AAP Approves 2023 Child and Adolescent Immunization Schedule

The American Academy of Pediatrics (AAP) said it supports the Recommended Childhood and Adolescent Immunization Schedule: United States, 2023.

In a policy statement published online today in the journal Pediatrics, the AAP said the updated recommendations do not include major changes from those released last year by the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Prevention and Control (CDC).

In one small shift, COVID-19 is now addressed in the main text instead of being relegated to the notes section.

Dr Sean O’Leary

“And a new vaccine — Priorix [GlaxoSmithKline] – has been added for MMR [measles, mumps, rubella], so now there are two available,” Sean T. O’Leary, MD, MPH, chair of the AAP’s Committee on Infectious Diseases, told Medscape Medical News. “There’s also a second pneumococcal conjugate vaccine listed, PCV15, and this and PCV13 can essentially be used interchangeably.”

Minor updates to the schedule, reflected on the cover page, relate to vaccines for COVID-19, dengue fever, and pneumococcal disease, added O’Leary, a professor of pediatrics at the University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado in Aurora.

The committee also changed layouts to improve the usability of the schedule. Updated annually, the guidance provides a table on recommended pediatric immunizations from birth to age 18 years, and catch-up recommendations for children aged 4 months to 18 years who start their vaccinations late or are more than 1 month behind the recommended age for vaccine administration.

“We hope this annual update will encourage clinicians to make sure all their patients are up to date on their routine vaccinations,” O’Leary said. “It’s an opportunity to develop strategies to improve vaccination rates.”

This year’s schedule follows news from the CDC last month that kindergarten vaccination rates declined during the 2021-2022 school year. Only 93% of kindergarteners obtained full vaccinations, representing a drop of 1 percentage point from the year before and 2 points from the 2019-2020 school year.

The dip in coverage has been attributed to disruptions caused by the COVID-19 pandemic. AAP advises healthcare professionals to urge families to make sure their child’s vaccines are current.

Among other additions:

In Table 1:

  • MMR: Second vaccine added (Priorix, GlaxoSmithKline Biologicals SA)

  • Pneumococcal disease: second conjugate vaccine, PCV15, added (Vaxneuvance, Merck Sharp & Dohme)

  • COVID-19: New row added

  • Dengue: Text changed from “Seropositive in endemic areas only” to “Seropositive in endemic dengue areas”

  • Inactivated polio vaccine: “See Notes” added to the column for children aged 18 years

In Table 2:

  • PCV: dose 3 to dose 4 interval revised to align with ACIP’s recommendation for dose 4. This dose is necessary only for children ages 12 months through 59 months regardless of risk, or age 60 months through 71 months with any risk who received 3 doses before age 12 months.

A parent-friendly vaccine schedule for children and adolescents is available on the CDC’s website.

“Vaccines are essential for the health of our whole society, including children and adolescents,” O’Leary said in a press release from AAP. “These schedules provide a roadmap [that] parents and pediatricians can follow to help children get the vaccines they need so their immune systems will be ready to recognize and resist diseases.”

As previously, the 2023 schedule was adjusted to ensure consistency between the formats of the childhood/adolescent and adult immunization guidance. A meeting of stakeholder organizations this past October harmonized the two formats.

Pediatrics. Published online February 9, 2023. Policy statement

Diana Swift is a medical journalist based in Toronto.

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