Notice to Readers
Recommended Childhood Immunization Schedule -- United States,
January 1995
Since the 1960s, the two groups that historically have
developed vaccine guidelines for the United States have been the
Advisory Committee on Immunization Practices (ACIP) and the
Committee on Infectious Diseases of the American Academy of
Pediatrics (AAP). During 1994, these organizations participated in
a working group that included representatives from the American
Academy of Family Physicians to develop one vaccination schedule
that would accommodate the current ACIP and AAP recommendations and
ensure the earliest administration of vaccines. The recommended
childhood immunization schedule Table_1 has been endorsed by
these groups and becomes effective January 1995.
In the first year of life, three doses each of diphtheria and
tetanus toxoids and pertussis vaccine (DTP), Haemophilus influenzae
type b (Hib) vaccine, and oral poliovirus vaccine (OPV) are
recommended to be administered at ages 2, 4, and 6 months; however,
the third dose of OPV may be administered through age 18 months,
and for children who receive Haemophilus b conjugate vaccine
(Meningococcal Protein Conjugate) (PRP-OMP) at ages 2 and 4 months,
a dose at age 6 months is not required. For hepatitis B vaccine,
the first dose is recommended at birth (but can be given up to age
2 months), the second at age 2 months (age 1-4 months is
acceptable, provided at least 1 month has elapsed since receipt of
the first dose), and the third at age 6- 18 months. Vaccines
recommended at age 12-15 months can be administered simultaneously
during one visit or during two separate visits. The second dose of
measles, mumps, and rubella vaccine (MMR) may be given at entry to
kindergarten or middle school. Diphtheria and tetanus toxoids (Td)
is recommended at age 11-12 years but may be given through age 14-
16 years. When this vaccine is given at age 11-12 years,
health-care providers can ensure that the child has received a
second dose of MMR.
Reported by: Advisory Committee on Immunization Practices. American
Academy of Pediatrics. American Academy of Family Physicians.
National Immunization Program, CDC.
Table_1 Note:
To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 1. Recommended childhood immunization schedule * --United States, January
1995
================================================================================================================================
2 4 6 12 + 15 18 4 - 6 11-12 14-16
Vaccine Birth Months Months Months Months Months Months Years Years Years
------------------------------------------------------------------------------------------------------------------------------
º- HB-1 --------º
Hepatitis B & º- HB-2 ---------º º- HB-3 --------------------------------º
Diphtheria, Tetanus, DTP DTP DTP º----------- DTP ------------º DTP or º- Td ---------º
Pertussis @ º- or DTaP at >= 15 months --º DTaP
H. influenzae Hib Hib Hib º------ Hib ------º
type b **
Poliovirus OPV OPV º- OPV ---------------------------------º OPV
Measles, Mumps, º------ MMR ------º MMR or MMR
Rubella ++
------------------------------------------------------------------------------------------------------------------------------
* Recommended vaccines are listed under the routinely recommended ages. Shaded bars
indicate range of acceptable ages for vaccination.
+ Vaccines recommended in the second year of life (i.e., 12-15 months of age) may be given
at either one or two visits.
& Infants born to hepatitis B surface antigen (HBsAg)-negative mothers should receive the
second dose of hepatitis B vaccine between 1 and 4 months of age, provided at least
1 month has elapsed since receipt of the first dose. The third dose is recommended between
6 and 18 months of age. Infants born to HBsAg-positive mothers should receive
immunoprophylaxis for hepatitis B with 0.5 ml Hepatitis B Immune Globulin (HBIG) within
12 hours of birth, and 0.5 ml of either Merck Sharpe & Dohme (West Point, Pennsylvania)
vaccine (Recombivax HB (R)) or of SmithKline Beecham (Philadelphia) vaccine (Engerix-B (R))
at a separate site. In these infants, the second dose of vaccine is recommended at 1 month
of age and the third dose at 6 months of age. All pregnant women should be screened for
HBsAg during an early prenatal visit.
@ The fourth dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP) may be
administered as early as 12 months of age, provided at least 6 months have elapsed since
the third dose of DTP. Combined DTP-Hib products may be used when these two vaccines
are administered simultaneously. Diphtheria and tetanus toxoids and acellular pertussis
vaccine (DTaP) is licensed for use for the fourth and/or fifth dose of DTP in children aged
>=15 months and may be preferred for these doses in children in this age group.
** Three H. influenzae type b conjugate vaccines are available for use in infants:
1) oligosaccharide conjugate Hib vaccine (HbOC) (HibTITER (R), manufactured by Praxis
Biologics, Inc. {West Henrietta, New York}, and distributed by Lederle-Praxis Biologicals,
{Wayne, New Jersey}); 2) polyribosylribitol phosphate-tetanus toxoid conjugate (PRP-T)
(ActHIB (TM), manufactured by Pasteur Merieux Serums & Vaccins, S.A. (Lyon, France), and
distributed by Connaught Laboratories, Inc. {Swiftwater, Pennsylvania}, and OmniHIB (TM),
manufactured by Pasteur Merieux Serums & Vaccins, S.A., and distributed by SmithKline
Beecham); and 3) Haemophilus b conjugate vaccine (Meningococcal Protein Conjugate)
(PRP-OMP) (PedvaxHIB (R), manufactured by Merck Sharp & Dohme). Children who have
received PRP-OMP at 2 and 4 months of age do not require a dose at 6 months of age.
After the primary infant Hib conjugate vaccine series is completed, any licensed Hib
conjugate vaccine may be used as a booster dose at age 12-15 months.
++ The second dose of measles-mumps-rubella vaccine should be administered EITHER at
4-6 years of age OR at 11-12 years of age.
Source: Advisory Committee on Immunization Practices, American Academy of Pediatrics,
and American Academy of Family Physicians.
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