2017 Vaccination Schedule: 0-18 Years of Age

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2017 VACCINATION SCHEDULE: 0−18 YEARS OF AGE
2017 VACCINATION SCHEDULE: 0−18 YEARS OF AGE
This schedule includes recommendations in effect as of February 1, 2017. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Considerations should include provider assessment, patient preference, and the potential for adverse events. Consult full product labeling for detailed recommendations.
Range of recommended
ages for all children
Range of recommended ages for catch‑up immunization Range of recommended ages for certain high-risk groups Range of recommended ages for non-high-risk groups that may receive vaccine, subject to individual clinical decision making
 
Vaccine Birth 1
mo
2
mos
4
mos
6
mos
9
mos
12
mos
15
mos
18
mos
19−23
mos
2−3
yrs
4−6
yrs
7−10
yrs
11−12
yrs
13−15
yrs
16
yrs
17−18
yrs
Hepatitis B1 (HepB) 1st
dose
2nd
dose
  3rd
dose
 
Rotavirus2 (RV)
RV1 (2‑dose series);
RV5 (3‑dose series)
    1st
dose
2nd
dose
see
footnote
2
                         
Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7yrs)     1st
dose
2nd
dose
3rd
dose
  4th
dose
  5th
dose
         
Haemophilus influenzae type b4 (Hib)     1st
dose
2nd
dose
see
footnote
4
  3rd or 4th 
dose
see footnote 4
   
Pneumococcal conjugate5 (PCV13)     1st
dose
2nd
dose
3rd
dose
  4th
dose
   
Inactivated poliovirus6 (IPV:<18yrs)     1st
dose
2nd
dose
3rd
dose
  4th
dose
   
Influenza7 (IIV)         Annual vaccination (IIV)
1 or 2 doses
Annual vaccination (IIV) 1 dose only
Measles, mumps, rubella8 (MMR)         see footnote
8
1st
dose
  2nd
dose
 
Varicella9 (VAR)             1st
dose
  2nd
dose
 
Hepatitis A10 (HepA)             2 dose series
see footnote 10
 
             
Meningococcal11 (Hib‑MenCY ≥ 6wks; MenACWY‑D ≥ 9mos; MenACWY‑CRM ≥ 2mos)       see footnote 11   1st
dose
  2nd
dose
   
Tetanus, diphtheria, & acellular pertussis12 (Tdap: ≥7yrs)                             Tdap  
Human papillomavirus13 (HPV)                                 see
footnote
13
 
                           
Meningococcal B11                               see footnote 11
                                     
Pneumococcal polysaccharide5 (PPSV23)                     see footnote 5
 

  1. Hepatitis B (HepB) vaccine. (Min age: birth)
At birth:

• Administer monovalent HepB vaccine to all newborns within 24hrs of birth.

• For infants born to hepatitis B surface antigen (HBsAg)–positive ­mothers, administer HepB vaccine and 0.5mL of hepatitis B immune globulin (HBIG) within 12hrs of birth. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9–12mos (preferably at the next well-child visit) or 1–2mos after completion of the HepB series if the series was delayed.

• If mother's HBsAg status is unknown, within 12hrs of birth administer HepB vaccine regardless of birth weight. For infants weighing <2,000g, administer HBIG in addition to HepB within 12hrs of birth. Determine mother's HBsAg status as soon as possible and, if she is HBsAg-positive, also administer HBIG for infants weighing ≥2,000g (no later than age 1wk).

   Doses after the birth dose:

• The 2nd dose should be administered at age 1 or 2mos. Monovalent HepB vaccine should be used for doses administered before age 6wks.

• Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a schedule of 0, 1–2mos, and 6mos starting as soon as feasible.

• Administer the 2nd dose 1–2mos after the 1st dose (min interval of 4wks), administer the 3rd dose at least 8wks after the 2nd dose AND at least 16wks after the 1st dose. The final (3rd or 4th) dose in the HepB vaccine series should be administered no earlier than age 24wks.

• Administration of a total of 4 doses of HepB vaccine is per­mitted when a combination vaccine containing HepB is administered after the birth dose.

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

• Administer a series of RV vaccine to all infants as follows:

1. If RV1 is used, administer a 2-dose series at 2 and 4mos of age.

2. If RV5 is used, administer a 3-dose series at ages 2, 4, and 6mos.

3. If any dose in series was RV5 or vaccine product is unknown for any dose in the series, a total of 3 doses of RV vaccine should be given.

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

• Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15–18mos, and 4–6yrs. The 4th dose may be administered as early as age 12mos, provided at least 6mos have elapsed since the 3rd dose. The 4th dose of DTaP need not be repeated if given at least 4mos after the 3rd dose of DTaP and the child was ≥12mos of age.

• 5th dose of DTap vaccine is not needed if 4th dose was given ≥4yrs of age.

  4Haemophilus 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])

• Administer a 2- or 3-dose Hib vaccine primary series and a booster dose (dose 3 or 4 depending on vaccine used in primary series) at age 12–15mos to complete a full Hib vaccine series.

• The primary series with ActHIB, MenHibrix, Hiberix, or Pentacel consists of 3 doses and should be administered at 2, 4, and 6mos of age. The primary series with PedvaxHIB consists of 2 doses and should be administered at 2 and 4mos of age; a dose at age 6mos is not indicated.

• One booster dose (dose 3 or 4 depending on vaccine used in primary series) of any Hib vaccine should be administered at age 12–15mos.

• Persons with high-risk conditions: refer to the ACIP 2017 Immunization Schedule footnotes.

  5. Pneumococcal vaccines. (Min age: 6wks for PCV13, 2yrs for PPSV23)
Routine vaccination with PCV13:

• Administer a 4-dose series of PCV13 vaccine at ages 2, 4, 6mos and at age 12–15mos.

• Persons with high-risk conditions: refer to the ACIP 2017 Immunization Schedule footnotes.

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

• Administer a 4-dose series of IPV at ages 2, 4, 6–18mos and 4–6yrs. The final dose in the series should be administered on or after the 4th birthday and at least 6mos after the previous dose.

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

• Administer influenza vaccine annually to all children beginning at age 6mos. For the 2016−2017 season, use of live attenuated influenza vaccine (LAIV) is not recommended.

   For children aged 6mos–8yrs:

• For the 2016–2017 season, administer 2 doses (separated by at least 4wks) to children who are receiving influenza vaccine for the first time or who have not previously received ≥2 doses before July 1, 2016.

   For children aged ≥9yrs:

• Administer 1 dose.

  8. Measles, mumps, and rubella (MMR) vaccine. (Min age: 12mos)

• Administer a 2-dose series of MMR vaccine at ages 12–15mos and 4–6yrs. The 2nd dose may be administered before age 4yrs, provided at least 4wks have elapsed since the 1st dose.

• Administer 1 dose of MMR vaccine to infants aged 6–11mos before departure from the U.S. for international travel. These children should be revaccinated with 2 doses of MMR vaccine, the first at age 12–15mos (12mos if the child remains in an area where disease risk is high), and the 2nd dose at least 4wks later.

• Administer 2 doses of MMR vaccine to children 12mos of age, before departure from the U.S. for international travel. The 1st dose should be administered on or after age 12mos and the 2nd dose at least 4wks later.

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

• Administer a 2-dose series of VAR vaccine at ages 12–15mos and 4–6yrs. The 2nd dose may be administered before age 4yrs, provided at least 3mos have elapsed since the 1st dose. If the 2nd dose was administered at least 4wks after the 1st dose, it can be accepted as valid.

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

• Initiate the 2-dose HepA vaccine series for children aged 12–23mos; separate the 2 doses by 6–18mos.

• Children who have received 1 dose of HepA vaccine before age 24mos, should receive a 2nd dose 6–18mos after the 1st dose.

• For any person ≥2yrs who has not already received the HepA vaccine series, 2 doses of HepA vaccine separated by 6–18mos may be given if immunity against hepatitis A virus infection is desired.

11. Meningococcal vaccines. (Min 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])

• Administer a single dose of Menactra or Menveo vaccine at age 11–12yrs, with a booster dose at age 16yrs.

• Young adults 16−23yrs (preferred range 16−18yrs) may be vaccinated with a 2-dose series of either Bexsero (0, ≥1mo) or Trumenba (0, 6mos) vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.

• If 2nd dose of Trumenba is given at an interval <6mos, a 3rd dose should be given ≥6mos after 1st dose; minimum interval between 2nd and 3rd doses is 4wks.

• Persons with high-risk conditions: refer to the ACIP 2017 Immunization Schedule footnotes.

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

• Give 1 dose of Tdap vaccine to all adolescents aged 11–12yrs.

• Tdap can be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.

• Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferably during the early part of gestational weeks 27−36) regardless of time since prior Td or Tdap vaccination.

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

• Give a 2dose series of HPV vaccine on a schedule of 0, 6−12mos to all adolescents aged 11−12yrs. The vaccine series can be started beginning at age 9yrs.

• 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.

• Administer HPV vaccine beginning at age 9yrs to children with any history of sexual abuse or assault.

• Immunocompromised persons should receive a 3-dose series, regardless of age at vaccine initiation.

NOTE: Refer to the ACIP 2017 Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger footnotes for vaccinations of persons with high risk conditions.

CHANGES IN THE SCHEDULE SINCE LAST RELEASE

• The HepB footnote was revised to reflect that the birth dose of HepB should be given within 24hrs of birth.

• The DTaP footnote was revised to more clearly present recommendations following an inadvertently early administered 4th dose of DTaP.

• The Tdap footnote for vaccination of pregnant adolescents has been updated to reflect a preference for vaccination earlier during gestational weeks 27−36.

• 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 pneumococcal vaccine footnote was revised to remove references to 7-valent pneumococcal conjugate vaccine (PCV7).

• Live attenuated influenza vaccine (LAIV) has been removed from the influenza row of the schedule. The influenza vaccine footnote has also been updated to recommend against the use of LAIV during the 2016–2017 influenza season.

• The 16yr age column of the schedule has been separated from the 17-18yrs age column to highlight the need for a meningococcal conjugate vaccine booster dose at age 16yrs. The meningococcal vaccines footnote has also been updated to reflect recommendations for the use of a 2-dose Trumenba schedule and vaccination of children with HIV.

• A blue bar was added to the schedule for HPV for children aged 9–10yrs to indicate possible vaccination even in the absence of a high-risk condition. The HPV vaccine footnote was also 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, please see product monographs at www.eMPR.com, contact company for full labeling, 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. https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html.

(Rev. 2/2017)

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