• American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents--United States, 2007. Pediatrics 2007 Jan;119(1):207-8, 3 p following 208. [2 references] PubMed



• Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years - United States, 2007. MMWR Recomm Rep 2007 Jan 5;55(51-52):Q1-4. [6 references]

• June 15, 2007, RotaTeq (Rotavirus, Live, Oral, Pentavalent Vaccine): Changes to the ADVERSE REACTIONS and POST-MARKETING sections of the product's prescribing information. The ADVERSE REACTIONS section was updated to include six cases of Kawasaki disease that were observed during the Phase 3 clinical trial.

The National Childhood Vaccine Injury Act requires that health-care providers provide parents or patients with copies of Vaccine Information Statements before administering each dose of the vaccines listed in the schedule. Additional information is available from state health departments and from the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/vaccines/pubs/default.htm.

Detailed recommendations for using vaccines are available from package inserts, ACIP statements on specific vaccines, and the 2003 Red Book. ACIP statements for each recommended childhood vaccine are available from CDC at http://www.cdc.gov/vaccines/recs/acip/default.htm. In addition, guidance for obtaining and completing a Vaccine Adverse Event Reporting System form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

Recommended Immunization Schedule for Ages 0 to 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 to 6 years. Additional information is available at http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm#printable. 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 (ACIP) 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 http://www.vaers.hhs.gov or by telephone, 800-822-7967.

*Note: The CDC has updated its recommendations regarding vaccination against meningococcal disease. See the CDC Web site for details.

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

   At birth:

   • Administer monovalent HepB to all newborns prior to hospital discharge.
   • If mother is hepatitis B 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 mothers' negative HBsAg laboratory report documented in the infant's medical record.

   Following 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 to 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 in a licensed HepB series, at age 9 to 18 months (generally at the next well-child visit).

   4-month dose of HepB:

   • It is permissible to administer 4 doses of HepB when combination vaccines are given after the birth dose. If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.

2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)
   • Administer the first dose between 6 and 12 weeks of age. Do not start the series later than age 12 weeks.
   • Administer the final dose in the series by 32 weeks of age. Do not administer a dose later than age 32 weeks.
   • There are insufficient data on safety and efficacy outside of these age ranges.

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 to 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 >12 months olds.

5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPV])
   • Administer PCV at ages 24 to 59 months in certain high-risk groups. Administer PPV to children aged >2 years in certain high-risk groups. See MMWR 2000; 49(RR-9):1-35.*

   *Note: Updated recommendations for the use of PCV7 in children aged 24 to 59 months have been released. Please see the CDC Web site for details.

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 to 59 months and close contacts of all children aged 0 to 59 months are recommended to receive influenza vaccine.
   • Influenza vaccine is recommended annually for children aged >59 months with certain risk factors, healthcare workers, and other persons (including household members) in close contact with persons in groups at high risk. See MMWR 2006; 55(RR-10);1-41.
   • For healthy persons aged 5 to 49 years, LAIV may be used as an alternative to TIV.
   • Children receiving TIV should receive 0.25 mL if aged 6 to 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 to 6 years. MMR may be administered before age 4 to 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 to 6 years. Varicella vaccine may be administered prior to age 4 to 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 at 1 year of age (i.e., 12 to 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(RR-7):1-23.

10. Meningococcal polysaccharide vaccine (MPSV4). (Minimum age: 2 years)
    • Administer MPSV4 to children aged 2 to 10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high risk groups. See MMWR 2005;54 (RR-7):1-21.

    Note: The CDC has updated its recommendations regarding vaccination against meningococcal disease. See the CDC Web site for details.

Recommended immunization schedule for persons aged 7 to 18 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 7 to 18 years. Additional information is available at http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm#printable. 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 ACIP 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 http://www.vaers.hhs.gov or by telephone, 800-822-7967.

*Note: The CDC has updated its recommendations regarding vaccination against meningococcal disease. See the CDC Web site for details.

1. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). (Minimum age: 10 years for BOOSTRIX^® and 11 years for ADACEL™)
   • Administer at age 11 to 12 years for those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a Td booster dose.
   • Adolescents 13 to 18 years who missed the 11 to 12 year Td/Tdap booster dose should also receive a single dose of Tdap if they have completed the recommended childhood DTP/DTaP vaccination series.

2. Human papillomavirus vaccine (HPV). (Minimum age: 9 years)
   • Administer the first dose of the HPV vaccine series to females at age 11 to 12 years.
   • Administer the second dose 2 months after the first dose and the third dose 6 months after the first dose.
   • Administer the HPV vaccine series to females at age 13 to 18 years if not previously vaccinated.

3. Meningococcal vaccine. (Minimum age: 11 years for meningococcal conjugate vaccine [MCV4]; 2 years for meningococcal polysaccharide vaccine [MPSV4])
   • Administer MCV4 at age 11 to 12-years and to previously unvaccinated adolescents at high school entry (approximately 15 years of age).
   • Administer MCV4 to previously unvaccinated college freshmen living in dormitories; MPSV4 is an acceptable alternative.
   • Vaccination against invasive meningococcal disease is recommended for children and adolescents aged >2 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high risk groups. See MMWR 2005;54 (RR-7):1-21. Use MPSV4 for children aged 2 to 10 years and MCV4 or MPSV4 for older children.

   Note: The CDC has updated its recommendations regarding vaccination against meningococcal disease. See the CDC Web site for details.

4. Pneumococcal polysaccharide vaccine (PPV). (Minimum age: 2 years)
   • Administer for certain high-risk groups. See MMWR 1997;46(RR-08); 1-24 and MMWR 2000;49(RR-9):1-35.

5. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 5 years for live, attenuated influenza vaccine [LAIV])
   • Influenza vaccine is recommended annually for persons with certain risk factors, healthcare workers, and other persons (including household members) in close contact with persons in groups at high risk. See MMWR 2006; 55(RR-10);1-41.
   • For healthy persons aged 5 to 49 years, LAIV may be used as an alternative to TIV.
   • 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).

6. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
   • The 2 doses in the series should be administered at least 6 months apart.
   • HepA is recommended for certain other groups of children including in areas where vaccination programs target older children. See MMWR 2006;55(RR-7):1-23.

7. Hepatitis B vaccine (HepB). (Minimum age: birth)
   • Administer the 3-dose series to those who were not previously vaccinated.
   • A 2-dose series of Recombivax HB® is licensed for 11 to 15 year olds.

8. Inactivated poliovirus vaccine (IPV). (Minimum age: 6 weeks)
   • For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not necessary if third dose was administered at age >4 years.
   • If both OPV and IPV were administered as part of a series, a total of 4 doses should be given, regardless of the child's current age.

9. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
   • If not previously vaccinated, administer 2 doses of MMR during any visit with >4 weeks between the doses.

10. Varicella vaccine. (Minimum age: 12 months)
    • Administer 2 doses of varicella vaccine to persons without evidence of immunity.
    • Administer 2 doses of varicella vaccine to persons aged <13 years at least 3 months apart. Do not repeat the second dose, if administered >28 days following the first dose.
    • Administer 2 doses of varicella vaccine to persons aged >13 years at least 4 weeks apart.

Catch-up Immunization Schedule for Persons Aged 4 Months to 18 Years Who Start Late or Who Are >1 Month Behind—United States, 2007

The tables below give 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 table appropriate for the child's age.

1. Hepatitis B vaccine (HepB). (Minimum age: birth)
   • Administer the 3-dose series to those who were not previously vaccinated.
   • A 2-dose series of Recombivax HB® is licensed for 11 to 15 year olds.

2. Rotavirus vaccine (Rota). (Minimum age: 6 weeks)
   • Do not start the series later than age 12 weeks.
   • Administer the final dose in the series by 32 weeks of age. 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 fifth dose is not necessary if the fourth dose was administered at age >4 years.
   • DTaP is not indicated for persons aged >7 years.

4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)
   • Vaccine is not generally recommended for children aged >5 years.
   • If current age <12 months and the first 2 doses were PRP-OMP (PedvaxHIB® or ComVax® [Merck]), the third (and final) dose should be administered at age 12 to 15 months and at least 8 weeks after the second dose.
   • If first dose given at age 7 to 11 months, give 2 doses separated by 4 weeks plus a booster at age 12 to 15 months.

5. Pneumococcal conjugate vaccine (PCV). (Minimum age: 6 weeks)
   • Vaccine is not generally recommended for children aged >5 years.

6. Inactivated poliovirus vaccine (IPV). (Minimum age: 6 weeks)
   • For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not necessary if third dose was administered at age >4 years.
   • If both OPV and IPV were administered as part of a series, a total of 4 doses should be given, regardless of the child's current age.

7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
   • The second dose of MMR is recommended routinely at age 4 to 6 years but may be administered earlier if desired.
   • If not previously vaccinated, administer 2 doses of MMR during any visit with >4 weeks between the doses.

8. Varicella vaccine. (Minimum age: 12 months)
   • The second dose of varicella vaccine is recommended routinely at age 4 to 6 years but may be administered earlier if desired.
   • Do not repeat the second dose in persons aged <13 years, if administered >28 days following the first dose.

9. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
   • HepA is recommended for certain groups of children including in areas where vaccination programs target older children. See MMWR 2006;55(RR-7):1-23.

10. Tetanus and diphtheria toxoids vaccine (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). (Minimum ages: 7 years for Td, 10 years for BOOSTRIX®, and 11 years for ADACEL™)
    • Tdap should be substituted for a single dose of Td in the primary catch-up series or as a booster if age-appropriate; use Td for other doses.
    • A five-year interval from the last Td dose is encouraged when Tdap is used as a booster dose. A booster (4th) dose is needed if any of the previous doses were administered at age <12 months. Refer to ACIP recommendations for further information. See MMWR 2006;55(RR-3).

11. Human papillomavirus vaccine (HPV). (Minimum age: 9 years)
    • Administer the HPV vaccine series to females at age 13 to 18 years if not previously vaccinated.

• American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents--United States, 2007. Pediatrics 2007 Jan;119(1):207-8, 3 p following 208. [2 references] PubMed



• Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years - United States, 2007. MMWR Recomm Rep 2007 Jan 5;55(51-52):Q1-4. [6 references]

Electronic copies: Available from the Centers for Disease Control and Prevention (CDC) Web site and the American Academy of Pediatrics (AAP) Policy Web site.

Print copies: Available from the Centers for Disease Control and Prevention, MMWR, Atlanta, GA 30333. Additional copies can be purchased from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402-9325; (202) 783-3238.

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