Native American children are at greater risk for certain diseases and conditions such as hepatitis A, hepatitis B, and diseases caused by Haemophilus influenzae andStreptococcus pneumoniae. Recommendations for vaccine use in many Native American communities differ from those for the general population; vigorous vaccination practices have resulted in a lowering of the rates of morbidity and mortality from these preventable diseases in Native American communities. This policy statement provides immunization recommendations for children residing in Native American communities, and will discuss how to modify these recommendations for Native American children in particular situations.

Before universal Hib immunization for infants was realized, invasive Hib disease occurred with increased frequency and at younger ages in American Indian/Alaska Native (AI/AN) children compared with the general US population. Annual case rates of Hib disease were as much as 10-fold greater in AI/AN children. In ANs, 25% of all Hib disease and 35%...

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