Peer-reviewed article
Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations
Francisco José Álvarez García, María José Cilleruelo Ortega, Javier Álvarez Aldeán, María Garcés‐Sánchez, Nuria García Sánchez et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001The Spanish Pediatric Association's 2021 immunisation recommendations outline optimal vaccination schedules for children and adolescents in Spain. The guidance recommends a 2+1 schedule for hexavalent and pneumococcal vaccines, inclusion of rotavirus, meningococcal B, and expanded meningococcal coverage, and universal HPV vaccination regardless of gender. The recommendations are based on available scientific evidence and aim to improve vaccine coverage across the population.
Key points
- A 2+1 vaccination schedule (at 2, 4, and 11 months) is recommended with hexavalent vaccines and 13-valent pneumococcal conjugate vaccine
- Rotavirus vaccine should be systematic for all infants, and meningococcal B vaccine should be included in the routine calendar with a 2+1 schedule
- Universal HPV vaccination is recommended for all children regardless of gender, preferably at age 12, with a 9-genotype vaccine extending coverage for both genders
- Tdpa vaccination is recommended in adolescents and in each pregnancy between 27 and 32 weeks
- Two-dose schedules are recommended for measles-mumps-rubella and varicella, with the second dose potentially applied as a tetraviral vaccine
Limitations
This document presents recommendations based on scientific evidence but does not evaluate the effectiveness of these vaccines or assess implementation outcomes in Spain. It does not report on actual vaccination coverage rates, adverse events, or the impact of these recommendations on child health outcomes.
Abstract
The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate. A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2 + 1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3–4 years) and varicella (15 months and 3–4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders. El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños y adolescentes residentes en España, teniendo en cuenta la evidencia científica disponible. Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y 32 semanas. La vacuna del rotavirus debería ser sistemática para todos los lactantes. Se insiste en la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes. Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta 18 años, inclusive, el CAV-AEP recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Se emplearán esquemas de dos dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda la vacunación sistemática universal frente al VPH, con independencia del género, preferentemente a los 12 años, insistiendo en un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos.