Recommended Schedule of Childhood Vaccinations
Winter 2001

With several of the vaccinations below, a range of several months is given during which certain doses in the sequence may be administered. A practitioner can simplify this process by determining that, in the normal run of things, children seen in his or her clinic will routinely receive a particular dose at a specific visit. For example, that children will be vaccinated for measles, mumps, and rubella (MMR) at the 12-month visit; that children will receive the third dose of IPV at the 6-month visit; etc.

DTaP

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Diphtheria, tetanus, pertussis

Dose 1

Dose 2

Dose 3

Dose 4

Booster

Td

Hep A

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Hepatitis A

In selected areas

Hep B

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Hepatitis B Newborns with HbsAg-negative mothers

Dose 1

Dose 2

Dose 3

Infants born to HbsAg-positive mothers

Dose 1 within 12 hrs of birth

Dose 2

Dose 3

Infants born to mothers with unknown HbsAG status

Dose 1 within 12 hrs of birth

Dose 2

Dose 3

Children through age 18 years

Children not immunized as infants should receive a complete series of three immunizations by 11 to 12 years of age. Give the second and third doses at least 1 and 4 months, respectively, after the first dose.

HiB H. influenza B

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

PedvaxHIB ComVax

Dose 1

Dose 2

Dose 3

Other conjugate HiB vaccines

Dose 1

Dose 2

Dose 3

Dose 4

IPV

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Polio

Dose 1

Dose 2

Dose 3

Booster

MMR

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Measles, mumps, rubella

Dose 1

Dose 2

Pneumo- coccus

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Pneumococcal conjugate vaccine (Prevnar)

Dose 1

Dose 2

Dose 3

Dose 4

Varicella

Birth

1 m

2 m

4 m

6 m

12 m

15 m

18 m

24 m

4-6 yrs

11-12 yrs

14-16 yrs

Infants

Dose 1

Children >13 years

2 doses, 4 wks apart

DTAP (diphtheria, tetanus, acellular pertussis - Dose 4 of DTaP (diphtheria and tetanus toxoids and acellular pertussis vaccine) should be given 6 months after Dose 3; child may be as young as 12 months old. Tetanus and diphtheria toxoids (Td) are recommended at 11-12 years of age, if at least 5 years have passed since last dose of DTP, DtaP, or DT. Routine boosters recommended every 10 years. HepA (hepatitis A) - Recommendations vary by state and region; consult your local public health authority. Hep B (hepatitis B) - Vaccination recommendations for Hep B vary depending on the HbsAG status of the child's mother: Infants born to HbsAg-negative mothers: First dose: By age 2 months. Second dose: At least one month after first dose. Third dose: At least four months after the first does and at least two months after the second dose, but not before infant is 6 months old. Infants born to HbsAg-positive mothers: First dose: Within 12 hours of birth, and at separate site, 0.5mL hep B immune globulin (HBIG). Second dose: 1 month of age. Third dose: 6 months of age Infants born to mother with unknown HbsAg status: First dose: Within 12 hours of birth. Maternal blood should be drawn at time of delivery; if HbsAg test is positive, infant should receive HBIG before one week old. All children and adolescents through 18 years old who have not been immunized may begin HepB series at any visit. Immunization is especially important for children who were born, or whose parents were born, in areas of the world where hepatitis B has moderate or high endemicity. HiB (haemophilus influenza type b) - Three HiB conjugate vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB or ComVax [Merck]) is given at 2 and 4 months, a dose at 6 months is not required. With other conjugate vaccines, give Dose 3 at 6 months. DTaP/HiB combination products should not be used for primary immunization in infants at 2, 4, or 6 months of age, as a lower immune response to the HiB component can result. IPV (polio) - To reduce the risk of vaccine-associated paralytic polio (VAPP), all-IPV immunization is now recommended for routine childhood vaccination in the US. Children should be vaccinated at 2 months, 4 months, 6-18 months, and 4-6 years. Oral polio vaccine (OPV) may be used only when: 1. Mass vaccination campaigns are enacted to control outbreaks of paralytic polio. 2. Unvaccinated children will be traveling in <4 weeks to areas of endemic/epidemic polio. 3. Parents won't accept the recommended number of IPV injections. These children may receive OPV only for the third or fourth dose or both. Administer OPV only after assessing risk of VAPP for others in the child's environment. MMR (measles, mumps, and rubella) - The MMR vaccine should be given at 12-15 months. Dose 2 should be given at 4-6 years of age, but no sooner than one month after Dose 1. Children who did not receive dose 2 at 4-6 years should get it at the 11-12 year visit. Varicella - Varicella vaccine is recommended on or at any visit after the first birthday. Children 13 years old and older who don't have a reliable history of chickenpox should receive two doses, four weeks apart.