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Immunization Schedule, UPDATED January - December 2003
CDC Recommended Childhood & Adolescent Immunization Schedule
The  yellow bars indicate range of recommended ages for immunization. The  pink bars indicate catch-up vaccinations. The  light blue bars indicate preadolescent assessment.
Vaccines below the blue dotted line are for selected populations.
Approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).
1 Hepatitis B vaccine (Hep B). All infants should receive the first dose of hepatitis B vaccine soon after birth and before hospital discharge; the first
dose may also be given by age 2 months if the infant’s mother is HBsAg-negative. Only monovalent hepatitis B vaccine can be used for the birth
dose. Monovalent or combination vaccine containing Hep B may be used to complete the series; four doses of vaccine may be administered if
combination vaccine is used. The second dose should be given at least 4 weeks after the first dose, except for Hib-containing vaccine which cannot
be administered before age 6 weeks. The third dose should be given at least 16 weeks after the first dose and at least 8 weeks after the second
dose. The last dose in the vaccination series (third or fourth dose) should not be administered before age 6 months.
Infants born to HBsAg-positive mothers should receive hepatitis B vaccine and 0.5 mL hepatitis B immune globulin (HBIG) within 12 hours of birth at
separate sites. The second dose is recommended at age 1-2 months and the vaccination series should be completed (third or fourth dose) at age 6
months.
Infants born to mothers whose HBsAg status is unknown should receive the first dose of the hepatitis B vaccine series within 12 hours of birth.
Maternal blood should be drawn at the time of delivery to determine the mother’s HBsAg status; if the HBsAg test is positive, the infant should
receive HBIG as soon as possible (no later than age 1 week).
2 Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). 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) is recommended at age 11-12 years if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid-containing
vaccine. Subsequent routine Td boosters are recommended every 10 years.
3 Haemophilus influenzae type b (Hib) conjugate vaccine. Three Hib conjugate vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB ®
or ComVax ® [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required. DTaP/Hib combination products should not
be used for primary immunization in infants at ages 2, 4 or 6 months, but can be used as boosters following any Hib vaccine.
4 Inactivated polio vaccine (IPV). An all-IPV schedule is recommended for routine childhood polio vaccination in the United States. All children
should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years.
5 Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4-6 years but may be administered
during any visit, provided at least 4 weeks have elapsed since the first dose and that both doses are administered beginning at or after age 12
months. Those who have not previously received the second dose should complete the schedule by the 11-12 year old visit
6 Varicella vaccine. Varicella vaccine is recommended at any visit at or after age 12 months for susceptible children, i.e. those who lack a reliable
history of chickenpox. Susceptible persons aged >13 years should receive two doses, given at least 4 weeks apart.
7 Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for all children age 2-23 months. It is also
recommended for certain children age 24-59 months. Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for
certain high-risk groups. See MMWR. 2000;49(RR-9):1-35.
8 Hepatitis A vaccine. Hepatitis A vaccine is recommended for use in selected states and regions, and for certain high-risk groups; consult your
local public health authority. See MMWR. 1999;48(RR-12):1-37.
9 Influenza vaccine. Influenza vaccine is recommended annually for children age > 6 months with certain risk factors (including but not limited to
asthma, cardiac disease, sickle cell disease, HIV, diabetes; see MMWR. 2001;50(RR-4):1- 44), and can be administered to all others wishing to
obtain immunity. Children aged <12 years should receive vaccine in a dosage appropriate for their age (0.25 mL if age 6-35 months or 0.5 mL if age
>3 years). Children aged <8 years who are receiving influenza vaccine for the first time should receive two doses separated by at least 4 weeks.
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