrics/early/2018/02/02/peds.2018-0083.full.pdf and will be published in the March issue of Pediatrics.
Printable versions of the 2018 immunization schedules for persons aged 0 through 18 years also are available at the website in several formats, including portrait, landscape, and pocket-sized versions. Catch-Up Vaccine Job-Aids for DTaP, Hib and Pneumococcal Vaccines are available again this year.
- MDPH’s Vaccine Administration and Clinical Guidance website reviews communication on vaccine decisions, vaccine administration, clinic protocols, provider resources, and model standing orders.
- CDC’s Easy-to-read schedules for parents:
Children from birth through age 6 (English)
Children from birth through age 6 (Spanish)
- CDC’s vaccine website for parents, which has useful information about immunization schedules, vaccines, vaccine-preventable diseases, and how to prepare for vaccine visits.
- CDC’s Provider Resources for Vaccine Conversations with Parents page to access information on talking to parents about vaccines, understanding vaccines and vaccine safety, and information related to the 14 vaccine-preventable diseases and the vaccines that prevent them.
- Schillie, S. Prevention of Hepatitis B Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR 2018; 67(No. RR-1).1-31.
If you have questions about the immunization schedule, please call the Immunization Program at 617-983-6800 and ask to speak to an immunization epidemiologist.
Susan M. Lett, MD, MPH
Medical Director, Immunization Program
Division of Epidemiology and Immunization
Massachusetts Department of Public Health