Immunization Schedule For Children And Adolescents Aged 18 Years Or Younger (Page 6 of 8) in pdf

For further guidance on the use of the vaccines mentioned below, see:

Catch-up vaccination:

(including sickle cell disease) and unimmunized* persons

1. If neither PCV13 nor PPSV23 has been received previ-

• If dose 1 was administered at ages 12 through 14 months,

5 through 18 years of age with HIV infection.

ously, administer 1 dose of PCV13 now and 1 dose of

administer a second (final) dose at least 8 weeks after

* Patients who have not received a primary series and

PPSV23 at least 8 weeks later.

dose 1, regardless of Hib vaccine used in the primary

booster dose or at least 1 dose of Hib vaccine after 14

2. If PCV13 has been received previously but PPSV23 has

series.

months of age are considered unimmunized.

not, administer 1 dose of PPSV23 at least 8 weeks after

• If both doses were PRP-OMP (PedvaxHIB or COMVAX) and

Pneumococcal vaccines. (Minimum age: 6 weeks for

the most recent dose of PCV13.

were administered before the first birthday, the third (and

PCV13, 2 years for PPSV23)

3. If PPSV23 has been received but PCV13 has not, admin-

final) dose should be administered at age 12 through 59

Routine vaccination with PCV13:

ister 1 dose of PCV13 at least 8 weeks after the most

months and at least 8 weeks after the second dose.

• Administer a 4-dose series of PCV13 at ages 2, 4, and 6

recent dose of PPSV23.

• If the first dose was administered at age 7 through 11

months and at age 12 through 15 months.

• For children aged 6 through 18 years with chronic heart

months, administer the second dose at least 4 weeks later

Catch-up vaccination with PCV13:

disease (particularly cyanotic congenital heart disease

and a third (and final) dose at age 12 through 15 months

• Administer 1 dose of PCV13 to all healthy children

and cardiac failure), chronic lung disease (including

or 8 weeks after second dose, whichever is later.

aged 24 through 59 months who are not completely

asthma if treated with high-dose oral corticosteroid

• If first dose is administered before the first birthday and

vaccinated for their age.

therapy), diabetes mellitus, alcoholism, or chronic liver

second dose administered at younger than 15 months,

• For other catch-up guidance, see Figure 2.

disease, who have not received PPSV23, administer 1

a third (and final) dose should be administered 8 weeks

Vaccination of persons with high-risk conditions with

dose of PPSV23. If PCV13 has been received previously,

later.

PCV13 and PPSV23:

then PPSV23 should be administered at least 8 weeks

• For unvaccinated children aged 15–59 months,

• All recommended PCV13 doses should be administered

after any prior PCV13 dose.

administer only 1 dose.

prior to PPSV23 vaccination if possible.

• A single revaccination with PPSV23 should be

• For other catch-up guidance, see Figure 2. For catch-up

• For children aged 2 through 5 years with any of the

administered 5 years after the first dose to children

guidance related to MenHibrix, see the meningococcal

following conditions: chronic heart disease (particularly

with sickle cell disease or other hemoglobinopathies;

vaccine footnotes and also MMWR February 28, 2014 /

cyanotic congenital heart disease and cardiac failure);

anatomic or functional asplenia; congenital or acquired

63(RR01):1-13, available at

chronic lung disease (including asthma if treated with

immunodeficiencies; HIV infection; chronic renal failure;

rr6301.pdf.

high-dose oral corticosteroid therapy); diabetes mellitus;

nephrotic syndrome; diseases associated with treatment

Vaccination of persons with high-risk conditions:

cerebrospinal fluid leak; cochlear implant; sickle cell

with immunosuppressive drugs or radiation therapy,

Children aged 12 through 59 months who are at increased

disease and other hemoglobinopathies; anatomic or

including malignant neoplasms, leukemias, lymphomas,

risk for Hib disease, including chemotherapy recipients

functional asplenia; HIV infection; chronic renal failure;

and Hodgkin disease; generalized malignancy; solid

and those with anatomic or functional asplenia (including

nephrotic syndrome; diseases associated with treatment

organ transplantation; or multiple myeloma.

sickle cell disease), human immunodeficiency virus (HIV )

with immunosuppressive drugs or radiation therapy,

Inactivated poliovirus vaccine (IPV). (Minimum age: 6

infection, immunoglobulin deficiency, or early component

including malignant neoplasms, leukemias, lymphomas,

weeks)

complement deficiency, who have received either no

and Hodgkin disease; solid organ transplantation; or

Routine vaccination:

doses or only 1 dose of Hib vaccine before age 12 months,

congenital immunodeficiency:

• Administer a 4-dose series of IPV at ages 2, 4, 6 through

should receive 2 additional doses of Hib vaccine, 8 weeks

1. Administer 1 dose of PCV13 if any incomplete schedule

18 months, and 4 through 6 years. The final dose in the

apart; children who received 2 or more doses of Hib vaccine

of 3 doses of PCV13 was received previously.

series should be administered on or after the fourth

before age 12 months should receive 1 additional dose.

2. Administer 2 doses of PCV13 at least 8 weeks apart if

birthday and at least 6 months after the previous dose.

• For patients younger than age 5 years undergoing

unvaccinated or any incomplete schedule of fewer than

Catch-up vaccination:

chemotherapy or radiation treatment who received a

3 doses of PCV13 was received previously.

• In the first 6 months of life, minimum age and minimum

Hib vaccine dose(s) within 14 days of starting therapy

3. The minimum interval between doses of PCV13 is 8

intervals are only recommended if the person is at risk of

or during therapy, repeat the dose(s) at least 3 months

weeks.

imminent exposure to circulating poliovirus (i.e., travel to

following therapy completion.

4. For children with no history of PPSV23 vaccination,

a polio-endemic region or during an outbreak).

• Recipients of hematopoietic stem cell transplant

administer PPSV23 at least 8 weeks after the most recent

• If 4 or more doses are administered before age 4 years, an

(HSCT) should be revaccinated with a 3-dose regimen

dose of PCV13.

additional dose should be administered at age 4 through

of Hib vaccine starting 6 to 12 months after successful

• For children aged 6 through 18 years who have

6 years and at least 6 months after the previous dose.

transplant, regardless of vaccination history; doses should

cerebrospinal fluid leak; cochlear implant; sickle cell

• A fourth dose is not necessary if the third dose was

be administered at least 4 weeks apart.

disease and other hemoglobinopathies; anatomic

administered at age 4 years or older and at least 6 months

• A single dose of any Hib-containing vaccine should be

or functional asplenia; congenital or acquired

after the previous dose.

administered to unimmunized* children and adolescents

immunodeficiencies; HIV infection; chronic renal failure;

• If both OPV and IPV were administered as part of a series,

15 months of age and older undergoing an elective

nephrotic syndrome; diseases associated with treatment

a total of 4 doses should be administered, regardless of

splenectomy; if possible, vaccine should be administered

with immunosuppressive drugs or radiation therapy,

the child’s current age. If only OPV was administered, and

at least 14 days before procedure.

including malignant neoplasms, leukemias, lymphomas,

all doses were given prior to age 4 years, 1 dose of IPV

• Hib vaccine is not routinely recommended for patients

and Hodgkin disease; generalized malignancy; solid

should be given at 4 years or older, at least 4 weeks after

5 years or older. However, 1 dose of Hib vaccine should

organ transplantation; or multiple myeloma:

the last OPV dose.

be administered to unimmunized* persons aged 5

• IPV is not routinely recommended for U.S. residents aged

years or older who have anatomic or functional asplenia

18 years or older.

Immunization Schedule For Children And Adolescents Aged 18 Years Or Younger Page 6

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