What vaccinations do my children need?
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Essential Vaccinations for Children: A Comprehensive Guide
Routine Childhood Vaccinations
Recommended Vaccines by Age 24 Months
The Advisory Committee on Immunization Practices (ACIP) recommends that children receive vaccinations against 14 potentially serious illnesses by the age of 24 months. These include vaccines for poliovirus, measles, mumps, rubella (MMR), hepatitis B (HepB), and varicella, among others1 6 7 10. High vaccination coverage rates have been observed, with over 90% of children receiving at least three doses of the poliovirus vaccine, one dose of MMR, three doses of HepB, and one dose of varicella vaccine1 6 7.
Influenza Vaccination
For influenza, young children are recommended to receive two doses in their first season of vaccination. However, a single dose can provide modest protection, which wanes after five months. Therefore, it is crucial to follow up with a second dose to ensure continued protection2.
Tick-Borne Encephalitis (TBE) Vaccination
In high-endemicity areas in Europe, TBE vaccination is recommended for children as young as 1-3 years old. Although TBE is generally milder in children than in adults, it can still result in long-term cognitive impairments, making vaccination important3.
Factors Influencing Vaccination Uptake
Socioeconomic and Insurance Disparities
Vaccination coverage tends to be lower among uninsured children and those insured by Medicaid compared to those with private insurance. Children living outside metropolitan areas also show lower vaccination rates. These disparities highlight the need for increased awareness and utilization of programs like Vaccines for Children (VFC) to improve access and reduce missed vaccination opportunities1 6 7 10.
Parental Beliefs and Information
Parental attitudes significantly influence vaccination uptake. Positive attitudes towards vaccines, trust in healthcare providers, and the perception of fewer practical difficulties are associated with higher vaccination rates. Conversely, concerns about vaccine safety and adverse effects can deter parents from vaccinating their children. Effective communication strategies that provide clear, balanced information about the benefits and risks of vaccines are essential to address these concerns4 8.
Special Considerations for Immunocompromised Children
Customized Vaccination Schedules
Immunocompromised children may require modified vaccination schedules, including higher antigenic content vaccines, additional doses, and more frequent boosters. Serological monitoring can help tailor these schedules to ensure adequate protection. It is also important to verify the vaccination status of household members to prevent transmission of infections to immunocompromised children5.
Conclusion
Ensuring that children receive the recommended vaccinations by the age of 24 months is crucial for preventing serious illnesses. While high coverage rates are generally observed, disparities based on socioeconomic status and insurance coverage need to be addressed. Effective communication and tailored vaccination schedules for immunocompromised children can further enhance vaccination uptake and protection. By following these guidelines, parents can help safeguard their children's health against preventable diseases.
Sources and full results
Most relevant research papers on this topic
Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017
High vaccination coverage for children aged 19-35 months in the United States, with coverage exceeding 90% for poliovirus, MMR, HepB, and varicella vaccines, but lower for uninsured, Medicaid-insured, and non-MSA children.
Observational Study
Highly CitedSingle dose vaccination among infants and toddlers provides modest protection against influenza illness which wanes after 5 months.
Partial vaccination in infants and toddlers provides some protection, but should be followed by a second dose to maintain effectiveness beyond 5 months.
Observational StudyTick-borne encephalitis (TBE) in children in Europe: Epidemiology, clinical outcome and comparison of vaccination recommendations.
TBE vaccination is important for children aged 1-3 years in high-endemicity countries, as it can cause long-term cognitive impairment, despite milder clinical course compared to adults.
Systematic ReviewA systematic review of factors affecting vaccine uptake in young children.
Positive attitudes towards vaccination, positive vaccine recommendations, and perceived fewer practical difficulties are strongly associated with increased vaccine uptake in young children.
Systematic ReviewHighly CitedVaccination of immune compromised children—an overview for physicians
Primary physicians play a crucial role in optimizing vaccination status for immune compromised children, ensuring vaccine safety and immunogenicity, while addressing perceived risks and improving vaccine acceptability.
Literature Review
Very Rigorous JournalVaccination Coverage Among Children Aged 19–35 Months — United States, 2016
Vaccination coverage among children aged 19-35 months in the United States remained high and stable in 2016, with minor changes from 2015.
Observational StudyHighly CitedVaccination Coverage by Age 24 Months Among Children Born in 2015 and 2016 — National Immunization Survey-Child, United States, 2016–2018
By age 24 months, 90% of children born in 2015 and 2016 had at least 90% coverage for poliovirus, MMR, HepB, and varicella vaccines, with lower coverage for influenza vaccine.
Observational StudyParents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence
Effective communication about childhood vaccinations can influence parents' decisions to vaccinate their children, addressing concerns and misconceptions.
Systematic ReviewVery Rigorous JournalHighly CitedBCG Vaccination at Birth and Rate of Hospitalization for Infection Until 15 Months of Age in Danish Children: A Randomized Clinical Multicenter Trial.
BCG vaccination at birth did not affect the rate of hospitalization for infection up to the age of 15 months in Danish children.
RCT
Large Human TrialVaccination Coverage by Age 24 Months Among Children Born During 2018–2019 — National Immunization Survey–Child, United States, 2019–2021
Vaccination coverage among children born during 2018-2019 increased for most recommended vaccines, but disparities persist by race, ethnicity, poverty status, health insurance status, and MSA residence.
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