ANSWER:
The Advisory Committee on Immunization Practices (ACIP) consists of 12 immunization experts who are selected by the Secretary of the U.S. Department of Health and Human Services (HHS). The goal of the ACIP is to provide advice to the HHS and the Nation in reducing the incidence of vaccine preventable diseases and to increase the safe usage of vaccines. The ACIP develops written recommendations for the scheduling and appropriate use of childhood and adult vaccines. Through a collaborative process, the ACIP, American Academy of Pediatrics and the American Academy of family Physicians, establish the recommended childhood immunization schedule. It is then left to individual states to determine which vaccines are required for entry into childcare settings and school.

ANSWER:
No, because waiting puts your child at increased risk for serious diseases. Many vaccine-preventable diseases are more severe and pose the greatest risk for complications in infants and very young children. Waiting until kindergarten, or even until after the first birthday, to have your child immunized can put him/her at unnecessary risk when he/she is most vulnerable.

Maternal antibodies fade during the first year, when the child is also more frequently exposed to other children and adults who may be infected with these diseases.

• Infants who are 6-7 months old are at the peak age to get Hib disease.
• Of the six individuals hospitalized because of pertussis in King County in 1998, all were younger than six months, and one death occurred.
• During the 1990 measles epidemic, 49% of the 352 cases in Washington State were in children younger than four years of age. The majority of these children could have received measles vaccine at 15 months of age, but did not. Now, children routinely get measles vaccine as early as 12 months (and sometimes as early as six months in outbreak situations).

ANSWER:
Yes, but it is best to stay as close as possible to the recommended schedule. An interruption in the schedule does not require a child to start the series over for any vaccines. However, until the entire vaccine series is received, the individual will not have the maximum protection against the disease. If a child is behind on the immunization schedule, a catch-up schedule can be determined by the child's doctor, nurse, or clinic.

ANSWER:
Yes! Immunizations can be given and should be requested during any visit to your doctor or nurse, even if your child has a minor illness, such as mild fever, a cold, diarrhea, or is taking antibiotics. The vaccine will still be effective. It will not make your child's illness worse. Receiving all immunizations when they are due is an important way to complete each vaccine series on time and avoid extra visits.

ANSWER:
Yes, sometimes there are medical reasons for not giving a vaccine or for delaying it. These are referred to as "contraindications" and "precautions". In general, a child should not receive an immunization if he or she:

• Has a medical condition that could be made more severe, or even life-threatening if the vaccine were given.
  Example: A child has a severe allergy to a vaccine component (e.g. neomycin, gelatin) that would cause a serious reaction, such as difficulty breathing, low blood pressure or shock, if the vaccine were given.
• Has a medical condition which could reduce the ability of the vaccine to produce the desired immunity (such as severe illness).
  Example: A child has recently received blood products (such as immune globulin, or a blood transfusion), and the antibodies in the blood could damage a live vaccine, such as measles vaccine.

In most instances, vaccines may be given if a child is breastfed, has an ear infection, is taking antibiotics, has mild diarrhea or has milk allergy. Infants or children living in a household with a pregnant woman may receive all vaccines, including live vaccines (such as MMR and varicella). Check with your health care provider if you have specific questions regarding these or other circumstances.