Most doctors follow the vaccination schedule recommended by the Centers for Disease Control and Prevention (CDC—see the CDC web site), which begins with the hepatitis B vaccine given in the hospital nursery. The recommended ages for vaccinations should not be construed as absolute. For example, 2 months can mean 6 to 10 weeks. Although parents should try to have their children vaccinated according to the schedule, a slight delay does not interfere with the final immunity achieved nor does it require children to restart the series of injections from the beginning. The rotavirus vaccine may be an exception. If it is not begun before age 12 weeks, experts recommend not giving it at all. Vaccination need not be delayed if the infant has a slight fever from a mild infection, such as an ordinary cold.
Some vaccines are recommended only under special circumstances.
More than one vaccine may be given during a visit to the doctor's office, but several vaccines are often combined into one injection. For example, there is a vaccine that combines pertussis, diphtheria, tetanus, polio, and Haemophilus influenzae type b vaccines in one injection. A combination vaccine simply reduces the number of injections needed and does not reduce the safety or effectiveness of the vaccines.
Vaccinating Infants and Children
Following the recommended vaccination schedule is important because it helps protect infants and children against infections that can be prevented. The schedule below is based on the one recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (see Immunization Schedules for Infants and Children). The schedule indicates which vaccines are needed, at what age, and how many doses (indicated by the numbers in the symbols).
There is a range of acceptable ages for many vaccines. A child's doctor can provide specific recommendations, which may vary depending on the child's known health conditions and other circumstances. Often, combination vaccines are used, so that children receive fewer injections. If children have not been vaccinated according to the schedule, catch-up vaccinations are recommended, and parents should contact a doctor or health department clinic to find out how to catch up. Parents should report any side effects after vaccinations to their child's doctor.
For more information about this schedule, parents should talk to a doctor or visit the Centers for Disease Control and Prevention's National Immunization Program web site.
aHepatitis B vaccine: This vaccine is given to all newborns before they are discharged from the hospital. The second dose is given at age 1 to 2 months, followed by the third dose at age 6 to 18 months.
bRotavirus vaccine: Depending on the vaccine used, two or three doses of the vaccine are given: at ages 2 months, 4 months, and 6 months or at ages 2 months and 4 months.
cHaemophilus influenzae type b (Hib) vaccine: Depending on the vaccine used, two or three doses of the Hib vaccine are given: at ages 2 months, 4 months, and 6 months or at ages 2 months and 4 months. These doses are followed by a booster dose given at age 12 to 15 months.
dPoliovirus vaccine: Four doses of the vaccine are given: at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years.
eDiphtheria, tetanus, and pertussis vaccine: Before age 11, children are given the diphtheria, tetanus, and pertussis (DTaP) preparation. Five doses of DTaP are given: at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years.
An adolescent preparation of tetanus, diphtheria, and pertussis (Tdap) is recommended at age 11 to 12 years.
fPneumococcal vaccine: Four doses of the vaccine are given: at ages 2 months, 4 months, 6 months, and 12 to 15 months.
hInfluenza vaccine: The influenza vaccine should be given yearly to all, beginning at age 6 months. Children who are 6 months to 8 years old should be given two doses at least 4 weeks apart if they are receiving the influenza vaccine for the first time.
kHepatitis A vaccine: Two doses of the hepatitis A vaccine are needed for lasting protection. The first dose is given between ages 12 to 23 months, and the second dose is given 6 to 18 months later. If children over age 23 months have not been vaccinated, they can be given the hepatitis A vaccine to protect them from hepatitis A.
lHuman papillomavirus vaccine: The human papillomavirus vaccine is given to adolescents (girls and boys) in 3 doses. The second dose is given 1 to 2 months after the first, and the third dose is given 4 months later.
Behavioral and developmental problems can become so troublesome that they threaten normal relationships between the child and others or interfere with emotional, social, and intellectual development. Which of the following describes the treatment goal for behavioral problems in children?