The new recommendations are updates to the childhood immunization guidelines. According to the CDC, pneumococcal disease, which can result in

kills more people in the United States every year -- 40,000 or more -- than all other vaccine-preventable diseases combined.

Older children, from 24 months to 59 months of age, who are at increased risk of pneumococcal disease -- such as children with sickle cell disorders, HIV infection, and other chronic medical conditions -- should also be vaccinated, according to the CDC, who recommend that "priority be given to children aged 24 to 35 months, American Indian/Alaska Native and black children, and children who attend child-care centers."

Hepatitis A vaccine guidelines were also revised. "For hepatitis A we wanted to extend the recommendation to include older adolescents up through age 18," Dr. Joanne Cono, with the CDC, told Reuters Health.

Hepatitis A vaccine is also recommended for routine use in some states and regions and in certain high-risk groups. "Healthcare providers should check with their state or local health department to see if this recommendation applies to their state or region," Cono said.

According to the CDC, all healthcare providers are required to give parents or patients copies of "Vaccine Information Statements" before administering each dose of recommended vaccines.

"People should bring up the vaccination with their doctors, who would be able to advise them and would also be able to give them vaccine information sheets," Cono said.

Morbidity and Mortality Weekly Report 2001;49: 7-10