Administer monovalent HepB to all newborns before hospital discharge.

If the mother is hepatitis B surface antigen (HBsAg)–positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 h of birth. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9–18 mo (preferably at the next well-child visit) or 1–2 mo after completion of the HepB series. The Centers for Disease Control and Prevention (CDC) recently recommended that testing occur at age 9–12 mo (Update: Shortened Interval for Postvaccination Serologic Testing of Infants Born to Hepatitis B-Infected Mothers).

If the mother’s HBsAg status is unknown, administer HepB vaccine to all infants within 12 h of birth, regardless of birth weight. If infants weigh < 2000 g, administer HBIG in addition to HepB vaccine within 12 h of birth. Determine the mother’s HBsAg status as soon as possible, and if she is HBsAg-positive, administer HBIG to infants weighing ≥ 2000 g (no later than age 7 days).

If RV-1 (Rotarix®) is used, administer 2 doses: at ages 2 mo and 4 mo.

If RV-5 (RotaTeq®) is used, administer 3 doses: at ages 2 mo, 4 mo, and 6 mo.

If any dose in a series was RV-5 (RotaTeq®) or is unknown, 3 doses should be administered.

The maximum age is 14 wk, 6 days for the first dose in the series and is 8 mo, 0 days for the final dose in the series. Vaccination should not be initiated for infants aged 15 wk, 0 days or older.

If RV-1 (Rotarix®) is administered for the first and 2nd doses, a 3rd dose is not indicated.

Administer a 2- or 3-dose Hib vaccine primary series with a booster dose (dose 3 or 4 depending on the vaccine used in the primary series) at age 12–15 mo to complete the full Hib series. The primary series consists of 3 doses given at ages 2, 4, and 6 mo for PRP-T and consists of 2 doses given at ages 2 and 4 mo for PRP-OMP.

If PRP-OMP (PedvaxHIB® or ComVax® [HepB-Hib]) is administered at ages 2 and 4 mo, a dose at age 6 mo is not indicated.

One booster dose (dose 3 or 4 depending on the vaccine used in the primary series) should be given at age 12–15 mo. An exception is Hiberix®, which should only be used for the booster (final) dose in children aged 12 mo–4 yr who have received at least 1 dose of Hib.

Hib vaccine is not routinely given to patients > 5 yr. However, 1 dose should be administered to unimmunized patients aged ≥ 5 yr if they have anatomic or functional asplenia (including sickle cell disease) and to unvaccinated patients aged 5–18 yr with HIV infection. Patients are considered unimmunized if they have not been given a primary series and booster dose or at least 1 dose of Hib vaccine after age 14 mo.

Administer only 1 dose to unvaccinated children aged ≥ 15 mo. For other catch-up recommendations, see Table: Catch-up Immunization Schedule for Ages 4 mo–18 yr.

If children aged 12–59 mo are at increased risk for Hib infection (including chemotherapy recipients and those with anatomic or functional asplenia [eg, with sickle cell disease], HIV infection, immunoglobulin deficiency, or early component complement deficiency) and have received no doses or only 1 dose of Hib vaccine before age 12 mo, they should be given 2 additional doses of Hib vaccine 8 wk apart. Children who were given ≥ 2 doses of Hib vaccine before age 12 mo should be given 1 additional dose.

If patients < 5 yr who are having chemotherapy or radiation therapy were given ≥ 1 Hib vaccine doses within 14 days of starting therapy or during therapy, the doses should be repeated at least 3 mo after therapy is completed.

Recipients of a hematopoietic stem cell transplant should be revaccinated with a 3-dose regimen of Hib vaccine starting 6–12 mo after successful transplantation, regardless of vaccination history; doses should be given at least 4 wk apart.

A single dose of any vaccine that contains Hib should be given to unimmunized children and adolescents aged ≥15 mo if they are having elective splenectomy; if possible, the vaccine should be given at least 14 days before the procedure.

Administer a 4-dose IPV series at ages 2, 4, 6–18 mo, and 4–6 yr. The final dose in the series should be administered on or after the 4th birthday and at least 6 mo after the previous dose.

During 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).

If ≥ 4 doses are administered before age 4 yr, an additional dose should be administered at age 4–6 yr and at least 6 mo after the previous dose.

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.

If both oral polio vaccine (OPV) and IPV were administered as part of a series, a total of 4 doses should be administered regardless of the child's current age. If only OPC was administered and all the doses were given before age 4 yr, one dose of IPV should be given at age ≥ 4 yr and at least 4 wk after the last OPV dose.

For most healthy children aged ≥ 2 yr, either LAIV or IIV may be used. However, LAIV should not be administered to some children, including children with asthma, children aged 2–4 yr who have had wheezing in the past 12 mo, and children who have any other medical conditions that predispose them to influenza complications. For all other contraindications to use of LAIV, see MMWR 62 (RR-7)1–43, 2013, available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm.

For children aged 6 mo–8 yr:

^■ For the 2015–16 season, administer 2 doses (separated by at least 4 wk) to children who are receiving the influenza vaccine for the first time. Some children who have been previously vaccinated also need 2 doses. For additional guidance, see the dosing guidelines in the 2015–16 ACIP recommendations for influenza vaccine in MMWR 64 (30):818–25, 2015, available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm.

^■ For more information, see the ACIP recommendations for influenza vaccine (available at http://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html).

The 2nd dose may be administered before age 4, provided at least 3 mo have elapsed since the first dose. If the 2nd dose was administered at least 4 wk after the first dose, it can be accepted as valid.

For children aged 2–18 mo who have persistent complement component deficiency (including patients with inherited or chronic deficiencies in C3, C5–9, properdin, factor D, or factor H and those taking eculizumab) or anatomic or functional asplenia (including sickle cell anemia), administer a 4-dose infant series of Hib-MenCY at age 2, 4, 6, and 12–15 mo or MenACWY-CRM at age 2, 4, 6, and 12 mo.

For children aged 7–23 mo who have persistent complement component deficiency and who have not initiated vaccination, there are two options. MenACWY-CRM may be given at age 7–23 mo in a 2-doses series, with the 2nd dose given after age 12 mo and at least 12 wk after the first dose. Or MenACWY-D may be given at age 9–23 mo given in a 2-dose series, with the doses given at least 12 wk apart.

For children aged 19–23 mo who have anatomic or functional asplenia and who have not been completely vaccinated with Hib-MenCY or MenACWY-CRM, administer 2 primary doses of Men-ACWY-CRM at least 12 wk apart.

For children aged ≥ 24 mo who have persistent complement component deficiency or anatomic or functional asplenia and who have not been completely vaccinated, administer 2 primary doses of either MenACWY-D or MenACWY-CRM vaccine at least 8 wk apart.

If MenACWY-D is used in children with anatomic or functional asplenia, administer at a minimum age of 2 yr and at least 4 wk after completion of all PCV13 doses.

If children with a high-risk condition live in or are traveling to countries where meningococcal disease is hyperendemic or epidemic (eg, the African meningitis belt, the Hajj), administer at age-appropriate formulation and series of MenACWY-D or MenACWY-CRM for protection against serogroups A and W. Prior vaccination with Hib-MenCY is not sufficient for children traveling to these areas (see MMWR 62 (RR2):1‒22, 2013; available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm).

If children with a high-risk condition are present during outbreaks caused by a vaccine serogroup, administer or complete an age- and formula-appropriate series of Hib-MenCY, MenACWY-D, MenACWY-CRM, MenB-4C, or MenB-FHbp.

If children with a high-risk condition receive the first dose of Hib-MenCY at or after age 12 mo, administer a total of 2 doses at least 8 wk apart to ensure protection against serogroups C and Y meningococcal disease.

If children with a high-risk condition receive the first dose of MenACWY-CRM at age 7–9 mo, administer a 2-dose series, with the 2nd dose given after age 12 mo and at least 3 mo after the first dose.

If patients ≥ 10 yr have persistent complement component deficiency or anatomic or functional asplenia and have not received a complete meningococcal vaccine series, they may be given 2 doses of Men B-4C at least 1 mo apart or 3 doses of Men B-FHbp, with the 2nd dose at least 2 mo after the first and the 3rd dose at least 6 mo after the first. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses.

For further guidance, including revaccination guidelines, see MMWR 62 (RR2):1–22, 2013 (available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm), MMWR 64 (41):1171–76, 2015 (available at http://www.cdc.gov/mmwr/pdf/wk/mm6441.pdf) and Meningococcal ACIP Vaccine Recommendations (available at http://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/mening.html).

Hib vaccine is not routinely given to patients > 5 yr. However, 1 dose should be administered to unimmunized patients aged ≥ 5 yr if they have anatomic or functional asplenia (including sickle cell disease) and to unvaccinated patients aged 5–18 yr with HIV infection. Patients are considered unimmunized if they have not received a primary series and booster dose or at least 1 dose of Hib vaccine after age 14 mo.

A single dose of any vaccine that contains Hib should be given to unimmunized children and adolescents aged ≥15 mo if they are having an elective splenectomy; if possible, the vaccine should be given at least 14 days before procedure.

The final dose in the series should be administered at least 6 mo after the previous dose.

If both oral poliovirus (OPV) and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child’s current age. If only OPC was administered and all the doses were given before age 4 yr, one dose of IPV should be given at age ≥ 4 yr and at least 4 wk after the last OPV dose.

IPV is not routinely recommended for US residents aged ≥ 18 yr.

The minimum interval between 2 doses of MMR vaccine is 4 wk.

Make sure all school-aged children and adolescents have had 2 doses of MMR vaccine.

A 2-dose HepA vaccine series is recommended for previously unvaccinated children 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.

Administer 2 doses at least 6 mo apart to unvaccinated people.

People aged 11–18 yr who have not received Tdap vaccine should receive a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10 yr thereafter.

Children aged 7–10 yr who are not fully immunized with the childhood DTaP vaccine series should be given Tdap vaccine as the first dose of Td in the catch-up series. If additional doses are needed, Td vaccine is used. These children should not be given adolescent Tdap vaccine.

An inadvertent dose of DTaP vaccine administered to children aged 7–10 yr can count as part of the catch-up series. This dose can count as the adolescent Tdap dose, or the child can later receive a Tdap booster dose at age 11–12 yr.

An inadvertent dose of DTaP vaccine administered to adolescents aged 11–18 yr should be counted as the adolescent Tdap dose.

Tdap vaccine can be administered regardless of the interval since the last tetanus and diphtheria toxoid–containing vaccine.

The maximum age is 14 wk 6 days for the first dose in the series and 8 mo 0 days for the final dose in the series. Vaccination should not be initiated for infants aged ≥ 15 wk 0 days.

If RV-1 was administered for the first and 2nd doses, a 3rd dose is not indicated.

One dose of Hib vaccine should be administered to unvaccinated or partially vaccinated children aged ≥ 5 yr who have sickle cell disease, leukemia, HIV infection, anatomic or functional asplenia, or another immunocompromising condition.

If the first 2 doses were PRP-OMP (PedvaxHIB® or ComVax® [HepB-Hib]) and were 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.

If the first dose was administered at age 12–14 mo, administer the 2nd dose at least 8 wk after the first dose.

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 regardless of the Hib vaccine used for the first dose.

Administer only 1 dose to unvaccinated children aged ≥ 15 mo.

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.

A ≥ 4 doses are administered before age 4 yr, an additional dose should be administered at age 4–6 yr.

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).

IPV is not routinely recommended for US residents age ≥ 18 yr.

If both oral polio vaccine (OPV) and IPV were administered as part of a series, a total of 4 doses should be administered regardless of the child's current age. If only OPC was administered and all the doses were given before age 4 yr, one dose of IPV should be given at age ≥ 4 yr and at least 4 wk after the last OPV dose.

Administer the 2nd dose routinely at age 4–6 yr.

Make sure all school-aged children and adolescents have had 2 doses of MMR vaccine. The minimal interval between doses is 4 wk.

For people ≥ 2 yr who have not received the HepA vaccine series, administer 2 doses separated by 6–18 mo if immunity against hepatitis A is desired for them.

Administer the vaccine series to previously unvaccinated females (either HPV2 or HPV4) and males (HPV4) at age 13–18 yr.

Use recommended routine dosing intervals for vaccine series catch-up (see Table: Recommended Immunization Schedule for Ages 7–18 yr).