Recommended Immunization Schedule for Persons Aged 0 Through 6 Years—United States • 2010

For those who fall behind or start late, see the catch-up schedule

1 2 4 6 12 15 18 19–23 2–3 4–6

Vaccine ▼ Age ► Birth month months months months months months months months years years
Hepatitis B1 HepB HepB HepB

Rotavirus 2 RV RV RV 2 Range of
recommended
see
Diphtheria, Tetanus, Pertussis3 DTaP DTaP DTaP footnote 3 DTaP DTaP ages for all
children except
Haemophilus influenzae type b4 Hib Hib Hib4 Hib certain high-risk
groups
Pneumococcal5 PCV PCV PCV PCV PPSV

Inactivated Poliovirus6 IPV IPV IPV IPV

Range of
Influenza7 Influenza (Yearly) recommended
ages for certain
Measles, Mumps, Rubella8 MMR see footnote 8 MMR high-risk groups
9
Varicella Varicella see footnote 9 Varicella

Hepatitis A10 HepA (2 doses) HepA Series

Meningococcal11 MCV

This schedule includes recommendations in effect as of December 15, 2009. Committee on Immunization Practices statement for detailed recommendations:
Any dose not administered at the recommended age should be administered at a http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse
subsequent visit, when indicated and feasible. The use of a combination vaccine events that follow immunization should be reported to the Vaccine Adverse Event
generally is preferred over separate injections of its equivalent component vaccines. Reporting System (VAERS) at http://www.vaers.hhs.gov or by telephone,
Considerations should include provider assessment, patient preference, and 800-822-7967.
the potential for adverse events. Providers should consult the relevant Advisory

1. Hepatitis B vaccine (HepB). (Minimum age: birth) 6. Inactivated poliovirus vaccine (IPV) (Minimum age: 6 weeks)
At birth: • The final dose in the series should be administered on or after the fourth
• Administer monovalent HepB to all newborns before hospital discharge. birthday and at least 6 months following the previous dose.
• If mother is hepatitis B surface antigen (HBsAg)-positive, administer HepB • If 4 doses are administered prior to age 4 years a fifth dose should be admin-
and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. istered at age 4 through 6 years. See MMWR 2009;58(30):829–30.
• If mother’s HBsAg status is unknown, administer HepB within 12 hours of 7. Influenza vaccine (seasonal). (Minimum age: 6 months for trivalent inacti-
birth. Determine mother’s HBsAg status as soon as possible and, if HBsAg- vated influenza vaccine [TIV]; 2 years for live, attenuated influenza vaccine
positive, administer HBIG (no later than age 1 week). [LAIV])
After the birth dose: • Administer annually to children aged 6 months through 18 years.
• The HepB series should be completed with either monovalent HepB or a com- • For healthy children aged 2 through 6 years (i.e., those who do not have under-
bination vaccine containing HepB. The second dose should be administered lying medical conditions that predispose them to influenza complications),
at age 1 or 2 months. Monovalent HepB vaccine should be used for doses either LAIV or TIV may be used, except LAIV should not be given to children
administered before age 6 weeks. The final dose should be administered no aged 2 through 4 years who have had wheezing in the past 12 months.
earlier than age 24 weeks. • Children receiving TIV should receive 0.25 mL if aged 6 through 35 months
• Infants born to HBsAg-positive mothers should be tested for HBsAg and or 0.5 mL if aged 3 years or older.
antibody to HBsAg 1 to 2 months after completion of at least 3 doses of the • Administer 2 doses (separated by at least 4 weeks) to children aged younger
HepB series, at age 9 through 18 months (generally at the next well-child than 9 years who are receiving influenza vaccine for the first time or who were
visit). vaccinated for the first time during the previous influenza season but only
• Administration of 4 doses of HepB to infants is permissible when a combina- received 1 dose.
tion vaccine containing HepB is administered after the birth dose. The fourth • For recommendations for use of influenza A (H1N1) 2009 monovalent vaccine
dose should be administered no earlier than age 24 weeks. see MMWR 2009;58(No. RR-10).
2. Rotavirus vaccine (RV). (Minimum age: 6 weeks) 8. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
• Administer the first dose at age 6 through 14 weeks (maximum age: 14 • Administer the second dose routinely at age 4 through 6 years. However, the
weeks 6 days). Vaccination should not be initiated for infants aged 15 weeks second dose may be administered before age 4, provided at least 28 days
0 days or older. have elapsed since the first dose.
• The maximum age for the final dose in the series is 8 months 0 days 9. Varicella vaccine. (Minimum age: 12 months)
• If Rotarix is administered at ages 2 and 4 months, a dose at 6 months is not • Administer the second dose routinely at age 4 through 6 years. However, the
indicated. second dose may be administered before age 4, provided at least 3 months
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). have elapsed since the first dose.
(Minimum age: 6 weeks) • For children aged 12 months through 12 years the minimum interval between
• The fourth dose may be administered as early as age 12 months, provided doses is 3 months. However, if the second dose was administered at least
at least 6 months have elapsed since the third dose. 28 days after the first dose, it can be accepted as valid.
• Administer the final dose in the series at age 4 through 6 years. 10. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
4. Haemophilus influenzae type b conjugate vaccine (Hib). • Administer to all children aged 1 year (i.e., aged 12 through 23 months).
(Minimum age: 6 weeks) Administer 2 doses at least 6 months apart.
• If PRP-OMP (PedvaxHIB or Comvax [HepB-Hib]) is administered at ages 2 • Children not fully vaccinated by age 2 years can be vaccinated at subsequent
and 4 months, a dose at age 6 months is not indicated. visits
• TriHiBit (DTaP/Hib) and Hiberix (PRP-T) should not be used for doses at ages • HepA also is recommended for older children who live in areas where vac-
2, 4, or 6 months for the primary series but can be used as the final dose in cination programs target older children, who are at increased risk for infection,
children aged 12 months through 4 years. or for whom immunity against hepatitis A is desired.
5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate 11. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate
vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPSV]) vaccine [MCV4] and for meningococcal polysaccharide vaccine [MPSV4])
• PCV is recommended for all children aged younger than 5 years. Administer • Administer MCV4 to children aged 2 through 10 years with persistent comple-
1 dose of PCV to all healthy children aged 24 through 59 months who are ment component deficiency, anatomic or functional asplenia, and certain other
not completely vaccinated for their age. conditions placing tham at high risk.
• Administer PPSV 2 or more months after last dose of PCV to children aged 2 • Administer MCV4 to children previously vaccinated with MCV4 or MPSV4
years or older with certain underlying medical conditions, including a cochlear after 3 years if first dose administered at age 2 through 6 years. See MMWR
implant. See MMWR 1997;46(No. RR-8). 2009;​58:1042–3.
CS207330-A

The Recommended Immunization Schedules for Persons Aged 0 through 18 Years are approved by the Advisory Committee on Immunization Practices
(http://www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).
Department of Health and Human Services • Centers for Disease Control and Prevention
 Recommended Immunization Schedule for Persons Aged 7 Through 18 Years— United States • 2010
For those who fall behind or start late, see the schedule below and the catch-up schedule

Vaccine ▼ Age ► 7–10 years 11–12 years 13–18 years

Tetanus, Diphtheria, Pertussis1 Tdap Tdap

Range of
Human Papillomavirus2 see footnote 2 HPV (3 doses) HPV series recommended
ages for all
children except
Meningococcal3 MCV MCV MCV
certain high-risk
groups
Influenza4 Influenza (Yearly)
5 PPSV
Pneumococcal
Range of
recommended
Hepatitis A6 HepA Series
ages for
catch-up
Hepatitis B7 Hep B Series immunization

Inactivated Poliovirus8 IPV Series

9 Range of
Measles, Mumps, Rubella MMR Series
recommended
ages for certain
Varicella10 Varicella Series high-risk groups

This schedule includes recommendations in effect as of December 15, 2009. Committee on Immunization Practices statement for detailed recommendations:
Any dose not administered at the recommended age should be administered at a http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse
subsequent visit, when indicated and feasible. The use of a combination vaccine events that follow immunization should be reported to the Vaccine Adverse Event
generally is preferred over separate injections of its equivalent component vaccines. Reporting System (VAERS) at http://www.vaers.hhs.gov or by telephone,
Considerations should include provider assessment, patient preference, and 800-822-7967.
the potential for adverse events. Providers should consult the relevant Advisory

1. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). 4. Influenza vaccine (seasonal).
(Minimum age: 10 years for Boostrix and 11 years for Adacel) • Administer annually to children aged 6 months through 18 years.
• Administer at age 11 or 12 years for those who have completed the recom- • For healthy nonpregnant persons aged 7 through 18 years (i.e., those who
mended childhood DTP/DTaP vaccination series and have not received a do not have underlying medical conditions that predispose them to influenza
tetanus and diphtheria toxoid (Td) booster dose. complications), either LAIV or TIV may be used.
• Persons aged 13 through 18 years who have not received Tdap should receive • Administer 2 doses (separated by at least 4 weeks) to children aged younger
a dose. than 9 years who are receiving influenza vaccine for the first time or who were
• A 5-year interval from the last Td dose is encouraged when Tdap is used as vaccinated for the first time during the previous influenza season but only
a booster dose; however, a shorter interval may be used if pertussis immunity received 1 dose.
is needed. • For recommendations for use of influenza A (H1N1) 2009 monovalent vaccine.
2. Human papillomavirus vaccine (HPV). (Minimum age: 9 years) See MMWR 2009;58(No. RR-10).
• Two HPV vaccines are licensed: a quadrivalent vaccine (HPV4) for the pre- 5. Pneumococcal polysaccharide vaccine (PPSV).
vention of cervical, vaginal and vulvar cancers (in females) and genital warts • Administer to children with certain underlying medical conditions, including a
(in females and males), and a bivalent vaccine (HPV2) for the prevention of cochlear implant. A single revaccination should be administered after 5 years
cervical cancers in females. to children with functional or anatomic asplenia or an immunocompromising
• HPV vaccines are most effective for both males and females when given condition. See MMWR 1997;46(No. RR-8).
before exposure to HPV through sexual contact. 6. Hepatitis A vaccine (HepA).
• HPV4 or HPV2 is recommended for the prevention of cervical precancers and • Administer 2 doses at least 6 months apart.
cancers in females. • HepA is recommended for children aged older than 23 months who live in areas
• HPV4 is recommended for the prevention of cervical, vaginal and vulvar where vaccination programs target older children, who are at increased risk for
precancers and cancers and genital warts in females. infection, or for whom immunity against hepatitis A is desired.
• Administer the first dose to females at age 11 or 12 years. 7. Hepatitis B vaccine (HepB).
• Administer the second dose 1 to 2 months after the first dose and the third • Administer the 3-dose series to those not previously vaccinated.
dose 6 months after the first dose (at least 24 weeks after the first dose). • A 2-dose series (separated by at least 4 months) of adult formulation
• Administer the series to females at age 13 through 18 years if not previously Recombivax HB is licensed for children aged 11 through 15 years.
vaccinated. 8. Inactivated poliovirus vaccine (IPV).
• HPV4 may be administered in a 3-dose series to males aged 9 through 18 • The final dose in the series should be administered on or after the fourth
years to reduce their likelihood of acquiring genital warts. birthday and at least 6 months following the previous dose.
3. Meningococcal conjugate vaccine (MCV4). • If both OPV and IPV were administered as part of a series, a total of 4 doses
• Administer at age 11 or 12 years, or at age 13 through 18 years if not previ- should be administered, regardless of the child’s current age.
ously vaccinated. 9. Measles, mumps, and rubella vaccine (MMR).
• Administer to previously unvaccinated college freshmen living in a • If not previously vaccinated, administer 2 doses or the second dose for those
dormitory. who have received only 1 dose, with at least 28 days between doses.
• Administer MCV4 to children aged 2 through 10 years with persistent comple- 10. Varicella vaccine.
ment component deficiency, anatomic or functional asplenia, or certain other • For persons aged 7 through 18 years without evidence of immunity (see
conditions placing them at high risk. MMWR 2007;56[No. RR-4]), administer 2 doses if not previously vaccinated
• Administer to children previously vaccinated with MCV4 or MPSV4 who or the second dose if only 1 dose has been administered.
remain at increased risk after 3 years (if first dose administered at age 2 • For persons aged 7 through 12 years, the minimum interval between doses
through 6 years) or after 5 years (if first dose administered at age 7 years or is 3 months. However, if the second dose was administered at least 28 days
older). Persons whose only risk factor is living in on-campus housing are not after the first dose, it can be accepted as valid.
recommended to receive an additional dose. See MMWR 2009;58:1042–3. • For persons aged 13 years and older, the minimum interval between doses
is 28 days.
CS207330-A

The Recommended Immunization Schedules for Persons Aged 0 through 18 Years are approved by the Advisory Committee on Immunization Practices
(http://www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).
Department of Health and Human Services • Centers for Disease Control and Prevention
 Catch-up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind—United States • 2010
The table below provides catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine
series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child’s age.
PERSONS AGED 4 MONTHS­THROUGH 6 YEARS
Minimum Age Minimum Interval Between Doses
Vaccine
for Dose 1 Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Dose 4 Dose 4 to Dose 5
8 weeks
Hepatitis B1 Birth 4 weeks
(and at least 16 weeks after first dose)
Rotavirus2 6 wks 4 weeks 4 weeks2
Diphtheria, Tetanus, Pertussis3 6 wks 4 weeks 4 weeks 6 months 6 months3
4 weeks 4 weeks4
if first dose administered at younger than age 12 months if current age is younger than 12 months
8 weeks (as final dose)
8 weeks (as final dose) 8 weeks (as final dose)4 This dose only necessary
if first dose administered at age 12–14 months if current age is 12 months or older and first dose for children aged 12 months
Haemophilus influenzae type b4 6 wks
administered at younger than age 12 months and through 59 months who
No further doses needed
second dose administered at younger than 15 months received 3 doses before
if first dose administered at age 15 months or older
age 12 months
No further doses needed
if previous dose administered at age 15 months or older
4 weeks 4 weeks
if current age is younger than 12 months 8 weeks (as final dose)
if first dose administered at younger than age 12 months
This dose only necessary
8 weeks (as final dose for healthy children) 8 weeks for children aged 12 months
if first dose administered at age 12 months or older (as final dose for healthy children) through 59 months who
Pneumococcal5 6 wks
or current age 24 through 59 months if current age is 12 months or older received 3 doses before
age 12 months or for high-
No further doses needed No further doses needed risk children who received
for healthy children if first dose for healthy children if previous dose administered at age 3 doses at any age
administered at age 24 months or older 24 months or older
Inactivated Poliovirus6 6 wks 4 weeks 4 weeks 6 months
Measles,Mumps, Rubella7 12 mos 4 weeks
Varicella8 12 mos 3 months
Hepatitis A9 12 mos 6 months

PERSONS AGED 7 THROUGH 18 YEARS

4 weeks
if first dose administered at younger than age 12 months 6 months
Tetanus,Diphtheria/
7 yrs10 4 weeks if first dose administered at
Tetanus,Diphtheria,Pertussis10 6 months younger than age 12 months
if first dose administered at 12 months or older
Human Papillomavirus11 9 yrs Routine dosing intervals are recommended11
Hepatitis A9 12 mos 6 months
8 weeks
Hepatitis B1 Birth 4 weeks
(and at least 16 weeks after first dose)
Inactivated Poliovirus6 6 wks 4 weeks 4 weeks 6 months
Measles,Mumps, Rubella7 12 mos 4 weeks
3 months
if person is younger than age 13 years
Varicella8 12 mos
4 weeks
if person is aged 13 years or older

1. Hepatitis B vaccine (HepB). • A fourth dose is not necessary if the third dose was administered at age 4 years
• Administer the 3-dose series to those not previously vaccinated. or older and at least 6 months following the previous dose.
• A 2-dose series (separated by at least 4 months) of adult formulation Recombivax • In the first 6 months of life, minimum age and minimum intervals are only recom-
HB is licensed for children aged 11 through 15 years. mended if the person is at risk for imminent exposure to circulating poliovirus (i.e.,
2. Rotavirus vaccine (RV). travel to a polio-endemic region or during an outbreak).
• The maximum age for the first dose is 14 weeks 6 days. Vaccination should not be 7. Measles, mumps, and rubella vaccine (MMR).
initiated for infants aged 15 weeks 0 days or older. • Administer the second dose routinely at age 4 through 6 years. However, the second
• The maximum age for the final dose in the series is 8 months 0 days. dose may be administered before age 4, provided at least 28 days have elapsed
• If Rotarix was administered for the first and second doses, a third dose is not since the first dose.
indicated. • If not previously vaccinated, administer 2 doses with at least 28 days between
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). doses.
• The fifth dose is not necessary if the fourth dose was administered at age 4 years 8. Varicella vaccine.
or older. • Administer the second dose routinely at age 4 through 6 years. However, the second
4. Haemophilus influenzae type b conjugate vaccine (Hib). dose may be administered before age 4, provided at least 3 months have elapsed
• Hib vaccine is not generally recommended for persons aged 5 years or older. No since the first dose.
efficacy data are available on which to base a recommendation concerning use of • For persons aged 12 months through 12 years, the minimum interval between
Hib vaccine for older children and adults. However, studies suggest good immu- doses is 3 months. However, if the second dose was administered at least 28 days
nogenicity in persons who have sickle cell disease, leukemia, or HIV infection, or after the first dose, it can be accepted as valid.
who have had a splenectomy; administering 1 dose of Hib vaccine to these persons • For persons aged 13 years and older, the minimum interval between doses is 28
who have not previously received Hib vaccine is not contraindicated. days.
• If the first 2 doses were PRP-OMP (PedvaxHIB or Comvax), and administered at 9. Hepatitis A vaccine (HepA).
age 11 months or younger, the third (and final) dose should be administered at • HepA is recommended for children aged older than 23 months who live in areas
age 12 through 15 months and at least 8 weeks after the second dose. where vaccination programs target older children, who are at increased risk for
• If the first dose was administered at age 7 through 11 months, administer the second infection, or for whom immunity against hepatitis A is desired.
dose at least 4 weeks later and a final dose at age 12 through 15 months. 10. Tetanus and diphtheria toxoids vaccine (Td) and tetanus
5. Pneumococcal vaccine. and diphtheria toxoids and acellular pertussis vaccine (Tdap).
• Administer 1 dose of pneumococcal conjugate vaccine (PCV) to all healthy children • Doses of DTaP are counted as part of the Td/Tdap series
aged 24 through 59 months who have not received at least 1 dose of PCV on or • Tdap should be substituted for a single dose of Td in the catch-up series or as a
after age 12 months. booster for children aged 10 through 18 years; use Td for other doses.
• For children aged 24 through 59 months with underlying medical conditions, admin- 11. Human papillomavirus vaccine (HPV).
ister 1 dose of PCV if 3 doses were received previously or administer 2 doses of • Administer the series to females at age 13 through 18 years if not previously
PCV at least 8 weeks apart if fewer than 3 doses were received previously. vaccinated.
• Administer pneumococcal polysaccharide vaccine (PPSV) to children aged 2 years • Use recommended routine dosing intervals for series catch-up (i.e., the second and
or older with certain underlying medical conditions, including a cochlear implant, third doses should be administered at 1 to 2 and 6 months after the first dose). The
at least 8 weeks after the last dose of PCV. See MMWR 1997;46(No. RR-8). minimum interval between the first and second doses is 4 weeks. The minimum
6. Inactivated poliovirus vaccine (IPV). interval between the second and third doses is 12 weeks, and the third dose should
• The final dose in the series should be administered on or after the fourth birthday be administered at least 24 weeks after the first dose.
and at least 6 months following the previous dose.
CS207330-A

Information about reporting reactions after immunization is available online at http://www.vaers.hhs.gov or by telephone, 800-822-7967. Suspected cases of vaccine-preventable diseases should be reported to the state
or local health department. Additional information, including precautions and contraindications for immunization, is available from the National Center for Immunization and Respiratory Diseases at http://www.cdc.gov/
vaccines or telephone, 800-CDC-INFO (800-232-4636).
Department of Health and Human Services • Centers for Disease Control and Prevention
 Reprinted By:

MC-1946
P.O. Box 149347
Austin, TX 78714-9347

Texas Department of State Health Services Stock No. 6-105

Immunization Branch Revised 01/2010