[An update on vaccines. Theory, realities and myths (and II) update in the Spanish vaccine schedule]

The criteria for modifying the immunization schedule depends on the disease (load, frequency, morbidity and mortality, killing potential) of the vaccine (immunogenicity, efficacy, effectiveness, efficiency, compatibility, safety and assurance of supply) and society (impact on the population and the health system, perception of disease in the population). In Spain there are 19 different vaccine schedules that are not justified from a health, epidemiological, social or economic perspective. The Spanish Association of Paediatrics recommends: vaccinating against rotavirus from the sixth week, against papillomavirus in preadolescent girls, achieving universal pneumococcal protection, administering a second dose of varicella at 3-4 years, changing the indications of the pertussis vaccine and flu vaccine and hepatitis A risk. We will review further the vaccines that have recently been introduced: rotavirus, pneumococcus and papillomavirus and mention the major changes in existing ones.