Child and Adolescent Immunization Schedule by Medical Indication

Recommendations for Ages 18 Years or Younger, United States, 2022

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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+ count1 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. | |
SCID2±
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. |
Influenza more info icon. (IIV4)
more info icon.
Influenza more info icon. (LAIV4)
± ± ± | | ± ± | |
Asthma, wheezing: 2-4yrs3±
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 D).
  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, 2022.

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 3-1, 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, and Immunization in Special Clinical Circumstances (In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 report of the Committee on Infectious Diseases. 31st ed. Itasca, IL: American Academy of Pediatrics, 2018:67–111).
  • 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 routine child and adolescent vaccines are covered by VICP except for pneumococcal polysaccharide vaccine (PPSV23). For more information, see www.hrsa.gov/vaccinecompensation/index.htmlexternal icon.

Dengue Vaccination

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], 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)


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Page last reviewed: February 17, 2022