The Advisory Committee on Vaccines of the Spanish Paediatric Association (CAV-AEP) updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the effectiveness and efficiency of vaccines.
The present schedule includes degrees of recommendation. We have graded as routine vaccinations those that the CAV-AEP believes all children should receive; as recommended those that fit the profile for universal childhood immunisation and would ideally be given to all children, but that can be prioritised according to the resources available for their public funding; and as risk group vaccinations those that specifically target individuals in risk situations. Immunisation schedules tend to be dynamic and to adjust to ongoing epidemiological changes. Nevertheless, achieving a unified immunisation schedule in all Spain is a top priority for the CAV-AEP.
Based on the latest epidemiological trends, the main changes introduced to the schedule are the administration of the first dose of the MMR and the varicella vaccines at age 12 months (range: 12-15 months) and the second dose at age 2-3 years, preferably at 2 years of age, and also the administration of the Tdap vaccine at age 4-6 years, always followed by another dose at 11-14 years of age.
The CAV-AEP believes that the coverage of vaccination against human papillomavirus in girls aged 11 to 14 years must increase. It reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule. Universal vaccination against varicella in the second year of life is an effective strategy and therefore a desirable objective. Vaccination against rotavirus is recommended in all infants due to the morbidity and elevated healthcare burden of the virus. The Committee stresses the need to vaccinate population groups considered at risk of influenza and hepatitis A. Finally, the Committee emphasises the need to bring incomplete vaccinations up to date using the accelerated immunisation schedule.