Every year, the major medical authorities in the United States issue new recommendations for immunizations of children from birth to age 18. These are updated every year as new vaccines and more effective schedules for existing vaccines are developed.

To view the 2006 childhood immunizations, go to the following link: www.cdc.gov/nip/recs/child-schedule-color-print.pdf.

Here are answers to some of your questions about the latest recommendations.

Which immunizations are currently recommended for children?
The current schedule recommends that young children and adolescents be immunized against 14 different diseases: hepatitis A, hepatitis B, diphtheria, tetanus, pertussis (whooping cough), haemophilus influenzae type B (HIB), polio, measles, mumps, rubella (German measles), varicella (chicken pox), meningococcus, pneumococcus and influenza (flu). Since the 2006 schedule was produced, the authorities have also recommended that babies be immunized with a new vaccine against rotavirus, the most common cause of infant diarrhea.

Are these vaccines given as shots?
Most are delivered as shots or injections. This helps ensure that children receive a quick and effective dose of the vaccine. The only exceptions are the new rotavirus vaccine, which is effective as an oral vaccine—babies receive it in liquid form by mouth—and the influenza vaccine, which is available for healthy children age 5 and up as a nasal vaccine, meaning the child receives a squirt of liquid in the nose.

When and how many shots should a child get?
Most of the immunizations are given to babies in their first 18 to 24 months of life, with each immunization given as a series with boosters. To reduce the number of shots for babies, some of the vaccines have been combined—for example diptheria-tetanus-pertussis, otherwise known as DTP. Vaccine manufacturers are developing newer vaccines that combine even more components and further reduce the number of shots.

After the series of infant shots, children usually have a few years free of shots, except for the yearly influenza vaccine. Children need another set of booster shots at the pre-kindergarten visit between 4 and 6. After that, the next set of shots is in middle school.

What are the main changes from the 2005 to 2006 immunization recommendations?

• Hepatitis B: Previously, the first dose was recommended any time from birth to 2 months of age. The new recommendations emphasize that the first dose should be given at birth, before the baby leaves the hospital. Booster shots are subsequently given at 1 and 6 months. This is important to protect children against hepatitis B infection of the liver and liver cancer.
• Rotavirus: This is a new oral vaccine given at 2, 4 and 6 months of age. It protects babies against the most common cause of diarrhea and dehydration.
• Influenza: Previously, the influenza vaccine was recommended for infants 6 to 23 months. Now it's recommended for all children from 6 months to 5 years. After the first flu shot at 6 months, a booster is given four weeks later. Then a shot is given each year until age 5. The shot usually becomes available in October. This is important to protect young children against serious respiratory illness.
• Hepatitis A: Previously, this vaccine was recommended only for children in higher risk Western states. Now it recommended for all children. The first dose is recommended at 1 year of age (12 to 23 months) with the second dose six months later. This is important to protect all children from hepatitis A infection of the liver.
• Tetanus-Diphtheria-Pertussis: Previously, adolescents got tetanus booster shots that simply contained tetanus-diphtheria vaccines (Td). Now it's recommended that adolescents ages 11 to12, older adolescents and adults get their tetanus-diphtheria booster containing an additional pertussis vaccine booster, called TdaP adolescent preparation. After this single pertussis booster, subsequent Td boosters are still recommended every 10 years. This pertussis booster is important to protect infants from catching whooping cough from their older family members and caregivers.
• Meningococcus: This new vaccine is recommended for 11- to 12-year-old children and unvaccinated older adolescents entering high school or college. This is given as a single shot. It protects against meningitis, a serious infection of the covering of the brain.

For more information about the current immunization recommendations visit the Centers for Disease website www.cdc.gov and follow the links for vaccines and immunizations.