“Catching-up” Kidsand Don’t Forget the Supplemental Dose of PCV13

December 2011

Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
“Catching-up” Kids – and Don’t Forget the Supplemental Dose of PCV13
Published December 2011
Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit www.immunize.org/acip/acip_vax.asp.
Healthcare providers often encounter children who are behind schedule for recommended vaccines. These children need to be “caught up.” Children who are more than one month or one dose behind schedule should be put on an accelerated immunization schedule, which means the intervals between doses should be reduced to the minimum allowable until the child is up to date. Each year, the U.S. recommended child immunization schedule comes with a catch-up schedule that spells out the minimum spacing interval recommended between various vaccine doses.
When children fall behind on their vaccinations, it’s best to get them caught up by administering all indicated vaccines at the same appointment. For more information on how to accomplish this, please refer to the December 2010 issue of “Technically Speaking.”
Once you have the child back on schedule, counsel the parents about the importance of bringing the child in on time for future vaccinations.
Many children up to age 5 need a supplemental dose of PCV13
In December 2010, ACIP recommended
PCV13 replace PCV7 for the four-dose early childhood series because PCV13 provides broader protection against invasive pneumococcal disease.
A supplemental dose of PCV13 for children ages 14-59 months who have already completed their PCV7 series. This dose will provide protection against the six serotypes not found in PCV7.
Unfortunately, CDC data from five Immunization Information System Sentinel Sites showed that only about half of children ages 12-23 months, and only a quarter of children ages 24-59 months, had received a supplemental dose of PCV13. Moreover, CDC surveillance indicated that the majority of children younger than age 5 years who were reported with invasive pneumococcal disease had not received a supplemental dose of PCV13. Please see the article in the November issue of AAP News, by Larry Pickering, MD, AAP Red® Book editor, on this subject.
So remember, when patients younger than age 5 years come to the office, check their immunization status to make sure that those who are recommended for a supplemental dose of PCV13 receive it. In addition, consider checking charts and recalling children who are behind, so they don’t miss this important opportunity for protection against invasive pneumococcal disease.


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