What is going on with vaccines: keeping up with the childhood immunization schedule.

In the last 25 years, the number of diseases prevented by vaccination in childhood has more than doubled, challenging practitioners to become familiar with a host of new vaccine recommendations. Incorporating new vaccines into practice is facilitated by an understanding of the processes that affect their use. Factors that influence the successful incorporation of a vaccine into routine practice include licensing, development of recommendations, identification of funding sources, liability coverage in the event of adverse outcomes, the development of mandates for use, and consideration of parental knowledge and attitudes. New vaccine recommendations offer increased protection against rotavirus, hepatitis A, varicella, pertussis, meningococcus, and human papillomavirus. With increasing complexity and changing recommendations, practitioners should refer to reliable resources for accessing up-to-date information.