1st March 2008
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]
Summary,

GUIDELINE OBJECTIVE(S)

2006 Guideline

To provide technical guidance regarding common immunization concerns for health-care providers who administer vaccines to infants, children, adolescents, and adults

2008 Addendum

To provide updated recommendations regarding the administration of the combination measles, mumps, rubella, and varicella (MMRV) vaccine

TARGET POPULATION

Infants, children, adolescents and adults residing in the United States (including internationally adopted children and those with other special situations [e.g., pregnancy, altered immunocompetence, blood disorders])

INTERVENTIONS AND PRACTICES CONSIDERED

Immunization Practices

1. Timing and spacing of immunobiologics, including the following considerations:
* Vaccine scheduling
* Spacing of multiple doses of the same antigen
* Simultaneous administration of vaccines
* Nonsimultaneous administration of vaccines
* Spacing of antibody-containing products and vaccines
* Interchangeability of vaccines from different manufacturers
* Managing lapsed vaccination schedules
* Managing unknown or uncertain vaccination status
2. Recognizing true and untrue contraindications and precautions to vaccine administration
3. Vaccine administration
* Infection control and sterile technique
* Injection route and injection site
* Intramuscular injections and needle length
* Subcutaneous injections
* Multiple vaccinations
* Use of jet injectors
* Methods for alleviating discomfort and pain associated with vaccination
* Use of nonstandard vaccination practices
* Preventing adverse reactions
* Managing acute vaccine reactions
* Implementing and enforcing occupational safety regulations
4. Storing and handling of immunobiologics
5. Managing special situations
* Vaccination of persons with altered immunocompetence, including recipients of hematopoietic stem cell transplant
* Concurrent administration of antimicrobial agents and vaccines
* Tuberculosis screening and skin test reactivity
* Severe allergy to vaccine components
* Latex allergy
* Vaccination of preterm infants
* Vaccination during breast-feeding
* Vaccination during pregnancy
* Vaccination of persons vaccinated outside the United States, including internationally adopted children
* Vaccination of persons with bleeding disorders and persons receiving anticoagulant therapy
6. Maintaining vaccination records and registries
7. Reporting adverse events after vaccination (e.g., Vaccine Injury Compensation Program, benefit and risk communication)
8. Adhering to standard vaccination programs to increase vaccination coverage

MAJOR OUTCOMES CONSIDERED

* Development of adequate and persisting antibody response (seroconversion rates)
* Adverse effects of vaccines
* Potency of vaccines
* Risk for occurrence of vaccine-preventable diseases