Recommended Childhood Immunization Schedule^%

%= This schedule indicates the recommended ages for routine administration of currently licensed childhood as November 1, 2000, for children through age 18 years. 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 the vaccine's other components are not contraindicated. Providers should consult the manufacturer's package inserts for detailed recommendations. back to top
*= Infants born to hepatitis B surface antigen (HBsAg)-negative mothers should receive the first dose of Hepatitis B vaccine (Hep B) by age 2 months. The second dose should be adminstered at least 1 month after the first dose. The third dose should be administered at least 4 months after the first dose and at least 2 months after the second dose, but not before age 6 months. Infants born to HBsAg-positive mothers should receive Hep B and 0.5 ml hepatitis B immuneglobulin (HBIG) within 12 hours of birth at separate sites. The second dose is recommended at 1-2 months and the third dose at age 6 months. Infants born to mothers whose HBsAg status is unknown should receive Hep B within 12 hours of birth. Maternal blood should be drawn at  delivery to determine the mother's HBsAg status; if the HBs Ag test is positive, the infant should receive HBIG as soon as possible (no later than 1 week). All children and adolescents (through 18 years) who have not been immunized against the hepatitis B virus should the series during any visit. Providers should make special efforts to immunize children who were born in or whose parents were born in areas of the world where hepatitis B virus infection is moderately or highly endemic. back to top
**= DTaP= diphtheria toxoid, tetanus toxoid, acellular pertussis vaccine; The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at age 15-18 months. Tetanus and diphtheria toxoids (Td) vaccine is recommended at age 11-12 years if at least 5 years have elapsed since the last dose of DTP, DTaP, or Td. Subsequent routine Td boosters are recommended every 10 years. back to top
&= Hib= Haemophilus influenzae type b conjugate vaccines= Three Hib vaccines are licensed for infant use. If Hib vaccine (PRP-OMO)(Pedvax HIB or ComVax [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required. Because clinical studies in infants have demonstrated that using some combination products may induce a lower immune response to the Hib vaccine component, DTaP/Hib combination products should not be used for primary immunization in infants at ages 2, 4, and 6 months unless approved by the Food and Drug Adminstration for these ages. back to top
$= IPV= Inactivated poliovirus vaccine. An all-IPV schedule is recommended for routine childhood polio vaccination in the United States. All children should receive four doses of IPV at age 2 months, 4 months, between ages 6-18 months, and between ages 4-6 years. Oral poliovirus vaccine should be used only in selected circumstances (1). back to top
$$= PCV= the heptavalent Streptococcus pneumoniae (pneumococcal) conjugate vaccine. PCV is recommended for all children age 2-23 months. It is also recommended for certain children age 24-59 months (2). back to top
&&= MMR= measles, mumps, and rubella vaccine= MMR is recommended routinely at age 4-6 years but may be adminstered during any visit, provided at least 4 weeks have elapsed since receipt of the first dose and that both doses are administered beginning at or after age 12 months. Those who previously have not received the second dose should complete the schedule no later than the routine visit to a health-care provider at age 11-12 years. back to top
+= Varicella vaccine (Var)= Var is recommended at any visit on or after the first birthday for susceptible children, (i.e., those who lack a reliable history of chickenpox as judged by a health-care provider and who have not been immunized). back to top
++= HepA= Hepatitis A vaccine= HepA is recommended for use in selected states and/or regions, and for certain high-risk groups. Information is available from local public health authorities (3). back to top

Additional information about the immunization schedule is available on the National Immunization Program World Wide Web site, http://www.cdc.gov/nip or by telephone, (800)232-2522 (English) or (800)232-0233 (Spanish).

References
 

1. CDC. Poliomyelitis prevention in the United States: updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000;49(no. RR-5).
2. CDC. Preventing pneumococcal disease among infants and young children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000;49(no. RR-9).
3. CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(no. RR-12).

Other useful References

1. CDC. Recommended childhood immunization schedule---United States, 2000. MMWR 2000;49:35--8,47.
2. American Academy of Pediatrics. Active and passive immunization. In: Pickering LK, ed. 2000 Red book: report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, Illinois: American Academy of Pediatrics, 2000:1--81
3. Year 2000 Childhood Immunization Schedule