key: cord-0027812-hw4autum authors: Wodi, A. Patricia; Murthy, Neil; Bernstein, Henry; McNally, Veronica; Cineas, Sybil; Ault, Kevin title: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2022 date: 2022-02-18 journal: MMWR Morb Mortal Wkly Rep DOI: 10.15585/mmwr.mm7107a2 sha: 121276648d86a494f077851f1400bcf1ff3845f5 doc_id: 27812 cord_uid: hw4autum nan child and adolescent immunization schedule is published annually to consolidate and summarize updates to ACIP recommendations on vaccination of children and adolescents, and to assist health care providers in implementing current ACIP recommendations. The use of vaccine trade names in this report and in the child and adolescent immunization schedule is for identification purposes only and does not imply specific product endorsement by ACIP or CDC. For further guidance on the use of each vaccine, health care providers are referred to the respective ACIP vaccine recommendations at https://www.cdc.gov/vaccines/hcp/acip-recs. Providers should be aware that changes in recommendations for specific vaccines can occur between these annual updates to the child and adolescent immunization schedule. If errors or omissions are discovered within the schedule, CDC will post revised versions on the CDC immunization schedule website. § Printable versions of the 2022 child and adolescent immunization schedule and ordering instructions are available on the immunization schedule website. For CDC's interim clinical considerations for the use of COVID-19 vaccines, health care providers are referred to https://www.cdc.gov/vaccines/ covid-19/clinical-considerations/covid-19-vaccines-us.html. Vaccine-specific changes in the 2022 child and adolescent immunization schedule for children and adolescents aged ≤18 years include new or updated ACIP recommendations for influenza vaccine (2), dengue vaccine (3) • The color of the columns for children aged 4-6 years, children aged 11-12 years, and adolescents aged 16 years has been changed from gray to black to align with the color of the other age range columns. The sentence in the table header stating "School entry and adolescent vaccine age groups are shaded in gray" has been deleted. • Tdap row: The overlying text in the column for children aged 11-12 years has been changed from "Tdap" to "1 dose" to be consistent with the format used for other vaccines in the table. • HPV row: The asterisk that was previously present for children aged 9-10 years and its associated descriptive text in the table legend (i.e., "*can be used in this age group") have been deleted. Instead, the color for children aged 9-10 years has been changed from blue to checked yellow, which is a new color in Table 1 . Within the table's legend, a new checked yellow box has been added, which now indicates that "Recommended vaccination can begin in this age group." • Dengue row: A new row has been added with the boxes for children and adolescents aged 9-16 years highlighted in yellow to indicate the recommended age for routine dengue vaccination. The overlying text "Seropositive in endemic areas only (see notes)" has been added to the yellow boxes. The text now reads, "if current age is younger than 12 months and first dose was administered at younger than age 7 months and at least 1 previous dose was PRP-T (ActHib, Pentacel, Hiberix), Vaxelis, or unknown." In addition, Hib-HepB (Comvax) was deleted from the text for the 8-week minimum interval between doses 2 and 3 because this vaccine product is no longer available. • Dengue row: A new row has been added for the dengue vaccine outlining the minimum age and minimum interval between doses. • The definition of severe immunosuppression because of HIV infection has been revised to be consistent with ACIP's General Best Practice Guidelines for Immunization (4) and now reads, "<15% or total CD4 cell count of <200/mm 3 ." • Legend: The text that defines the red box in the table's legend has been edited for clarity and now reads, "Contraindicated or not recommended-vaccine should not be administered." In addition, the text that defines the checked yellow box in the table's legend has been edited and now reads, "Vaccination is recommended, and additional doses might be necessary based on medical condition or vaccine. See Notes." • Dengue: A new row has been added to outline dengue vaccine recommendations by medical conditions or other indications. The text for COVID-19 vaccination has been updated to include a hyperlink to the webpage for CDC's interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. • Dengue: This new section was added to provide details for routine dengue vaccination in areas with endemic dengue. In addition, a hyperlink referring health care providers to the latest guidance on areas with endemic dengue and prevaccination laboratory testing is included. • Hib: The note was updated to include the recommendations for routine and catch-up vaccination when DTaP-IPV-Hib-HepB (Vaxelis) is used. • HepA: The note was revised to clarify that the age for routine vaccination is age 12-23 months. • HepB: In the "Special situations" section, the text has been revised to clarify and emphasize the recommendations for postvaccination serology and revaccination. • HPV: In the "Special situations" section, the text for immunocompromising conditions has been revised to clarify that 3 doses should be administered regardless of age at initial vaccination. • Influenza: The note has been updated to reflect the recommendations for the 2021-22 influenza season. The "Special situations" section was condensed by moving information on contraindications and precautions for influenza vaccines to the newly created appendix. • MMR: The note on routine vaccination was updated to include recommendations for use of measles, mumps, rubella, and varicella vaccine (MMRV). • MenACWY: Language was added to the notes regarding the recommendation for simultaneous administration with meningococcal serogroup B vaccine (MenB). The text reads, "MenACWY vaccines may be administered simultaneously with MenB vaccines if indicated, but at a different anatomic site, when feasible." • VAR: The note has been updated to include recommendations for using MMRV and to clarify that a second dose inadvertently administered after at least a 4-week interval may be counted as a valid dose. A newly created appendix listing the contraindications and precautions for each vaccine type included in the 2022 child and adolescent immunization schedule has been added. The information in the appendix is adapted from ACIP General Best Practice Guidelines for Immunization (4) and ACIP recommendations for use of 2021-22 influenza vaccines (2). The Recommended Child and Adolescent Immunization Schedule, United States, 2022 is available at https://www. cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. The full ACIP recommendations for each vaccine are also available at https://www.cdc.gov/vaccines/hcp/acip-recs. All vaccines identified in Tables 1, 2, and All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Henry Bernstein reports that he is the editor of Current Opinion in Pediatrics Office Pediatrics Series and received a presentation honorarium from the Florida chapter of American Academy of Pediatrics. Veronica McNally reports that she is the president of the Franny Strong Foundation. Kevin Ault reports having received a grant from the National Cancer Institute, consulting fees from PathoVax, and payments supporting attending meetings and/or travel from the American College of Obstetricians and Gynecologists. In addition, Kevin Ault reports that he serves as a volunteer on the medical advisory board of Family Fighting Flu, and as a member of the infectious disease working group for the American College of Obstetricians and Gynecologists. No other potential conflicts of interest were disclosed. US Department of Health and Human Services, CDC Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 influenza season Dengue vaccine: recommendations of the Advisory Committee on Immunization Practices, United States General best practice guidelines for immunization: best practices guidance of the Advisory Committee on Immunization Practices (ACIP) Rosters of current and past members of the Advisory Committee on Immunization Practices (ACIP) are available at https://www.cdc. gov/vaccines/acip/committee/members-archive.html.