2017 Catch-Up Vaccination Schedules: 4 Months-18 Years

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2016 CATCH-UP VACCINATION SCHEDULE: 4 MONTHS−18 YEARS*
2017 CATCH-UP VACCINATION SCHEDULE: 4 MONTHS−18 YEARS*
Vaccine Minimum
Age for
Dose 1
Minimum Interval Between Doses
Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Dose 4 Dose 4 to
Dose 5
Persons Aged 4 Months−6 Years
HepB1 Birth 4 weeks

8 weeks
and at least 16wks after 1st dose; minimum age for the final dose is 24wks



RV2 6 weeks 4 weeks 4 weeks2

DTaP3 6 weeks 4 weeks 4 weeks 6 months 6 months3
Hib4 6 weeks

4 weeks
if 1st dose given before 1st birthday

8 weeks (as final dose)
if 1st dose given at age 12−14mos

No further doses needed
if 1st dose given at age ≥15mos

4 weeks4
if current age is <12mos and 1st dose was given at <7mos of age, and at least 1 previous dose was PRP-T (ActHib, Pentacel, Hiberix) or unknown

8 weeks and age 12−59mos (as final dose)4
if current age is <12mos and 1st dose was given at age 7−11mos; OR if current age is 12−59mos and 1st dose was given before 1st birthday, and 2nd dose given at <15mos of age; OR if both doses were PRP-OMP (PedvaxHIB; Comvax) and were given before 1st birthday

No further doses needed
if previous dose given at age ≥15mos

8 weeks (as final dose)
This dose only necessary for ages 12−59mos who received 3 doses before 1st birthday


PCV13, PPSV235 6 weeks

4 weeks
if 1st dose given before 1st birthday

8 weeks (as final dose for healthy children)
if 1st dose given at or after 1st birthday

No further doses needed
for healthy children if 1st dose given at age ≥24mos

4 weeks
if current age <12mos and previous dose given at age <7mos

8 weeks (as final dose for healthy children)
previous dose given between 7−11mos (wait until at least 12mos old); OR if current age is ≥12mos and at least 1 dose was given before age 12mos.

No further doses needed
for healthy children if previous dose given at age ≥24mos

8 weeks (as final dose)
This dose only necessary for ages 12−59mos who received 3 doses before age 12mos or for high-risk children who received 3 doses at any age


IPV6 6 weeks 4 weeks6 4 weeks6

6 months6
minimum age 4yrs for final dose


MMR8 12mos 4 weeks


VAR9 12mos 3 months


HepA10 12mos 6 months


Meningococcal11 6 weeks 8 weeks11 see footnote 11 see footnote 11
Persons Aged 7−18 Years
Meningococcal11 N/A 8 weeks11


Td/Tdap12 7 years12 4 weeks

4 weeks
if 1st dose of DTaP/DT given before 1st birthday

6 months (as final dose)
if 1st dose of DTaP/DT or Tdap/Td given at or after 1st birthday

6 months
if 1st dose of DTaP/DT given before 1st birthday


HPV13 9 years Routine dosing intervals are recommended13
HepA10 N/A 6 months      
HepB1 N/A 4 weeks

8 weeks
and at least 16wks after 1st dose



IPV6 N/A 4 weeks 4 weeks6 6 months6
MMR8 N/A 4 weeks


VAR9 N/A

3 months
if person is <13yrs

4 weeks
if person is ≥13yrs




Footnotes to 2017 CATCH-UP VACCINATION SCHEDULES: 4 MONTHS−18 YEARS OF AGE

*The tables provide catch‑up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child's age. Always use this table in conjunction with the child and adolescent immunization schedules (“Vaccination Schedule: 0−18 Years of Age”) and their respective footnotes.

1. Hepatitis B (HepB) vaccine. (Minimum age: birth)

• Unvaccinated persons should complete a 3‑dose series.

• A 2‑dose series (doses separated by at least 4mos) of adult formulation Recombivax HB is licensed for use in children aged 11−15yrs.

2. Rotavirus (RV) vaccines (Minimum age: 6wks for both RV1 [Rotarix] and RV5 [RotaTeq]).

• Max age for the 1st dose in the series is 14wks, 6 days; vaccination should not be initiated for infants aged 15wks 0 days or older.

• The max age for the final dose in the series is 8mos, 0 days.

3. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (Minimum age: 6wks. Exception: DTaP‑IPV [Kinrix, Quadracel]: 4yrs)

• The 5th dose of DTaP vaccine is not necessary if the 4th dose was given at age ≥4yrs.

4. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6wks for PRP‑T [ACTHIB, DTaP‑IPV/Hib (Pentacel), Hiberix, and Hib‑MenCY (MenHibrix)], PRP‑OMP [PedvaxHIB])

• If dose 1 was given at ages 12−14mos, give 2nd (final) dose at least 8wks after dose 1, regardless of Hib vaccine used in the primary series.

• If both doses were PRP‑OMP (PedvaxHIB or COMVAX), and were given before 1st birthday, the 3rd (and final) dose should be given at age 12−59mos and at least 8wks after the 2nd dose.

• If the 1st dose was given at age 7−11mos, give the 2nd dose at least 4wks later and a 3rd (and final) dose at age 12−15mos or 8wks after 2nd dose, whichever is later.

• If first dose is given before 1st birthday and 2nd dose is given <15mos of age, a 3rd (and final) dose should be given 8wks later.

• For unvaccinated children aged 15–59mos, give only 1 dose.

5. Pneumococcal vaccines. (Minimum age: 6wks for PCV13, 2yrs for PPSV23)

• Administer 1 dose of PCV13 to all healthy children aged 24−59mos who are not completely vaccinated for their age.

6. Inactivated poliovirus vaccine (IPV). (Minimum age: 6wks)

• In the first 6mos of life, minimum age and minimum intervals are only recommended if the person is at risk for imminent exposure to circulating poliovirus (eg, travel to a polio-endemic region or during an outbreak).

• If ≥4 doses are given before age 4yrs, an additional dose should be given at age 4−6yrs and at least 6mos after the previous dose.

• A 4th dose is not necessary if the 3rd dose was given at age ≥4yrs and at least 6mos after the previous dose.

• If both OPV and IPV were given as part of a series, a total of 4 doses should be given, regardless of the child's current age. If only OPV were given, and all doses given before 4yrs of age, 1 dose of IPV should be given at ≥4yrs, at least 6mos after last OPV dose.

• IPV is not routinely recommended for U.S. residents aged ≥18yrs.

7. Influenza vaccines. (Minimum age: 6mos for inactivated influenza vaccine [IIV]; 18yrs for recombinant influenza vaccine [RIV]).

• See “VACCINATION SCHEDULE: 0−18 YEARS OF AGE” for further guidance.

8. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12mos for routine vaccination)

• Ensure that all school-aged children and adolescents have had 2 doses of MMR vaccine; the minimum interval between the 2 doses is 4wks.

9. Varicella (VAR) vaccine. (Minimum age: 12mos)

• Ensure that all persons aged 7−18yrs without evidence of immunity have 2 doses of varicella vaccine. For children aged 7−12yrs, the recommended minimum interval between doses is 3mos (if the 2nd dose was given at least 4wks after the 1st dose, it can be accepted as valid); for persons aged ≥13yrs, the minimum interval between doses is 4wks.

10. Hepatitis A vaccine (HepA). (Minimum age: 12mos)

• The minimum interval between the 2 doses is 6mos.

11. Meningococcal vaccines. (Minimum age: 6wks for Hib-MenCY [MenHibrix], 9mos for MenACWY-D [Menactra], 2mos for MenACWY-CRM [Menveo], 10yrs for serogroup B meningococcal [MenB] vaccines: MenB-4C [Bexsero] and MenB-FHbp [Trumenba])

• Give Menactra or Menveo vaccine at age 13−18yrs if not previously vaccinated.

• If the 1st dose is given at age 13−15yrs, a booster dose should be given at age 16−18yrs with a minimum interval of at least 8wks between doses.

• If the 1st dose is given at age ≥16yrs, a booster dose is not needed.

12. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10yrs for Boostrix and Adacel).

• Persons aged ≥7yrs who are not fully immunized with DTaP vaccine should receive Tdap vaccine as 1 dose (preferably the 1st) in the catch‑up series; if additional doses are needed, use Td vaccine. For children 7−10yrs who receive a dose of Tdap as part of the catch‑up series, an adolescent Tdap vaccine dose at age 11−12yrs may be given.

• Persons aged 11−18yrs who have not received Tdap vaccine should receive a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10yrs thereafter.

• Inadvertent doses of DTaP vaccine:

− If administered inadvertently to a child aged 7–10yrs, the dose may count as part of the catch‑up series. This dose may count as the adolescent Tdap dose, or the child can later receive a Tdap booster dose at age 11−12yrs.

− If administered inadvertently to an adolescent aged 11−18yrs, the dose should be counted as the adolescent Tdap booster.

13. Human papillomavirus (HPV) vaccines. (Minimum age: 9yrs for 4vHPV [Gardasil] and 9vHPV [Gardasil 9])

• Give HPV vaccine to all adolescents through age 18yrs who were not previously adequately vaccinated.

• Give 2 doses at 0, 6−12mos if initiating vaccination before age 15yrs. Minimum interval between 1st and 2nd dose is 5mos. If 2nd dose given at a shorter interval, a 3rd dose should be given a minimum of 12wks after 2nd dose and minimum of 5mos after 1st dose.

• Give 3 doses at 0, 1−2, 6mos if initiating vaccination at age ≥15yrs. Minimum intervals are 4wks between 1st and 2nd dose, 12wks between 2nd and 3rd dose, and 5mos between 1st and 3rd dose. If dose given at a shorter interval, it should be readministered after another minimum interval has been met since the most recent dose.

CHANGES IN THE SCHEDULE SINCE LAST RELEASE

• The Hib vaccine footnote was revised to remove COMVAX and add Hiberix to the list of vaccines that may be used for the primary vaccination series.

• The IPV vaccine footnote was revised to include a new update which changed the interval between the IPV dose and the last OPV dose to 6mos, in persons who only received OPV.

• Live attenuated influenza vaccine (LAIV) has been removed from the influenza vaccine footnote.

• The HPV vaccine footnote has been updated to include the new 2-dose series for persons initiating HPV vaccination before age 15yrs and to remove the bivalent HPV vaccine (Cervarix) from the schedule.

REFERENCES

For information on individual vaccines see product monographs, contact the manufacturer, or call the National Immunization Hotline at (800) 232-4636. Source: Advisory Committee on Immunization Practices (ACIP). Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger— United States, 2017. http://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html

(Rev. 2/2017)

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