51
HEALTH SERVICES AND UTILIZATION
RECOMMENDED CHILDHOOD IMMUNIZATION SCHEDULE, UNITED STATES, JANUARY DECEMBER 2000
Source (III.3): Centers for Disease Control and Prevention
VACCINE
Routinely recommended age for vaccination
*
AGE
*
Birth
1 mo.
2 mos.
4 mos.
6 mos.
12 mos.
15 mos.
18 mos.
24 mos.
4-6 yrs.
11-12 yrs.
14-16 yrs.
Hepatitis B
2
Hep B
Hep B
Hep B
Hep B
Diphtheria, Tetanus,
DTaP
DTaP
DTaP
Pertussis
DTaP
3
3
DTaP
Td
H. influenzae type b
4
Hib
Hib
Hib
Hib
Polio
5
IPV
IPV
IPV
5
IPV
5
Measles, Mumps, Rubella
6
MMR
MMR
6
MMR
6
Varicella
7
Var
Var
7
Hepatitis A
8
Hep A
8
-in selected areas
Vaccines
1
are listed under routinely recommended ages.
Bars
indicate range of recommended ages for immunization. Any dose not given at the recommended age should be given as a catch-up immunization at any
subsequent visit when indicated and feasible.
Ovals
indicate vaccines to be given if previously recommended doses were missed or given earlier than the recommended minimum age.
On October 22, 1999, the Advisory Committee on Immunization Practices (ACIP)
All children and adolescents (through 18 years of age) who have not been immunized
1. Mass vaccination campaigns to control outbreaks of paralytic polio.
recommended that Rotashield (RRV-TV), the only U.S.-licensed rotavirus vaccine, no
against hepatitis B may begin the series during any visit. Special efforts should be made
2. Unvaccinated children who will be traveling in <4 weeks to areas where polio is
longer be used in the United States (MMWR, Volume 48, Number 43, Nov. 5,
to immunize children who were born in or whose parents were born in areas of the
endemic or epidemic.
1999). Parents should be reassured that their children who received rotavirus vaccine
world with moderate or high endemicity of hepatitis B virus infection.
3. Children of parents who do not accept the recommended number of vaccine injec-
before July are not at increased risk for intussusception now.
3The 4th dose of DTaP (diphtheria and tetanus toxoids and acellular pertussis vac-
tions. These children may receive OPV only for the third or fourth dose or both; in
1This schedule indicates the recommended ages for routine administration of currently
cine) may be administered as early as 12 months of age, provided 6 months have
this situation, health-care providers should administer OPV only after discussing the
licensed childhood vaccines as of 11/1/99. Additional vaccines may be licensed and
elapsed since the 3rd dose and the child is unlikely to return at age 15-18 months. Td
risk for VAPP with parents or caregivers.
recommended during the year. Licensed combination vaccines may be used whenever any
(tetanus and diptheria toxoids) is recommended at 11-12 years of age if at least 5
4. During the transition to an all-IPV schedule, recommendations for the use of
components of the combination are indicated and its other components are not con-
years have elapsed since the last dose of DTP, DTaP or DT. Subsequent routine Td
remaining OPV supplies in physicians' offices and clinics have been issued by the
traindicated. Providers should consult the manufacturers' package inserts for detailed
boosters are recommended every 10 years.
American Academy of Pediatrics (see Pediatrics, December 1999).
recommendations.
4Three Haemophilus influenzae type b (Hib) conjugate vaccines are licensed for infant
6The 2nd dose of measles, mumps, and rubella (MMR) vaccine is recommended rou-
2Infants born to HBsAg-negative mothers should receive the 1st dose of hepatitis B
use. If PRP-OMP (PedvaxHIB or ComVax [Merck]) is administered at 2 and 4
tinely at 4-6 years of age but may be administered during any visit, provided at least
(Hep B) vaccine by age 2 months. The 2nd dose should be at least one month after the
months of age, a dose at 6 months is not required. Because clinical studies in infants
4 weeks have elapsed since receipt of the 1st dose and that both does are administered
1st dose. The 3rd dose should be administered at least 4 months after the 1st dose and
have demonstrated that using some combination products may induce a lower immune
beginning at or after 12 months of age. Those who have not previously received the sec-
at least 2 months after the 2nd dose, but not before 6 months of age for infants.
response to the Hib vaccine component, DTaP/Hib combination products should not
ond dose should complete the schedule by the 11-12 year old visit.
Infants born to HBsAg-positive mothers should receive hepatitis B vaccine and 0.5 mL
be used for primary immunization in infants at 2, 4 or 6 months of age, unless FDA-
7Varicella (Var) vaccine is recommended at any visit on or after the first birthday for
hepatitis B immune globulin (HBIG) within 12 hours of birth at separate sites. The
approved for these ages.
susceptible children, i.e. those who lack a reliable history of chickenpox (as judged by
2nd dose is recommended at 1-2 months of age and the 3rd dose at 6 months of age.
5To eliminate the risk of vaccine-associated paralytic polio (VAPP), an all-IPV
a health care provider) and who have not been immunized. Susceptible persons 13
Infants born to mothers whose HBsAG status is unknown should receive hepa-
schedule is now recommended for routine childhood polio vaccination in the United
years of age or older should receive 2 doses, given at least 4 weeks apart.
titis B vaccine within 12 hours of birth. Maternal blood should be drawn at the time
States. All children should receive four doses of IPV at 2 months, 4 months, 6-18
8Hepatitis A (Hep A) is shaded to indicate its recommended use in selected states
of delivery to determine the mother's HBsAg status; if the HBsAg test is positive, the
months, and 4-6 years. OPV (if available) may be used only for the following special
and/or regions; consult your local public health authority. (Also see MMWR Oct. 01,
infant should receive HBIG as soon as possible (no later than 1 week of age).
circumstances:
1999/48(RR12); 1-37).
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