During the last 10 - and especially the last 5 years - changes in the number of vaccines and recommendations for their use has been tremendous. Keeping current is difficult and textbooks can be outdated by publication! Although we provide updates for significant changes in the immunization schedule, new vaccines, contraindications/side effects, and controversial issues, the ultimate responsibility "to know" rests on the health care provider. "I didn't know" is not an acceptable professional or legal excuse for errors in clinical practice.
It is much easier to keep current if you know where to look for the official recommendations of the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP). The primary sources are publications and the internet. You can also contact each organization to request information:
American Academy of PediatricsAnother excellent internet site is the National Library of Medicine: www.ncbi.nlm.nih.gov/PubMed/. It's an excellent way to search Medline and is now free.
The AAP'S Report of the Committee on Infectious Diseases, known as the Red Book, is an authoritative source of information on vaccines and other important pediatric infectious diseases. However, it lacks an indepth review and reference list of controversial issues. The recommendations in the Red Book first appear in the journal Pediatrics and/or the AAP News. Typically, the most recent immunization schedule appears in the January issue of the journal. If significant changes occur during the first six months, an updated schedule may appear in the July issue.
The publication from the CDC, Mortality and Morbidity Report (MMWR), contains comprehensive reviews of the literature as well as important background data regarding vaccine efficacy and side effects. To receive a weekly email copy, use CDC's online subscription form. Electronic copy also is avaliable from CDC's website or via FTP. To subscribe for paper copy, contact Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402; Phone: 202-512-1800.
Immunization Gateway: Your Vaccine Fact-Finder provides direct links to all the best vaccine resources on the Internet.
Before a health care provider vaccinates a child or an adult with a dose of DTaP, DTP, Td, MMR, varicella, polio, Hib, or hepatitis B vaccine, the provider is required by the National Childhood Vaccine Injury Act to provide a copy of the Vaccine Information Statements (VIS) to either the adult vaccinee or to the child's parent/legal guardian. VISs are also availabe for influenza, pneumococcal, and hepatitis A vaccines, and their use is recommended but not required by federal law. They are not required because these additional vaccines are not routinely recommended for children and therefore are not covered by the National Childhood Vaccine Injury Act. VISs are availabe by calling your state or local health department. They also can be downloaded from the websites for the Immunization Action Coaltion or the CDC.
NOTE: The Whaley-Wong Update series routinely includes information on changes in immunization information.
March 15, 2002