1. TM 2011 Immunization Recommendations H. Cody Meissner, M.D. Professor of Pediatrics Tufts University School of Medicine Boston Floating Hospital for Children Tufts Medical Center TM Prepared for your next patient.

2. TM Disclaimers  Statements and opinions expressed are those of the author and not necessarily those of the American Academy of Pediatrics.  Mead Johnson sponsors programs such as this to give healthcare professionals access to scientific and educational information provided by experts. The presenter has complete and independent control over the planning and content of the presentation, and is not receiving any compensation from Mead Johnson for this presentation. The presenter’s comments and opinions are not necessarily those of Mead Johnson. In the event that the presentation contains statements about uses of drugs that are not within the drugs' approved indications, Mead Johnson does not promote the use of any drug for indications outside the FDA-approved product label.

3. TM Considerations which Influence the Age at which a Vaccine is Recommended  Age-specific risk of a disease  Immune response to vaccine  Interference by maternal antibody  Waning immunity  Programmatic issues  “Crowding of the schedule”

4. TM Use of Tetanus and Diphtheria and Acellular Pertussis (Tdap) Vaccines  Removal of interval between Tdap and tetanus or diphtheria toxoid containing vaccine  Use of Tdap in certain adults ≥65 years of age  Use of Tdap in under-vaccinated children 7 through 10 years of age

5. TM Changes to the Meningococcal Conjugate Vaccine Schedule  Booster dose  Routine vaccination at 11 through 12 years with booster dose at 16 through 21 years  If first dose at 13 through 15 years, booster dose preferred at 16 through 18 years  Persons 2 through 54 years at increased risk of meningococcal disease should receive a 2 dose primary series (2 months apart), then booster dose every 5 years

6. TM 13 Valent Pneumococcal Conjugate Vaccine (PCV13) Recommendations  PCV13 recommended for all children 2 through 59 months  A 4 dose series at 2,4,6 and 12 through 15 months  Complete series with PCV13 if begun with PCV7  Supplemental dose of PCV13 for children 14-59 months who completed PCV7 schedule  Supplemental dose of PCV13 for children 60 through 71 months after PCV7 schedule if increased risk

7. TM 2010-2011 Influenza Vaccine Recommendations  Routine vaccination of all persons ≥6 months with emphasis on high risk groups  For children 6 months through 8 years  If vaccinated for 1 st time, 2 doses needed  If only 1 dose of seasonal vaccine in 2009-2010 and none in previous years, then 2 doses needed  If no doses of novel H1N1 last year, then 2 doses needed  Healthy, non-pregnant persons 2 through 49 years can receive TIV or LAIV

8. TM HPV Vaccine Recommendations  Quadrivalent HPV vaccine (HPV4) or bivalent (HPV2) vaccine recommended for prevention of cervical precancers and cancers in females  HPV4 recommended for prevention of precancers, cancers and genital warts in females  HPV4 may be administered to males to reduce risk of genital warts

9. TM Haemophilus influenzae type b Vaccine  For people ≥5 years at increased risk of infection, one dose should be considered  Sickle cell disease  Leukemia  HIV infection  Lack a spleen

10. TM Hepatitis B Vaccine  For infants who do not receive a birth dose:  Administer 3 doses of HepB on a schedule of 0, 1 and 6 months  The final (3 rd or 4 th ) dose in the HepB series should be administered no earlier than age 24 weeks

11. TM For more information….  On this topic and a host of other topics, visit www.pediatriccareonline.org. Pediatric Care Online is a convenient electronic resource for immediate expert help with virtually every pediatric clinical information need. Must-have resources are included in a comprehensive reference library and time-saving clinical tools.. www.pediatriccareonline.org Haven't activated your Pediatric Care Online trial subscription yet? It's quick and easy: simply follow the steps on the back of the card you received from your Mead Johnson representative. Haven't received your free trial card? Contact your Mead Johnson representative or call 888/363-2362 today.