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Recommended Immunization Schedule
Ages 0-6 Years

UNITED STATES • 2008

Age
 Vaccine

Birth

1
month
2
months
4
months
6
months
12
months
15
months
18
months
19-23
months
2-3
years
4-6
years
Hepatitis B Hep B Hep B click for footnote Hep B      
Rotavirus     Rota Rota Rota            
Diphtheria, Tetanus, Pertussis     DTaP DTaP DTaP click for footnote DTaP     DTaP
Haemophilus influenzae type b     Hib Hib Hib Hib        
Pneumococcal     PCV PCV PCV PCV     PPV
Inactivated Poliovirus     IPV IPV IPV     IPV
Influenza         Influenza (yearly)    
Measles, Mumps, Rubella           MMR       MMR
Varicella           Varicella       Varicella
Hepatitis A           Hep A (2 doses) Hep A Series
Meningococcal                   MCV4

 


This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2007, for children aged 0 through 6 years. Additional information is available at www.cdc.gov/vaccines/recs/schedules. Any dose not administered at the recommended age should be administered at any subsequent visit, when indicated and feasible. 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 and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the respective Advisory Committee on Immunization Practices statement for detailed recommendations, including for high risk conditions: www.cdc.gov/vaccines/pubs/ACIP-list.htm. 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 VAERS form is available at www.vaers.hhs.gov or by telephone, 800-822-7967.
   
 
1. Hepatitis B vaccine (HepB). (Minimum age: birth)

At birth:

  • Administer monovalent HepB to all newborns prior to hospital discharge.
  • If mother is hepatitis B surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.
  • If mother’s HBsAg status is unknown, administer HepB within 12 hours of birth. Determine the HBsAg status as soon as possible and if HBsAg-positive, administer HBIG (no later than age 1 week).
  • If mother is HBsAg-negative, the birth dose can be delayed, in rare cases, with a provider’s order and a copy of the mother’s negative HBsAg laboratory report in the infant’s medical record.

After the birth dose:

  • The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1–2 months. The final dose should be administered no earlier than age 24 weeks. Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of at least 3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).

4-month dose:

  • It is permissible to administer 4 doses of HepB when combination vaccines are administered after the birth dose. If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.

2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)

  • Administer the first dose at age 6–12 weeks.
  • Do not start the series later than age 12 weeks.
  • Administer the final dose in the series by age 32 weeks. Do not administer a dose later than age 32 weeks.
  • Data on safety and efficacy outside of these age ranges are insufficient.

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

4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)

  • If PRP-OMP (PedvaxHIB® or ComVax® [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.
  • TriHiBit® (DTaP/Hib) combination products should not be used for primary immunization but can be used as boosters following any Hib vaccine in children aged 12 months.

5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPV])

6. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV])

  • Administer annually to children aged 6–59 months and to all close contacts of children aged 0–59 months.
  • Administer annually to children 5 years of age and older with certain risk factors, to other persons (including household members) in close contact with persons in groups at higher risk, and to any child whose parents request vaccination.
  • For healthy nonpregnant persons (those who do not have underlying medical conditions that predispose them to influenza complications) ages 2–49 years, either LAIV or TIV may be used.
  • Children receiving TIV should receive 0.25 mL if age 6-35 mos or 0.5 mL if age 3 years or older.
  • Administer 2 doses (separated by 4 weeks or longer) to children younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season, but only received one dose.

7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)

  • Administer the second dose of MMR at age 4–6 years. MMR may be administered before age 4–6 years, provided 4 weeks have elapsed since the first dose and both doses are administered at age >12 months.

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

  • Administer second dose at age 4–6 years; may be administered 3 months after first does.
  • Don't repeat second dose if administered 28 days after first dose.

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

  • HepA is recommended for all children aged 1 year (i.e., aged 12–23 months). The 2 doses in the series should be administered at least 6 months apart.
  • Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.
  • HepA is recommended for certain other groups of children, including in areas where vaccination programs target older children.

10. Meningococcal polysaccharide vaccine (MPSV4). (Minimum age: 2 years for meningococcal conjugate vaccine (MCV4) and for meningococcal polysaccharide vaccine (MPSV4))

  • MPSV4 is recommended for children aged 2–10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high-risk groups.  Use of MPSV4 is also acceptable.
  • Persons who received MPSV4 3 years prior and remain at increased risk for meningococcal disease should be vaccinated with MSV4.
Changes from 2007 Schedule
  • The pneumococcal conjugate vaccine (PCV) footnote reflects updated recommendations for incompletely vaccinated children aged 24–59 months, including those with underlying medical conditions.
  • Recommendations for use of the live attenuated influenza vaccine (LAIV) now include healthy children as young as 2 years. LAIV should not be administered to children younger than 5 years with recurrent wheezing. Children aged under 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season, but only received 1 dose, should have 2 doses of vaccine, at least 4 weeks apart. Other updates are included.
  • For meningococcal vaccines, changes affect certain children aged 2–10 years. Vaccinating with meningococcal conjugate vaccine (MCV4) is preferred to meningococcal polysaccharide vaccine (MPSV4) for children at increased risk for meningococcal disease, including children who are traveling to or residents of countries in which the disease is hyperendemic or epidemic, children who have terminal complement component deficiencies, and children who have anatomic or functional asplenia.

This page was last updated on January 30, 2008