Vaccination of Native American Children

American Family Physician,  Feb 15, 2000  

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The Committee on Native American Child Health and the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) have issued a policy statement on the immunization of Native American children. The AAP policy statement appears in the September 1999 issue of Pediatrics.

Native American children are at greater risk for hepatitis A, hepatitis B and diseases caused by Haemophilus influenzae and Streptococcus pneumoniae, as a result of genetics and environment. Because of the prevalence of these illnesses among this population, the AAP committee feels that all physicians must be aware of the different cultural and genetic needs of the patients they treat.

The AAP committee suggests the incorporation of the following recommendations to maximize the efficacy of vaccines currently available for Native American children:

* Polyribosylribitol phosphate polysaccharide conjugated to a meningococcal outer membrane protein (PRP-OMP) Haemophilus influenzae type B (Hib) conjugate vaccine is the preferred initial immunizing dose for prevention of Haemophilus infections. For subsequent doses, PRP-OMP or any other conjugate Hib vaccine may be used.

* Hepatitis A vaccine should be administered routinely to all American Indian and Alaska Native children at the earliest recommended age (currently two years). Hepatitis A vaccine should be administered to children between two and 18 years of age who are frequently exposed to persons living in areas with endemic or epidemic hepatitis A.

* All infants and children should be immunized with hepatitis B vaccine. The age for initiating vaccination depends on the mother's hepatitis B surface antigen status, the local epidemiology of hepatitis B infections and the availability of thimerosal-free vaccines.

* A single dose of pneumococcal 23-valent polysaccharide vaccine should be considered for Native American children at two years of age who live in areas where an increased risk of invasive pneumococcal disease has been demonstrated after two years of age.

* To reduce the number of injections, combined PRP-OMP conjugate vaccine/hepatitis B vaccine may be used at visits scheduled for either single vaccine for infants at least six weeks of age.

COPYRIGHT 2000 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group