• The yellow bars indicate the recommended age range
for all children and contain a notation indicating the
recommended number of doses by age.
• The green bars indicate the recommended catch-up age.
• The purple bars designate the range for immunization for certain groups at high risk.
• The blue bars indicate the range of recommended doses for people in non-high-risk groups who
may receive a vaccine, subject to individual decision-making.
• The white boxes show the ages when a vaccine is
not recommended routinely.
• The columns that begin with a gray-shaded box
indicate vaccine recommendations for school entry
and at adolescent visits.
The following changes have been made to Figure 1
in the 2017 schedule:
• A column has been added for adolescents at 16
years of age. This age group has been separated
from 17- to 18-year-olds to emphasize the need for
a meningococcal conjugate vaccine (MenACWY)
booster dose at age 16.
• Reference to live attenuated influenza vaccine
(LAIV) has been removed from the influenza vaccine row.
• A blue bar has been added to the HPV vaccine row
at 9-10 years to indicate that even in the absence of
a high-risk condition, children may receive the HPV
vaccine series at this age.
Figure 2 is the catch-up immunization schedule offering recommendations for children and adolescents
who start late or are more than one month behind.
As in previous years, the catch-up schedule is divided
into sections for children 4 months through 6 years
and children and adolescents 7 through 18 years. No
changes have been made to the 2017 catch-up immunization figure.
Tables (job-aids) are available to clarify recommended use of Haemophilus influenzae type b, pneumococcal
and pertussis-containing vaccines as a function of age,
the number of doses previously administered and the
time interval since the last dose.
The new Figure 3 indicates vaccines that may be
administered during pregnancy or to children and adolescents with an immunocompromising condition;
kidney, heart or liver disease; a cochlear implant; a
cerebrospinal fluid leak; asplenia; a complement deficiency or diabetes. Figure 3 in the childhood/adolescent
schedule is similar to Figure 2 in the adult immunization schedule.
Changes to footnotes
Footnotes contain recommendations for routine vaccination, for catch-up vaccination as well as for vaccination of children and adolescents with high-risk conditions or in special circumstances. Recommendations
in the figures should be read with the corresponding
Changes have been made to the following footnotes:
• Hepatitis B. Updated recommendations reflect
that a monovalent birth dose should be administered to all newborns within 24 hours of birth.
Revised wording indicates that infants born to hepatitis B surface antigen (HBsAg) positive mothers
should be tested for HBsAg and antibody to HBsAg at 9 through 12 months (rather than 9 through
• Haemophilus influenzae type b. Comvax vaccine
has been removed because the vaccine is no longer
available commercially and all available doses have
expired. Hiberix has been added to the list of vaccines that may be used for a primary vaccination
• Pneumococcal conjugate. References to PCV7
vaccine have been removed because all children
who may have received PCV7 as part of a primary
series have now aged out of the recommendation
for pneumococcal vaccine.
• Influenza. Wording has been added to indicate
that LAIV is not recommended for the 2016-’ 17
• Meningococcal ACWY. Recommendations now
include vaccination of children with HIV infection.
• Meningococcal B. Wording has been added to
note that people 16 through 23 years may be
vaccinated based on clinical discretion. Updated
recommendations regarding a two-dose Trumenba
schedule have been added.
• Tdap. Revised wording indicates a preference for
administration of one dose to pregnant women as
early as possible during the 27 to 36 week gesta-tional-age period. Wording is changed to indicate
that for children 7 through 10 years who receive
Tdap as part of a catch-up series, either Tdap or
Td may be administered for the adolescent dose at
11 through 12 years.
• Human papillomavirus. Wording reflects that
the number of recommended doses is based on
age at administration of the first dose. Two doses are recommended for people starting the series
before their 15th birthday, while three doses are
recommended for those who start the series on or
after their 15th birthday and for people with certain immunocompromising conditions. 2vHPV
(Cervarix) has been removed from the schedule
because it is no longer available and all available
doses expired on Jan. 1.
In addition to publication of the schedules in the
March issue of Pediatrics, the 2017 version of Figures 1-3,
catch-up schedule, footnotes and job-aids are available
on pages 26-29 and on the AAP website at https://www.
aspx, and the CDC website at https://www.cdc.gov/
combined-schedule.pdf. The schedules also are available on HealthyChildren.org at https://www.healthy
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 can be obtained
at www.vaers.hhs.gov or by calling 800-822-7967.
Additional information can be found in the AAP Red
Book and at Red Book Online, http://aapredbook.aap
Dr. Meissner is professor of pediatrics
at Floating Hospital for Children, Tufts
Medical Center. He is also an ex officio
member of the AAP Committee on Infectious Diseases and associate editor of the
AAP Visual Red Book.
Immunization schedules continued from front page
• Statements from ACIP that contain details of recommendations for individual vaccines, including recommendations for children with high-risk conditions, are
available at https://www.cdc.gov/vaccines/hcp/acip-recs/ index.html.
• Information on new vaccine releases, vaccine supplies
and interim recommendations resulting from vaccine
shortages and statements on specific vaccines can be
found at www.cdc.gov/vaccines/pubs/ACIP-list.htm.
• A parent-friendly vaccine schedule for children and adolescents is available at http://www.cdc.gov/vaccines/
• An adult immunization schedule is published in February of each year and is available at www.cdc.gov/