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What is ACIP’s stand on informing parents that using Pediarix for 3 doses is O.K. for children who have already had a birth dose of Hepatitis B vaccine?

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What is ACIP’s stand on informing parents that using Pediarix for 3 doses is O.K. for children who have already had a birth dose of Hepatitis B vaccine?

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It is reasonable to disclose the fact that the child is going to receive a fourth dose. You should also add that ACIP and the American Academy of Pediatrics (AAP) consider this an acceptable practice. It is not a problem. In fact, you could argue that it will make their antibody titers even higher. Inform the parent that this practice has been considered very carefully by the ACIP and the AAP and in their opinion there is really no harm and no problem with giving the extra dose. We do want to continue to give the birth dose of hepatitis B vaccine. That is a very important intervention. Therefore, four doses are not an issue and the ACIP and NIP have included this in a footnote on the 2004 immunization schedule, which you can use as a reference, http://www.cdc.gov/nip/recs/child-schedule.pdf.

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