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AAP updates several vaccine recommendations

Friday September 30, 2011
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The American Academy of Pediatrics has issued updates to several recommendations for vaccines, including one for the hepatitis A virus.

The policy statement expands on previous recommendations to immunize only travelers who seek to adopt children from countries with medium to high HAV infection rates. The new policy recommends routine administration of the vaccine for all household members and close contacts, including babysitters, during the 60-day period after the arrival of the adopted child.

The first dose of the two-dose series should be given when the adoption is planned, ideally two or more weeks before arrival. The second dose should be given at least six months after the first dose in order to provide long-term immunity from HAV infection.

Tdap

The AAP and the Centers for Disease Control and Prevention have revised previous recommendations for the use of the Tdap vaccine in children and adults. There is no longer any minimum interval between receiving a tetanus or diphtheria toxoid-containing vaccine and Tdap.

The AAP advises that a single dose of Tdap should be administered to children ages 7 through 10 who were under-immunized or who have an incomplete vaccine history. The AAP continues to recommend vaccination of adolescents and pregnant women. A single dose should be given to adults who have contact with infants — even if the adults are older than 65 — and to healthcare workers of any age.

Polio

Despite significant progress in eliminating polio, wild poliovirus persists in a small number of Asian and African countries. The AAP noted the need to ensure high levels of immunity in U.S. children to prevent outbreaks in case the virus is imported here. In a new policy statement, it provides updated guidance on using several combination vaccines containing inactivated poliovirus vaccine, including the appropriate intervals between doses, immunization before travel to a country where polio is endemic, vaccination of immunocompromised children and vaccination of adults at risk of exposure.

The policy statements are available on the website of the journal Pediatrics: http://pediatrics.aappublications.org/content/early/recent.


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