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INTRODUCTION

Immunization is one of the greatest public health achievements of modern times. Largely due to immunization, the annual incidences of diphtheria, paralytic poliomyelitis, measles, mumps, rubella, and Haemophilus influenzae type b (Hib) in the United States have fallen by more than 99% compared with the average annual incidences of these diseases in the 20th century. Invasive pneumococcal disease in children younger than 5 years has declined steeply since routine pneumococcal vaccination began in 2000. Similarly, rotavirus vaccination is associated with substantial declines in hospitalizations and emergency department visits for diarrheal illnesses in young children. Childhood immunization has also led, through herd immunity, to significant decreases in several infectious illnesses in adults, including pneumococcal, rotavirus, and varicella disease. The coronavirus disease 2019 (COVID-19) pandemic disrupted health care delivery and was associated with declines in routine vaccination for infants, children, and adolescents; efforts to regain these coverage losses are ongoing.

Every year, approximately 3.6 million children are born in the United States, and successful immunization of each birth cohort requires the concerted effort of parents, health care providers, public health officials, and vaccine manufacturers. Modern vaccines have a high degree of safety, serious adverse events following vaccination are rare, and vaccination benefits strongly outweigh these rare risks.

This chapter starts with general principles regarding immunization and the recommended pediatric and adolescent vaccination schedules, followed by a discussion of vaccine safety. Each recommended vaccine is then discussed. Vaccines given in special circumstances are discussed in the final section. Commonly used acronyms (eg, Centers for Disease Control and Prevention [CDC]) in this and other vaccine-related publications are defined with their first use in the text.

Because the immunization field is rapidly changing, it is important for health care providers to seek the most up-to-date information available. The recommendations outlined are current but will change as technology evolves and our understanding of the epidemiology of vaccine-preventable diseases changes. Several useful sources for regularly updated information about immunization are the following:

  1. The Centers for Disease Control and Prevention (CDC). It maintains a website with extensive vaccine-related resources, including recommendations of the Advisory Committee on Immunization Practices (ACIP), vaccination schedules, Vaccine Information Statements (VISs), and detailed information for the public and providers. Available at: www.cdc.gov/vaccines.

  2. CDC Contact Center. The CDC-INFO contact center provides services to the public and health care professionals regarding a variety of health-related issues, including immunizations. Available at: www.cdc.gov/cdc-info, or by phone at 1-800-232-4636 (English and Spanish).

  3. The Red Book: Report of the Committee on Infectious Diseases. Published at 3-year intervals by the American Academy of Pediatrics (AAP). A revised Red Book was published in 2024. Updates are published in the journal Pediatrics and can also be accessed at redbook.solutions.aap.org/.

  4. Immunize.org. This nonprofit organization creates and distributes educational materials for the public and health care providers. All materials are provided free of charge and can be accessed at www.vaccineinformation.org (for the ...

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