The US Public Health Service joined with pediatricians and the National Foundation for Infectious Diseases (NFID) this past March to praise the new 1997 childhood immunization schedule. The schedule gives pediatricians and parents more choices when selecting vaccines, without compromising safety and efficacy. Details of the new schedule--and reasons for the changes--were discussed at a press conference in Washington, DC, sponsored by NFID.

"We are experiencing record high immunization coverage, with most childhood diseases that are preventable with vaccines at or near all-time low levels," stated Walter A. Orenstein, MD, director of the National Immunization Program at the Centers for Disease Control and Prevention (CDC). "The new changes, which have been recommended by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatricians (AAP), and the American Academy of Family Physicians (AAFP), should help continue this trend."

The three new recommendations are as follows:

1. Expanded options to use the inactivated polio vaccine--which is administered as a shot--rather than the oral polio vaccine for the first two polio immunizations a child receives.
2. Use of the acellular pertussis vaccine as the preferred pertussis vaccine for infants, beginning with the first shot of the series. Previously, the acellular pertussis vaccine, which produces fewer side effects than the whole cell vaccine, was not available for the primary series.
3. Use of combination vaccines, where appropriate, as a way to reduce the overall number of shots at any single visit.

This view was also shared by Joel I. Ward, MD, professor of pediatrics, UCLA Center for Vaccine Research. "More combination vaccines should simplify the schedule, reduce the need for clinic office visits, and may increase immunization levels," he said. "For example, in 1995, 92 percent of all toddlers were vaccinated against Haemophilus influenzae type B (Hib), while only 68 percent of children had received their hepatitis B shots. Use of a new combination vaccine, which combines protection against Hib and hepatitis B, may help bring the immunization rates for hepatitis B to the same high levels as Hib."

Samuel L. Katz, MD, professor of pediatrics at Duke University Medical Center, said that many pediatricians note that greater success in reducing or eliminating childhood diseases may "lead to public complacency about the need for vaccines." He said, "Most parents today have never seen devastating diseases like diphtheria, measles, and Hib, which can cause meningitis.

"In the 1950s, parents were personally familiar with devastating childhood diseases, such as polio, which caused 25,000 or more victims annually to end up with braces, crutches, wheelchairs, or in iron lungs," continued Dr. Katz. "Parents were also familiar with the effects of rubella (German measles) during pregnancy, since in just one year in the 1960s, more than 25,000 infants were born deaf, blind, mentally retarded, and/or with congenital heart disease. It is critically important to realize that the organisms causing these diseases have not disappeared, but have only receded into the background. Children must continue to receive their vaccinations on schedule, for this is the only way to avoid renewed suffering from these dreaded diseases."

The press conference was sponsored by NFID through an unrestricted educational grant from Merck & Co., Inc.