Recommended Immunization Schedule For Persons Aged 0 Through 18 Years (Page 3 of 5) in pdf

Footnotes — Recommended immunization schedule for persons aged 0 through 18 years—United States, 2014

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 relevant ACIP statement available online

• 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 or less 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 MMWR, General Recommendations on Immunization and Reports / Vol. 60 / No. 2; Table 1. Recommended and minimum ages and intervals between vaccine doses 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 ; and American Academy of Pediatrics. Immunization in Special Clinical Circumstances, in Pickering LK, Baker CJ,

Kimberlin DW, Long SS eds. Red Book: 2012 report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics.

Hepatitis B (HepB) vaccine. (Minimum age: birth)

Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (Minimum age: 6 weeks.

Routine vaccination:

Exception: DTaP-IPV [Kinrix]: 4 years)

At birth:

Routine vaccination:

• Administer monovalent HepB vaccine to all newborns before hospital discharge.

• Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15 through 18 months, and 4 through 6 years.

• For infants born to hepatitis B surface antigen (HBsAg)-positive mothers, administer HepB vaccine and

The fourth dose may be administered as early as age 12 months, provided at least 6 months have

0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. These infants should be tested

elapsed since the third dose.

for HBsAg and antibody to HBsAg (anti-HBs) 1 to 2 months after completion of the HepB series, at age

Catch-up vaccination:

9 through 18 months (preferably at the next well-child visit).

• The fifth dose of DTaP vaccine is not necessary if the fourth dose was administered at age 4 years or older.

• If mother’s HBsAg status is unknown, within 12 hours of birth administer HepB vaccine regardless of

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

birth weight. For infants weighing less than 2,000 grams, administer HBIG in addition to HepB vaccine

Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for

within 12 hours of birth. Determine mother’s HBsAg status as soon as possible and, if mother is HBsAg-

Boostrix, 11 years for Adacel)

Routine vaccination:

positive, also administer HBIG for infants weighing 2,000 grams or more as soon as possible, but no

later than age 7 days.

• Administer 1 dose of Tdap vaccine to all adolescents aged 11 through 12 years.

Doses following the birth dose:

• Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.

• The second dose should be administered at age 1 or 2 months. Monovalent HepB vaccine should be

• Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferred during

used for doses administered before age 6 weeks.

27 through 36 weeks gestation) regardless of time since prior Td or Tdap vaccination.

• Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a

Catch-up vaccination:

schedule of 0, 1 to 2 months, and 6 months starting as soon as feasible. See Figure 2.

• Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap

• Administer the second dose 1 to 2 months after the first dose (minimum interval of 4 weeks),

vaccine as 1 (preferably the first) dose in the catch-up series; if additional doses are needed, use Td

administer the third dose at least 8 weeks after the second dose AND at least 16 weeks after the first

vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an

dose. The final (third or fourth) dose in the HepB vaccine series should be administered no earlier than

adolescent Tdap vaccine dose at age 11 through 12 years should NOT be administered. Td should be

age 24 weeks.

administered instead 10 years after the Tdap dose.

• Administration of a total of 4 doses of HepB vaccine is permitted when a combination vaccine

• Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose followed

containing HepB is administered after the birth dose.

by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.

Catch-up vaccination:

• Inadvertent doses of DTaP vaccine:

• Unvaccinated persons should complete a 3-dose series.

- If administered inadvertently to a child aged 7 through 10 years may count as part of the catch-up

• A 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed

series. This dose may count as the adolescent Tdap dose, or the child can later receive a Tdap

for use in children aged 11 through 15 years.

booster dose at age 11 through 12 years.

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

- If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be

Rotavirus (RV) vaccines. (Minimum age: 6 weeks for both RV1 [Rotarix] and RV5 [RotaTeq])

counted as the adolescent Tdap booster.

Routine vaccination:

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

Administer a series of RV vaccine to all infants as follows:

Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6 weeks for PRP-T [ACTHIB,

1. If Rotarix is used, administer a 2-dose series at 2 and 4 months of age.

DTaP-IPV/Hib (Pentacel) and Hib-MenCY (MenHibrix)], PRP-OMP [PedvaxHIB or COMVAX], 12 months

2. If RotaTeq is used, administer a 3-dose series at ages 2, 4, and 6 months.

for PRP-T [Hiberix])

3. If any dose in the series was RotaTeq or vaccine product is unknown for any dose in the series, a total

Routine vaccination:

of 3 doses of RV vaccine should be administered.

• Administer a 2- or 3-dose Hib vaccine primary series and a booster dose (dose 3 or 4 depending on

Catch-up vaccination:

vaccine used in primary series) at age 12 through 15 months to complete a full Hib vaccine series.

• The maximum age for the first dose in the series is 14 weeks, 6 days; vaccination should not be

• The primary series with ActHIB, MenHibrix, or Pentacel consists of 3 doses and should be administered

initiated for infants aged 15 weeks, 0 days or older.

at 2, 4, and 6 months of age. The primary series with PedvaxHib or COMVAX consists of 2 doses and

• The maximum age for the final dose in the series is 8 months, 0 days.

should be administered at 2 and 4 months of age; a dose at age 6 months is not indicated.

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

• One booster dose (dose 3 or 4 depending on vaccine used in primary series) of any Hib vaccine should

be administered at age 12 through 15 months. An exception is Hiberix vaccine. Hiberix should only

be used for the booster (final) dose in children aged 12 months through 4 years who have received at

least 1 prior dose of Hib-containing vaccine.

Recommended Immunization Schedule For Persons Aged 0 Through 18 Years Page 3

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