AAP Approves CDC's Child/Adolescent Vax Schedule for 2022

The American Academy of Pediatrics (AAP) said it supports the Recommended Childhood and Adolescent Immunization Schedule: United States, 2022.

In a policy statement published online February 17 in Pediatrics, the AAP said the updated recommendations differ little from those released last year by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Prevention and Control (CDC).

Dr Sean O'Leary

"The only significant change this year was to add the dengue vaccine to the schedule," Sean T. O'Leary, MD, MPH, vice chair of the AAP's 2021–2022 Committee on Infectious Diseases and a co-author of the statement, told Medscape Medical News. "But that is really only relevant for children living in endemic areas, primarily Puerto Rico but some other smaller US territories as well."

Dengue fever also is endemic in American Samoa and the US Virgin Islands.

Notably, a new section has been added on routine recommendations for use of the Dengvaxia vaccine.

The 2022 policy statement addresses regular immunization of children from birth to 18 years and catch-up vaccination for those aged 4 months to 18 years. In addition to the AAP, multiple complementary physician and nurse organizations have approved the updates. The ACIP schedule is revised annually to reflect current recommendations on vaccines licensed by the US Food and Drug Administration.

Most of the other changes this year involve minor updates to clarify language or improve usability. "CDC and AAP are always working to make the schedule as user-friendly as possible, with improvements made every year," O'Leary, professor of pediatric infectious diseases at the University of Colorado, Denver, said.

In terms of physician acceptance, he added, "I don't think any of the changes would be considered controversial."

Among other updates and clarifications:

For Haemophilus influenzae type b (Hib) vaccination, the text now includes recommendations for the hexavalent Vaxelis vaccine (diphtheria, tetanus, pertussis, polio, Hib, and hepatitis B) for both routine and catch-up vaccination.
For hepatitis A, the relevant note has been updated to clarify the age for routine vaccination.
For human papillomavirus (HPV), the note now clarifies when an HPV series is complete with no additional dose recommended.
The special situations section has been amended to specify which persons with immunocompromising conditions such as HIV should receive three doses of HPV vaccine regardless of age at initial vaccination.
For measles, mumps, and rubella, routine vaccination now includes recommendations on the combination measles, mumps, rubella, and varicella vaccine.
For meningococcal serogroup A, C, W, and Y vaccines, the augmented text explains when these can be simultaneously administered with serogroup B meningococcal vaccines, preferably at different anatomic sites. The language for the dosing schedule for Menveo vaccination in infants also has been clarified.
In the catch-up immunization schedule for late-starting children aged 4 months to 18 years, the text on Hib has been changed so that the minimum interval between dose 2 and dose 3 now refers to Vaxelis, while reference to the discontinued Comvax (Hib-Hep B) vaccine has been removed.

As in other years, graphic changes have been made to table coloration and layout to improve accessibility. And as previously, the 2022 childhood and adolescent immunization schedule has been updated to ensure consistency between its format and that of the 2022 adult immunization schedules.

The AAP committee stressed that clinically significant adverse events after immunization should be reported to the Vaccine Adverse Event Reporting System.

The full 2022 schedule can be found on the CDC's website.

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