Institute for Vaccine Safety - 2009 Immunization Schedule

Recommended Immunization Schedule
Ages 0-6 Years

UNITED STATES • 2009

Age ▶ ▼ Vaccine	Birth	1 month	2 months	4 months	6 months	12 months	15 months	18 months	19-23 months	2-3 years	4-6 years
Hepatitis B	Hep B	Hep B		click for footnote	Hep B
Rotavirus			RV	RV	RV
Diphtheria, Tetanus, Pertussis			DTaP	DTaP	DTaP	click for footnote	DTaP				DTaP
Haemophilus influenzae type b			Hib	Hib	Hib	Hib
Pneumococcal			PCV	PCV	PCV	PCV				PPSV
Inactivated Poliovirus			IPV	IPV	IPV						IPV
Influenza					Influenza (yearly)
Measles, Mumps, Rubella						MMR					MMR
Varicella						Varicella					Varicella
Hepatitis A						Hep A (2 doses)				Hep A Series
Meningococcal										MCV

This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of December 1, 2007, for children aged 0 through 6 years. Additional information is available at www.cdc.gov/vaccines/recs/schedules. 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 statement for detailed recommendations, including for high risk conditions: www.cdc.gov/vaccines/pubs/ACIP-list.htm. 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 VAERS form is available at www.vaers.hhs.gov or by telephone, 800-822-7967.

2009 Schedule for ages 0-6 years | catch-up schedule
2009 Schedule for ages 7-18 years | catch-up schedule
2009 Schedule for Adults | special

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, if HBsAg-positive, administer HBIG (no later than age 1 week).

After 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 1–2 months. The final dose should be administered no earlier than age 24 weeks.
Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of at least 3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).

4-month dose:

It is permissible to administer 4 doses of HepB when combination vaccines are administered after the birth dose.

2. Rotavirus vaccine (RV). (Minimum age: 6 weeks)

Administer the first dose at age 6 -14 weeks (maximum age: 14 weeks 6 days). Vaccination should not be initiated for infants ≥ 15 weeks (i.e., 15 weeks 0 days or older).

Administer the final dose in the series by age 8 months 0 days.

If Rotarix^® is administered at ages 2 and 4 months, a dose at 6 months is not indicated.

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 4–6 years.

4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)

If PRP-OMP (PedvaxHIB® or ComVax® [HepB-Hib]) is administered at ages 2 and 4 months, a dose at age 6 months is not required.
TriHiBit® (DTaP/Hib) should not be used for doses at ages 2, 4, or 6 months but can be used as the final dose in children aged ≥ 12 months.

5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPSV])

PCV is recommended for all children aged <5 years. Administer one dose of PCV to all healthy children aged 24–59 months having any incomplete schedule.
Administer PPV to children aged ≥ 2 years with underlying medical conditions (see MMWR 2000;49[No. RR-9]), including a cochlear implant.

6. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV])

Administer annually to children aged 6 months - 18 years.
For healthy nonpregnant persons (those who do not have underlying medical conditions that predispose them to influenza complications) ages 2–49 years, either LAIV or TIV may be used.
Children receiving TIV should receive 0.25 mL if age 6-35 mos or 0.5 mL if ≥ 3 years.
Administer 2 doses (separated by 4 weeks or longer) to children younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season, but only received one dose.

7. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)

Administer the second dose of MMR at age 4–6 years. MMR may be administered before age 4–6 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 second dose at age 4–6 years; may be administered before age 4 if ≥ 3 months after first does.
For children aged 12 months - 12 years the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.

9. Hepatitis A vaccine (HepA). (Minimum age: 12 months)

HepA is recommended for all children aged 1 year (i.e., aged 12–23 months). Administer 2 doses at least 6 months apart.
Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.
HepA also is recommended for children older than 1 year who live in areas where vaccination programs target older children or who are at increased risk of infection. See MMWR 2005;54(No RR-7)..

10. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate vaccine (MCV) and for meningococcal polysaccharide vaccine (MPSV))

MCV is recommended for children aged 2–10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high-risk groups. See MMWR 2005;54(No RR-7).
Persons who received MPSV ≥ 3 years prior and remain at increased risk for meningococcal disease should be vaccinated with MCV.

Changes from 2008 Schedule

Recommendations for rotavirus vaccines include changes for the maximum age for the first dose (14 weeks 6 days) and the maximum age for any dose (8 months 0 days). The rotavirus footnote also indicates that if RV1 (Rotarix®) is administered at ages 2 and 4 months, a dose at 6 months is not indicated.
Routine annual influenza vaccination is recommended for all children aged 6 months through 18 years. Children aged younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous season but only received 1 dose should receive 2 doses of influenza vaccine at least 4 weeks apart. Healthy nonpregnant persons aged 2 through 49 years may receive either live attenuated influenza vaccine or inactivated influenza vaccine.
The minimum interval between tetanus and diphtheria toxoids (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) for persons aged 10 through 18 years is addressed. An interval less than 5 years may be used if pertussis immunity is needed.
Information about the use of Haemophilus influenzae type b (Hib) conjugate vaccine among persons aged 5 years and older at increased risk for invasive Hib disease has been added. Use of Hib vaccine for these persons is not contraindicated.
Catch-up vaccination with human papillomavirus (HPV) vaccine is clarified. Routine dosing intervals should be used for series catch-up (i.e., the second and third doses should be administered 2 and 6 months after the first dose). The third dose should be given at least 24 weeks after the first dose.
Abbreviations for rotavirus, pneumococcal polysaccharide and meningococcal polysaccharide vaccines have been changed.

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 schedules. Additional information is available from state health departments and from CDC at http://www.cdc.gov/vaccines/pubs/vis/default.htm.

Detailed recommendations for using vaccines are available from ACIP statements (available at http://www.cdc.gov/vaccines/pubs/acip-list.htm), and the 2006 Red Book. Guidance regarding the Vaccine Adverse Event Reporting System form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

This page was last updated on January 12, 2010