Physician breaks down the vaccine schedule process

Who determines when children should receive which immunizations? Dr. Sandra Arnold, an infectious disease specialist at Le Bonheur, explains the organization responsible for these guidelines and its process.

What is the immunization schedule?

The Recommended Childhood and Adolescent Immunization Schedule— this format has existed in the United States for more than 30 years although there are many more vaccines given now than were given back then.

The timing and number of doses of each vaccine has been determined by medical researchers studying these vaccines in animals and then in humans. This results in the best and most rapid response to vaccines, which leads to early protection for vulnerable infants against potentially fatal diseases such as bacterial meningitis, whooping cough and tetanus.

Alternative vaccine schedules, which have been created to allay fears of giving too many vaccines too soon, are not based on science and result in delayed protection against these serious diseases and should not be used.

When is the schedule updated and who updates it?

Each year, the immunization schedule for children and adolescents is reviewed and updated based on data from new research and discussions among specialists in infectious diseases and public health. The 2014 schedule was released in early February.

The primary responsibility for reviewing and revising the schedule and making recommendations for vaccines is a group called the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention. This committee has regular members who are appointed for fixed terms in addition to liaison representatives from other government organizations such as the Food and Drug Administration as well as from professional organizations including the American Academy of Pediatrics, American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

The ACIP meets four times per year to discuss and sometimes vote on immunization issues and recommendations. Sometimes there are new vaccines added to the immunization schedule. More commonly, recommendations regarding existing vaccines are made based on new data from medical research and systems used to monitor vaccine efficacy and safety.

Understanding the schedule

The immunization schedule is organized in the following way. There is a single schedule for children 0 through 18 years of age.

  • The yellow bars show the recommended age range for the vaccine and the recommended dose number by age.
  • The green bars indicate the recommended ages for catch-up immunizations if shots were missed along the way.
  • The purple bars show the age range for immunization for certain children who may be at high risk for a particular disease.
  • The white boxes show the ages when a vaccine is not recommended routinely.

Were there any changes this year?

For 2014, there were only minor changes to the immunization schedule. There were no new vaccines added, and there were no major changes to the timing and number of vaccines recommended for children. All the changes that were made are found in the footnotes that accompany the immunization schedule. The changes made to the schedule this year predominantly address minor changes in recommendations, for example, for certain vaccines in children with immune system problems or clarifications in the timing of vaccine doses.

Learn more about childhood immunizations

vaccination, prevention