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Section 1. Active and Passive Immunization
ACTIVE IMMUNIZATION
Scheduling Immunizations
A vaccine is intended to be administered to a person who is capable of an appropriate immunologic response and who likely will benefit from the protection given. However, optimal immunologic response for the person must be balanced against the need to achieve effective protection against disease. For example, pertussis-containing vaccines may be less immunogenic in early infancy than in later infancy, but the benefit of conferring protection in young infants mandates that immunization should be given early despite a lessened serum antibody response. For this reason, in some developing countries, OPV vaccine is given at birth, in accordance with recommendations of the World Health Organization.
With parenterally administered live-virus vaccines, the inhibitory effect of residual specific maternal antibody determines the optimal age of administration. For example, live-virus measles-containing vaccine in use in the United States provides suboptimal rates of seroconversion during the first year of life mainly because of interference by transplacentally acquired maternal antibody. If a measles-containing vaccine is administered before 12 months of age, the child should be reimmunized at 12 to 15 months of age with MMR or MMRV; a third dose of MMR is indicated at 4 to 6
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