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This page is formatted to be read by screen-reader software used by the visually-impaired. The content is identical to that of the .pdf version of the "Recommended Childhood and Adolescent Immunization Schedule UNITED STATES, 2005". Page last updated April 27, 2005.

Recommended Childhood and Adolescent Immunization Schedule UNITED STATES, 2005


Vaccine Birth 1 month 2 months 4 months 6 months 12 months 15 months 18 months 24 months 4 to 6 years 11 to 12 years 13 to 18 years

Hepatitis B

See footnote 1

Hep B dose 1 recommended.

HepB dose 1 recommended only if mother is hepatitis B surface antigen (HBsAg) negative. Hep B dose 2 recommended

Date for this dose depends on date of initial Hep B dose.

HepB dose 1 Recommended only if mother is hepatitis B surface antigen (HBsAg) negative. Hep B dose 2 recommended.

Date for this dose depends on date of initial Hep B dose.

Hep B dose 2 recommended.

Date for this dose depends on date of initial Hep B dose.

Hep B dose 3 recommended

Date for this dose depends on date of initial and subsequent Hep B doses.

Hep B dose 3 recommended

Date for this dose depends on date of initial and subsequent Hep B doses.

Hep B dose 3 recommended

Date for this dose depends on date of initial and subsequent Hep B doses.

Hep B dose 3 recommended

Date for this dose depends on date of initial and subsequent Hep B doses.

Hep B Series Catch-up. Hep B Series Catch-up. Hep B Series Catch-up. Preadolescent Assessment. Hep B Series Catch-up.
Diphtheria, Tetanus, Pertussis (DTaP)2     DTaP dose 1 recommended. DTaP dose 2 recommended. DTaP dose 3 recommended.   DTaP dose 4 recommended, depending on date of previous dose. DTaP dose 4 recommended, depending on date of previous dose.   DTaP dose 5 recommended. Tetanus, Diphtheria (Td) recommended. Preadolescent Assessment. Tetanus, Diphtheria (Td) booster recommended.
Haemophilus Influenzae Type b (HIB)3     HIB dose1 recommended. HIB dose 2 recommended.

HIB dose 3 recommended

See footnote 3.

HIB dose 4 recommended, depending on date of previous dose. HIB dose 4 recommended depending on date of previous dose.       Preadolescent Assessment.  
Inactivated Poliovirus (IPV)     IPV dose 1 recommended. IPV dose 2 recommended.

IPV dose 3 recommended during this time period.

Range for this dose is 6-18 months. Consult your healthcare professional for recommended date of this dose.

 

  IPV #4 recommended. Preadolescent Assessment.  

Measles, Mumps, Rubella (MMR)

See footnote 4

          MMR dose 1 recommended. MMR dose 1 can be given at this time.     MMR dose 2 recommended. MMR dose 2 Catch-up recommended. Preadolescent Assessment. MMR #2 Catch-up recommended.

Varicella (Chickenpox)

See footnote 5

          Varicella recommended. Recommended alternative date for Varicella. Recommended alternative date for Varicella. Varicella Catch-up recommended. Recommended alternative date for Varicella Catch-up. Varicella Catch-up recommended. Preadolescent Assessment. Recommended alternative date for Varicella Catch-up.

Pneumococcal Conjugate (PCV)

See footnote 6

    PCV dose 1 recommended. PCV dose 2 recommended. PCV dose 3 recommended. PCV #4 recommended. Alternative recommended date for PCV dose 4.   PCV recommended for certain groups, and PPV recommended for other groups. PCV recommended for certain groups, and PPV recommended for other groups. PPV recommended for certain groups. Preadolescent Assessment. PPV recommended for certain groups.

Influenza (flu)

See footnote 7

       

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Influenza recommended for certain groups yearly. Consult healthcare professional for dose and timing. Preadolescent Assessment.

Influenza recommended for certain groups yearly.

Consult healthcare professional for dose and timing.

Hepatitis A

See footnote 8

                Hepatitis A recommended for certain groups. Consult healthcare professional for timing. Hepatitis A recommended for certain groups. Consult healthcare professional for timing.

Hepatitis A recommended for certain groups.

Consult healthcare professional for timing.

Preadolescent Assessment.

Hepatitis A recommended for certain groups. Consult healthcare professional for timing.

This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of April 1, 2004, for children through age 18 years. Any dose not administered at the recommended age should be administered at any subsequent visit when indicated and feasible. The text listed as “catch-up” indicates age groups that warrant special effort to administer those vaccines not previously administered. Additional vaccines may be licensed and recommended during the year. Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not contraindicated. Providers should consult the manufacturers' package inserts for detailed recommendations. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form are available by telephone, 800-822-7967.

Footnote 1. Hepatitis B (Hep B) vaccine. All infants should receive the first dose of hepatitis B vaccine soon after birth and before hospital discharge; the first dose may also be administered by age 2 months if the mother is hepatitis B surface antigen (HBsAg) negative. Only monovalent Hep B may be used for the birth dose. Monovalent or combination vaccine containing Hep B may be used to complete the series. Four doses of vaccine may be administered when a birth dose is given. The second dose should be administered at least 4 weeks after the first dose, except for combination vaccines which cannot be administered before age 6 weeks. The third dose should be given at least 16 weeks after the first dose and at least 8 weeks after the second dose. The last dose in the vaccination series (third or fourth dose) should not be administered before age 24 weeks.

Infants born to HBsAg-positive mothers should receive Hep B and 0.5 mL of Hepatitis B Immune Globulin (HBIG) at separate sites within 12 hours of birth. The second dose is recommended at age 1 to 2 months. The final dose in the immunization series should not be administered before age 24 weeks. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9 to 15 months.

Infants born to mothers whose HBsAg status is unknown should receive the first dose of the Hep B series within 12 hours of birth. Maternal blood should be drawn as soon as possible to determine the mother's HBsAg status; if the HBsAg test is positive, the infant should receive HBIG as soon as possible (no later than age 1 week). The second dose is recommended at age 1 to 2 months. The last dose in the immunization series should not be administered before age 24 weeks.

Footnote 2. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at age 15 to 18 months. The final dose in the series should be given at age greater than or equal to 4 years. Tetanus and diphtheria toxoids (Td) is recommended at age 11 to 12 years if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine. Subsequent routine Td boosters are recommended every 10 years.

Footnote 3. Haemophilus influenzae type b (HIB) conjugate vaccine. Three HIB conjugate vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB (registered product) or ComVax (registered product) [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required. DTaP/HIB combination products should not be used for primary immunization in infants at ages 2, 4, or 6 months but can be used as boosters after any HIB vaccine. The final dose in the series should be administered at age greater than or equal to 12 months.

Footnote 4. Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4 to 6 years but may be administered during any visit, provided at least 4 weeks have elapsed since the first dose and both doses are administered beginning at or after age 12 months. Those who have not previously received the second dose should complete the schedule by age 11 to 12 years.

Footnote 5. Varicella vaccine. Varicella vaccine is recommended at any visit at or after age 12 months for susceptible children (i.e., those who lack a reliable history of chickenpox). Susceptible persons age greater than or equal to 13 years should receive 2 doses, administered at least 4 weeks apart.

Footnote 6. Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for all children age 2 to 23 months and for certain children aged 24 to 59 months. It is also recommended for certain children age 24 to 59 months. The final dose in the series should be given at age greater than or equal to 12 months. Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain high-risk groups. See MMWR 2000;49(RR-9):1-35.

Footnote 7. Influenza vaccine (flu vaccine). Influenza vaccine is recommended annually for children age greater than or equal to 6 months with certain risk factors (including but not limited to children with asthma, cardiac disease, sickle cell disease, human immunodeficiency virus infection [HIV], and diabetes), healthcare workers, and other persons (including househod members) in close contact with persons in groups at high risk (see MMWR 2004; 53; [RR-6]:1-40). In addition, healthy children aged 6 to 23 months and close contacts of healthy children aged 0 to 23 months are recommended to receive influenza vaccine because children in this age group are at substantially increased risk for influenza-related hospitalizations. For healthy persons age 5 to 49 years, the intranasally administered, live, attenuated influenza vaccine (LAIV) is an acceptable alternative to the intramuscular trivalent inactivated influenza vaccine (TIV). See MMWR 2004; 53; [RR-6]:1-40. Children receiving TIV should be administered a dosage appropriate for their age (0.25 mL if aged 6 to 35 months or 0.5 mL if aged greater than or equal to 3 years). Children aged less than or equal to 8 years who are receiving influenza vaccine for the first time should receive 2 doses (separated by at least 4 weeks for TIV and at least 6 weeks for LAIV).

Footnote 8. Hepatitis A vaccine. Hepatitis A vaccine is recommended for children and adolescents in selected states and regions and for certain high-risk groups; consult your local public health authority. Children and adolescents in these states, regions, and high-risk groups who have not been immunized against hepatitis A can begin the hepatitis A immunization series during any visit. The 2 doses in the series should be administered at least 6 months apart. See MMWR 1999;48(RR-12):1-37.

For additional information about vaccines, including precautions and contraindications for immunization and vaccine shortages, please visit the National Immunization Program Web site at www.cdc.gov/nip/

Additional information about the vaccines listed below and contraindications for immunization is available at http://www.cdc.gov/nip

General immunization questions can be answered by the CDC Contact Center at 1-800-CDC-INFO
(1-800-232-4636) English and Español.

Questions about vaccines and vaccine-preventable diseases frequently asked by people calling the T.T.Y. Service Hotline can be viewed in American Sign Language at 1-888-232-6348 (T.T.Y. hotline)

The Childhood and Adolescent Immunization Schedule is approved by the Advisory Committee on Immunization Practices (www.cdc.gov/nip/acip), the American Academy of Pediatrics (www.aap.org), and the American Academy of Family Physicians (www.aafp.org).