Child and Adolescent Immunization Schedule by Medical Indication

Recommendations for Ages 18 Years or Younger, United States, 2024

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¶ = Recommended for all age-eligible children who lack documentation of a complete vaccination series
§ = Not recommended for all children, but is recommended for some children based on increased risk for or severe outcomes from disease
» = Recommended for all age-eligible children, and additional doses may be necessary based on medical condition or other indications. See Notes.
| = Precaution: Might be indicated if benefit of protection outweighs risk of adverse reaction
± = Contraindicated or not recommended *Vaccinate after pregnancy, if indicated
• = No Guidance/Not Applicable

child indications vaccine schedule
Vaccine and other immunizing agents
Pregnancy Immunocompromised status (excluding HIV infection) HIV infection CD4 percentage and counta CSF leak or cochlear implant Asplenia or persistent complement component deficiencies Heart disease or chronic lung disease Kidney failure,
End-stage
renal disease
or on Dialysis
Chronic liver disease Diabetes
<15% or <200mm ≥15% and ≥200/mm3
RSV-mAb more info icon. (nirsevimab) 2nd RSV season » 1 dose depending on maternal
RSV vaccination status, See notes
2nd RSV season for
chronic lung disease (See notes
1 dose depending on maternal RSV vaccination status, See notes
Hepatitis B more info icon.
Rotavirus more info icon. | |
SCIDb±
DTaP/Tdap more info icon. DTaP•
Tdap: 1 dose each pregnancy»
Hib more info icon. See notes See notes
HSCT: 3 doses»
Pneumococcal more info icon. »
IPV more info icon. |
COVID-19 more info icon. See notes
IIV4 more info icon.
LAIV4 more info icon. ± | |
Asthma, wheezing: 2–4 yearsc±
Measles, mumps, rubella more info icon. ±
VAR more info icon. ±
Hepatitis A more info icon.
Human papillomavirus more info icon. * 3 dose series. See notes»
Meningococcal ACWY more info icon. » »
Meningococcal B more info icon. | »
RSV more info icon. (Abrysvo) Seasonal administration, See notes
Dengue more info icon. | ± | §
Mpox more info icon. See notes§ §
  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, 2024.

Additional information

  • 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, RSV, Mpox, and COVID-19 vaccines. Mpox and COVID-19 vaccines 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])

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], 2 years [MenACWY-TT, MenQuadfi]), 10 years [MenACWY-TT/MenB-FHbp, Penbraya])

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

Mpox vaccination
(minimum age: 18 years [Jynneos®])

Pneumococcal vaccination
(minimum age: 6 weeks [PCV15], [PCV 20]; 2 years [PPSV23])

Poliovirus vaccination
(minimum age: 6 weeks)

Respiratory syncytial virus immunization
(minimum age: birth [Nirsevimab, RSV-mAb (Beyfortus™)

Respiratory syncytial virus vaccination
(RSV [Abrysvo™])

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)


In addition to the recommendations presented in the previous sections of this immunization schedule, ACIP has approved the following recommendations by majority vote since October 26, 2023. The following recommendations have been adopted by the CDC Director and are now official. Links are provided if these recommendations have been published in Morbidity and Mortality Weekly Report (MMWR).

child schedule addendum
Vaccines Recommendations Effective Date of Recommendation*
No new vaccines or vaccine recommendations to report

*The effective date is the date when the CDC director adopted the recommendation and when the ACIP recommendation became official.


Vaccines and Other Immunizing Agents in the Child and Adolescent Immunization Schedule*

New Vaccines and Other Immunizing Agents added to the Schedule (See Addendum)

Monoclonal antibody
Monoclonal antibody Abbreviation(s) Trade name(s)
Respiratory syncytial virus monoclonal antibody (Nirsevimab) RSV-mAb Beyfortus
child acronyms
Vaccines Abbreviation(s) Trade name(s)
COVID-19 1vCOV-mRNA Comirnaty®/Pfizer- BioNTech COVID-19 Vaccine
Spikevax®/Moderna COVID-19 Vaccine
1vCOV-aPS Novavax COVID-19 Vaccine
Dengue vaccine DEN4CYD Dengvaxia®
Diphtheria, tetanus, and acellular pertussis vaccine DTaP Daptacel®
Infanrix®
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-CRM Menveo®
MenACWY-TT MenQuadfi®
Meningococcal serogroup B vaccine MenB-4C Bexsero®
MenB-FHbp Trumenba®
Meningococcal serogroup A, B, C, W, Y vaccine MenACWY-TT/MenB-FHbp Penbraya
Mpox vaccine Mpox Jynneos®
Pneumococcal conjugate vaccine PCV15 Vaxneuvance
PCV20 Prevnar 20®
Pneumococcal polysaccharide vaccine PPSV23 Pneumovax 23®
Poliovirus vaccine (inactivated) IPV Ipol®
Respiratory syncytial virus vaccine RSV Abrysvo
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)

(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.