Objective To estimate, using simulations, the time necessary to administer and document the additional vaccines added since 2000 to the routine child immunization schedule in the U.S.

Design and Methods Using guidelines published by the Advisory Committee on Immunization Practices we calculated the incremental time needed to administer and document the following vaccines to panels of 1,000, 1,200, 1,500, 1,800, and 2,000 patients: PCV-7; Influenza; MCV4; Tdap.; Hep A; Rotavirus; 3 HPV vaccines to girls; and a second varicella. Age/sex distribution of patient panels was adopted from published reports. Nursing time of vaccine administration and documentation was measured at a single urban academic pediatric practice.

Results See table.

Conclusions Time associated with administering and documenting new vaccines added since 2000 to the routine childhood immunization schedule can amount to up to 16 weeks of a full time nurse equivalent for a busy practitioner. The public policy implications merit serious attention.