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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

A Parent's Life A Parent's Life

Immunization Updates for 2013

February 15, 2013

By Claire McCarthy

Each year, the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) update the immunization recommendations.

This year, there are changes to the pertussis recommendation and the vaccine schedule itself.


Pertussis, or whooping cough, is a respiratory illness. It can be very serious, especially for infants.

We've been seeing more pertussis recently. Some of the increase has been in communities where children aren't vaccinated. But the rise is also because the effectiveness of the pertussis vaccine decreases over time.

Kids get a booster dose in middle school. But it's becoming clear that some may need it before then, and that the dose isn't enough to fully protect kids into adulthood.

Infants, especially really young ones, are at highest risk of getting very sick and even dying from pertussis. This is because of their age, and because they are too young to be immunized. Babies don't get their first pertussis dose until they are 2 months old. The rest of the doses are given again at 4 months, 6 months and between 12 and 18 months. All doses are necessary to be fully protected.

So, to help protect young infants, the AAP and CDC now want pregnant women to get the combined tetanus, diphtheria and pertussis (Tdap) vaccination during each pregnancy. This will help because a women can pass her immunity to the baby during pregnancy. And if she is protected, she will be less likely to pass the illness to the infant. The vaccine is safe for pregnant women.

The immunization recommendation only applies to pregnant women. But it makes sense that everyone who comes into contact with the baby is immunized. It creates a cocoon of safety for the infant. Fathers, grandparents and daycare providers should talk to their doctors about getting the TdaP vaccine, which is easily available and very safe.

A Simpler Schedule

Health care professionals are welcoming this change. The schedule is much easier to read. There are some small clarifications and reminders with certain vaccines.

The schedule is pretty straightforward, as long as parents bring in their children when they are supposed to and get every vaccine on time. It gets complicated, however, when they don't. That's because:

  • Each vaccine has a minimum time between doses.
  • Sometimes the number of doses will change depending on when they are given.
  • Some vaccines, like the rotavirus, can't be given past a certain age.

The previous schedule took up four pages. It was divided into two sections by age. Those were divided up by regular and delayed schedules. There were lots of footnotes, too. All of this sometimes made it very time consuming and difficult to figure out what shots a child needs.

You can print out the CDC's parent-friendly immunization schedules. This way you can spend some time getting familiar with them. If you have any questions, talk to your doctor.

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Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston.

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