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Breast Feeding

  • PrimeCare Pediatrics > Articles by: admin

    • Breast Feeding

    Post by : admin | Post on : April 5, 2017 at 9:34 am

    Breast feeding is a very rewarding experience for the mother. It can be challenging too, especially for the first-time mom.

    The decision to breast-feed is one that most pediatricians encourage and actively support. However, not every mother eventually ends up breast feeding their children, and some that do so, do it for varying lengths of time.

    We encourage every mother to make the decision to breast feed. We also understand that some mothers are not able to breast-fed for various reasons. For those mothers, there are several alternatives out there that will provide your offspring with adequate nutrition.

    Before you choose not to breast feed, consider the following advantages of breast feeding.

    Advantages to the BABY

    Breastfeeding is good for your baby because:

    1. It provides warmth and closeness. The physical contact helps create a special bond between you and your baby.
    2. Human milk has many benefits.
      • It’s easier for your baby to digest.
      • It doesn’t need to be prepared.
      • It’s always available and at the right temperature
      • It has all the nutrients, calories, and fluids your baby needs to be healthy.
      • It has growth factors that ensure the best development of your baby’s organs.
      • It has antibodies (that formulas don’t have) that protect your baby from a variety of diseases and infections. Because of these protective substances, breast fed children are less likely to have
        • Ear infections
        • Diarrhea
        • Pneumonia, wheezing, and bronchiolitis
        • Other bacterial and viral infections, such as meningitis
        • Research also suggests that breastfeeding may help to protect against obesity, diabetes, sudden infant death syndrome (SIDS), and some cancers.

    Advantages to the MOTHER:

    Breastfeeding is good for your health because it helps:

    • Release hormones in your body that promote mothering behavior.
    • Return your uterus to the size it was before pregnancy more quickly.
    • Burn more calories, which may help you lose the weight you gained during pregnancy.
    • Delay the return of your menstrual period to help keep iron in your body.
    • Reduce the risk of ovarian cancer and breast cancer.
    • Keep bones strong, which helps protect against bone fractures in older age.

    Importance of Good Positioning and Latch-on during Breast feeding

    There are various factors that can determine whether you have a successful breast feeding experience or not. One of them is positioning. The other is proper latch-on. You can adopt one of many positions during breast-feeding depending on your preference and what suits you and your baby best. The importance of this cannot be over emphasized, because done wrongly, it can frustrate you and your baby.

    Useful Breast Feeding Tips

    • Nurse early and often
    • Nurse with the nipple and areola fully in the baby’s mouth, not just the nipple
    • Breast feed on demand as much as possible
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    Videos of Some Vaccine Preventable Diseases

    Post by : admin | Post on : April 5, 2017 at 9:06 am

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    Images of Some Vaccine Preventable Diseases

    Post by : admin | Post on : April 5, 2017 at 9:03 am

    Varicella(Chicken pox)
    Tetanus
    Hepatitis
    Measles
    Mumps
    Rubella(German Measles)
    Poliomyelitis
    Pertussis(Whooping Cough)
    Diphtheria

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    Vaccines and Disease Prevention

    Post by : admin | Post on : April 5, 2017 at 7:15 am

    Immunizations are an important part of our health care delivery to our community.

    We strongly recommend that every child be given the opportunity to be immunized as recommended by the American Academy of Pediatrics, using vaccines that are already approved by the Center for Disease Control (CDC) and and the Food and Administration Association (FDA).

    Every parent is encouraged to take the time to become familiar with the immunizations that their children are given or required to take from time to time. This will enable them to gain knowledge about the usefulness of these vaccines and also provide information about potential side effects.

    Below is a list of the vaccines that are currently recommended for children and adolescents and a summarized list of the diseases they help to prevent.

    Type of Immunization Diseases They Prevent
    Hepatitis A vaccine Hepatitis A
    Hepatitis B vaccine Hepatitis B
    DTaP vaccine Diphtheria
    Tetanus
    Pertussis (Whooping cough)
    Rotavirus vaccine Rotavirus gastroenteritis
    Hemophilus influenzae type b (Hib) Ear infections
    Sinusitis
    Other infections
    Pneumococcal vaccine(PCV) Pneumonia, Ear infections
    Infection at other sites, e.g. Brain, bones, soft tissues
    Tdap Diphtheria
    Tetanus
    Pertussis (Whooping cough)
    IPV Poliomyelitis
    Influenza vaccine The flu
    MMR Measles
    Mumps
    Rubella
    Varicella vaccine Chicken pox
    Meningococcal vaccine Meningitis
    HPV vaccine Human Papilloma virus

    Important Immunization Information

    Immunization Requirement For School

    Two doses each of Hepatitis A and Varicella (Chicken Pox) are now required for entry into all Georgia schools beginning in 2007. Both series can be given beginning at 12 months of age.

    The latest recommendation is for middle-schoolers to receive the Tdap, Meningitis and HPV vaccines. This is also true for all teenagers. These vaccines can be conveniently administered at the 11-year well check.

    Read More

    Catch-up Schedule

    Post by : admin | Post on : April 5, 2017 at 6:30 am

    Catch-up Immunization Schedule

    For persons age 4 months through 18 years who start late or who are more than 1 month behind

    United States, 2016

    Print PDF document of this schedule

    The tables below provide catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child’s age. Always use these tables in conjunction with schedule for persons age 0 through 18 years and the footnotes that follow. For DTaP, Hib, and pneumococcal conjugate vaccines, catch-up guidance job aids are also available to assist health care providers in interpreting Figure 2.

    Children age 4 months through 6 years

    Vaccine Minimum Age for Dose 1 Minimum Interval Between Doses
    Dose 1 to dose 2 Dose 2 to dose 3 Dose 3 to dose 4 Dose 4 to dose 5
    Hepatitis B1 Birth 4 weeks 8 weeks
    and at least 16 weeks after first dose    . Minimum age for the final dose is 24 weeks.
    Rotavirus2 6 weeks 4 weeks 4 weeks2
    Diphtheria, tetanus, & acellular pertussis3 6 weeks 4 weeks 4 weeks 6 months 6 months3
    Haemophilus influenzaetype b4 6 weeks 4 weeks if first dose administered before the 1stbirthday.
    8 weeks (as final dose) if first dose was administered at age 12 through 14 months
    No further doses needed if first dose was administered at age 15 months or older    		 4 weeks4 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) or unknown.
    8 weeks and age 12 through 59 months (as final dose)4

    • if current age is younger than 12 monthsand first dose was administered at age 7 through 11 months; OR
    • if current age is 12 through 59 months andfirst dose was administered before the 1st birthday, and second dose administered at younger than 15 months; OR
    • if both doses were PRP-OMP (PedvaxHIB; Comvax) andwere administered before the 1st birthday.

    No further doses needed if previous dose was administered at age 15 months or older.

    		 8 weeks (as final dose)This dose only necessary for children age 12 through 59 months who received 3 doses before the 1stbirthday.
    Pneumococcal5 6 weeks 4 weeks if first dose administered before the 1stbirthday.
    8 weeks (as final dose for healthy children)if first dose was administered at the 1stbirthday or after.
    No further doses needed for healthy children if first dose administered at age 24 months or older.    		 4 weeks if current age is younger than 12 months and previous dose given at < 7 months old.
    8 weeks (as final dose for healthy children) if previous dose given between 7-11 months (wait until at least 12 months old); OR if current age is 12 months or older and at least 1 dose was given before age 12 months.
    No further doses needed for healthy children if previous dose administered at age 24 months or older.    		 8 weeks (as final dose)This dose only necessary for children aged 12 through 59 months who received 3 doses before age 12 months or for children at high risk who received 3 doses at any age.
    Inactivated Poliovirus6 6 weeks 4 weeks6 4 weeks6 6 months6(minimum age 4 years for final dose).
    Measles, mumps, rubella8 12 months 4 weeks
    Varicella9 12 months 3 months
    Hepatitis A10 12 months 6 months
    Meningococcal11
    (Hib-MenCY ≥ 6 weeks; MenACWY-D ≥9 mos; MenACWY-CRM ≥ 2 mos)    		 6 weeks 8 weeks11 See footnote 11 See footnote 11

    Note: The above recommendations must be read along with the footnotes of this schedule.

    Children and adolescents age 7 through 18 years

    Vaccine Minimum Age for Dose 1 Minimum Interval Between Doses
    Dose 1 to dose 2 Dose 2 to dose 3 Dose 3 to dose 4
    Meningococcal11
    (Hib-MenCY ≥ 6 weeks; MenACWY-D ≥9 mos; MenACWY-CRM ≥ 2 mos)    		 N/A 8 weeks11
    Tetanus, diphtheria; tetanus, diphtheria, and acellular pertussis12 7 years 12 4 weeks 4 weeks if first dose of DTaP/DT was administered before the 1stbirthday.
    6 months (as final dose) if first dose of DTaP/DT or Tdap/Td was administered at or after the 1st birthday.    		 6 months if first dose of DTaP/DT was administered before the 1stbirthday.
    Human papillomavirus13 9 years Routine dosing intervals are recommended.13
    Hepatitis A10 N/A 6 months
    Hepatitis B1 N/A 4 weeks 8 weeks and at least 16 weeks after first dose
    Inactivated Poliovirus6 N/A 4 weeks 4 weeks6 6 months6
    Measles, mumps, rubella9 N/A 4 weeks
    Varicella10 N/A 3 months if younger than age 13 years.
    4 weeks if age 13 years or older

    Note: The above recommendations must be read along with the footnotes of this schedule.

    Footnotes

    Catch-up Immunization Schedule

    United States, 2016

    For additional guidance for use of the vaccines described in this publication, see the ACIP Recommendations.

    1. Hepatitis B (HepB) vaccine. (Minimum age: birth)

      Routine vaccination:
      At birth

      • Administer monovalent HepB vaccine to all newborns before hospital discharge.
      • For infants born to hepatitis B surface antigen (HBsAg)-positive mothers, administer HepB vaccine and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9 through 18 months (preferably at the next well-child visit) or 1 to 2 months after completion of the HepB series if the series was delayed; CDC recently recommended testing occur at age 9 through 12 months; see MMWR October 9, 2015;64(39):1118-20).
      • If mother’s HBsAg status is unknown, within 12 hours of birth administer HepB vaccine regardless of birth weight. For infants weighing less than 2,000 grams, administer HBIG in addition to HepB vaccine within 12 hours of birth. Determine mother’s HBsAg status as soon as possible and, if mother is HBsAg-positive, also administer HBIG for infants weighing 2,000 grams or more as soon as possible, but no later than age 7 days.

      Doses following the birth dose

      • The second dose should be administered at age 1 or 2 months. Monovalent HepB vaccine should be used for doses administered before age 6 weeks.
      • Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a schedule of 0, 1 to 2 months, and 6 months starting as soon as feasible. See Catch-up Schedule.
      • Administer the second dose 1 to 2 months after the first dose (minimum interval of 4 weeks), administer the third dose at least 8 weeks after the second dose AND at least 16 weeks after the first dose. The final (third or fourth) dose in the HepB vaccine series should be administered no earlier than age 24 weeks.
      • Administration of a total of 4 doses of HepB vaccine is permitted when a combination vaccine containing HepB is administered after the birth dose.

      Catch-up vaccination:

      • Unvaccinated persons should complete a 3-dose series.
      • A 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years.
      • For other catch-up guidance, see Catch-up Schedule.
    2. Rotavirus (RV) vaccines. (Minimum age: 6 weeks for both RV1 [Rotarix] and RV5 [RotaTeq])

      Routine vaccination:

      • Administer a series of RV vaccine to all infants as follows:
        1. If Rotarix is used, administer a 2-dose series at 2 and 4 months of age.
        2. If RotaTeq is used, administer a 3-dose series at ages 2, 4, and 6 months.
        3. If any dose in the series was RotaTeq or vaccine product is unknown for any dose in the series, a total of 3 doses of RV vaccine should be administered.

      Catch-up vaccination:

      • The maximum age for the first dose in the series is 14 weeks, 6 days; vaccination should not be initiated for infants aged 15 weeks, 0 days or older.
      • The maximum age for the final dose in the series is 8 months, 0 days.
      • For other catch-up guidance, see Catch-up Schedule.
    3. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (Minimum age: 6 weeks. Exception: DTaP-IPV [Kinrix, Quadracel]: 4 years)

      Routine vaccination:

      • Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15 through 18 months, and 4 through 6 years. The fourth dose may be administered as early as age 12 months, provided at least 6 months have elapsed since the third dose.
      • Inadvertent administration of 4th DTaP dose early: If the fourth dose of DTaP was administered at least 4 months, but less than 6 months, after the third dose of DTaP, it need not be repeated.

      Catch-up vaccination:

      • The fifth dose of DTaP vaccine is not necessary if the fourth dose was administered at age 4 years or older.
      • For other catch-up guidance, see Catch-up Schedule.
    4. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6 weeks for PRP-T [ACTHIB, DTaP-IPV/Hib (Pentacel) and Hib-MenCY (MenHibrix)], PRP-OMP [PedvaxHIB or COMVAX], 12 months for PRP-T [Hiberix])

      Routine vaccination:

      • Administer a 2- or 3-dose Hib vaccine primary series and a booster dose (dose 3 or 4 depending on vaccine used in primary series) at age 12 through 15 months to complete a full Hib vaccine series.
      • The primary series with ActHIB, MenHibrix, or Pentacel consists of 3 doses and should be administered at 2, 4, and 6 months of age. The primary series with PedvaxHib or COMVAX consists of 2 doses and should be administered at 2 and 4 months of age; a dose at age 6 months is not indicated.
      • One booster dose (dose 3 or 4 depending on vaccine used in primary series) of any Hib vaccine should be administered at age 12 through 15 months. An exception is Hiberix vaccine. Hiberix should only be used for the booster (final) dose in children aged 12 months through 4 years who have received at least 1 prior dose of Hib-containing vaccine.
      • For recommendations on the use of MenHibrix in patients at increased risk for meningococcal disease, please refer to the meningococcal vaccine footnotes and also to MMWR February 28, 2014;63(RR01):1-13[20 pages].

      Catch-up vaccination:

      • If dose 1 was administered at ages 12 through 14 months, administer a second (final) dose at least 8 weeks after dose 1, regardless of Hib vaccine used in the primary series.
      • If both doses were PRP-OMP (PedvaxHIB or COMVAX), and were administered before the first birthday, the third (and final) dose should be administered at age 12 through 59 months and at least 8 weeks after the second dose.
      • If the first dose was administered at age 7 through 11 months, administer the second dose at least 4 weeks later and a third (and final) dose at age 12 through 15 months or 8 weeks after second dose, whichever is later.
      • If first dose is administered before the first birthday and second dose administered at younger than 15 months, a third (and final) dose should be administered 8 weeks later.
      • For unvaccinated children aged 15 months or older, administer only 1 dose.
      • For other catch-up guidance, see Catch-up Schedule. For catch-up guidance related to MenHibrix, please see the meningococcal vaccine footnotes and also MMWR February 28, 2014;63(RR01):1-13[20 pages].

      Vaccination of persons with high-risk conditions:

      • Children aged 12 through 59 months who are at increased risk for Hib disease, including chemotherapy recipients and those with anatomic or functional asplenia (including sickle cell disease), human immunodeficiency virus (HIV) infection, immunoglobulin deficiency, or early component complement deficiency, who have received either no doses or only 1 dose of Hib vaccine before 12 months of age, should receive 2 additional doses of Hib vaccine 8 weeks apart; children who received 2 or more doses of Hib vaccine before 12 months of age should receive 1 additional dose.
      • For patients younger than 5 years of age undergoing chemotherapy or radiation treatment who received a Hib vaccine dose(s) within 14 days of starting therapy or during therapy, repeat the dose(s) at least 3 months following therapy completion.
      • Recipients of hematopoietic stem cell transplant (HSCT) should be revaccinated with a 3-dose regimen of Hib vaccine starting 6 to 12 months after successful transplant, regardless of vaccination history; doses should be administered at least 4 weeks apart.
      • A single dose of any Hib-containing vaccine should be administered to unimmunized* children and adolescents 15 months of age and older undergoing an elective splenectomy; if possible, vaccine should be administered at least 14 days before procedure.
      • Hib vaccine is not routinely recommended for patients 5 years or older. However, 1 dose of Hib vaccine should be administered to unimmunized* persons aged 5 years or older who have anatomic or functional asplenia (including sickle cell disease) and unvaccinated persons 5 through 18 years of age with HIV infection.

      * Patients who have not received a primary series and booster dose or at least 1 dose of Hib vaccine after 14 months of age are considered unimmunized.

    5. Pneumococcal vaccines. (Minimum age: 6 weeks for PCV13, 2 years for PPSV23)Routine vaccination with PCV13:
      • Administer a 4-dose series of PCV13 vaccine at ages 2, 4, and 6 months and at age 12 through 15 months.
      • For children aged 14 through 59 months who have received an age-appropriate series of 7-valent PCV (PCV7), administer a single supplemental dose of 13-valent PCV (PCV13).

      Catch-up vaccination with PCV13:

      • Administer 1 dose of PCV13 to all healthy children aged 24 through 59 months who are not completely vaccinated for their age.
      • For other catch-up guidance, see Catch-up Schedule.

      Vaccination of persons with high-risk conditions with PCV13 and PPSV23:

      • All recommended PCV13 doses should be administered prior to PPSV23 vaccination if possible.
      • For children 2 through 5 years of age with any of the following conditions: chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy); diabetes mellitus; cerebrospinal fluid leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; solid organ transplantation; or congenital immunodeficiency:
        1. Administer 1 dose of PCV13 if any incomplete schedule of 3 doses of PCV (PCV7 and/or PCV13) were received previously.
        2. Administer 2 doses of PCV13 at least 8 weeks apart if unvaccinated or any incomplete schedule of fewer than 3 doses of PCV (PCV7 and/or PCV13) were received previously.
        3. Administer 1 supplemental dose of PCV13 if 4 doses of PCV7 or other age-appropriate complete PCV7 series was received previously.
        4. The minimum interval between doses of PCV (PCV7 or PCV13) is 8 weeks.
        5. For children with no history of PPSV23 vaccination, administer PPSV23 at least 8 weeks after the most recent dose of PCV13.
      • For children aged 6 through 18 years who have cerebrospinal fluid leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiencies; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma:
        1. If neither PCV13 nor PPSV23 has been received previously, administer 1 dose of PCV13 now and 1 dose of PPSV23 at least 8 weeks later.
        2. If PCV13 has been received previously but PPSV23 has not, administer 1 dose of PPSV23 at least 8 weeks after the most recent dose of PCV13.
        3. If PPSV23 has been received but PCV13 has not, administer 1 dose of PCV13 at least 8 weeks after the most recent dose of PPSV23.
      • For children aged 6 through 18 years with chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure), chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy), diabetes mellitus, alcoholism, or chronic liver disease, who have not received PPSV23, administer 1 dose of PPSV23. If PCV13 has been received previously, then PPSV23 should be administered at least 8 weeks after any prior PCV13 dose.
      • A single revaccination with PPSV23 should be administered 5 years after the first dose to children with sickle cell disease or other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiencies; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma.
    6. Inactivated poliovirus vaccine (IPV). (Minimum age: 6 weeks)

      Routine vaccination:

      • Administer a 4-dose series of IPV at ages 2, 4, 6 through 18 months, and 4 through 6 years. The final dose in the series should be administered on or after the fourth birthday and at least 6 months after the previous dose.

      Catch-up vaccination:

      • In the first 6 months of life, minimum age and minimum intervals are only recommended if the person is at risk for imminent exposure to circulating poliovirus (i.e., travel to a polio-endemic region or during an outbreak).
      • If 4 or more doses are administered before age 4 years, an additional dose should be administered at age 4 through 6 years and at least 6 months after the previous dose.
      • A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6 months after the previous dose.
      • If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age. If only OPV were administered, and all doses were given prior to 4 years of age, one dose of IPV should be given at 4 years or older, at least 4 weeks after the last OPV dose.
      • IPV is not routinely recommended for U.S. residents aged 18 years or older.
      • For other catch-up guidance, see Catch-up Schedule.
    7. Influenza vaccines. (Minimum age: 6 months for inactivated influenza vaccine [IIV], 2 years for live, attenuated influenza vaccine [LAIV])

      Routine vaccination:

      • Administer influenza vaccine annually to all children beginning at age 6 months. For most healthy, nonpregnant persons aged 2 through 49 years, either LAIV or IIV may be used. However, LAIV should NOT be administered to some persons, including 1) persons who have experienced severe allergic reactions to LAIV, any of its components, or to a previous dose of any other influenza vaccine; 2) children 2 through 17 years receiving aspirin or aspirin-containing products; 3) persons who are allergic to eggs; 4) pregnant women; 5) immunosuppressed persons; 6) children 2 through 4 years of age with asthma or who had wheezing in the past 12 months; or 7) persons who have taken influenza antiviral medications in the previous 48 hours. For all other contraindications and precautions to use of LAIV, see MMWR August 7, 2015;64(30):818-25 [28 pages].

      For children aged 6 months through 8 years:

      • For the 2015-16 season, administer 2 doses (separated by at least 4 weeks) to children who are receiving influenza vaccine for the first time. Some children in this age group who have been vaccinated previously will also need 2 doses. For additional guidance, follow dosing guidelines in the 2015-16 ACIP influenza vaccine recommendations, MMWR August 7, 2015 ;64(30);88-25 [28 pages]
      • For the 2016-17 season, follow dosing guidelines in the 2016 ACIP influenza vaccine recommendations.

      For persons aged 9 years and older:

      • Administer 1 dose.
    8. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12 months for routine vaccination)

      Routine vaccination:

      • Administer a 2-dose series of MMR vaccine at ages 12 through 15 months and 4 through 6 years. The second dose may be administered before age 4 years, provided at least 4 weeks have elapsed since the first dose.
      • Administer 1 dose of MMR vaccine to infants aged 6 through 11 months before departure from the United States for international travel. These children should be revaccinated with 2 doses of MMR vaccine, the first at age 12 through 15 months (12 months if the child remains in an area where disease risk is high), and the second dose at least 4 weeks later.
      • Administer 2 doses of MMR vaccine to children aged 12 months and older before departure from the United States for international travel. The first dose should be administered on or after age 12 months and the second dose at least 4 weeks later.

      Catch-up vaccination:

      • Ensure that all school-aged children and adolescents have had 2 doses of MMR vaccine; the minimum interval between the 2 doses is 4 weeks.
    9. Varicella (VAR) vaccine. (Minimum age: 12 months)

      Routine vaccination:

      • Administer a 2-dose series of VAR vaccine at ages 12 through 15 months and 4 through 6 years. The second dose may be administered before age 4 years, provided at least 3 months have elapsed since the first dose. If the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid.

      Catch-up vaccination:

      • Ensure that all persons aged 7 through 18 years without evidence of immunity (see MMWR 2007;56[No. RR-4][48 pages]), have 2 doses of varicella vaccine. For children aged 7 through 12 years, the recommended minimum interval between doses is 3 months (if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid); for persons aged 13 years and older, the minimum interval between doses is 4 weeks.
    10. Hepatitis A (HepA) vaccine. (Minimum age: 12 months)

      Routine vaccination:

      • Initiate the 2-dose HepA vaccine series at 12 through 23 months; separate the 2 doses by 6 to 18 months.
      • Children who have received 1 dose of HepA vaccine before age 24 months should receive a second dose 6 to 18 months after the first dose.
      • For any person aged 2 years and older who has not already received the HepA vaccine series, 2 doses of HepA vaccine separated by 6 to 18 months may be administered if immunity against hepatitis A virus infection is desired.

      Catch-up vaccination:

      • The minimum interval between the 2 doses is 6 months.

      Special populations:

      • Administer 2 doses of HepA vaccine at least 6 months apart to previously unvaccinated persons who live in areas where vaccination programs target older children, or who are at increased risk for infection. This includes persons traveling to or working in countries that have high or intermediate endemicity of infection; men having sex with men; users of injection and non-injection illicit drugs; persons who work with HAV-infected primates or with HAV in a research laboratory; persons with clotting-factor disorders; persons with chronic liver disease; and persons who anticipate close, personal contact (e.g., household or regular babysitting) with an international adoptee during the first 60 days after arrival in the United States from a country with high or intermediate endemicity. The first dose should be administered as soon as the adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.
    11. Meningococcal vaccines. (Minimum age: 6 weeks for Hib-MenCY [MenHibrix], 9 months for MenACWY-D [Menactra], 2 months for MenACWY-CRM [Menveo], 10 years for serogroup B meningococcal [MenB] vaccines: MenB-4C [Bexsero] and MenB-FHbp [Trumenba])

      Routine vaccination:

      • Administer a single dose of Menactra or Menveo vaccine at age 11 through 12 years, with a booster dose at age 16 years.
      • Adolescents aged 11 through 18 years with human immunodeficiency virus (HIV) infection should receive a 2-dose primary series of Menactra or Menveo with at least 8 weeks between doses.
      • For children aged 2 months through 18 years with high-risk conditions, see below.

      Catch-up vaccination:

      • Administer Menactra or Menveo vaccine at age 13 through 18 years if not previously vaccinated.
      • If the first dose is administered at age 13 through 15 years, a booster dose should be administered at age 16 through 18 years with a minimum interval of at least 8 weeks between doses.
      • If the first dose is administered at age 16 years or older, a booster dose is not needed.
      • For other catch-up guidance, see Catch-up Schedule.

      Clinical discretion:

      • Young adults aged 16 through 23 years (preferred age range is 16 through 18 years) may be vaccinated with either a 2-dose series of Bexsero or a 3-dose series of Trumenba vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.

      Vaccination of persons with high-risk conditions and other persons at increased risk of disease:

      • Children with anatomic or functional asplenia (including sickle cell disease):Meningococcal conjugate ACWY vaccines:
        • Menveo
          • Children who initiate vaccination at 8 weeks. Administer doses at 2, 4, 6 and 12 months of age.
          • Unvaccinated children who initiate vaccination at 7 through 23 months. Administer two doses, with the second dose at least 12 weeks after the first dose AND after the first birthday.
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart.
        • MenHibrix
          • Children who initiate vaccination at 6 weeks. Administer doses at 2, 4, 6 and 12 through 15 months of age.
          • If the first dose of MenHibrix is given at or after 12 months of age, a total of 2 doses should be given at least 8 weeks apart to ensure protection against serogroups C and Y meningococcal disease.
        • Menactra
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart. If Menactra is administered to a child with asplenia (including sickle cell disease), do not administer Menactra until 2 years of age and at least 4 weeks after the completion of all PCV13 doses.

        Meningococcal B vaccines:

        • Bexsero or Trumenba
          • Persons 10 years or older who have not received a complete series.  Administer a 2 dose series of Bexsero, at least 1 month apart. Or a 3-dose series of Trumenba, with the second dose at least 2 months after the first and the third dose at least 6 months after the first. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.
      • Children with persistent complement component deficiency (includes persons with inherited or chronic deficiencies in C3, C5-9, properidin, factor D, factor H, or taking eculizumab (Soliris®):Meningococcal conjugate ACWY vaccines:
        • Menveo
          • Children who initiate vaccination at 8 weeks.  Administer doses at 2, 4, 6 and 12 months of age.
          • Unvaccinated children who initiate vaccination at 7 through 23 months. Administer two doses, with the second dose at least 12 weeks after the first dose AND after the first birthday.
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart.
        • MenHibrix
          • Children who initiate vaccination at 6 weeks.  Administer doses at 2, 4, 6 and 12 through 15 months of age.
          • If the first dose of MenHibrix is given at or after 12 months of age, a total of 2 doses should be given at least 8 weeks apart to ensure protection against serogroups C and Y meningococcal disease.
        • Menactra
          • Children 9 through 23 months; Administer two primary doses at least 12 weeks apart.
          • Children 24 months and older who have not received a complete series: Administer two primary doses at least 8 weeks apart.

        Meningococcal B vaccines:

        • Bexsero or Trumenba
          • Persons 10 years or older who have not received a complete series.  Administer a 2-dose series of Bexsero, at least 1 month apart, or a 3-dose series of Trumenba®, with the second dose at least 2 months after the first and the third dose at least 6 months after the first. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.
      • For children who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj:
        • Administer an age-appropriate formulation and series of Menactra or Menveo for protection against serogroups A and W meningococcal disease. Prior receipt of MenHibrix is not sufficient for children traveling to the meningitis belt or the Hajj because it does not contain serogroups A or W.
      • For children at risk during a community outbreak attributable to a vaccine serogroup:
        • Administer or complete an age- and formulation-appropriate series of MenHibrix, Menactra, Menveo, Bexsero, or Trumenba.

      For booster doses among persons with high-risk conditions, refer to MMWR 2013;62(RR02):1-22.

      For other catch-up recommendations for these persons, and complete information on use of meningococcal vaccines, including guidance related to vaccination of persons at increased risk of infection, see MMWR March 22, 2013;62(RR02):1-22[32 pages] and MMWR Ocutober 23, 2015;64(41):1171-1176 [24 pages].

    12. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for both Boostrix and Adacel)

      Routine vaccination:

      • Administer 1 dose of Tdap vaccine to all adolescents aged 11 through 12 years.
      • Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.
      • Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferred during 27 through 36 weeks gestation) regardless of time since prior Td or Tdap vaccination.

      Catch-up vaccination:

      • Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap vaccine as 1 (preferably the first) dose in the catch-up series; if additional doses are needed, use Td vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an adolescent Tdap vaccine dose at age 11 through 12 years should NOT be administered. Td should be administered instead 10 years after the Tdap dose.
      • Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.
      • Inadvertent doses of DTaP vaccine:
        • If administered inadvertently to a child aged 7 through 10 years may count as part of the catch-up series. This dose may count as the adolescent Tdap dose, or the child can later receive a Tdap booster dose at age 11 through 12 years.
        • If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be counted as the adolescent Tdap booster.
      • For other catch-up guidance, see Catch-up Schedule.
    13. Human papillomavirus (HPV) vaccines. (Minimum age: 9 years for 2vHPV [Cervarix], 4vHPV [Gardasil], and 9vHPV [Gardasil 9])

      Routine vaccination:

      • Administer a 3-dose series of HPV vaccine on a schedule of 0, 1-2, and 6 months to all adolescents aged 11 through 12 years. 9vHPV, 4vHPV or 2vHPV may be used for females, and only 9vHPV or 4vHPV may be used for males.
      • The vaccine series may be started at age 9 years,
      • Administer the second dose 1 to 2 months after the first dose (minimum interval of 4 weeks), administer the third dose 16 weeks after the second dose (minimum interval of 12 weeks) and 24 weeks after the first dose.
      • Administer HPV vaccine beginning at age 9 years to children and youth with any history of sexual abuse or assault who have not initiated or completed the 3-dose series.

      Catch-up vaccination:

      • Administer the vaccine series to females (2vHPV, 4vHPV, or 9vHPV) and males (4vHPV or 9vHPV) at age 13 through 18 years if not previously vaccinated.
      • Use recommended routine dosing intervals (see above) for vaccine series catch-up.

    See additional notes for Recommended Immunization Schedule for Persons Age 0 Through 18 Years and Catch-up Immunization Schedule.

    This schedule includes recommendations in effect as of January 1, 2016. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations. Clinically significant adverse events that follow vaccination should be reported to Vaccine Adverse Event Reporting System (VAERS) online or by telephone (800-822-7967). Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Additional information, including precautions and contraindications for vaccination, is available from CDC’s Vaccines and Immunizationonline site or by telephone (800-CDC-INFO [800-232-4636]).

    This schedule is approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG).

    Page last reviewed: February 1, 2016

    Page last updated: February 1, 2016

    Content source: National Center for Immunization and Respiratory Diseases

    Provided by: Centers for Disease Control and Prevention (CDC)

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    Recommended Immunization Schedule

    Post by : admin | Post on : April 4, 2017 at 5:43 am

    Recommended Immunization Schedule for Persons Aged 0 Through 18 Years

    United States, 2016

    Compliant version of the schedule

    Print PDF document of this schedule

    These recommendations must be read with the footnotes that follow. For those who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars in tables below. To determine minimum intervals between doses, see the catch-up schedule. School entry and adolescent vaccine age groups are 4-6 yrs and 11-12 yrs.

    Birth to 15 Months

    Vaccine Birth 1 mo 2 mos 4 mos 6 mos 9 mos 12 mos 15 mos
    Hepatitis B1 (HepB) 1stdose ←2nddose→ ←3rd dose→
    Rotavirus2 (RV)
    RV1 (2-dose series); RV5 (3-dose series)    		 1stdose 2nddose See footnote 2
    Diphtheria, tetanus, & acellular pertussis3(DTaP: <7 yrs) 1stdose 2nddose 3rd dose ←4thdose→
    Haemophilus influenzae type b4 (Hib) 1stdose 2nddose See footnote 4 ←3rd or 4thdose,
    See footnote 4→
    Pneumococcal conjugate5(PCV13) 1stdose 2nddose 3rd dose ←4th dose→
    Inactivated poliovirus6 (IPV:<18 yrs) 1stdose 2nddose ←3rd dose→
    Influenza7 (IIV; LAIV) Annual vaccination (IIV only) 1 or 2 doses
    Measles, mumps, rubella8(MMR) See footnote 8 ←1st dose→
    Varicella9 (VAR) ←1st dose→
    Hepatitis A10 (HepA) ←2 dose series, See footnote 10→
    Meningococcal11 (Hib-MenCY ≥ 6 weeks; MenACWY-D ≥9 mos; MenACWY-CRM ≥ 2 mos) See footnote 11
    Tetanus, diphtheria, & acellular pertussis12(Tdap: ≥7 yrs)
    Human papillomavirus13(2vHPV:females only; 4vHPV, 9vHPV:males and females)
    Meningococcal B11
    Pneumococcal polysaccharide5 (PPSV23)

    Legend

    Range of recommended ages for all children Range of recommended ages for catch-up immunization Range of recommended ages for certain high-risk groups Range of recommended ages for non-high-risk groups that may receive vaccine, subject to individual clinical decision making No recommendation

    18 Months to 18 Years

    Vaccines 18 mos 19-23 mos 2-3 yrs 4-6 yrs 7-10 yrs 11-12 yrs 13-15 yrs 16-18 yrs
    Hepatitis B1 (HepB) ←3rddose→
    Rotavirus2 (RV)
    RV1 (2-dose series); RV5 (3-dose series)
    Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs) ←4thdose→ 5thdose
    Haemophilus influenzae type b4(Hib)
    Pneumococcal conjugate5(PCV13)
    Inactivated poliovirus6 (IPV)(<18 yrs) ←3rddose→ 4thdose
    Influenza7 (IIV; LAIV) Annual vaccination (IIV only) 1 or 2 doses Annual vaccination (LAIV or IIV) 1 or 2 doses Annual vaccination (LAIV or IIV) 1 dose only
    Measles, mumps, rubella8(MMR) 2nddose
    Varicella9 (VAR) 2nddose
    Hepatitis A10 (HepA) ←2 dose series, See footnote 10→
    Meningococcal11 (Hib-MenCY ≥ 6 weeks; MenACWY-D ≥9 mos; MenACWY-CRM ≥ 2 mos) See footnote 11 1stdose Booster
    Tetanus, diphtheria, & acellular pertussis12 (Tdap: ≥7 yrs) (Tdap)
    Human papillomavirus13(2vHPV:females only; 4vHPV, 9vHPV:males and females) (3 dose series)
    Meningococcal B11 See footnote 11
    Pneumococcal polysaccharide5(PPSV23) See footnote 5

    Note: The above recommendations must be read along with the footnotes of this schedule.

    Footnotes

    Recommended Immunization Schedule for Persons Age 0 Through 18 Years

    United States, 2016

    For further guidance on the use of the vaccines mentioned below, see the ACIP Recommendations.

    For vaccine recommendations for persons 19 years of age and older, see the adult immunization schedule.

    1. Hepatitis B (HepB) vaccine. (Minimum age: birth)

      Routine vaccination:
      At birth

      • Administer monovalent HepB vaccine to all newborns before hospital discharge.
      • For infants born to hepatitis B surface antigen (HBsAg)-positive mothers, administer HepB vaccine and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9 through 18 months (preferably at the next well-child visit) or 1 to 2 months after completion of the HepB series if the series was delayed; CDC recently recommended testing occur at age 9 through 12 months; see MMWR October 9, 2015;64(39):1118-20).
      • If mother’s HBsAg status is unknown, within 12 hours of birth administer HepB vaccine regardless of birth weight. For infants weighing less than 2,000 grams, administer HBIG in addition to HepB vaccine within 12 hours of birth. Determine mother’s HBsAg status as soon as possible and, if mother is HBsAg-positive, also administer HBIG for infants weighing 2,000 grams or more as soon as possible, but no later than age 7 days.

      Doses following the birth dose

      • The second dose should be administered at age 1 or 2 months. Monovalent HepB vaccine should be used for doses administered before age 6 weeks.
      • Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a schedule of 0, 1 to 2 months, and 6 months starting as soon as feasible. See Catch-up Schedule.
      • Administer the second dose 1 to 2 months after the first dose (minimum interval of 4 weeks), administer the third dose at least 8 weeks after the second dose AND at least 16 weeks after the first dose. The final (third or fourth) dose in the HepB vaccine series should be administered no earlier than age 24 weeks.
      • Administration of a total of 4 doses of HepB vaccine is permitted when a combination vaccine containing HepB is administered after the birth dose.

      Catch-up vaccination:

      • Unvaccinated persons should complete a 3-dose series.
      • A 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years.
      • For other catch-up guidance, see Catch-up Schedule.
    2. Rotavirus (RV) vaccines. (Minimum age: 6 weeks for both RV1 [Rotarix] and RV5 [RotaTeq])

      Routine vaccination:

      • Administer a series of RV vaccine to all infants as follows:
        1. If Rotarix is used, administer a 2-dose series at 2 and 4 months of age.
        2. If RotaTeq is used, administer a 3-dose series at ages 2, 4, and 6 months.
        3. If any dose in the series was RotaTeq or vaccine product is unknown for any dose in the series, a total of 3 doses of RV vaccine should be administered.

      Catch-up vaccination:

      • The maximum age for the first dose in the series is 14 weeks, 6 days; vaccination should not be initiated for infants aged 15 weeks, 0 days or older.
      • The maximum age for the final dose in the series is 8 months, 0 days.
      • For other catch-up guidance, see Catch-up Schedule.
    3. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (Minimum age: 6 weeks. Exception: DTaP-IPV [Kinrix, Quadracel]: 4 years)

      Routine vaccination:

      • Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15 through 18 months, and 4 through 6 years. The fourth dose may be administered as early as age 12 months, provided at least 6 months have elapsed since the third dose.
      • Inadvertent administration of 4th DTaP dose early: If the fourth dose of DTaP was administered at least 4 months, but less than 6 months, after the third dose of DTaP, it need not be repeated.

      Catch-up vaccination:

      • The fifth dose of DTaP vaccine is not necessary if the fourth dose was administered at age 4 years or older.
      • For other catch-up guidance, see Catch-up Schedule.
    4. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6 weeks for PRP-T [ACTHIB, DTaP-IPV/Hib (Pentacel) and Hib-MenCY (MenHibrix)], PRP-OMP [PedvaxHIB or COMVAX], 12 months for PRP-T [Hiberix])

      Routine vaccination:

      • Administer a 2- or 3-dose Hib vaccine primary series and a booster dose (dose 3 or 4 depending on vaccine used in primary series) at age 12 through 15 months to complete a full Hib vaccine series.
      • The primary series with ActHIB, MenHibrix, or Pentacel consists of 3 doses and should be administered at 2, 4, and 6 months of age. The primary series with PedvaxHib or COMVAX consists of 2 doses and should be administered at 2 and 4 months of age; a dose at age 6 months is not indicated.
      • One booster dose (dose 3 or 4 depending on vaccine used in primary series) of any Hib vaccine should be administered at age 12 through 15 months. An exception is Hiberix vaccine. Hiberix should only be used for the booster (final) dose in children aged 12 months through 4 years who have received at least 1 prior dose of Hib-containing vaccine.
      • For recommendations on the use of MenHibrix in patients at increased risk for meningococcal disease, please refer to the meningococcal vaccine footnotes and also to MMWR February 28, 2014;63(RR01):1-13[20 pages].

      Catch-up vaccination:

      • If dose 1 was administered at ages 12 through 14 months, administer a second (final) dose at least 8 weeks after dose 1, regardless of Hib vaccine used in the primary series.
      • If both doses were PRP-OMP (PedvaxHIB or COMVAX), and were administered before the first birthday, the third (and final) dose should be administered at age 12 through 59 months and at least 8 weeks after the second dose.
      • If the first dose was administered at age 7 through 11 months, administer the second dose at least 4 weeks later and a third (and final) dose at age 12 through 15 months or 8 weeks after second dose, whichever is later.
      • If first dose is administered before the first birthday and second dose administered at younger than 15 months, a third (and final) dose should be administered 8 weeks later.
      • For unvaccinated children aged 15 months or older, administer only 1 dose.
      • For other catch-up guidance, see Catch-up Schedule. For catch-up guidance related to MenHibrix, please see the meningococcal vaccine footnotes and also MMWR February 28, 2014;63(RR01):1-13[20 pages].

      Vaccination of persons with high-risk conditions:

      • Children aged 12 through 59 months who are at increased risk for Hib disease, including chemotherapy recipients and those with anatomic or functional asplenia (including sickle cell disease), human immunodeficiency virus (HIV) infection, immunoglobulin deficiency, or early component complement deficiency, who have received either no doses or only 1 dose of Hib vaccine before 12 months of age, should receive 2 additional doses of Hib vaccine 8 weeks apart; children who received 2 or more doses of Hib vaccine before 12 months of age should receive 1 additional dose.
      • For patients younger than 5 years of age undergoing chemotherapy or radiation treatment who received a Hib vaccine dose(s) within 14 days of starting therapy or during therapy, repeat the dose(s) at least 3 months following therapy completion.
      • Recipients of hematopoietic stem cell transplant (HSCT) should be revaccinated with a 3-dose regimen of Hib vaccine starting 6 to 12 months after successful transplant, regardless of vaccination history; doses should be administered at least 4 weeks apart.
      • A single dose of any Hib-containing vaccine should be administered to unimmunized* children and adolescents 15 months of age and older undergoing an elective splenectomy; if possible, vaccine should be administered at least 14 days before procedure.
      • Hib vaccine is not routinely recommended for patients 5 years or older. However, 1 dose of Hib vaccine should be administered to unimmunized* persons aged 5 years or older who have anatomic or functional asplenia (including sickle cell disease) and unvaccinated persons 5 through 18 years of age with HIV infection.

      * Patients who have not received a primary series and booster dose or at least 1 dose of Hib vaccine after 14 months of age are considered unimmunized.

    5. Pneumococcal vaccines. (Minimum age: 6 weeks for PCV13, 2 years for PPSV23)Routine vaccination with PCV13:
      • Administer a 4-dose series of PCV13 vaccine at ages 2, 4, and 6 months and at age 12 through 15 months.
      • For children aged 14 through 59 months who have received an age-appropriate series of 7-valent PCV (PCV7), administer a single supplemental dose of 13-valent PCV (PCV13).

      Catch-up vaccination with PCV13:

      • Administer 1 dose of PCV13 to all healthy children aged 24 through 59 months who are not completely vaccinated for their age.
      • For other catch-up guidance, see Catch-up Schedule.

      Vaccination of persons with high-risk conditions with PCV13 and PPSV23:

      • All recommended PCV13 doses should be administered prior to PPSV23 vaccination if possible.
      • For children 2 through 5 years of age with any of the following conditions: chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy); diabetes mellitus; cerebrospinal fluid leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; solid organ transplantation; or congenital immunodeficiency:
        1. Administer 1 dose of PCV13 if any incomplete schedule of 3 doses of PCV (PCV7 and/or PCV13) were received previously.
        2. Administer 2 doses of PCV13 at least 8 weeks apart if unvaccinated or any incomplete schedule of fewer than 3 doses of PCV (PCV7 and/or PCV13) were received previously.
        3. Administer 1 supplemental dose of PCV13 if 4 doses of PCV7 or other age-appropriate complete PCV7 series was received previously.
        4. The minimum interval between doses of PCV (PCV7 or PCV13) is 8 weeks.
        5. For children with no history of PPSV23 vaccination, administer PPSV23 at least 8 weeks after the most recent dose of PCV13.
      • For children aged 6 through 18 years who have cerebrospinal fluid leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiencies; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma:
        1. If neither PCV13 nor PPSV23 has been received previously, administer 1 dose of PCV13 now and 1 dose of PPSV23 at least 8 weeks later.
        2. If PCV13 has been received previously but PPSV23 has not, administer 1 dose of PPSV23 at least 8 weeks after the most recent dose of PCV13.
        3. If PPSV23 has been received but PCV13 has not, administer 1 dose of PCV13 at least 8 weeks after the most recent dose of PPSV23.
      • For children aged 6 through 18 years with chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure), chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy), diabetes mellitus, alcoholism, or chronic liver disease, who have not received PPSV23, administer 1 dose of PPSV23. If PCV13 has been received previously, then PPSV23 should be administered at least 8 weeks after any prior PCV13 dose.
      • A single revaccination with PPSV23 should be administered 5 years after the first dose to children with sickle cell disease or other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiencies; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma.
    6. Inactivated poliovirus vaccine (IPV). (Minimum age: 6 weeks)

      Routine vaccination:

      • Administer a 4-dose series of IPV at ages 2, 4, 6 through 18 months, and 4 through 6 years. The final dose in the series should be administered on or after the fourth birthday and at least 6 months after the previous dose.

      Catch-up vaccination:

      • In the first 6 months of life, minimum age and minimum intervals are only recommended if the person is at risk for imminent exposure to circulating poliovirus (i.e., travel to a polio-endemic region or during an outbreak).
      • If 4 or more doses are administered before age 4 years, an additional dose should be administered at age 4 through 6 years and at least 6 months after the previous dose.
      • A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6 months after the previous dose.
      • If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age. If only OPV were administered, and all doses were given prior to 4 years of age, one dose of IPV should be given at 4 years or older, at least 4 weeks after the last OPV dose.
      • IPV is not routinely recommended for U.S. residents aged 18 years or older.
      • For other catch-up guidance, see Catch-up Schedule.
    7. Influenza vaccines. (Minimum age: 6 months for inactivated influenza vaccine [IIV], 2 years for live, attenuated influenza vaccine [LAIV])

      Routine vaccination:

      • Administer influenza vaccine annually to all children beginning at age 6 months. For most healthy, nonpregnant persons aged 2 through 49 years, either LAIV or IIV may be used. However, LAIV should NOT be administered to some persons, including 1) persons who have experienced severe allergic reactions to LAIV, any of its components, or to a previous dose of any other influenza vaccine; 2) children 2 through 17 years receiving aspirin or aspirin-containing products; 3) persons who are allergic to eggs; 4) pregnant women; 5) immunosuppressed persons; 6) children 2 through 4 years of age with asthma or who had wheezing in the past 12 months; or 7) persons who have taken influenza antiviral medications in the previous 48 hours. For all other contraindications and precautions to use of LAIV, see MMWR August 7, 2015;64(30):818-25 [28 pages].

      For children aged 6 months through 8 years:

      • For the 2015-16 season, administer 2 doses (separated by at least 4 weeks) to children who are receiving influenza vaccine for the first time. Some children in this age group who have been vaccinated previously will also need 2 doses. For additional guidance, follow dosing guidelines in the 2015-16 ACIP influenza vaccine recommendations, MMWR August 7, 2015 ;64(30);88-25 [28 pages]
      • For the 2016-17 season, follow dosing guidelines in the 2016 ACIP influenza vaccine recommendations.

      For persons aged 9 years and older:

      • Administer 1 dose.
    8. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12 months for routine vaccination)

      Routine vaccination:

      • Administer a 2-dose series of MMR vaccine at ages 12 through 15 months and 4 through 6 years. The second dose may be administered before age 4 years, provided at least 4 weeks have elapsed since the first dose.
      • Administer 1 dose of MMR vaccine to infants aged 6 through 11 months before departure from the United States for international travel. These children should be revaccinated with 2 doses of MMR vaccine, the first at age 12 through 15 months (12 months if the child remains in an area where disease risk is high), and the second dose at least 4 weeks later.
      • Administer 2 doses of MMR vaccine to children aged 12 months and older before departure from the United States for international travel. The first dose should be administered on or after age 12 months and the second dose at least 4 weeks later.

      Catch-up vaccination:

      • Ensure that all school-aged children and adolescents have had 2 doses of MMR vaccine; the minimum interval between the 2 doses is 4 weeks.
    9. Varicella (VAR) vaccine. (Minimum age: 12 months)

      Routine vaccination:

      • Administer a 2-dose series of VAR vaccine at ages 12 through 15 months and 4 through 6 years. The second dose may be administered before age 4 years, provided at least 3 months have elapsed since the first dose. If the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid.

      Catch-up vaccination:

      • Ensure that all persons aged 7 through 18 years without evidence of immunity (see MMWR 2007;56[No. RR-4][48 pages]), have 2 doses of varicella vaccine. For children aged 7 through 12 years, the recommended minimum interval between doses is 3 months (if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid); for persons aged 13 years and older, the minimum interval between doses is 4 weeks.
    10. Hepatitis A (HepA) vaccine. (Minimum age: 12 months)

      Routine vaccination:

      • Initiate the 2-dose HepA vaccine series at 12 through 23 months; separate the 2 doses by 6 to 18 months.
      • Children who have received 1 dose of HepA vaccine before age 24 months should receive a second dose 6 to 18 months after the first dose.
      • For any person aged 2 years and older who has not already received the HepA vaccine series, 2 doses of HepA vaccine separated by 6 to 18 months may be administered if immunity against hepatitis A virus infection is desired.

      Catch-up vaccination:

      • The minimum interval between the 2 doses is 6 months.

      Special populations:

      • Administer 2 doses of HepA vaccine at least 6 months apart to previously unvaccinated persons who live in areas where vaccination programs target older children, or who are at increased risk for infection. This includes persons traveling to or working in countries that have high or intermediate endemicity of infection; men having sex with men; users of injection and non-injection illicit drugs; persons who work with HAV-infected primates or with HAV in a research laboratory; persons with clotting-factor disorders; persons with chronic liver disease; and persons who anticipate close, personal contact (e.g., household or regular babysitting) with an international adoptee during the first 60 days after arrival in the United States from a country with high or intermediate endemicity. The first dose should be administered as soon as the adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.
    11. Meningococcal vaccines. (Minimum age: 6 weeks for Hib-MenCY [MenHibrix], 9 months for MenACWY-D [Menactra], 2 months for MenACWY-CRM [Menveo], 10 years for serogroup B meningococcal [MenB] vaccines: MenB-4C [Bexsero] and MenB-FHbp [Trumenba])

      Routine vaccination:

      • Administer a single dose of Menactra or Menveo vaccine at age 11 through 12 years, with a booster dose at age 16 years.
      • Adolescents aged 11 through 18 years with human immunodeficiency virus (HIV) infection should receive a 2-dose primary series of Menactra or Menveo with at least 8 weeks between doses.
      • For children aged 2 months through 18 years with high-risk conditions, see below.

      Catch-up vaccination:

      • Administer Menactra or Menveo vaccine at age 13 through 18 years if not previously vaccinated.
      • If the first dose is administered at age 13 through 15 years, a booster dose should be administered at age 16 through 18 years with a minimum interval of at least 8 weeks between doses.
      • If the first dose is administered at age 16 years or older, a booster dose is not needed.
      • For other catch-up guidance, see Catch-up Schedule.

      Clinical discretion:

      • Young adults aged 16 through 23 years (preferred age range is 16 through 18 years) may be vaccinated with either a 2-dose series of Bexsero or a 3-dose series of Trumenba vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.

      Vaccination of persons with high-risk conditions and other persons at increased risk of disease:

      • Children with anatomic or functional asplenia (including sickle cell disease):Meningococcal conjugate ACWY vaccines:
        • Menveo
          • Children who initiate vaccination at 8 weeks. Administer doses at 2, 4, 6 and 12 months of age.
          • Unvaccinated children who initiate vaccination at 7 through 23 months. Administer two doses, with the second dose at least 12 weeks after the first dose AND after the first birthday.
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart.
        • MenHibrix
          • Children who initiate vaccination at 6 weeks. Administer doses at 2, 4, 6 and 12 through 15 months of age.
          • If the first dose of MenHibrix is given at or after 12 months of age, a total of 2 doses should be given at least 8 weeks apart to ensure protection against serogroups C and Y meningococcal disease.
        • Menactra
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart. If Menactra is administered to a child with asplenia (including sickle cell disease), do not administer Menactra until 2 years of age and at least 4 weeks after the completion of all PCV13 doses.

        Meningococcal B vaccines:

        • Bexsero or Trumenba
          • Persons 10 years or older who have not received a complete series.  Administer a 2 dose series of Bexsero, at least 1 month apart. Or a 3-dose series of Trumenba, with the second dose at least 2 months after the first and the third dose at least 6 months after the first. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.
      • Children with persistent complement component deficiency (includes persons with inherited or chronic deficiencies in C3, C5-9, properidin, factor D, factor H, or taking eculizumab (Soliris®):Meningococcal conjugate ACWY vaccines:
        • Menveo
          • Children who initiate vaccination at 8 weeks.  Administer doses at 2, 4, 6 and 12 months of age.
          • Unvaccinated children who initiate vaccination at 7 through 23 months. Administer two doses, with the second dose at least 12 weeks after the first dose AND after the first birthday.
          • Children 24 months and older who have not received a complete series. Administer two primary doses at least 8 weeks apart.
        • MenHibrix
          • Children who initiate vaccination at 6 weeks.  Administer doses at 2, 4, 6 and 12 through 15 months of age.
          • If the first dose of MenHibrix is given at or after 12 months of age, a total of 2 doses should be given at least 8 weeks apart to ensure protection against serogroups C and Y meningococcal disease.
        • Menactra
          • Children 9 through 23 months; Administer two primary doses at least 12 weeks apart.
          • Children 24 months and older who have not received a complete series: Administer two primary doses at least 8 weeks apart.

        Meningococcal B vaccines:

        • Bexsero or Trumenba
          • Persons 10 years or older who have not received a complete series.  Administer a 2-dose series of Bexsero, at least 1 month apart, or a 3-dose series of Trumenba®, with the second dose at least 2 months after the first and the third dose at least 6 months after the first. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.
      • For children who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj:
        • Administer an age-appropriate formulation and series of Menactra or Menveo for protection against serogroups A and W meningococcal disease. Prior receipt of MenHibrix is not sufficient for children traveling to the meningitis belt or the Hajj because it does not contain serogroups A or W.
      • For children at risk during a community outbreak attributable to a vaccine serogroup:
        • Administer or complete an age- and formulation-appropriate series of MenHibrix, Menactra, Menveo, Bexsero, or Trumenba.

      For booster doses among persons with high-risk conditions, refer to MMWR 2013;62(RR02):1-22.

      For other catch-up recommendations for these persons, and complete information on use of meningococcal vaccines, including guidance related to vaccination of persons at increased risk of infection, see MMWR March 22, 2013;62(RR02):1-22[32 pages] and MMWR Ocutober 23, 2015;64(41):1171-1176 [24 pages].

    12. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for both Boostrix and Adacel)

      Routine vaccination:

      • Administer 1 dose of Tdap vaccine to all adolescents aged 11 through 12 years.
      • Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.
      • Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferred during 27 through 36 weeks gestation) regardless of time since prior Td or Tdap vaccination.

      Catch-up vaccination:

      • Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap vaccine as 1 (preferably the first) dose in the catch-up series; if additional doses are needed, use Td vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an adolescent Tdap vaccine dose at age 11 through 12 years should NOT be administered. Td should be administered instead 10 years after the Tdap dose.
      • Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.
      • Inadvertent doses of DTaP vaccine:
        • If administered inadvertently to a child aged 7 through 10 years may count as part of the catch-up series. This dose may count as the adolescent Tdap dose, or the child can later receive a Tdap booster dose at age 11 through 12 years.
        • If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be counted as the adolescent Tdap booster.
      • For other catch-up guidance, see Catch-up Schedule.
    13. Human papillomavirus (HPV) vaccines. (Minimum age: 9 years for 2vHPV [Cervarix], 4vHPV [Gardasil], and 9vHPV [Gardasil 9])

      Routine vaccination:

      • Administer a 3-dose series of HPV vaccine on a schedule of 0, 1-2, and 6 months to all adolescents aged 11 through 12 years. 9vHPV, 4vHPV or 2vHPV may be used for females, and only 9vHPV or 4vHPV may be used for males.
      • The vaccine series may be started at age 9 years,
      • Administer the second dose 1 to 2 months after the first dose (minimum interval of 4 weeks), administer the third dose 16 weeks after the second dose (minimum interval of 12 weeks) and 24 weeks after the first dose.
      • Administer HPV vaccine beginning at age 9 years to children and youth with any history of sexual abuse or assault who have not initiated or completed the 3-dose series.

      Catch-up vaccination:

      • Administer the vaccine series to females (2vHPV, 4vHPV, or 9vHPV) and males (4vHPV or 9vHPV) at age 13 through 18 years if not previously vaccinated.
      • Use recommended routine dosing intervals (see above) for vaccine series catch-up.

    See additional notes for Recommended Immunization Schedule for Persons Age 0 Through 18 Years and Catch-up Immunization Schedule.

    This schedule includes recommendations in effect as of January 1, 2016. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations. Clinically significant adverse events that follow vaccination should be reported to Vaccine Adverse Event Reporting System (VAERS) online or by telephone (800-822-7967). Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Additional information, including precautions and contraindications for vaccination, is available from CDC’s Vaccines and Immunizationonline site or by telephone (800-CDC-INFO [800-232-4636]).

    This schedule is approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG).

    Page last reviewed: February 1, 2016
    Page last updated: February 1, 2016
    Content source: National Center for Immunization and Respiratory Diseases
    Provided by: Centers for Disease Control and Prevention (CDC)

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    Vaccine Policy

    Post by : admin | Post on : April 4, 2017 at 5:42 am

    PrimeCare Pediatrics Vaccine Policy Statement

    We at PrimeCare Pediatrics want to give you and your family the very best care based on research. We follow the guidelines of the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices (ACIP).

    What has changed?
    We can no longer accept the risk that un-immunized or under-immunized children or adolescents (kids who haven’t gotten all their shots) pose to other children and their families in our practice and in our communities. So, if you decide NOT to fully immunize your child or adolescent, we will not be able to see him or her in our office. We are doing this to protect all our patients. Many other pediatric practices in our city and across the country have already made this change.

    What are the benefits?
    We believe vaccinating children and adolescents is one of the most important services we offer to our patients. Here are the reasons:

    • Vaccines can prevent serious illness and save lives.
    • Vaccines are extremely safe.

    Parents and caretakers may feel that the decision to vaccinate their child is a personal one, and we acknowledge that. However, our duty is to practice medicine the best way we can and to provide all of our patients with a safe environment while meeting their health care needs.

    If you choose NOT to vaccinate your children, this can affect the health of other children and adults in our society and country as a whole. The recent outbreak of measles and pertussis (Whooping cough) in certain parts of the country is a testimony to this fact.

    What about all the negative information I’ve heard?
    We firmly believe vaccines do not cause autism or harm to a child’s learning, language or behavior. Our belief is based on research studies that show the benefits outweigh the risks of harm from vaccines. Thousands of scientists and doctors in our field have helped with the research and data collection to come up with the current list of vaccines.

    Vaccines are safer today than they have ever been in history. It is completely safe to give multiple or combination vaccines at the same office visit. Because we live in a world where we do not see children suffering and dying from preventable diseases, some people have forgotten about the threat of some of these diseases.

    Children who are NOT vaccinated could experience the following:

    • Lose hearing
    • Have brain damage
    • Death from diseases such as haemophilus meningitis or pneumococcal meningitis
    • Become crippled or lose the ability to breathe
    • Contract and spread diseases

     

    EXISTING PATIENTS

    We know this new vaccine policy may impact some of our patients. For children who are already patients in our practice, we will work with each family over the next few months and come up with a plan to get their children fully immunized, and according to the standards and periodicity set out by the American Academy of Pediatrics and the ACIP, as long as they are willing.

    However, if they are unwiling to reconsider their stand and refuse to abide by this new vaccine policy, we will have no choice but to encourage them to seek another provider who will best meet their needs.

     

    NEW PATIENTS

    For new patients considering our practice, begining immediately, we will not be able to see, accept or schedule an appointment for your child or children if you refuse to accept our vaccine policy. We are willing to work dilligently with you in such a way that will make your child or children fully vaccinated in due course according to the standards and periodicity set out by the American Academy of Pediatrics and the ACIP, as long as you understand and adhere to this new policy.
    Thank you for reading our policy. Our providers are happy to talk with you if you have questions.

    Resoures for additional information about vaccines
    Below are links to reputable websites to help answer your questions about vaccines.

    Why Immunize? www.cdc.gov/vaccines/vac-gen/why
    School vaccine requirements www.nvic.org
    American Academy of Pediatrics www.aap.org
    Centers for Disease Control and Prevention www.cdc.gov/vaccines
    Immunization Action Coalition www.immunize.org
    Institute for Vaccine Safety www.vaccinesafety.edu
    Prepare Your Family for Flu Season 11 Things for Parents
    What is the Flu? The Flu: Seasonal Influenza 2015-2016

     

    The current immunization schedule can be viewed here.

     

    Important Immunization Information

     

    Immunization Requirement For School

    Two doses each of Hepatitis A and Varicella (Chicken Pox) are now required for entry into all Georgia schools beginning in 2007. Both series can be given beginning at 12 months of age.

    The latest recommendation is for middle-schoolers to receive the Tdap, Meningitis and HPV vaccines. This is also true for all teenagers. These vaccines can be conveniently administered at the 11-year well check.

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    What to Expect at Your Physicals

    Post by : admin | Post on : April 4, 2017 at 5:41 am

    There are several reasons to schedule checkups or health physical examination for children. It may be time for routine vaccinations. There may be a particular physical or behavioral issue of concern. It may be a requirement for participation in sports or camp. Whatever the reason for the appointment, all checkup visits have the same goal: to evaluate your child’s health and educate both parent and child for optimal growth and development.

    Before your checkup, make a list of any concerns you want to discuss with the provider. Gather pertinent records (vaccine records, information from other physicians), any camp or sports forms that need to be signed, and names and dosages of current medications. For infants 2-18 months of age, you may give a dose of acetaminophen (Tylenol) before the visit as they may be getting vaccines. Click here for dosing guidelines.

    We also encourage you to get online and read up on vaccines.

    All checkups start with vital signs: weight, height, head circumference for babies, blood pressure for children 3 and up, and heart rates before and after exercise for sports physicals. Children ages 3 and up will need to provide a urine specimen. Kindergarten physicals also include hearing and vision screens. The nurse will then ask some questions concerning your child’s development, nutrition, any recent illnesses, or concerns you would like the provider to address.

    The provider will evaluate your child’s growth, development, and immunization status. IT IS VERY IMPORTANT THAT YOU PROVIDE US WITH AN UP-TO-DATE COPY OF YOUR CHILD’S VACCINES. Then all children receive a head-to-toe examination (this includes teens for sports and camp). We allow our teen patients to decide whether or not they would like their parent to remain in the room for the exam. (helpful hint: if your child is embarrassed to be examined in their underwear, have them wear a bathing suit instead) Afterwards, we can discuss any concerns you may have about your child. Again, for teens, we request some time for the patient to have the opportunity to discuss any issues alone with the physician that they may not want to discuss in front of their parent. Remember, many of the things teens ask us about in private are NOT the world-changing issues you may be worried about.

    NOTE:

    • For parents who have extensive concerns about their child’s behavior or school problems, we suggest a “parent conference”. We schedule these immediately after lunch so we can have extra time to discuss these complicated issues.
    • After the provider is finished, the nurse will return to perform vaccines and blood work. Most infants will receive vaccines at 2, 4, 6, 12, 15 and 18 months. Children typically receive vaccines at age 4 or 5 years, then again when they are 11 or 12 years old. You can follow the links provided to get more information about the different immunizations offered at each visit. You can also visit the CDC website, www.cdc.gov,  for additional information.
    • Please remember to bring your pre-participation forms for sports or camp, so we can fill these out during your visit. Make sure to complete the “medical history” section prior to the checkup (it MUST be complete before the physician can sign off on the form). For school sports in Georgia, you can download and print the sports physical form here on our website.
    • For infants and toddlers receiving vaccines, we recommend giving Tylenol every 4-6 hours for the 24 hours following the injections. The most common vaccine side effects are fever (usually low grade), crankiness, sleepiness, minor swelling at the injection site. Your nurse and physician can discuss vaccines with you in more detail during your visit.
    • Checkups should be fun (at most ages) and informative, not just a requirement to be completed. Please feel free to ask ANY questions regarding your child. We’re here to help you and your child.
    • You may want to print the Sports participation forms from our website, fill them and bring them with you. This will shorten the time you spend during your visit.
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    Recommended Well Visits And Physicals

    Post by : admin | Post on : April 4, 2017 at 5:40 am

    At PrimeCare Pediatrics, we believe in and emphasize the importance and value of regularly scheduled well-visits for all children; this includes newborns, infants, pre-teens, and teens according to guidelines provided by the Bright Futures initiative of the American Academy of Pediatrics (AAP) for excellence in pediatric care for the prevention and health promotion for infants, children, adolescents, and their families .

    These wellness visits are designed for the health supervision of your baby. Recommended immunizations are commonly given at these visits. They afford the physician the opportunity of providing you with important information regarding the growth and development of your child. They are also a means of identifying problems or potential problems and providing early intervention if necessary.

    The typical periodicity of well visits as recommended by the AAP for all children from birth through 18 years is given below. You may click on Recommendations for Preventative Pediatric Health Care to access the full details.

    Your child’s schedule may vary slightly. This is mainly because the immunization schedule is usually updated from time to time by the government and other regulatory bodies and may vary from the previous year. Other reasons include vaccine availability and the fact that different states and offices may also adopt a slightly modified schedule.

    At Birth – Newborn Hospital visit

    Dr. Tega will visit you in the hospital and examine your baby soon after birth, once our office is informed. The hospitals that we currently cover are Piedmont Newnan Hospital, Piedmont Fayette Hospital, and Southern Regional Medical Center. Make sure you inform the nurses during registration, at check-in and at the delivery ward that your baby’s pediatrician is Dr. Tega, so the hospital can contact us once your baby is born.

    Circumcision: If you elect to have your newborn son circumcised, Dr. Tega will be happy to perform this surgical procedure for you.

    First Office Visit

    Once your baby is discharged from the hospital, you will need to follow-up in our office within a week, usually in 1-3 days. The importance of this visit is to examine your baby thoroughly again and make sure that baby is healthy and both baby and mon are off to a great start. The baby’s feeding schedule will also be reviewed including weight and color check for jaundice.

    After this initial office visit, the typical schedule is as summarized below.

    1 month well visit

    Review your child’s growth and physical development.

    2 months well-visit

    This visit is important because this will be the time that your baby starts the immunization series. Usually a number of shots are given.

    4 months well-visit

    Immunizations – first booster doses are given

    6 months well-visit

    Immunizations – booster doses continue

    9 months well-visit

    Focuses on your child’s physical development as well as issues regarding infant-toddler safety; includes tips for home safety and a comprehensive review of Child Home Safety Check List. We will also address your home’s childproof measures and safety concerns, and car seat safety issues if any.

    12 months well-visit

    The first in the series of vaccines for Chicken-pox and MMR prevention are usually given.

    Child may also be screened for anemia.

    15 months well-visit

    Immunizations – booster doses continue

    18 months well-visit

    Initial series of immunizations may be completed at this visit

    24 months well-visit (2 yrs)

    Child may need to receive additional immunizations to catch-up

    3-18 years well-visit

    A yearly wellness physical is recommended.

    Highlights:
    4-5 yrs – Booster doses of immunizations given
    11 yrs and beyond – Booster doses of Tetanus and other vaccines are given. Girls will need the HPV vaccine. College age kids will need to be vaccinated against meningitis.

    Prenatal Visit

    PrimeCare Pediatrics encourages all prospective mothers and parents-to-be, to make an appointment to meet with Dr. Tega and our office staff during the third trimester and before the arrival of their baby. This is a wonderful opportunity for them to meet with their pediatrician. It also provides us with the time to personally get-to-know the prospective parents and address any concerns they might have with regard to the expected baby.

    Sports Physicals/College/Camp Physicals

    These types of physicals are provided as needed.

    Please contact us or your health care provider if you have any questions or need additional information.

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    Well Child Information

    Post by : admin | Post on : April 4, 2017 at 5:39 am

    There is nothing more joyful to us as loving parents than that moment when we hold our precious little baby, or babies, in our arms after birth. We should acknowledge them as gifts from God and count ourselves blessed to have them.

    Behold, children are a heritage from the Lord, the fruit of the womb is a reward.

    Psalm 127:3 NJKV

    As we watch them grow and share many memorable moments and events together through life, we come to see the wonders of God unfold before our very eyes.

    As their earthly parents, we are but care-takers and only for a season. While we are at it, it is our responsibility to give it our best shot.

    You may track your child’s development at every stage as they grow throughout their young and eventful life

     

     

    Well Child Information

    There are a number of regularly scheduled well visits that are recommended for optimal health supervision of your baby. These visits usually begin once you leave the hospital.

    What to expect at your Physicals

    Check out the link below. You may find very useful information there for you and your family.

     
    Medline Plus

    Please contact us or your health care provider if you have any questions or need additional information.

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