| Catch-up Immunization Schedule for Ages 4 mo–18 yr |
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Vaccine
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Minimum Age for Dose 1
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Minimum Interval Between
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Doses 1 and 2
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Doses 2 and 3
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Doses 3 and 4
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Doses 4 and 5
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For ages 4 mo–6 yr
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Hepatitis B (HepB)a
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Birth
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4 wk
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8 wk (and at least 16 wk after the first dose)
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—
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—
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Rotavirus (RV)b
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6 wk
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4 wk
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4 wkb
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—
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—
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Diphtheria, tetanus, pertussis (DTaP)c
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6 wk
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4 wk
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4 wk
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6 mo
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6 moc
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Haemophilus influenzae type b (Hib)d
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6 wk
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4 wk if the first dose is administered at age < 12 mo
8 wk (as the final dose) if the first dose is administered at age 12–14 mo
No further doses needed if the first dose is administered at age ≥15 mo
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4 wkd if current age is < 12 mo
8 wk (as the final dose)d if current age is ≥ 12 mo and the first dose is administered at age < 12 mo and the 2nd dose is administered at age < 15 mo
No further doses needed if the previous dose is administered at age ≥ 15 mo
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8 wk (as the final dose)
Only necessary for children aged 12–59 mo who received 3 doses before age 12 mo
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—
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Pneumococcal vaccinee
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6 wk
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4 wk if the first dose is administered at age < 12 mo
8 wk (as the final dose for healthy children) if the first dose is administered at age ≥ 12 mo or current age is 24–59 mo
No further doses needed for healthy children if the first dose is administered at age ≥ 24 mo
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4 wk if current age is < 12 mo
8 wk (as the final dose for healthy children) if current age is ≥ 12 mo
No further doses needed for healthy children if previous dose is administered at age ≥ 24 mo
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8 wk (as the final dose)
Only necessary for children aged 12–59 mo who received 3 doses before age 12 mo or for high-risk children who received 3 doses at any age
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Inactivated polio virus (IPV)f
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6 wk
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4 wk
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4 wk
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6 mo
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—
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Measles, mumps, rubella (MMR)g
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12 mo
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4 wk
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—
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—
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—
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Varicellah
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12 mo
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3 mo
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—
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—
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—
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Hepatitis A (HepA)i
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12 mo
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6 mo
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—
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—
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—
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For ages 7–18 yr
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Tetanus, diphtheria (Td)
Tetanus, diphtheria, pertussis (Tdap)j
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7 yrj
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4 wk
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4 wk if the first dose is administered at age < 12 mo
6 mo if the first dose is administered at age ≥ 12 mo
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6 mo if the first dose is administered at age < 12 mo
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—
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Human papillomavirus (HPV)k
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9 yr
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Routine dosing intervals recommendedk
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Hepatitis A (HepA)i
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12 mo
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6 mo
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—
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—
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—
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Hepatitis B (HepB)a
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Birth
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4 wk
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8 wk (and at least 16 wk after first dose)
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—
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—
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Inactivated polio virus (IPV)f
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6 wk
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4 wk
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4 wk
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6 mo
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—
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Measles, mumps, rubella (MMR)g
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12 mo
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4 wk
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—
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—
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—
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Varicellah
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12 mo
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3 mo if age is < 13 yr
4 wk if age is ≥ 13 yr
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—
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—
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—
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Note: For children whose vaccinations were started late or are > 1 mo behind, the table provides catch-up schedules and minimum intervals between doses. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child's age. Information about reporting reactions after immunization is available online at
vaers.hhs.gov/index
or by telephone, 800-822-7967. Suspected cases of vaccine-preventable diseases should be reported.
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a Hepatitis B vaccine (HepB).
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b Rotavirus vaccine (RV).
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The maximum age for the first dose is 14 wk 6 days. Vaccination should not be initiated for infants aged ≥ 15 wk 0 days.
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The maximum age for the final dose in the series is 8 mo 0 days.
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If Rotarix® was administered for the first and 2nd doses, a 3rd dose is not indicated.
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c Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP).
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d
Haemophilus influenzae
type b conjugate vaccine (Hib).
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Hib vaccine is not generally recommended for people aged ≥ 5 yr. There are no efficacy data to support a recommendation for use of Hib vaccine in older children and adults. However, studies suggest good immunogenicity in patients who have sickle cell disease, leukemia, or HIV infection or who have had a splenectomy; administering 1 dose of Hib vaccine to these patients if they have not previously received Hib vaccine is not contraindicated.
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If the first 2 doses were PRP-OMP (PedvaxHIB® or ComVax® [HepB-Hib) and administered at age ≤ 11 mo, the 3rd (and final) dose should be administered at age 12–15 mo and at least 8 wk after the 2nd dose.
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If the first dose was administered at age 7–11 mo, administer the 2nd dose at least 4 wk later and a final dose at age 12–15 mo.
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e Pneumococcal vaccine.
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Administer 1 dose of pneumococcal conjugate vaccine (PCV) to all healthy children aged 24–59 mo if they have not received at least 1 dose of PCV on or after age 12 mo.
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For children aged 24–59 mo with medical conditions, administer 1 dose of PCV if 3 doses were received previously, or administer 2 doses of PCV at least 8 wk apart if < 3 doses were received previously.
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Administer pneumococcal polysaccharide vaccine (PPSV) to children aged ≥ 2 yr with certain medical conditions, including a cochlear implant, at least 8 wk after the last dose of PCV (see Morbidity and Mortality Weekly Review 46 [RR-8], 1997).
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f Inactivated poliovirus vaccine (IPV).
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The final dose in the series should be administered on or after the 4th birthday and at least 6 mo after the previous dose.
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A 4th dose is not necessary if the 3rd dose was administered at age ≥ 4 yr and at least 6 mo after the previous dose.
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In the first 6 mo of life, minimum age and minimum intervals are recommended only if the infant is at risk of imminent exposure to circulating poliovirus (eg, traveling to a polio-endemic region, during an outbreak).
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g Measles, mumps, and rubella vaccine (MMR).
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Administer the 2nd dose routinely at age 4–6 yr. However, the 2nd dose may be administered before age 4, provided at least 28 days have elapsed since the first dose.
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For children not previously vaccinated, administer 2 doses with at least 28 days between doses.
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h Varicella vaccine.
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Administer the 2nd dose routinely at age 4–6 yr. However, the 2nd dose may be administered before age 4, provided at least 3 mo have elapsed since the first dose.
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For ages 12 mo–12 yr, the minimum interval between doses is 3 mo. However, if the 2nd dose was administered at least 28 days after the first dose, it can be accepted as valid.
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For ages ≥ 13 yr, the minimum interval between doses is 28 days.
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i Hepatitis A vaccine (HepA).
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HepA is recommended for children aged > 23 mo if they live in areas where vaccination programs target older children, if they are at increased risk of infection, or if immunity against hepatitis A is desired for them.
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j Tetanus and diphtheria toxoids vaccine (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap).
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k Human papillomavirus vaccine (HPV).
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Administer the series to females at age 13–18 yr if not previously vaccinated.
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Use recommended routine dosing intervals for series catch-up (ie, the 2nd and 3rd doses should be administered at 1–2 mo and 6 mo after the first dose). The minimum interval between the first and 2nd doses is 4 wk. The minimum interval between the 2nd and 3rd doses is 12 wk, and the 3rd dose should be administered at least 24 wk after the first dose.
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). Many health care practitioners currently in practice have seen few or no cases of diseases that were once extremely common and fatal. 
