Table 1. Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, 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).

Legend

Range of recommended ages for all children

Range of recommended ages for catch-up immunization

Range of recommended ages for certain high-risk groups

Range of recommended ages for non-high-risk
groups that may receive vaccine, subject to
individual clinical decision-making

No recommendation

Birth to 15 Months

child vaccine schedule table 1
Vaccine Birth 1 mo 2 mos 4 mos 6 mos 9 mos 12 mos 15 mos
Hepatitis B more info icon.
(HepB)
1st dose 2nd dose ←3rd dose→
Rotavirus more info icon.
(RV) RV1 (2-dose series); RV5 (3-dose series)
1st dose 2nd dose See notes
Diphtheria, tetanus, & acellular pertussis more info icon.
(DTaP: <7 yrs)
1st dose 2nd dose 3rd dose ←4th dose→
Haemophilus influenzae type b more info icon.
(Hib)
1st dose 2nd dose See notes ←3rd or 4th dose,
See notes
Pneumococcal conjugate more info icon.
(PCV13)
1st dose 2nd dose 3rd dose ←4th dose→
Inactivated poliovirus more info icon.
(IPV: <18 yrs)
1st dose 2nd dose ←3rd dose→
Influenza (IIV) more info icon. Annual vaccination 1 or 2 doses
more info icon.
Influenza (LAIV) more info icon.
Measles, mumps, rubella more info icon.
(MMR)
See notes ←1st dose→
Varicella more info icon.
(VAR)
←1st dose→
Hepatitis A more info icon.
(HepA)
See notes ←2-dose series, See notes
Meningococcal more info icon.
(MenACWY-D: ≥9 mos; MenACWY-CRM: ≥2 mos)
See notes
Tetanus, diphtheria, & acellular pertussis more info icon.
(Tdap: ≥7 yrs)
Human papillomavirus more info icon.
(HPV)
Meningococcal B more info icon.
(MenB)
Pneumococcal polysaccharide more info icon.
(PPSV23)

18 Months to 18 Years

child vaccine schedule table 2
Vaccines 18 mos 19-23 mos 2-3 yrs 4-6 yrs 7-10 yrs 11-12 yrs 13-15 yrs 16 yrs 17-18 yrs
Hepatitis B more info icon.
(HepB)
←3rd dose→
Rotavirus more info icon.
(RV) RV1 (2-dose series); RV5 (3-dose series)
Diphtheria, tetanus, & acellular pertussis more info icon.
(DTaP: <7 yrs)
←4th dose→ 5th dose
Haemophilus influenzae type b more info icon.
(Hib)
Pneumococcal conjugate more info icon.
(PCV13)
Inactivated poliovirus more info icon.
(IPV: <18 yrs)
←3rd dose→ 4th dose
Influenza (IIV) more info icon. Annual vaccination 1 or 2 doses Annual vaccination 1 dose only
more info icon.
Influenza (LAIV) more info icon.
more info icon.
Annual vaccination 1 or 2 doses
Annual vaccination 1 dose only
Measles, mumps, rubella more info icon.
(MMR)
2nd dose
Varicella more info icon.
(VAR)
2nd dose
Hepatitis A more info icon.
(HepA)
← 2-dose series, See notes
Meningococcal more info icon.
(MenACWY-D: ≥9 mos; MenACWY-CRM: ≥2 mos)
See notes 1st dose 2nd dose
Tetanus, diphtheria, & acellular pertussis more info icon.
(Tdap: ≥7 yrs)
Tdap
Human papillomavirus more info icon.
(HPV)
See notes
Meningococcal B more info icon.
(MenB)
See notes
Pneumococcal polysaccharide more info icon.
(PPSV23)
See notes

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.

Notes

Recommended Child and Adolescent Immunization 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

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