Recommended Immunization Schedule For Persons Aged 0 Through 18 Years (Page 4 of 5) in pdf

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

Haemophilus influenzae type b (Hib) conjugate vaccine (cont’d)

Pneumococcal vaccines (cont’d)

• For recommendations on the use of MenHibrix in patients at increased risk for meningococcal disease,

3. Administer 1 supplemental dose of PCV13 if 4 doses of PCV7 or other age-appropriate complete PCV7

please refer to the meningococcal vaccine footnotes and also to MMWR March 22, 2013; 62(RR02);1-22,

series was received previously.

available at

4. The minimum interval between doses of PCV (PCV7 or PCV13) is 8 weeks.

Catch-up vaccination:

5. For children with no history of PPSV23 vaccination, administer PPSV23 at least 8 weeks after the most

• If dose 1 was administered at ages 12 through 14 months, administer a second (final) dose at least 8

recent dose of PCV13.

weeks after dose 1, regardless of Hib vaccine used in the primary series.

• For children aged 6 through 18 years who have cerebrospinal fluid leak; cochlear implant; sickle cell disease

• If the first 2 doses were PRP-OMP (PedvaxHIB or COMVAX), and were administered at age 11 months or

and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiencies;

younger, the third (and final) dose should be administered at age 12 through 15 months and at least 8

HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with

weeks after the second dose.

immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and

• If the first dose was administered at age 7 through 11 months, administer the second dose at least 4

Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma:

weeks later and a third (and final) dose at age 12 through 15 months or 8 weeks after second dose,

1. If neither PCV13 nor PPSV23 has been received previously, administer 1 dose of PCV13 now and 1

whichever is later, regardless of Hib vaccine used for first dose.

dose of PPSV23 at least 8 weeks later.

• If first dose is administered at younger than 12 months of age and second dose is given between 12

2. If PCV13 has been received previously but PPSV23 has not, administer 1 dose of PPSV23 at least 8

through 14 months of age, a third (and final) dose should be given 8 weeks later.

weeks after the most recent dose of PCV13.

• For unvaccinated children aged 15 months or older, administer only 1 dose.

3. If PPSV23 has been received but PCV13 has not, administer 1 dose of PCV13 at least 8 weeks after the

• For other catch-up guidance, see Figure 2. For catch-up guidance related to MenHibrix, please see the

most recent dose of PPSV23.

meningococcal vaccine footnotes and also MMWR March 22, 2013; 62(RR02);1-22, available at

• For children aged 6 through 18 years with chronic heart disease (particularly cyanotic congenital heart

disease and cardiac failure), chronic lung disease (including asthma if treated with high-dose oral

Vaccination of persons with high-risk conditions:

corticosteroid therapy), diabetes mellitus, alcoholism, or chronic liver disease, who have not received

• Children aged 12 through 59 months who are at increased risk for Hib disease, including

PPSV23, administer 1 dose of PPSV23. If PCV13 has been received previously, then PPSV23 should be

chemotherapy recipients and those with anatomic or functional asplenia (including sickle cell disease),

administered at least 8 weeks after any prior PCV13 dose.

human immunodeficiency virus (HIV) infection, immunoglobulin deficiency, or early component

• A single revaccination with PPSV23 should be administered 5 years after the first dose to children

complement deficiency, who have received either no doses or only 1 dose of Hib vaccine before 12

with sickle cell disease or other hemoglobinopathies; anatomic or functional asplenia; congenital

months of age, should receive 2 additional doses of Hib vaccine 8 weeks apart; children who received

or acquired immunodeficiencies; HIV infection; chronic renal failure; nephrotic syndrome; diseases

2 or more doses of Hib vaccine before 12 months of age should receive 1 additional dose.

associated with treatment with immunosuppressive drugs or radiation therapy, including malignant

• For patients younger than 5 years of age undergoing chemotherapy or radiation treatment who

neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ

received a Hib vaccine dose(s) within 14 days of starting therapy or during therapy, repeat the dose(s)

transplantation; or multiple myeloma.

at least 3 months following therapy completion.

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

Routine vaccination:

• Recipients of hematopoietic stem cell transplant (HSCT) should be revaccinated with a 3-dose regimen

of Hib vaccine starting 6 to 12 months after successful transplant, regardless of vaccination history;

• Administer a 4-dose series of IPV at ages 2, 4, 6 through 18 months, and 4 through 6 years. The final

doses should be administered at least 4 weeks apart.

dose in the series should be administered on or after the fourth birthday and at least 6 months after

• A single dose of any Hib-containing vaccine should be administered to unimmunized* children and

the previous dose.

Catch-up vaccination:

adolescents 15 months of age and older undergoing an elective splenectomy; if possible, vaccine

should be administered at least 14 days before procedure.

• In the first 6 months of life, minimum age and minimum intervals are only recommended if the person is at risk

• Hib vaccine is not routinely recommended for patients 5 years or older. However, 1 dose of Hib vaccine

for imminent exposure to circulating poliovirus (i.e., travel to a polio-endemic region or during an outbreak).

should be administered to unimmunized* persons aged 5 years or older who have anatomic or

• If 4 or more doses are administered before age 4 years, an additional dose should be administered at

functional asplenia (including sickle cell disease) and unvaccinated persons 5 through 18 years of age

age 4 through 6 years and at least 6 months after the previous dose.

with human immunodeficiency virus (HIV) infection.

• A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6

* Patients who have not received a primary series and booster dose or at least 1 dose of Hib vaccine

months after the previous dose.

after 14 months of age are considered unimmunized.

• If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless

Pneumococcal vaccines. (Minimum age: 6 weeks for PCV13, 2 years for PPSV23)

of the child’s current age. IPV is not routinely recommended for U.S. residents aged 18 years or older.

Routine vaccination with PCV13:

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

• Administer a 4-dose series of PCV13 vaccine at ages 2, 4, and 6 months and at age 12 through 15 months.

Influenza vaccines. (Minimum age: 6 months for inactivated influenza vaccine [IIV], 2 years for live,

• For children aged 14 through 59 months who have received an age-appropriate series of 7-valent PCV

attenuated influenza vaccine [LAIV])

(PCV7), administer a single supplemental dose of 13-valent PCV (PCV13).

Routine vaccination:

Catch-up vaccination with PCV13:

• Administer influenza vaccine annually to all children beginning at age 6 months. For most healthy,

• Administer 1 dose of PCV13 to all healthy children aged 24 through 59 months who are not

nonpregnant persons aged 2 through 49 years, either LAIV or IIV may be used. However, LAIV should

completely vaccinated for their age.

NOT be administered to some persons, including 1) those with asthma, 2) children 2 through 4 years who

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

had wheezing in the past 12 months, or 3) those who have any other underlying medical conditions that

Vaccination of persons with high-risk conditions with PCV13 and PPSV23:

predispose them to influenza complications. For all other contraindications to use of LAIV, see MMWR

2013; 62 (No. RR-7):1-43, available at

• All recommended PCV13 doses should be administered prior to PPSV23 vaccination if possible.

• For children 2 through 5 years of age with any of the following conditions: chronic heart disease

For children aged 6 months through 8 years:

(particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including

• For the 2013–14 season, administer 2 doses (separated by at least 4 weeks) to children who are

asthma if treated with high-dose oral corticosteroid therapy); diabetes mellitus; cerebrospinal fluid

receiving influenza vaccine for the first time. Some children in this age group who have been

leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional

vaccinated previously will also need 2 doses. For additional guidance, follow dosing guidelines in the

asplenia; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment

2013-14 ACIP influenza vaccine recommendations, MMWR 2013; 62 (No. RR-7):1-43, available at

with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias,

lymphomas, and Hodgkin disease; solid organ transplantation; or congenital immunodeficiency:

• For the 2014–15 season, follow dosing guidelines in the 2014 ACIP influenza vaccine

1. Administer 1 dose of PCV13 if 3 doses of PCV (PCV7 and/or PCV13) were received previously.

recommendations.

2. Administer 2 doses of PCV13 at least 8 weeks apart if fewer than 3 doses of PCV (PCV7 and/or PCV13)

For persons aged 9 years and older:

were received previously.

• Administer 1 dose.

Recommended Immunization Schedule For Persons Aged 0 Through 18 Years Page 4

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