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Childhood Vaccination Schedule

By

Michael J. Smith

, MD, MSCE, Duke University School of Medicine

Last full review/revision Nov 2021| Content last modified Jun 2022
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Vaccination follows a schedule recommended by the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. See tables Recommended Immunization Schedule for Ages 0–6 Years Recommended Immunization Schedule for Ages 0–6 Years Recommended Immunization Schedule for Ages 0–6 Years , Recommended Immunization Schedule for Ages 7–18 Years Recommended Immunization Schedule for Ages 7–18 Years Recommended Immunization Schedule for Ages 7–18 Years , and Catch-up Immunization Schedule for Ages 4 Months–18 Years Catch-up Immunization Schedule for Ages 4 Months–18 Years Catch-up Immunization Schedule for Ages 4 Months–18 Years .

Practitioners should also check the CDC's latest recommendations (also available as a free mobile app), consult the CDC's child–adolescent immunization schedules and catch-up immunization schedule, and consult the relevant Advisory Committee on Immunization Practices (ACIP) statements for detailed recommendations and updates. Vaccination status should be reassessed at every visit.

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COVID-19 vaccination in children

In addition to the immunizations noted in the immunization schedules, children in the US in certain age groups are now eligible for COVID-19 vaccination COVID-19 Vaccine COVID-19 vaccines provide protection against COVID-19. COVID-19 is the disease caused by infection with the SARS-CoV-2 virus. There are multiple COVID-19 vaccines currently in use worldwide... read more . The BNT162b2 COVID-19 vaccine (mRNA) produced by Pfizer-BioNTech (Comirnaty) has Emergency Use Authorization (EUA) for children 6 months to 15 years of age and is approved for use in people 16 years of age and older:

  • The dose for children 6 months to 4 years of age is 0.2 mL (3 mcg) IM, given in a 3-dose primary series. The second dose is given at least 3 to 8 weeks after the first dose. The third dose is given at least 8 weeks after the second dose.

  • The dose for children 5 to 11 years of age is 0.2 mL (10 mcg) IM, also given in a primary 2-dose series at least 3 to 8 weeks apart.

  • The dose for children 12 to 17 years of age is 0.3 mL (30 mcg) IM, given in a primary 2-dose series at least 3 to 8 weeks apart.

EUA has also been granted for an additional primary dose, given at least 4 weeks after the second dose, for children 5 years of age and older who have a moderately to severely compromised immune system. Moderately to severely immunocompromised children who are 5 to 17 years of age should also get a booster shot at least 3 months after the third primary dose. For those 12 to 17 years of age, a second booster dose may be given at least 4 months after the first booster dose. (See also Guidance for COVID-19 vaccination for people who are moderately or severely immunocompromised.)

A first booster dose is recommended for all BNT162b2 vaccine recipients 5 to 17 years of age who are not immunocompromised and who completed their primary 2-dose series 5 or more months ago. Unlike people 18 years of age and older who can choose any available COVID-19 vaccine as a booster shot, only BNT162b2 vaccine has EUA for booster shots for children 5 to 17 years of age.

The mRNA-1273 COVID-19 vaccine (mRNA) produced by Moderna has EUA for children 6 months to 17 years of age:

  • The dose for children 6 months to 5 years of age is 0.25 mL (25 mcg) IM, given in a 2-dose primary series at least 4 to 8 weeks apart.

  • The dose for children 6 to 11 years of age is 0.5 mL (50 mcg) IM, given in a 2-dose primary series at least 4 to 8 weeks apart.

  • The dose for children 12 to 17 years of age is 0.5 mL (100 mcg) IM, given in a 2-dose primary series at least 4 to 8 weeks apart.

EUA has also been granted for an additional primary dose, given at least 4 weeks after the second dose, for children 6 months of age and older who have a moderately to severely compromised immune system.

COVID-19 vaccine may be given at the same time as routine immunizations.

  • Severe allergic reaction to a previous dose

  • Severe allergic reaction to a vaccine component

  • An immediate allergic reaction of any severity to a previous dose or known (diagnosed) allergy to a component of the vaccine

Polyethylene glycol (PEG) is used in mRNA vaccines and is the most commonly implicated allergen.

COVID-19 vaccination in children reference

Malaria vaccination in children

On October 6, 2021, the World Health Organization (WHO) recommended widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high Plasmodium falciparum malaria transmission. (See WHO recommends groundbreaking malaria vaccine for children at risk.)

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Drugs Mentioned In This Article

Drug Name Select Trade
COMIRNATY, SPIKEVAX
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