Table 2. Catch-up immunization schedule for persons aged 4 months–18 years who start late or who are more than 1 month behind, United States, 2019

Always make recommendations by determining needed vaccines based on age (Table 1), determining appropriate intervals for catch-up, if needed (Table 2), assessing for medical indications (Table 3), and reviewing special situations (Notes).

Vaccine Catch-Up Guidance

CDC has developed catch-up guidance job aids to assist health care providers in interpreting Table 2 in the childhood and adolescent immunization schedule.

Children Age 4 Months through 6 Years

Vaccine Minimum Age for Dose 1 Minimum Interval Between Doses
Dose
1 to Dose 2
Dose
2 to Dose 3
Dose
3 to Dose 4
Dose
4 to Dose 5
Hepatitis B more info icon. Birth 4 weeks 8 weeks and at least 16 weeks after first dose. Minimum age for the final dose is 24 weeks.
Rotavirus more info icon. 6 weeks Maximum age for first dose is 14 weeks, 6 days. 4 weeks 4 weeks
Maximum age for final dose is 8 months, 0 days.
Diphtheria, tetanus, and acellular pertussis more info icon. 6 weeks 4 weeks 4 weeks 6 months 6 months
Haemophilus influenzae type b more info icon. 6 weeks No further doses needed if first dose was administered at age 15 months or older.
4 weeks
if first dose was administered before the 1st birthday.
8 weeks (as final dose)
if first dose was administered at age 12 through 14 months.
No further doses needed if previous dose was administered at age 15 months or older.
4 weeks
if current age is younger than 12 months and first dose was administered at younger than age 7 months,
and at least 1 previous dose was PRP-T (ActHib, Pentacel, Hiberix) or unknown.
8 weeks and age 12 through 59 months (as final dose)
if current age is younger than 12 months and first dose was administered at age 7 through 11 months;
OR
if current age is 12 through 59 months and first dose was administered before the 1st birthday, and second dose administered at younger than 15 months;
OR
if both doses were PRP-OMP (PedvaxHIB; Comvax) and were administered before the 1st birthday.
8 weeks (as final dose)
This dose only necessary for children age 12 through
59 months who received 3 doses before the 1st birthday.
Pneumococcal conjugate more info icon. 6 weeks No further doses needed for healthy children if first dose was administered at
age 24 months or older.
4 weeks
if first dose administered before the
1st birthday.
8 weeks (as final dose for healthy
children)

if first dose was administered at the
1st birthday or after.
No further doses needed for healthy children if previous dose administered at age 24 months or older.
4 weeks
if current age is younger than 12 months and previous dose given at <7 months old.
8 weeks (as final dose for healthy children)
if previous dose given between 7-11 months (wait until at least 12 months old);
OR
if current age is 12 months or older and at least 1 dose was given before age 12 months.
8 weeks (as final dose)
This dose only necessary for children age 12 through 59 months who received
3 doses before age 12 months or for children at high risk who received 3 doses at any age.
Inactivated poliovirus more info icon. 6 weeks 4 weeks 4 weeks if current age is < 4 years.

6 months (as final dose) if current age is 4 years or older.

6 months (minimum age 4 years for final dose).
Measles, mumps, rubella more info icon. 12 months 4 weeks
Varicella more info icon. 12 months 3 months
Hepatitis A more info icon. 12 months 6 months
Meningococcal more info icon. 2 months MenACWY- CRM
9 months MenACWY-D
8 weeks See notes See notes

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Children and Adolescents Age 7 through 18 Years

Vaccine Minimum Age for Dose 1 Minimum Interval Between Doses
Dose
1 to Dose 2
Dose
2 to Dose 3
Dose
3 to Dose 4
Meningococcal more info icon. Not Applicable (N/A) 8 weeks
Tetanus, diphtheria; tetanus, diphtheria, and acellular pertussis more info icon. 7 years 4 weeks 4 weeks
if first dose of DTaP/DT was administered before the 1st birthday.
6 months (as final dose)
if first dose of DTaP/DT or Tdap/Td was administered at or after the 1st birthday.
6 months if first dose of DTaP/DT was administered before the 1st birthday.
Human papillomavirus more info icon. 9 years Routine dosing intervals are recommended.
Hepatitis A more info icon. N/A 6 months
Hepatitis B more info icon. N/A 4 weeks 8 weeks and at least 16 weeks after first dose.
Inactivated poliovirus more info icon. N/A 4 weeks 6 months
A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6 months after the previous dose.
A fourth dose of IPV is indicated if all previous doses were administered at <4 years or if the third dose was administered <6 months after the second dose.
Measles, mumps, rubella more info icon. N/A 4 weeks
Varicella more info icon. N/A 3 months if younger than age 13 years.
4 weeks if age 13 years or older.

Notes

Recommended Child and Adolescent Schedule for ages 18 years or younger, United States, 2019

For vaccine recommendations for persons 19 years of age and older, see the Recommended Adult Immunization Schedule.

Additional information

Diphtheria, tetanus, and pertussis (DTaP) vaccination (minimum age: 6 weeks [4 years for Kinrix or Quadracel])

Routine vaccination

Catch-up vaccination

Haemophilus influenzae type b vaccination
(minimum age: 6 weeks)

Routine vaccination

Catch-up vaccination

Special situations

*Unvaccinated = Less than routine series (through 14 months) OR no doses (14 months or older)

Hepatitis A vaccination
(minimum age: 12 months for routine vaccination)

Routine vaccination

Catch-up vaccination

International travel

Special situations

At risk for hepatitis A infection: 2-dose series as above

Hepatitis B vaccination (minimum age: birth)

Birth dose (monovalent HepB vaccine only)

Routine series

Catch-up vaccination

Human papillomavirus vaccination (minimum age: 9 years)

Routine and catch-up vaccination

Special situations

Inactivated poliovirus vaccination (minimum age: 6 weeks)

Routine vaccination

Catch-up vaccination

Series containing oral polio vaccine (OPV), either mixed OPV- IPV or OPV-only series:

Influenza vaccination (minimum age: 6 months [IIV], 2 years [LAIV], 18 years [RIV])

Routine vaccination

Special situations

Measles, mumps, and rubella vaccination (minimum age: 12 months for routine vaccination)

Routine vaccination

Catch-up vaccination

Special situations

International travel

Meningococcal serogroup A,C,W,Y vaccination (minimum age: 2 months [MenACWY-CRM, Menveo], 9 months [MenACWY-D, Menactra])

Routine vaccination

Catch-up vaccination

Special situations

Anatomic or functional asplenia (including sickle cell disease), HIV infection, persistent complement component deficiency, eculizumab use:

Travel in countries with hyperendemic or epidemic meningococcal disease, including countries in the African meningitis belt or during the Hajj:

First-year college students who live in residential housing (if not previously vaccinated at age 16 years or older) or military recruits: 1 dose of Menveo or Menactra

Note: Menactra should be administered either before or at the same time as DTaP. For MenACWY booster dose
recommendations for groups listed under “Special situations” above and additional meningococcal vaccination information, see meningococcal MMWR publications.

Meningococcal serogroup B vaccination (minimum age: 10 years [MenB-4C, Bexsero; MenB-FHbp, Trumenba])

Clinical discretion

Special situations

Anatomic or functional asplenia (including sickle cell disease), persistent complement component deficiency, eculizumab use:

Bexsero and Trumenba are not interchangeable; the same product should be used for all doses in a series.

For additional meningococcal vaccination information, see meningococcal MMWR publications.

Pneumococcal vaccination (minimum age: 6 weeks [PCV13], 2 years [PPSV23])

Routine vaccination with PCV13

Catch-up vaccination with PCV13

Special situations

High-risk conditions below: When both PCV13 and PPSV23 are indicated, administer PCV13 first. PCV13 and PPSV23 should not be administered during same visit.

Chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma treated with high-dose, oral corticosteroids); diabetes mellitus:

Age 2–5 years
Age 6–18 years

Cerebrospinal fluid leak, cochlear implant:

Age 2–5 years
Age 6–18 years

Sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiency; HIV infection; chronic renal failure; nephrotic syndrome; malignant neoplasms, leukemias, lymphomas, Hodgkin disease, and other diseases associated with treatment with immunosuppressive drugs or radiation therapy; solid organ transplantation; multiple myeloma:

Age 2–5 years
Age 6–18 years

Chronic liver disease, alcoholism:

Age 6–18 years

*An incomplete series is defined as not having received all doses in either the recommended series or an age-appropriate catch-up series. See Tables 8, 9, and 11 in the ACIP pneumococcal vaccine recommendations Cdc-pdf PDF [24 pages] for complete schedule details.

Rotavirus vaccination (minimum age: 6 weeks)

Routine vaccination

If any dose in the series is either RotaTeq or unknown, default to 3-dose series.

Catch-up vaccination

Tetanus, diphtheria, and pertussis (Tdap) vaccination (minimum age: 11 years for routine vaccination, 7 years for catch-up vaccination)

Routine vaccination

Catch-up vaccination

Varicella vaccination (minimum age: 12 months)

Routine vaccination

Catch-up vaccination

Vaccines in the Child and Adolescent Immunization Schedule*

child acronyms
Vaccines Abbreviations Trade Names
Diphtheria, tetanus, and acellular pertussis vaccine DTaP Daptacel
Infanrix
Diphtheria, tetanus vaccine DT No Trade Name
Haemophilus influenzae type B vaccine Hib (PRP-T)
Hib (PRP-OMP)
ActHIB Hiberix
PedvaxHIB
Hepatitis A vaccine HepA Havrix
Vaqta
Hepatitis B vaccine HepB Engerix-B
Recombivax HB
Human papillomavirus vaccine HPV Gardasil 9
Influenza vaccine (inactivated) IIV Multiple
Influenza vaccine (live, attenuated) LAIV FluMist
Measles, mumps, and rubella vaccine MMR M-M-R II
Meningococcal serogroups A, C, W, Y vaccine MenACWY-D
MenACWY-CRM
Menactra
Menveo
Meningococcal serogroup B vaccine MenB-4C
MenB-FHbp
Bexsero
Trumenba
Pneumococcal 13-valent conjugate vaccine PCV13 Prevnar 13
Pneumococcal 23-valent polysaccharide vaccine PPSV23 Pneumovax
Poliovirus vaccine (inactivated) IPV IPOL
Rotavirus vaccine RV1
RV5
Rotarix
RotaTeq
Tetanus, diphtheria, and acellular pertussis vaccine Tdap Adacel
Boostrix
Tetanus and diphtheria vaccine Td Tenivac
Td vaccine
Varicella vaccine VAR Varivax

Combination Vaccines

(Use combination vaccines instead of separate injections when appropriate)

Vaccines Abbreviations Trade Names
DTaP, hepatitis B, and inactivated poliovirus vaccine DTaP-HepB-IPV Pediarix
DTaP, inactivated poliovirus, and Haemophilus influenzae type B vaccine DTaP-IPV/Hib Pentacel
DTaP and inactivated poliovirus vaccine DTaP-IPV Kinrix
Quadracel
Measles, mumps, rubella, and varicella vaccines MMRV ProQuad
*Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to vaccine series for extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.

This schedule is Recommended by the Advisory Committee on Immunization Practices (ACIP), and approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAPExternal file_external ), American Academy of Family Physicians (AAFPExternal file_external ), and American College of Obstetricians and Gynecologists (ACOGExternal file_external ).

The comprehensive summary of the ACIP recommended changes made to the child and adolescent immunization schedule can be found in the February 8, 2019 MMWR.


Page last reviewed: February 5, 2019