VACCINE ; INDICATION ; Pregnancy
status (excluding HIV
Kidney failure, end-
stage renal disease, on
chronic lung disease
Asplenia and persistent
Diphtheria, tetanus, & acellular pertussis
Haemophilus influenzae type b
Measles, mumps, rubella
Meningococcal ACW Y1 1
Tetanus, diphtheria, & acellular pertussis1 2
Meningococcal B1 1
Figure 3. Vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications
*Severe Combined Immunodeficiency
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. See footnotes.
No recommendation Contraindicated Precaution for vaccination
Footnotes — Recommended Immunization Schedule for
Children and Adolescents Aged 18 Years or Younger,
UNI TED STATES, 2017
For further guidance on the use of the vaccines mentioned
below, see www.cdc.gov/vaccines/hcp/acip-recs/index.html.
For vaccine recommendations for persons 19 years of age and
older, see the Adult Immunization Schedule.
• For contraindications and precautions to use of a vaccine and
for additional information regarding that vaccine, vaccination
providers should consult the ACIP General Recommendations on
Immunization and the relevant ACIP statement, available online
• For purposes of calculating intervals between doses, 4 weeks
= 28 days. Intervals of 4 months or greater are determined by
• Vaccine doses administered ≤ 4 days before the minimum interval are considered valid. Doses of any vaccine administered ≥ 5
days earlier than the minimum interval or minimum age should
not be counted as valid doses 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 1, “Recommended and minimum ages and intervals
between vaccine doses,” in MMWR, General Recommendations
on Immunization and Reports / Vol. 60 / No. 2, available online at
• Information on travel vaccine requirements and recommendations is available at wwwnc.cdc.gov/travel/.
• For vaccination of persons with primary and secondary immunodeficiencies, see Table 13, “Vaccination of persons with primary
and secondary immunodeficiencies,” in General Recommendations on Immunization (ACIP), available at www.cdc.gov/mmwr/
pdf/rr/rr6002.pdf; and “Immunization in Special Clinical Circumstances,” (American Academy of Pedatrics) in Kimberlin DW,
Brady MT, Jackson MA, Long SS, eds. Red Book: 2015 Report of
the Committee on Infectious Diseases. 30th ed. Elk Grove Village,
IL: American Academy of Pediatrics, 2015:68-107.
• The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine
injury petitions. Created by the National Childhood Vaccine Injury
Act of 1986, it provides compensation to people found to be injured by certain vaccines. All vaccines within the recommended
childhood immunization schedule are covered by VICP except for
pneumococcal polysaccharide vaccine (PPSV). For more information; see www.hrsa.gov/vaccinecompensation/index.html.
1. Hepatitis B (HepB) vaccine. (Minimum age: birth)
• Administer monovalent HepB vaccine to all newborns within 24
hours of birth.
• For infants born to hepatitis B surface antigen (HBsAg)-positive
mothers, administer HepB vaccine and 0.5 mL of hepatitis B immune
globulin (HBIG) within 12 hours of birth. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9 through 12
months (preferably at the next well-child visit) or 1 to 2 months after
completion of the HepB series if the series was delayed.
• If mother’s HBsAg status is unknown, within 12 hours of birth,
administer HepB vaccine regardless of birth weight. For infants
weighing less than 2,000 grams, administer HBIG in addition
to HepB vaccine within 12 hours of birth. Determine mother’s
HBsAg status as soon as possible and, if mother is HBsAg-pos-itive, also administer HBIG to infants weighing 2,000 grams or
more as soon as possible, but no later than age 7 days.
Doses following the birth dose:
• The second dose should be administered at age 1 or 2 months.
Monovalent HepB vaccine should be used for doses administered
before age 6 weeks.
• Infants who did not receive a birth dose should receive 3 doses
of a HepB-containing vaccine on a schedule of 0, 1 to 2 months,
and 6 months, starting as soon as feasible (see figure 2).
• Administer the second dose 1 to 2 months after the first dose
(minimum interval of 4 weeks); administer the third dose at least
8 weeks after the second dose AND at least 16 weeks after the
first dose. The final (third or fourth) dose in the HepB vaccine
series should be administered no earlier than age 24 weeks.
• Administration of a total of 4 doses of HepB vaccine is permitted
when a combination vaccine containing HepB is administered after
the birth dose.
• Unvaccinated persons should complete a 3-dose series.
• A 2-dose series (doses separated by at least 4 months) of adult
formulation Recombivax HB is licensed for use in children aged
11 through 15 years.
• For other catch-up guidance, see Figure 2.
2. Rotavirus (RV) vaccines. (Minimum age: 6 weeks for both
RV1 [Rotarix] and RV5 [Rota Teq])
• Administer a series of RV vaccine to all infants as follows:
• If Rotarix is used, administer a 2-dose series at ages 2 and 4
• If Rota Teq is used, administer a 3-dose series at ages 2, 4, and
• If any dose in the series was Rota Teq or vaccine product is unknown for any dose in the series, a total of 3 doses of RV vaccine
should be administered.
• The maximum age for the first dose in the series is 14 weeks,
6 days; vaccination should not be initiated for infants aged 15
weeks, 0 days, or older.
• The maximum age for the final dose in the series is 8 months, 0 days.
• For other catch-up guidance, see Figure 2.
3. Diphtheria and tetanus toxoids and acellular pertussis
(DTaP) vaccine. (Minimum age: 6 weeks. Exception:
DTaP- IPV [Kinrix, Quadracel]: 4 years)
• Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15
through 18 months, and 4 through 6 years. The fourth dose may
be administered as early as age 12 months, provided at least 6
months have elapsed since the third dose.
NOTE: The above recommendations must be read along with the footnotes of this schedule (see below).