Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2

10 Immunizations That Are Recommended for Infants

OCTOBER 04, 2017

Counseling parents on the importance of vaccines is one of the most important roles of the pharmacist. Vaccination is one of the best ways to protect infants from many harmful diseases such as hepatitis B (HepB), measles, and pertussis. The CDC website contains an interactive tool for parents to play an active role in their infant’s immunization schedule, which can be found at 2a.cdc.gov/nip/kidstuff/newscheduler_le/.1 All that is needed is the child’s date of birth, and an immunization schedule is provided that includes the vaccine name, description of the disease it protects against, and the recommended vaccine date of administration. 

Infants are classified as children from birth through 1 year of age. It is especially important to ensure that this population is vaccinated with the appropriate immunizations at the right time, as they are vulnerable to life-threatening diseases.

The following includes an overview of the CDC recommended infant immunizations.

1. HepB Vaccine2
The monovalent HepB vaccine should be administered to all newborns within 24 hours of birth. The second dose should be administered at 1 or 2 months. The third dose should be administered at least 8 weeks after the second dose and at least 16 weeks after the first dose.  Four doses of the HepB vaccine can be administered when a combination vaccine containing HepB is given after the birth dose. Infants born to HepB surface antigen positive mothers should receive both the HepB vaccine and HepB immune globulin within 12 hours of birth. Vaccine-related adverse effects are rare but may include pain at the injection site and fever.

2. Rotavirus Vaccines (Rotarix and RotaTeq)2
Rotarix is administered as a 2-dose series at 2 and 4 months. RotaTeq is administered as a 3-dose series at 2, 4, and 6 months. If any dose in the series was RotaTeq or the vaccine product is unknown for any dose in the series, then a total of 3 doses of the rotavirus vaccine should be administered. The first dose must be received before 15 weeks of age and the last by 8 months. Vaccine-related adverse effects may include irritability, diarrhea, and vomiting.

3. 
Haemophilus Influenza Type b (Hib) Conjugate Vaccine2

Infants should receive a 2- or 3-dose Hib vaccine primary series and a booster dose at 12 to 15 months to complete the full vaccine series. The primary series with ActHIB, MenHibrix, Hiberix, or Pentacel consists of 3 doses and should be administered at 2, 4, and 6 months. The primary series of PedvaxHIB consists of 2 doses and should be administered at 2 and 4 months. Comvax has been removed from the market, and all available doses have expired. Vaccine-related adverse effects may include pain at the injection site and fever.

4. Pneumococcal Vaccine2
Infants should receive a 4-dose series of PCV13 at 2, 4, and 6 months and at 12 to 15 months.  Vaccine adverse effects may include drowsiness, pain and swelling at the injection site, irritability, and fever.

5. Inactivated Poliovirus Vaccine (IPV)2
The 4-dose series of IPV should be administered at  2, 4, 6 to 18 months, and 4 to 6 years. Vaccine-related adverse effects may include pain at the injection site.

6. Influenza Vaccine2
The influenza vaccine should be administered to all infants starting at 6 months of age. The live attenuated influenza vaccine is not recommended for the 2017 to 2018 flu season due to research demonstrating a lack of efficacy. Infants receiving the influenza vaccine for the first time should receive 2 doses separated by at least 28 days. Vaccine-related adverse effects are generally minor and may include fever, pain at the injection site, cough, headache, and fatigue.  There is a small risk of severe allergic reactions. including anaphylaxis. Additionally, there is a very small risk (1 to 2 cases per million people vaccinated) of Guillain-Barre Syndrome, a condition in which the immune system attacks the nerve cells, causing muscle weakness and sometimes paralysis.

7. Measles, Mumps, and Rubella (MMR) Vaccine2
The MMR is administered as a 2-dose series at 12 to 15 months and 4 to 6 years. One dose of the MMR vaccine should be administered to infants age 6 to 11 months before departure from the United States for international travel. These infants should be revaccinated with 2 doses of the MMR vaccine, the first at age 12 to 15 months (12 months if the child remains in an area where disease risk is high), and the second dose at least 4 weeks later. Two doses of the MMR vaccine should be administered to children 12 months of age and older before departure from the United States for international travel. The first dose should be administered on or after 12 months of age and the second dose at least 4 weeks later. Vaccine-related adverse effects may include fever, mild rash, and cheek or neck gland swelling. 

8. Varicella Vaccine2
The 2-dose series should be administered at ages 12 to 15 months and 4 to 6 years. Vaccine-related adverse effects may include soreness or swelling at the injection site, fever, and mild rash, occurring up to 1 month after vaccination.

9. Hepatitis A Vaccine2
The 2-dose vaccine series should be administered at 12 to 23 months. The doses should be separated by 6 to 18 months. Vaccine-related adverse effects are rare but may include pain at the injection site, low-grade fever, headache, and tiredness.

10. Meningococcal vaccines2
Infants with certain conditions such as sickle cell disease, HIV infection, persistent complement component deficiency, or those taking the medication eculizumab (Soliris) should receive the meningococcal vaccine. Infants receiving the Menveo vaccination at 8 weeks should be vaccinated at ages 2, 4, 6, and 12 months. Patients receiving MenHibrix at 6 weeks should be vaccinated at ages 2, 4, 6, and 12 months. Infants who are 9 to 23 months of age with persistent complement component deficiency receiving Menactra should be administered 2 primary doses at least 12 weeks apart. Vaccine-related adverse effects may include pain at the injection site and mild fever.

References

1.  1. CDC. Infant childhood immunization schedule. 2a.cdc.gov/nip/kidstuff/newscheduler_le/. Updated February 6, 2017. Accessed October 2, 2017.

2.  2. CDC. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2017. cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Updated March 6, 2017. Accessed October 2, 2017.



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