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Notes

Immunization Schedule

  1. Hepatitis B vaccine (HepB). (Minimum age: birth)
    • At birth:
      • Administer monovalent HepB to all newborns before hospital discharge.
      • If mother is hepatitis surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.
      • If mother's HBsAg status is unknown, administer HepB within 12 hours of birth. Determine the HBsAg status as soon as possible and if HBsAg-positive, administer HBIG (no later than age 1 week).
      • If mother is HBsAg-negative, the birth dose can only be delayed with physician’s order and mother’s negative HBsAg laboratory report documented in the infant’s medical record.
    • After the birth dose
      • The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1–2 months. The final dose should be administered at age Gteq24 weeks. Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of Gteq3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).
    • 4-month dose:
      • It is permissible to administer 4 doses of HepB when combination vaccines are administered after the birth dose. If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.
  2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)
    • Administer the first dose at age 6–12 weeks. Do not start the series later than age 12 weeks.
    • Administer the final dose in the series by age 32 weeks. Do not administer a dose later than age 32 weeks.
    • Data on safety and efficacy outside of these age ranges are insufficient.
  3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). (Minimum age: 6 weeks)
    • The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose.
    • Administer the final dose in the series at age 4–6 years.
  4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)
    • If PRP-OMP (PedvaxHIB® or ComVax® [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.
    • TriHiBit® (DTaP/Hib) combination products should not be used for primary immunization but can be used as boosters following any Hib vaccine in children aged Gteq12 months.
  5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPV])
    • Administer PCV at ages 24–59 months in certain high-risk groups. Administer PPV to children aged Gteq2 years in certain high-risk groups. See MMWR2000;49(No. RR-9):1–35.
  6. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 5 years for live, attenuated influenza vaccine [LAIV])
    • All children aged 6–59 months and close contacts of all children aged 0–59 months are recommended to receive influenza vaccine.
    • Influenza vaccine is recommended annually for children aged Gteq59 months with certain risk factors, health-care workers, and other persons (including household members) in close contact with persons in groups at high risk. See MMWR2006;55(No. RR-10):1–41.
    • For healthy persons aged 5–49 years, LAIV may be used as an alternative to TIV.
    • Children receiving TIV should receive 0.25 mL if aged 6–35 months or 0.5 mL if aged Gteq3 years.
    • Children aged <9 years who are receiving influenza vaccine for the first time should receive 2 doses (separated by Gteq4 weeks for TIV and Gteq6 weeks for LAIV).
  7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
    • Administer the second dose of MMR at age 4–6 years. MMR may be administered before age 4–6 years, provided Gteq4 weeks have elapsed since the first dose and both doses are administered at age Gteq12 months.
  8. Varicella vaccine. (Minimum age: 12 months)
    • Administer the second dose of varicella vaccine at age 4–6 years. Varicella vaccine may be administered before age 4–6 years, provided that Gteq3 months have elapsed since the first dose and both doses are administered at age Gteq12 months. If second dose was administered Gteq28 days following the first dose, the second dose does not need to be repeated.
  9. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
    • HepA is recommended for all children aged 1 year (i.e., aged 12–23 months). The 2 doses in the series should be administered at least 6 months apart.
    • Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.
    • HepA is recommended for certain other groups of children, including in areas where vaccination programs target older children. See MMWR2006;55(No. RR-7):1–23.
  10. Meningococcal polysaccharide vaccine (MPSV4). (Minimum age: 2 years)
    • Administer MPSV4 to children aged 2-10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other highrisk groups. See MMWR2005;54(No. RR-7):1-21.
    • Persons who received MPSV 3 or more years previously and who remain at increased risk for meningococcal disease should be revaccinated with MCV.

The Recommended Immunization Schedules for Persons Aged 0 Through 18 Years are approved by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).

DEPARTMENT OF HEALTH AND HUMAN SERVICES · CENTERS FOR DISEASE CONTROL AND PREVENTION

Immunization Schedule