Immunization Schedule For Children And Adolescents Aged 18 Years Or Younger Page 5


Footnotes — Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, UNITED STATES, 2017
For further guidance on the use of the vaccines mentioned below, see:
For vaccine recommendations for persons 19 years of age and older, see the Adult Immunization Schedule.
Additional information
• For contraindications and precautions to use of a vaccine and for additional information regarding that vaccine, vaccination providers should consult the ACIP General Recommendations on
Immunization and the relevant ACIP statement, available online at
• For purposes of calculating intervals between doses, 4 weeks = 28 days. Intervals of 4 months or greater are determined by calendar months.
• Vaccine doses administered ≤4 days before the minimum interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum interval or minimum age should not
be counted as valid doses and should be repeated as age-appropriate. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, see
Table 1, Recommended and minimum ages and intervals between vaccine doses, in MMWR, General Recommendations on Immunization and Reports / Vol. 60 / No. 2, available online at
• Information on travel vaccine requirements and recommendations is available at
• For vaccination of persons with primary and secondary immunodeficiencies, see Table 13, Vaccination of persons with primary and secondary immunodeficiencies, in General Recommendations
on Immunization (ACIP), available at mmwr/pdf/rr/rr6002.pdf.; and Immunization in Special Clinical Circumstances, (American Academy of Pedatrics). In: Kimberlin DW, Brady MT,
Jackson MA, Long SS, eds. Red Book: 2015 report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2015:68-107.
• The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury petitions. Created by the National Childhood Vaccine
Injury Act of 1986, it provides compensation to people found to be injured by certain vaccines. All vaccines within the recommended childhood immunization schedule are covered by VICP
except for pneumococcal polysaccharide vaccine (PPSV). For more information; see
Hepatitis B (HepB) vaccine. (Minimum age: birth)
• Administration of a total of 4 doses of HepB vaccine is
provided at least 6 months have elapsed since the third
Routine vaccination:
permitted when a combination vaccine containing HepB
At birth:
is administered after the birth dose.
• Inadvertent administration of fourth DTaP dose early:
• Administer monovalent HepB vaccine to all newborns
Catch-up vaccination:
If the fourth dose of DTaP was administered at least 4
within 24 hours of birth.
• Unvaccinated persons should complete a 3-dose series.
months after the third dose of DTaP and the child was 12
• For infants born to hepatitis B surface antigen (HBsAg)-
• A 2-dose series (doses separated by at least 4 months) of
months of age or older, it does not need to be repeated.
positive mothers, administer HepB vaccine and 0.5 mL
adult formulation Recombivax HB is licensed for use in
Catch-up vaccination:
of hepatitis B immune globulin (HBIG) within 12 hours
children aged 11 through 15 years.
• The fifth dose of DTaP vaccine is not necessary if the
of birth. These infants should be tested for HBsAg and
• For other catch-up guidance, see Figure 2.
fourth dose was administered at age 4 years or older.
antibody to HBsAg (anti-HBs) at age 9 through 12 months
Rotavirus (RV) vaccines. (Minimum age: 6 weeks for both
• For other catch-up guidance, see Figure 2.
Haemophilus influenzae type b (Hib) conjugate vaccine.
(preferably at the next well-child visit) or 1 to 2 months
RV1 [Rotarix] and RV5 [RotaTeq])
after completion of the HepB series if the series was
Routine vaccination:
(Minimum age: 6 weeks for PRP-T [ActHIB, DTaP-IPV/Hib
Administer a series of RV vaccine to all infants as follows:
(Pentacel), Hiberix, and Hib-MenCY (MenHibrix)], PRP-
• If mother’s HBsAg status is unknown, within 12 hours of
1. If Rotarix is used, administer a 2-dose series at ages 2
OMP [PedvaxHIB])
birth, administer HepB vaccine regardless of birth weight.
and 4 months.
Routine vaccination:
For infants weighing less than 2,000 grams, administer
2. If RotaTeq is used, administer a 3-dose series at ages 2,
• Administer a 2- or 3-dose Hib vaccine primary series
HBIG in addition to HepB vaccine within 12 hours of birth.
4, and 6 months.
and a booster dose (dose 3 or 4, depending on vaccine
Determine mother’s HBsAg status as soon as possible
3. If any dose in the series was RotaTeq or vaccine product
used in primary series) at age 12 through 15 months to
and, if mother is HBsAg-positive, also administer HBIG to
is unknown for any dose in the series, a total of 3 doses
complete a full Hib vaccine series.
infants weighing 2,000 grams or more as soon as possible,
of RV vaccine should be administered.
• The primary series with ActHIB, MenHibrix, Hiberix,
but no later than age 7 days.
Catch-up vaccination:
or Pentacel consists of 3 doses and should be
Doses following the birth dose:
• The maximum age for the first dose in the series is 14
administered at ages 2, 4, and 6 months. The primary
• The second dose should be administered at age 1 or 2
weeks, 6 days; vaccination should not be initiated for
series with PedvaxHIB consists of 2 doses and should be
months. Monovalent HepB vaccine should be used for
infants aged 15 weeks, 0 days, or older.
administered at ages 2 and 4 months; a dose at age 6
doses administered before age 6 weeks.
• The maximum age for the final dose in the series is 8
months is not indicated.
• Infants who did not receive a birth dose should receive 3
months, 0 days.
• One booster dose (dose 3 or 4, depending on vaccine
doses of a HepB-containing vaccine on a schedule of 0,
• For other catch-up guidance, see Figure 2.
used in primary series) of any Hib vaccine should be
Diphtheria and tetanus toxoids and acellular pertussis
1 to 2 months, and 6 months, starting as soon as feasible
administered at age 12 through 15 months.
(see figure 2).
(DTaP) vaccine. (Minimum age: 6 weeks. Exception: DTaP-
• For recommendations on the use of MenHibrix in patients
• Administer the second dose 1 to 2 months after the first
IPV [Kinrix, Quadracel]: 4 years)
at increased risk for meningococcal disease, refer to the
dose (minimum interval of 4 weeks); administer the third
Routine vaccination:
meningococcal vaccine footnotes and also to MMWR
dose at least 8 weeks after the second dose AND at least
• Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6,
February 28, 2014 / 63(RR01):1-13, available at
16 weeks after the first dose. The final (third or fourth)
15 through 18 months, and 4 through 6 years. The fourth
dose in the HepB vaccine series should be administered
dose may be administered as early as age 12 months,
no earlier than age 24 weeks.


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