Volume 31 • Number 6 • June 2010
Policy outlines PCV13 recommendations
by Mary P. Glode, M.D., FAAP
How will health care
reform impact smaller
An updated AAP policy on the prevention of infections due to
Streptococcus pneumoniae in infants and children provides
recommendations for use of the newly licensed 13-valent
pneumococcal polysaccharide protein-conjugate vaccine
(Prevnar 13 [PCV13], Wyeth Pharmaceuticals Inc., a
subsidiary of Pfizer Inc.).
PCV13 will replace Prevnar(PCV7), a highly successful
vaccine that has been in use since 2000. PCV13 provides
protection against six serotypes of pneumococcus in
addition to the seven pneumococcal serotypes in PCV7.
The statement, written by the AAP Committee on
Infectious Diseases, provides recommendations for:
• the transition from PCV7 to PCV13;
• the routine use of PCV13 for healthy children and
children with an underlying medical condition that
increases the risk of invasive pneumococcal disease
• a supplemental dose of PCV13 for healthy children
14 through 59 months of age who have completed
the PCV7 series and children 14 through 71 months
of age with an underlying medical condition that
increases the risk of IPD who have completed the
To view the policy statement, visit http://pediatrics.aap
For more information on PCV13, see the April issue of
AAP News, http://aapne ws.aappublications.org/cgi/con
• “catch-up” immunization for children behind sched-
• PCV13 for certain high-risk children from 6 through
18 years of age.
Recommendations for use of pneumococcal polysaccharide vaccine (PPSV23) for children at high risk of
IPD also are updated.
The Academy has prepared implementation guidelines
to inform and aid providers in their efforts to include
PCV13 among the immunizations provided in their
practices. A link to the implementation guidelines
is included in the policy statement (see
Dr. Glode is a member of the AAP Committee on Infectious Diseases.
by Anne B. Francis, M.D., FAAP, and
Jay E. Berkelhamer, M.D., FAAP
Many small pediatric practices may want to provide health insurance benefits to attract and retain
the best employees, yet most find the costs prohibitive. Health reform includes immediate improvements to help smaller pediatric practices provide
health insurance benefits to their employees, while
continuing to have the flexibility to select health
care coverage and benefits they offer their employees.
While the new law will not require small businesses (those with fewer than 50 employees working
more than 30 hours/week) to provide health insurance, it does offer incentives through tax credits
and, beginning in 2014, assesses penalties to larger,
The law provides a sliding scale tax credit
(retroactive to Jan. 1) to small businesses — many
See Reform, page 4
Pediatricians and the Law
General peds face increased
scrutiny in newborn nursery
by Jay P. Goldsmith, M.D., FAAP
While care of the newborn remains an integral part of the general pediatrician’s practice, neonatologists and hospital-based physicians have assumed
much of this care in recent years.
However, depending on the local environment and hospital policies,
pediatricians may attend problematic deliveries and Caesarean sections,
provide routine care and guidance to seemingly well newborns, screen for
many potential problems in the neonatal period and provide initial care to
sick newborns before transfer to an intensive care nursery.
With increasing parental expectations of early diagnosis and perfect outcomes, the pediatrician’s role in this area has come under increased scrutiny
with the potential for being named as a defendant in a malpractice suit. Following is a review of some of the high-risk areas in providing neonatal care.
See Law, page 10
With increasing parental expectations of early diagnosis and perfect outcomes, the pediatrician’s
role in the care of newborns has come under greater scrutiny with the potential for being named
as a defendant in a malpractice suit.
In this issue
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