An immunization update for primary health care providers

Despite notoriously low immunization levels among children in the United States in recent decades, provisional statistics for 1994 are encouraging. This may be related to several recent governmental initiatives that have focused attention on immunizations. A new vaccination schedule, effective January 1995, marked major progress in the clarification of immunization guidelines. This article discusses current recommendations for both pediatric and adult immunizations. The text includes information about the current incidence of communicable diseases, recent governmental policies affecting availability of vaccines, standards for immunization practice, and guidelines for storage and handling of vaccines. A table outlines recommended vaccines in the following areas: 1) vaccine antigen, dose, and route, 2) routine schedule for administration, 3) precautions and contraindications, 4) adverse reactions, 5) serious adverse reactions, and 6) education.