Institute for Vaccine Safety - 2010 Immunization Schedule

Recommended Immunization Schedule
Ages 0-6 Years

UNITED STATES • 2010

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			Hep B
Rotavirus			RV	RV	RV^*
Diphtheria, Tetanus, Pertussis			DTaP	DTaP	DTaP	click for footnote	DTaP				DTaP
Haemophilus influenzae type b			Hib	Hib	Hib^*	Hib
Pneumococcal			PCV	PCV	PCV	PCV				PPSV
Inactivated Poliovirus			IPV	IPV	IPV						IPV
Influenza					Influenza (yearly)
Measles, Mumps, Rubella						MMR			click for footnote		MMR
Varicella						Varicella			click for footnote		Varicella
Hepatitis A						Hep A (2 doses)				Hep A Series
Meningococcal										MCV

This schedule includes recommendations in effect as of December 15, 2009. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Considerations should include provider assessment, patient preference, and the potential for adverse events. 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.

Changes from 2009 schedule

2010 Schedules PDF (adobe acrobat)

2010 Schedule for ages 0-6 years | catch-up schedule

2010 Schedule for ages 7-18 years | catch-up schedule

2010 Schedule for Adults | special

1. Hepatitis B vaccine (HepB). (Minimum age: birth)

At birth:
• Administer monovalent Hep B 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, if HBsAg-positive, administer HBIG (no later than age 1 week).

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 or 2 months. Monovalent HepB vaccine should be used for doses administered before age 6 weeks. 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 1 to 2 months after completion of at least 3 doses of the HepB series, at age 9 through 18 months (generally at the next well-child visit).
• Administration of 4 doses of HepB to infants is permissible when a combination vaccine containing HepB is administered after the birth dose. The fourth dose should be administered no earlier than age 24 weeks.

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

Administer the first dose at age 6 -14 weeks (maximum age: 14 weeks 6 days). Vaccination should not be initiated for infants ≥ 15 weeks (i.e., 15 weeks 0 days or older).
Administer the final dose in the series by age 8 months 0 days.

If Rotarix® is administered at ages 2 and 4 months, a dose at 6 months is not indicated.

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

The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose.

Administer the final dose in the series at age 4–6 years.

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

If PRP-OMP (PedvaxHIB® or ComVax® [HepB-Hib]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.

TriHiBit® (DTaP/Hib) should not be used for doses at ages 2, 4, or 6 months for the primary series but can be used as the final dose in children aged 12 months - 4 years.

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

PCV is recommended for all children aged <5 years. Administer one dose of PCV to all healthy children aged 24–59 months not completely vaccinated for their age.

Administer PPSV to children aged ≥ 2 years with underlying medical conditions (see MMWR 2000;49[No. RR-9]), including a cochlear implant.

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

The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose.
If 4 doses are administered prior to age 4 years a fifth dose should be administered at age 4 through 6 years. See MMWR 2009;58(30):829--30.

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

Administer annually to children aged 6 months - 18 years.

For healthy children 2-6 years old (i.e., those who do not have underlying medical conditions that predispose them to influenza complications), either LAIV or TIV may be used, except LAIV should not be given to children 2-4 years old who have had wheezing in the past 12 months.

Children receiving TIV should receive 0.25 mL if aged 6 -35 months or 0.5 mL if ≥3 years.

Administer 2 doses (separated by at least 4 weeks) to children aged < 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose.

For recommendations for use of influenza A (H1N1) 2009 monovalent vaccine see MMWR 2009;58(No. RR-10).

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

Administer the second dose of MMR at age 4–6 years; may be administered before age 4 if ≥ 28 days after first does.

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

Administer second dose at age 4–6 years; may be administered before age 4 if ≥ 3 months after first does.

For children 12 months - 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered ≥28 days after the first dose, it can be accepted as valid.

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

Administer to all children aged 1 year (i.e., aged 12–23 months). Administer 2 doses at least 6 months apart.

Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.

HepA also is recommended for children older than 1 year who live in areas where vaccination programs target older children or who are at increased risk of infection.

11. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate vaccine (MCV) and for meningococcal polysaccharide vaccine (MPSV))

Administer MCV4 to children aged 2–10 years persistent complement component deficiency, anatomic or functional asplenia, and certain other conditions placing them at high risk.
Administer MCV4 to children previously vaccinated with MCV4 or MPSV4 after 3 years if first dose administered at age 2 through 6 years. See MMWR 2009;58:1042-3.

Changes from 2009 Schedule

The statement concerning use of combination vaccines in the introductory paragraph has been changed to reflect the revised ACIP recommendation on this issue .
The last dose in the inactivated poliovirus vaccine series is now recommended to be administered on or after the fourth birthday and at least 6 months after the previous dose. In addition, if 4 doses are administered before age 4 years, an additional (fifth) dose should be administered at age 4 through 6 years (ACIP Recommendations).
The hepatitis A footnote has been revised to allow vaccination of children older than 23 months for whom immunity against hepatitis A is desired.
Revaccination with meningococcal conjugate vaccine is now recommended for children who remain at increased risk for meningococcal disease after 3 years (if the first dose was administered at age 2 through 6 years), or after 5 years (if the first dose was administered at age 7 years or older) (ACIP Recommendations).
Footnotes for human papillomavirus (HPV) vaccine have been modified to include 1) the availability of and recommendations for bivalent HPV vaccine, and 2) a permissive recommendation for administration of quadrivalent HPV vaccine to males aged 9 through 18 years to reduce the likelihood of acquiring genital warts (ACIP Provisional Recommendations).

The National Childhood Vaccine Injury Act requires that health-care providers provide parents or patients with copies of Vaccine Information Statements before administering each dose of the vaccines listed in the schedules. Additional information is available from state health departments and from CDC at http://www.cdc.gov/vaccines/pubs/vis/default.htm.

Detailed recommendations for using vaccines are available from ACIP statements (available at http://www.cdc.gov/vaccines/pubs/acip-list.htm), and the 2006 Red Book. Guidance regarding the Vaccine Adverse Event Reporting System form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

This page was last updated on January 21, 2010