Institute for Vaccine Safety - 2012 Immunization Schedule

Recommended Immunization Schedule
Ages 0-6 Years

UNITED STATES • 2012

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					MCV4

Range of recommended ages for
all children

Range of recommended ages for
certain high-risk groups

Range of recommended ages for
all children & certain high-risk groups

This schedule includes recommendations in effect as of December 23, 2011. 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.
Vaccination providers should consult the relevant Advisory Committee on Immunization Practices statement for detailed recommendations: 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) at www.vaers.hhs.gov or by 800-822-7967.

Changes from last schedule

2012 Schedules PDF (adobe acrobat)

2012 Schedule for ages 0-6 years | catch-up schedule

2012 Schedule for ages 7-18 years | catch-up schedule

2012 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. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) 1 to 2 months after receiving the last dose of the series.
• If mother’s HBsAg status is unknown, within 12 hours of birth administer HepB vaccine for infants weighing ≥2,000 grams, and HepB vaccine plus HBIG for infants weighing <2,000 grams. Determine mother’s HBsAg status as soon as possible and, if she is HBsAg-positive, administer HBIG for infants weighing ≥2,000 grams (no later than age 1 week).

Doses following the birth dose:
• The second dose should be administered at age 1 or 2 months. Monovalent HepB should be used for doses administered before age 6 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.
• Infants who did not receive a birth dose should receive 3 doses of HepB on a schedule of 0, 1, and 6 months.
• The final (3rd or 4th) dose in the HepB series 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).

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 at least 6 months have elapsed since the third dose.

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.

Hiberix should only be used for the booster (final) dose in children aged 12 months through 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 younger than 5 years. Administer 1 dose of PCV to all healthy children aged 24 through 59 months who are not completely vaccinated for their age.
A PCV series begun with 7-valent PCV (PCV7) should be completed with 13-valent PCV (PCV13).
A single supplemental dose of PCV13 is recommended for all children aged 14 through 59 months who have received an age-appropriate series of PCV7.
A single supplemental dose of PCV13 is recommended for all children aged 60 through 71 months with underlying medical conditions who have received an age-appropriate series of PCV7.
The supplemental dose of PCV13 should be administered at least 8 weeks after the previous dose of PCV7. See MMWR 2010:59(No. RR-11).
Administer PPSV at least 8 weeks after last dose of PCV to children aged 2 years or older with certain underlying medical conditions, including a cochlear implant.

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

If 4 or more doses are administered prior to age 4 years an additional dose should be administered at age 4 through 6 years.
The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose.

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

For most healthy children aged 2 years and older, either LAIV or TIV may be used. However, LAIV should not be administered to some children, including 1) children with asthma, 2) children 2 through 4 years who had wheezing in the past 12 months, or 3) children who have any other underlying medical conditions that predispose them to influenza complications. For all other contraindications to use of LAIV, see MMWR 2010;59(No. RR-8):33–34.
For children aged 6 months through 8 years:
- For the 2011–12 season, administer 2 doses (separated by at least 4 weeks) to those who did not receive at least 1 dose of the 2010–11 vaccine. Those who received at least 1 dose of the 2010–11 vaccine require 1 dose for the 2011–12 season.
- For the 2012–13 season, follow dosing guidelines in the 2012 ACIP influenza vaccine recommendations.

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

The second dose may be administered before age 4 years, provided at least 4 weeks have elapsed since the first dose.
Administer MMR vaccine to infants aged 6 through 11 months who are traveling internationally. These children should be revaccinated with 2 doses of MMR vaccine, the first at ages 12 through 15 months and at least 4 weeks after the previous dose, and the second at ages 4 through 6 years.

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

The second dose may be administered before age 4 years, provided at least 3 months have elapsed since the first dose.
For children aged 12 months through 12 years the recommended minimum interval between doses is 3 months. However, if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid.

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

Administer the second (final) dose 6 to18 months after the first.

Unvaccinated children 24 months and older at high risk should be vaccinated. See MMWR 2006;55(No. RR-7).

HepA is recommended for children aged older A 2-dose HepA vaccine series is recommended for anyone aged 24 months and older, previously unvaccinated, for whom immunity against hepatitis A virus infection is desired.

11. Meningococcal conjugate vaccine, quadrivalent (MCV4). (Minimum age: 9 months for Menactra [MCV4-D], 2 years for Menveo [MCV4-CRM])

For children aged 9 through 23 months 1) with persistent complement component deficiency; 2) who are residents of or travelers to countries with hyperendemic or epidemic disease; or 3) who are present during outbreaks caused by a vaccine serogroup, administer 2 primary doses of MCV4-D, ideally at ages 9 months and 12 months or at least 8 weeks apart.
For children aged 24 months and older with 1) persistent complement component deficiency who have not been previously vaccinated; or 2) anatomic/functional asplenia, administer 2 primary doses of either MCV4 at least 8 weeks apart.
For children with anatomic/functional asplenia, if MCV4-D (Menactra) is used, administer at a minimum age of 2 years and at least 4 weeks after completion of all PCV oses.
See MMWR 2011;60:72–6 and Vaccines for Children Program resolution No. 6/11-1 and MMWR 2011;60:1391–2 for further guidance, including revaccination guidelines.

Changes from 2011

HepA: A wording change has been introduced in the HepA vaccine yellow bar; wording now states, “Dose 1.” A new yellow and purple bar has been added to reflect HepA vaccine recommendations for children aged 2 years and older. HepA vaccine footnotes have been updated to clarify that the second dose of HepA vaccine should be administered 6–18 months after dose 1.
HepB: Guidance is provided for administration of hepatitis B (HepB) vaccine in infants with birthweights <2,000 grams and ≥2,000 grams. Clarification is provided for doses after administration of the birth dose of HepB vaccine.
Haemophilus influenzae type b conjugate vaccine footnotes have been condensed, and use of Hiberix for the booster (final) dose has been clarified. Guidance for use of Hib vaccine in persons aged 5 years and older in the catch-up schedule has been updated.
Influenza vaccine footnotes have been updated to provide guidance on live, attenuated influenza vaccine (LAIV) contraindications. Influenza vaccine footnotes also have been updated to clarify dosing for children aged 6 months through 8 years for the 2011–12 and 2012–13 seasons.
MCV4: Purple bar has been extended to reflect licensure of MCV4-D (Menactra) use in children as young as age 9 months. MCV4 footnotes have been updated to reflect recent recommendations published in MMWR.
MMR: Guidance is provided for use of measles, mumps, and rubella (MMR) vaccine in infants aged 6 through 11 months. Footnotes in the catch-up schedule have been condensed.
Pneumococcal vaccine footnotes have been condensed.
Rotavirus: RV vaccine footnotes have been condensed.

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 an> 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 February 08, 2012