Volume 32 • Number 2 • February 2011
2011 immunization schedules
reflect updates on use of 7 vaccines
Some pediatricians report
problems when using new
immunization administration codes
by H. Cody Meissner, M.D., FAAP
for use of vaccines licensed by the Food and Drug
Administration and approved by the Academy, the
Advisory Committee on Immunization Practices
(ACIP) of the Centers for Disease Control and Prevention, and the American Academy of Family
As in previous years,
three schedules provide
advice on administration
of immunizations for children 0 through 6 years, 7
through 18 years and a “catch-up” schedule.
from the AAP Department of Practice
The immunization schedules for 2011 include
updated recommendations for the 13-valent pneumococcal conjugate vaccine, seasonal influenza vaccines, quadrivalent meningococcal conjugate vaccines, combination pertussis vaccines, Haemophilus
influenza type b vaccines, human
papillomavirus vaccines and hepatitis B vaccines.
At the beginning of each year, updated schedules
are published that include current recommendations
Three updated immunization schedules
can be found on pages 13-15.
See Updates, page 12
The healthy tourist
Since the new CPT codes for immunization administration (IA) took effect on Jan. 1, the Academy has
received reports of numerous issues with implementation of the new codes.
AAP resources are available to assist practices in
addressing some of the issues, and the Academy is advocating for timely resolution of these problems.
The new codes replace codes 90465-90468 and are
reported based on the number of vaccine components
administered rather than the number of injections/
administrations. The Academy worked to develop the
new codes at the request of pediatricians who needed
a way to cover the costs of administering combination
vaccines more appropriately.
See Codes, page 10
Since parents often
don’t check in with a
doctor before traveling
abroad with their
children, take the lead
to keep your patients
safe and healthy.
See story on page 4.
issued for treating
by Mary Anne Jackson, M.D., FAAP
An estimated 10% of more than 60 million Americans who travel internationally are children. Pediatricians
can offer advice before a trip and remind parents to bring their child in right away if he or she returns home
with an illness.
The Infectious Diseases Society
of America has published clinical
practice guidelines for the treatment of methicillin-resistant
Staphylococcus aureus (MRSA) infections in children
This comprehensive document, which is
endorsed by the Academy, was written by experts
and includes evidence-based recommendations
describing the care of patients with a variety of
MRSA clinical presentations. The guideline
includes 77 recommendations. The main points
related to the care of children are outlined below.
The most important principle in treating this
common skin infection is to drain the abscess. A
retrospective study and a pediatric randomized
controlled trial showed that in skin and soft tissue
infections, drainage alone of abscesses less than 5
centimeters (cm) is as effective as drainage plus
Antibiotic therapy in addition to drainage should
be used in the following settings:
• abscesses greater than 5 cm;
• ill appearing child (as evidenced by fever, etc.);
• abscess site that is difficult to drain (e.g., genitalia, face, hands);