Child and Adolescent Immunization Schedule by Medical Indication

Recommendations for Ages 18 Years or Younger, United States, 2023

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¶ = Vaccination according to the routine schedule recommended
§ = Recommended for persons with an additional risk factor for which the vaccine would be indicated
» = Vaccination is recommended, and additional doses may be necessary based on medical condition or vaccine. See Notes.
| = Precaution—vaccine might be indicated if benefit of protection outweighs risk of adverse reaction
± = Contraindicated or not recommended—vaccine should not be administered. *Vaccinate after pregnancy
• = No recommendation/Not applicable

child indications vaccine schedule
Vaccine Indication
Pregnancy Immunocompromised status (excluding HIV infection) HIV infection CD4+ counta Kidney failure, end-stage renal disease, or on hemodialysis Heart disease or chronic lung disease CSF leaks or cochlear implants Asplenia or persistent complement component deficiencies Chronic liver disease Diabetes
<15% or total CD4 cell count of <200/mm3 ≥15% and total CD4 cell count of ≥200/mm3
Hepatitis B more info icon.
Rotavirus more info icon. | |
SCIDb±
Diphtheria, tetanus, and acellular pertussis more info icon. (DTaP)
Haemophilus influenzae type b more info icon. » » »
Pneumococcal conjugate more info icon. » » » » » » » »
Inactivated poliovirus more info icon. |
COVID-19 more info icon. (See notes (See notes
Influenza more info icon. (IIV4)
more info icon.
Influenza more info icon. (LAIV4)
± ± ± | | ± ± | |
Asthma, wheezing: 2-4yrsc±
Measles, mumps, rubella more info icon. * ± ± ±
Varicella more info icon. * ± ± ±
Hepatitis A more info icon.
Tetanus, diphtheria, and acellular pertussis more info icon. (Tdap) »
Human papillomavirus more info icon. * ± » »
Meningococcal ACWY more info icon. » »
Meningococcal B more info icon. | § § § § § » § §
Pneumococcal polysaccharide more info icon. § » » » » » » » »
Dengue more info icon. | ± ± |
  1. For additional information regarding HIV laboratory parameters and use of live vaccines, see the General Best Practice Guidelines for Immunization, “Altered Immunocompetence,” and Table 4-1 (footnote J).
  2. Severe Combined Immunodeficiency
  3. LAIV4 contraindicated for children 2–4 years of age with asthma or wheezing during the preceding 12 months

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

For vaccination recommendations for persons ages 19 years or older, see the Recommended Adult Immunization Schedule, 2023.

Additional information

  • Consult relevant ACIP statements for detailed recommendations.
  • For calculating intervals between doses, 4 weeks = 28 days. Intervals of ≥4 months are determined by calendar months.
  • Within a number range (e.g., 12–18), a dash (–) should be read as “through.”
  • Vaccine doses administered ≤4 days before the minimum age or interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum age or minimum interval should not be counted as valid and should be repeated as age-appropriate. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, see Table 3-2, Recommended and minimum ages and intervals between vaccine doses, in General Best Practice Guidelines for Immunization.
  • Information on travel vaccination requirements and recommendations is available at https://www.cdc.gov/travel/.
  • For vaccination of persons with immunodeficiencies, see Table 8-1, Vaccination of persons with primary and secondary immunodeficiencies, in General Best Practice Guidelines for Immunization, Immunization in Special Clinical Circumstances (In: Kimberlin DW, Barnett ED, Lynfield Ruth, Sawyer MH, eds. Red Book: 2021–2024 Report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: American Academy of Pediatrics; 2021:72–86).
  • For information about vaccination in the setting of a vaccine-preventable disease outbreak, contact your state or local health department.
  • The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury claims. All vaccines included in the child and adolescent vaccine schedule are covered by VICP except for dengue, PPSV23 and COVID-19 vaccines. COVID-19 vaccines that are authorized or approved by the FDA are covered by the Countermeasures Injury Compensation Program (CICP). For more information, see www.hrsa.gov/vaccinecompensation or www.hrsa.gov/cicp.

COVID-19 vaccination
(minimum age: 6 months [Moderna and Pfizer-BioNTech COVID-19 vaccines], 12 years [Novavax COVID-19 Vaccine])

COVID-19 vaccination recommendations have changed. See the latest recommendations.

Dengue Vaccination
(minimum age: 9 years)

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

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

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

Hepatitis B vaccination
(minimum age: birth)

Human papillomavirus vaccination
(minimum age: 9 years)

Influenza vaccination
(minimum age: 6 months [IIV], 2 years [LAIV4], 18 years [recombinant influenza vaccine, RIV4])

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

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

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

Pneumococcal vaccination
(minimum age: 6 weeks [PCV13], [PCV15], 2 years [PPSV23])

Poliovirus vaccination
(minimum age: 6 weeks)

Rotavirus vaccination
(minimum age: 6 weeks)

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

Varicella vaccination
(minimum age: 12 months)


Vaccines in the Child and Adolescent Immunization Schedule*

child acronyms
Vaccines Abbreviation(s) Trade name(s)
COVID-19 1vCOV-mRNA Comirnaty®/Pfizer- BioNTech COVID-19 Vaccine
SPIKEVAX®/Moderna COVID-19 Vaccine
2vCOV-mRNA Pfizer-BioNTech COVID-19 Vaccine, Bivalent
Moderna COVID-19 Vaccine, Bivalent
1vCOV-aPS Novavax COVID-19 Vaccine
Dengue vaccine DEN4CYD Dengvaxia®
Diphtheria, tetanus, and acellular pertussis vaccine DTaP Daptacel®
Infanrix®
Diphtheria, tetanus vaccine DT No Trade Name
Haemophilus influenzae type B vaccine Hib (PRP-T) ActHIB®
Hiberix®
Hib (PRP-OMP) PedvaxHIB®
Hepatitis A vaccine HepA Havrix®
Vaqta®
Hepatitis B vaccine HepB Engerix-B®
Recombivax HB®
Human papillomavirus vaccine HPV Gardasil 9®
Influenza vaccine (inactivated) IIV4 Multiple
Influenza vaccine (live, attenuated) LAIV4 FluMist® Quadrivalent
Measles, mumps, and rubella vaccine MMR M-M-R II®
Priorix®
Meningococcal serogroups A, C, W, Y vaccine MenACWY-D Menactra®
MenACWY-CRM Menveo®
MenACWY-TT MenQuadfi®
Meningococcal serogroup B vaccine MenB-4C Bexsero®
MenB-FHbp Trumenba®
Pneumococcal conjugate vaccine PCV13 Prevnar 13®
PCV15 Vaxneuvance
Pneumococcal polysaccharide vaccine PPSV23 Pneumovax 23®
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®
TDvax™
Varicella vaccine VAR Varivax®

Combination Vaccines

(Use combination vaccines instead of separate injections when appropriate)

Vaccines Abbreviation(s) Trade name(s)
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®
DTaP, inactivated poliovirus, Haemophilus influenzae type b, and hepatitis B vaccine DTaP-IPV-Hib-HepB Vaxelis®
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.