This report, concerning the immunization of adolescents (ie, persons 11 to 21 years old, as defined by the American Medical Association [AMA] and the American Academy of Pediatrics [AAP]), is a supplement to previous publications (ie, MMWR.1994;43 [No. RR-1]1–38; the AAP 1994 Red Book: Report of the Committee on Infectious Diseases; Summary of Policy Recommendations for Periodic Health Examination, August 1996 from the American Academy of Family Physicians [AAFP]; and AMA Guidelines for Adolescent Preventive Services [GAPS]: Recommendations and Rationale). This report presents a new strategy to improve the delivery of vaccination services to adolescents and to integrate recommendations for vaccination with other preventive services provided to adolescents. This new strategy emphasizes vaccination of adolescents 11 to 12 years old by establishing a routine visit to their health-care providers. Specifically, the purposes of this visit are to a) vaccinate adolescents who have not been previously vaccinated with varicella virus vaccine, hepatitis B vaccine, or the second dose of the measles, mumps, and rubella (MMR) vaccine; b) provide a booster dose of tetanus and diphtheria toxoids; c) administer other vaccines that may be recommended for certain adolescents; and d) provide other recommended preventive services. The recommendations for vaccination of adolescents are based on new or current information for each vaccine. The most recent recommendations from the Advisory Committee on Immunization Practices (ACIP), AAP, AAFP, and AMA concerning specific vaccines and delivery of preventive services should be consulted for details (Exhibit

EXHIBIT 2

ACIP
 
CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1994;43 (No. RR-1) 
CDC. Measles prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1989;38 (No. S-9) 
CDC. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR.1991;40(No. RR-10).  
CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR. 1996;45 (No. RR-11)  
CDC. Pneumococcal polysaccharide vaccine: recommendations of the Immunization Practices Advisory Committee. MMWR. 1989;38:64–68, 73–76  
CDC. Mumps prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1989;38:388–92, 397–400  
CDC. Rubella prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR.1990;39 (No. RR-15)  
CDC. Prevention and control of influenza: part 1, vaccines—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1993;42 (No. RR-6)  
CDC. Update on adult immunization: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40 (No. RR-12) 
CDC. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40 (No. RR-13)  
CDC. Recommended childhood immunization schedule—United States, July–December 1996. MMWR. 1996;45:635–638  
CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1996. In press  
 
AAP
 
American Academy of Pediatrics. In: Peter G, ed. 1994 Red Book: Report of the Committee on Infectious Diseases. 23rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 1994  
Recommended childhood immunization schedule—United States, January–December 1997.Pediatrics. 1997;99:136–138  
American Academy of Pediatrics, Committee on Practice and Ambulatory Medicine. Recommendations for preventive pediatric health care.Pediatrics. 1995;96:373–374  
American Academy of Pediatrics, Committee on Infectious Diseases. Recommendations for the use of live attenuated varicella vaccine. Pediatrics.1995;95:791–796  
 
AAFP
 
American Academy of Family Physicians. Summary of policy recommendations for periodic health examination. Kansas City, MO: American Academy of Family Physicians, August 1996. (AAFP order no. 962, reprint no. 510) 
American Academy of Family Physicians. Recommended immunization schedule, United States, July–December 1996. (AAFP order no. 974, reprint no. 520)  
 
AMA
 
American Medical Association. Rationale and recommendations: infectious diseases. In: Elster AB, Kuznets NJ, eds. AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale.Chicago, IL: Williams & Wilkins; 1994:165–171 
ACIP
 
CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1994;43 (No. RR-1) 
CDC. Measles prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1989;38 (No. S-9) 
CDC. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR.1991;40(No. RR-10).  
CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR. 1996;45 (No. RR-11)  
CDC. Pneumococcal polysaccharide vaccine: recommendations of the Immunization Practices Advisory Committee. MMWR. 1989;38:64–68, 73–76  
CDC. Mumps prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1989;38:388–92, 397–400  
CDC. Rubella prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR.1990;39 (No. RR-15)  
CDC. Prevention and control of influenza: part 1, vaccines—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1993;42 (No. RR-6)  
CDC. Update on adult immunization: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40 (No. RR-12) 
CDC. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40 (No. RR-13)  
CDC. Recommended childhood immunization schedule—United States, July–December 1996. MMWR. 1996;45:635–638  
CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1996. In press  
 
AAP
 
American Academy of Pediatrics. In: Peter G, ed. 1994 Red Book: Report of the Committee on Infectious Diseases. 23rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 1994  
Recommended childhood immunization schedule—United States, January–December 1997.Pediatrics. 1997;99:136–138  
American Academy of Pediatrics, Committee on Practice and Ambulatory Medicine. Recommendations for preventive pediatric health care.Pediatrics. 1995;96:373–374  
American Academy of Pediatrics, Committee on Infectious Diseases. Recommendations for the use of live attenuated varicella vaccine. Pediatrics.1995;95:791–796  
 
AAFP
 
American Academy of Family Physicians. Summary of policy recommendations for periodic health examination. Kansas City, MO: American Academy of Family Physicians, August 1996. (AAFP order no. 962, reprint no. 510) 
American Academy of Family Physicians. Recommended immunization schedule, United States, July–December 1996. (AAFP order no. 974, reprint no. 520)  
 
AMA
 
American Medical Association. Rationale and recommendations: infectious diseases. In: Elster AB, Kuznets NJ, eds. AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale.Chicago, IL: Williams & Wilkins; 1994:165–171 

ACIP, AAP, AAFP, and AMA Documents

Abbreviations: ACIP, Advisory Committee on Immunization Practices; AAP, American Academy of Pediatrics; AAFP, American Academy of Family Physicians; AMA, American Medical Association.

2).

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