Immunization
FIGURE 2: Recommended immunization schedule for persons aged 7 through 18 years—United States, 2012 (for those who fall behind or start late, see the schedule below and the catch-up schedule [Figure 3])
Tetanus, diphtheria, pertussis1 Human papillomavirus2 Meningococcal3 4
Pneumococcal5 Hepatitis A6 Hepatitis B7
Inactivated poliovirus8 Measles, mumps, rubella9 Varicella10
7–10 years 1 dose (if indicated)
see footnote2 See footnote3
11–12 years 1 dose
3 doses Dose 1
See footnote 5
Complete 2-dose series Complete 3-dose series Complete 3-dose series Complete 2-dose series Complete 2-dose series
13–18 years 1 dose (if indicated) Complete 3-dose series Booster at 16 years old Range of
recommended ages for catch-up
immunization Range of
recommended ages for all children
Range of Complete 2-Dose Series
recommended ages for certain high-risk groups
This schedule includes recommendations in effect as of December 23, 2011. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations, available online at
http://www.cdc.gov/vaccines/ pubs/
acip-list.htmhttp://www.
vaers.hhs.gov) or by telephone (800-822-7967).
1. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for Boostrix and 11 years for Adacel) Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.
Tdap vaccine should be substituted for a single dose of Td in the catch- up series for children aged 7 through 10 years. Refer to the catch-up schedule if additional doses of tetanus and diphtheria toxoid–containing vaccine are needed.
Tdap vaccine can be administered regardless of the interval since the last tetanus and diphtheria toxoid–containing vaccine.
2. Human papillomavirus (HPV) vaccines (HPV4 [Gardasil] and HPV2 [Cervarix]). (Minimum age: 9 years) Either HPV4 or HPV2 is recommended in a 3-dose series for females aged 11 or 12 years. HPV4 is recommended in a 3-dose series for males aged 11 or 12 years.
The vaccine series can be started beginning at age 9 years. dose).
See MMWR wk/mm5920.pdf.
3. Meningococcal conjugate vaccines, quadrivalent (MCV4). Administer MCV4 at age 11 through 12 years with a booster dose at age 16 years.
Administer MCV4 at age 13 through 18 years if patient is not previously vaccinated.
dose should be administered at age 16 through 18 years with a minimum interval of at least 8 weeks after the preceding dose.
not needed.
Administer 2 primary doses at least 8 weeks apart to previously or anatomic/functional asplenia, and 1 dose every 5 years thereafter.
virus (HIV) infection should receive a 2-dose primary series of MCV4, at least 8 weeks apart.
See MMWR pdf/wk/mm6003.pdf, and Vaccines for Children Program resolution No. 6/11-1, available at
http://www.cdc.gov/vaccines/programs/vfc/downloads/ resolutions/06-11mening-mcv.pdf, for further guidelines.
4. For most healthy, nonpregnant persons, either LAIV or TIV may be used, except LAIV should not be used for some persons, including those with asthma or any other underlying medical conditions that predispose them see MMWR pdf/rr/rr5908.pdf.
Administer 1 dose to persons aged 9 years and older. For children aged 6 months through 8 years:
— For the 2011–12 season, administer 2 doses (separated by at least 4 weeks) to those who did not receive at least 1 dose of the 2010– 11 vaccine. Those who received at least 1 dose of the 2010–11 vaccine require 1 dose for the 2011–12 season.
— For the 2012–13 season, follow dosing guidelines in the 2012 ACIP
5. Pneumococcal vaccines (pneumococcal conjugate vaccine [PCV] and pneumococcal polysaccharide vaccine [PPSV]). A single dose of PCV may be administered to children aged 6 through 18 years who have anatomic/functional asplenia, HIV infection or other leak. See MMWR 2010:59(No. RR-11), available at
http://www.cdc.gov/ mmwr/pdf/rr/rr5911.pdf.
Administer PPSV at least 8 weeks after the last dose of PCV to children aged 2 years or older with certain underlying medical conditions, including a cochlear implant. A single revaccination should be administered after 5 years to children with anatomic/functional asplenia or an immunocompromising condition.
6. Hepatitis A (HepA) vaccine. HepA vaccine is recommended for children older than 23 months who live in areas where vaccination programs target older children, who are at increased risk for infection, or for whom immunity against hepatitis A virus infection is desired. See MMWR
www.cdc.gov/mmwr/pdf/rr/rr5507.pdf.
Administer 2 doses at least 6 months apart to unvaccinated persons.
7. Hepatitis B (HepB) vaccine. Administer the 3-dose series to those not previously vaccinated. For those with incomplete vaccination, follow the catch-up recommendations (Figure 3).
A 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years.
8. Inactivated poliovirus vaccine (IPV). after the previous dose.
If both 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.
IPV is not routinely recommended for U.S. residents aged18 years or older.
9. Measles, mumps, and rubella (MMR) vaccine. The minimum interval between the 2 doses of MMR vaccine is 4 weeks.
10. Varicella (VAR) vaccine. For persons without evidence of immunity (see MMWR 4], available at
http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf), administer 2 doses if not previously vaccinated or the second dose if only 1 dose has been administered.
For persons aged 7 through 12 years, the recommended minimum interval between doses is 3 months. However, if the second dose was administered
For persons aged 13 years and older, the minimum interval between doses is 4 weeks.
This schedule is approved by the Advisory Committee on Immunization Practices (
http://www.cdc.gov/vaccines/recs/acip),
the American Academy of Pediatrics (
http://www.aap.org), and the American Academy of Family Physicians (
http://www.aafp.org).
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