Immunization Schedule
Recommended Immunization Schedule
for Persons Aged 0–6 Years
UNITED STATES • 2007
This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2006, for children aged 0–6 years. Additional information is available at http://www.cdc.gov/nip/recs/child-schedule.htm. Any dose not administered at the recommended age should be administered at any subsequent visit, when indicated and feasible. Additional vaccines may be licensed and recommended during the year. Licensed combination vaccines may be used whenever any components of the combination are indicated and other components of the vaccine are not contraindicated and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the respective Advisory Committee on Immunization Practices statement for detailed recommendations. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at www.vaers, hhs.gov or by telephone, 800-822-7967.
1. Hepatitis B vaccine (HepB). (Minimum age: birth)
At birth:
Administer monovalent HepB to all newborns before hospital discharge.
If mother is hepatitis surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.
If mother’s HBsAg status is unknown, administer HepB within 12 hours of birth. Determine the HBsAg status as soon as possible and if HBsAg-positive, administer HBIG (no later than age 1 week).
If mother is HBsAg-negative, the birth dose can only be delayed with
physician’s order and mother’s negative HBsAg laboratory report
documented in the infant’s medical record.
After the birth dose:
The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1–2 months. The final dose should be administered at age ≥24 weeks. Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of ≥3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).
4-month dose:
2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)
Administer the first dose at age 6–12 weeks. Do not start the series later than age 12 weeks.
Administer the final dose in the series by age 32 weeks. Do not administer a dose later than age 32 weeks.
Data on safety and efficacy outside of these age ranges are insufficient.
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). (Minimum age: 6 weeks)
The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose.
Administer the final dose in the series at age 4–6 years.
4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)
If PRP-OMP (PedvaxHIB® or ComVax® [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.
TriHiBit® (DTaP/Hib) combination products should not be used for primary immunization but can be used as boosters following any Hib vaccine in children aged ≥12 months.
5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPV])
Administer PCV at ages 24–59 months in certain high-risk groups.
Administer PPV to children aged ≥2 years in certain high-risk groups.
See MMWR 2000;49(No. RR-9):1–35.
6. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 5 years for live, attenuated influenza vaccine [LAIV])
All children aged 6–59 months and close contacts of all children aged 0–59 months are recommended to receive influenza vaccine.
Influenza vaccine is recommended annually for children aged ≥59 months with certain risk factors, health-care workers, and other persons (including household members) in close contact with persons in groups at high risk. See MMWR 2006;55(No. RR-10):1–41.
For healthy persons aged 5–49 years, LAIV may be used as an alternative to TIV.
Children receiving TIV should receive 0.25 mL if aged 6–35 months or 0.5 mL if aged ≥3 years.
Children aged <9 years who are receiving influenza vaccine for the first time should receive 2 doses (separated by ≥4 weeks for TIV and ≥6 weeks for LAIV).
7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
Administer the second dose of MMR at age 4–6 years. MMR may be administered before age 4–6 years, provided ≥4 weeks have elapsed since the first dose and both doses are administered at age ≥12 months.
8. Varicella vaccine. (Minimum age: 12 months)
Administer the second dose of varicella vaccine at age 4–6 years. Varicella vaccine may be administered before age 4–6 years, provided that ≥3 months have elapsed since the first dose and both doses are administered at age ≥12 months. If second dose was administered ≥28 days following the first dose, the second dose does not need to be repeated.
9. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
HepA is recommended for all children aged 1 year (i.e., aged 12–23 months). The 2 doses in the series should be administered at least 6 months apart.
Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.
HepA is recommended for certain other groups of children, including in areas where vaccination programs target older children. See MMWR 2006;55(No. RR-7):1–23.
10. Meningococcal polysaccharide vaccine (MPSV4). (Minimum age: 2 years)
The Recommended Immunization Schedules for Persons Aged 0–18 Years are approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.