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

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

Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12 months for routine vaccination)

13.

Meningococcal conjugate vaccines. (Minimum age: 6 weeks for Hib-MenCY [MenHibrix], 9 months for

Routine vaccination:

MenACWY-D [Menactra], 2 months for MenACWY-CRM [Menveo])

• Administer a 2-dose series of MMR vaccine at ages12 through 15 months and 4 through 6 years. The second

Routine vaccination:

dose may be administered before age 4 years, provided at least 4 weeks have elapsed since the first dose.

• Administer a single dose of Menactra or Menveo vaccine at age 11 through 12 years, with a booster

• Administer 1 dose of MMR vaccine to infants aged 6 through 11 months before departure from the

dose at age 16 years.

United States for international travel. These children should be revaccinated with 2 doses of MMR

• Adolescents aged 11 through 18 years with human immunodeficiency virus (HIV) infection should

vaccine, the first at age 12 through 15 months (12 months if the child remains in an area where disease

receive a 2-dose primary series of Menactra or Menveo with at least 8 weeks between doses.

risk is high), and the second dose at least 4 weeks later.

• For children aged 2 months through 18 years with high-risk conditions, see below.

• Administer 2 doses of MMR vaccine to children aged 12 months and older before departure from the

Catch-up vaccination:

United States for international travel. The first dose should be administered on or after age 12 months

• Administer Menactra or Menveo vaccine at age 13 through 18 years if not previously vaccinated.

and the second dose at least 4 weeks later.

• If the first dose is administered at age 13 through 15 years, a booster dose should be administered at

Catch-up vaccination:

age 16 through 18 years with a minimum interval of at least 8 weeks between doses.

• Ensure that all school-aged children and adolescents have had 2 doses of MMR vaccine; the minimum

• If the first dose is administered at age 16 years or older, a booster dose is not needed.

interval between the 2 doses is 4 weeks.

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

10.

Varicella (VAR) vaccine. (Minimum age: 12 months)

Vaccination of persons with high-risk conditions and other persons at increased risk of disease:

Routine vaccination:

• Children with anatomic or functional asplenia (including sickle cell disease):

• Administer a 2-dose series of VAR vaccine at ages 12 through 15 months and 4 through 6 years. The

1. For children younger than 19 months of age, administer a 4-dose infant series of MenHibrix or Menveo

second dose may be administered before age 4 years, provided at least 3 months have elapsed since

at 2, 4, 6, and 12 through 15 months of age.

the first dose. If the second dose was administered at least 4 weeks after the first dose, it can be

2. For children aged 19 through 23 months who have not completed a series of MenHibrix or Menveo,

accepted as valid.

administer 2 primary doses of Menveo at least 3 months apart.

Catch-up vaccination:

3. For children aged 24 months and older who have not received a complete series of MenHibrix or

• Ensure that all persons aged 7 through 18 years without evidence of immunity (see MMWR 2007; 56

Menveo or Menactra, administer 2 primary doses of either Menactra or Menveo at least 2 months apart.

[No. RR-4], available at

) have 2 doses of varicella vaccine.

If Menactra is administered to a child with asplenia (including sickle cell disease), do not administer

For children aged 7 through 12 years, the recommended minimum interval between doses is 3 months

Menactra until 2 years of age and at least 4 weeks after the completion of all PCV13 doses.

(if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid);

• Children with persistent complement component deficiency:

for persons aged 13 years and older, the minimum interval between doses is 4 weeks.

1. For children younger than 19 months of age, administer a 4-dose infant series of either MenHibrix or

11.

Hepatitis A (HepA) vaccine. (Minimum age: 12 months)

Menveo at 2, 4, 6, and 12 through 15 months of age.

Routine vaccination:

2. For children 7 through 23 months who have not initiated vaccination, two options exist depending

• Initiate the 2-dose HepA vaccine series at 12 through 23 months; separate the 2 doses by 6 to 18 months.

on age and vaccine brand:

• Children who have received 1 dose of HepA vaccine before age 24 months should receive a second dose

a. For children who initiate vaccination with Menveo at 7 months through 23 months of age, a 2-dose

6 to 18 months after the first dose.

series should be administered with the second dose after 12 months of age and at least 3 months

• For any person aged 2 years and older who has not already received the HepA vaccine series, 2 doses of

after the first dose.

HepA vaccine separated by 6 to 18 months may be administered if immunity against hepatitis A virus

b. For children who initiate vaccination with Menactra at 9 months through 23 months of age, a 2-dose

infection is desired.

series of Menactra should be administered at least 3 months apart.

Catch-up vaccination:

c. For children aged 24 months and older who have not received a complete series of MenHibrix,

• The minimum interval between the two doses is 6 months.

Menveo, or Menactra, administer 2 primary doses of either Menactra or Menveo at least 2 months

Special populations:

apart.

• Administer 2 doses of HepA vaccine at least 6 months apart to previously unvaccinated persons who

• For children who travel to or reside in countries in which meningococcal disease is hyperendemic

live in areas where vaccination programs target older children, or who are at increased risk for infection.

or epidemic, including countries in the African meningitis belt or the Hajj, administer an age-

This includes persons traveling to or working in countries that have high or intermediate endemicity of

appropriate formulation and series of Menactra or Menveo for protection against serogroups A and

infection; men having sex with men; users of injection and non-injection illicit drugs; persons who work

W meningococcal disease. Prior receipt of MenHibrix is not sufficient for children traveling to the

with HAV-infected primates or with HAV in a research laboratory; persons with clotting-factor disorders;

meningitis belt or the Hajj because it does not contain serogroups A or W.

persons with chronic liver disease; and persons who anticipate close, personal contact (e.g., household

• For children at risk during a community outbreak attributable to a vaccine serogroup, administer or

or regular babysitting) with an international adoptee during the first 60 days after arrival in the United

complete an age- and formulation-appropriate series of MenHibrix, Menactra, or Menveo.

States from a country with high or intermediate endemicity. The first dose should be administered as

• For booster doses among persons with high-risk conditions, refer to MMWR 2013; 62(RR02);1-22,

soon as the adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.

available at

12.

Human papillomavirus (HPV) vaccines. (Minimum age: 9 years for HPV2 [Cervarix] and HPV4

Catch-up recommendations for persons with high-risk conditions:

[Gardisil])

1. If MenHibrix is administered to achieve protection against meningococcal disease, a complete age-

Routine vaccination:

appropriate series of MenHibrix should be administered.

• Administer a 3-dose series of HPV vaccine on a schedule of 0, 1-2, and 6 months to all adolescents aged 11

2. If the first dose of MenHibrix is given at or after 12 months of age, a total of 2 doses should be given at

through 12 years. Either HPV4 or HPV2 may be used for females, and only HPV4 may be used for males.

least 8 weeks apart to ensure protection against serogroups C and Y meningococcal disease.

• The vaccine series may be started at age 9 years.

3. For children who initiate vaccination with Menveo at 7 months through 9 months of age, a 2-dose

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

series should be administered with the second dose after 12 months of age and at least 3 months

administer the third dose 24 weeks after the first dose and 16 weeks after the second dose (minimum

after the first dose.

interval of 12 weeks).

4. For other catch-up recommendations for these persons, refer to MMWR 2013; 62(RR02);1-22, available

Catch-up vaccination:

• Administer the vaccine series to females (either HPV2 or HPV4) and males (HPV4) at age 13 through 18

years if not previously vaccinated.

For complete information on use of meningococcal vaccines, including guidance related to

vaccination of persons at increased risk of infection, see MMWR March 22, 2013; 62(RR02);1-22,

• Use recommended routine dosing intervals (see above) for vaccine series catch-up.

available at

Recommended Immunization Schedule For Persons Aged 0 Through 18 Years Page 5

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