Delays in protection are masked by national immunization coverage rates*[3,4]
A recent CDC† study revealed significant vaccination delays‡ in the first 2 years of life[4]
In this study, delays were counted beginning 1 full month following the maximum ACIP/AAP/AAFP§ recommended age for each immunization[4]
—Included a delay in the receipt of 1 or more of the recommended
doses of DTaP, IPV, MMR, Hib, Hep B, or varicella
* Overall vaccination coverage rates reached 80.9%, as reported in the most recent (2004) National Immunization Survey (NIS) of a sample population of 21,998 children 19 to 35 months of age, 2000 to 2004. Includes ≥4 doses of DTaP, ≥3 doses of IPV, ≥1 dose of MMR, ≥3 doses of Hib, and ≥3 doses of Hep B[3] † Centers for Disease Control and Prevention. ‡ Based on an analysis of 14,810 children 24 to 35 months of age from the 2003 NIS.[4] § Advisory Committee on Immunization Practices, American Academy of Pediatrics, and American Academy of Family Physicians
ACIP/AAP/AAFP preference for combination vaccines[6]:
"The use of combination vaccines is preferred over separate injections
of their equivalent component vaccines."
"To minimize the number of injections children receive, parenteral combination vaccines
should be used, if licensed and indicated for patient's age, instead of their equivalent
component vaccines."
Rationale: The use of licensed combination vaccines:
• is a practical way to overcome the constraints of multiple injections
• might improve timely vaccination coverage
–ACIP/AAP/AAFP recommendations state that administering 4 doses of Hep B, as a part of a combination vaccine to complete a series is permissible and not found to be harmful[6,8]
ll Should be administered at separate sites.
¶ Centers for Disease Control and Prevention. Recommendations by the ACIP for use of Haemophilus b conjugate vaccine and a combined diphtheria, tetanus, pertussis, and Haemophilus b vaccine.
In clinical studies, adverse events included injection-site reactions (pain, redness, or swelling), fever and fussiness for PEDIARIX and INFANRIX, and drowsiness for INFANRIX. As with other vaccines, rare adverse events may occur. Administration with PEDIARIX was associated with higher rates of fever relative to separately administered vaccines (see Adverse Reactions section of the package insert). PEDIARIX and INFANRIX are contraindicated in people with known hypersensitivity to any component of the vaccine, including yeast, neomycin, and polymyxin B in PEDIARIX. As with any vaccine, vaccination may not protect 100% of susceptible individuals.
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