Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 1 OF 6

Vaccine name Schedule for routine vaccination and other guidelines Schedule for catch-up vaccination Contraindications and precautions
and route (any vaccine can be given with another, unless otherwise noted) and related issues (mild illness is not a contraindication)

Hepatitis B ••Give HepB dose #1 within 24hrs of birth to all medically stable infants ••Do not restart series, no matter how Contraindication
(HepB) weighing >2000g and born to HBsAg-negative mothers. Give dose long since previous dose. Previous severe allergic reaction (e.g., anaphylaxis) to this
#2 at age 1–2m and the final dose at age 6–18m (the last dose in the ••3-dose series can be started at any age. vaccine or to any of its components, including hypersensitivity
Give IM
infant series should not be given earlier than age 24wks). After the ••Minimum intervals between doses: to yeast.
birth dose, the series may be completed using 2 doses of single-antigen 4wks between #1 and #2, 8wks Precautions
vaccine (ages 1–2m, 6–18m) or with 3 doses of Pediarix (ages 2m, between #2 and #3, and at least ••Moderate or severe acute illness, with or without fever.
4m, 6m), which may result in giving a total of 4 doses of HepB vaccine. 16wks between #1 and #3 (and give ••For infants who weigh less than 2000g, see ACIP recommenda-
••If mother is HBsAg-positive: Give HBIG and HepB dose #1 within dose #3 no earlier than age 24wks). tions at www.cdc.gov/mmwr/PDF/rr/rr5416.pdf.
12hrs of birth; complete series by age 6m.
••If mother’s HBsAg status is unknown: Give HepB dose #1 within
12 hrs of birth. If low birth weight (less than 2000g), also give HBIG Special Dosing of HepB: Monovalent vaccine brands are interchangeable. For people
within 12hrs. For infants weighing 2000g or more whose mother Notes on age 0 through 19yrs, give 0.5 mL of 3 doses of Engerix-B or Recombivax HB; unvac-
is subsequently found to be HBsAg positive, give the infant HBIG Hepatitis B cinated people age 18yrs and older may also be given 2 doses of Heplisav-B spaced
ASAP (no later than age 7d) and follow HepB immunization schedule Vaccine 4wks apart.
for infants born to HBsAg-positive mothers. (HepB) Alternative dosing schedule for unvaccinated adolescents age 11 through 15yrs:
••Vaccinate all other children and teens who have not completed a Give 2 doses Recombivax HB 1.0 mL (adult formulation) spaced 4–6m apart.
series of HepB vaccine. (Engerix-B is not licensed for a 2-dose schedule.)

DTaP, DT ••Give to children at ages 2m, 4m, 6m, 15–18m, and 4–6yrs. ••Dose #2 and #3 may be given 4wks
Contraindications
(Diphtheria, ••May give dose #1 as early as age 6wks. after previous dose. ••Previous severe allergic reaction (e.g., anaphylaxis) to this
tetanus, ••May give #4 as early as age 12m if 6m have elapsed since #3. ••Dose#4 may be given 6m after #3.
vaccine or to any of its components, with or without fever.
acellular ••Do not give DTaP/DT to children age 7yrs and older. ••If dose #4 is given before 4th
••For all pertussis-containing vaccines: Encephalopathy not attrib-
pertussis) ••If possible, use the same DTaP product for all doses. birthday, wait at least 6m for #5
utable to an identifiable cause, within 7d after DTP/DTaP/Tdap.
Give IM (age 4–6yrs). Precautions
••Moderate or severe acute illness.
••If dose #4 is given after 4th birthday,
#5 is not needed. ••History of Arthus reaction following a prior dose of tetanus or
diphtheria toxoid-containing vaccine (including MenACWY);
Td, Tdap ••For children and teens lacking previous Tdap: Give Tdap routinely ••DTaP and DT should not be used defer vaccination until at least 10yrs have elapsed since the last
(Tetanus, at age 11–12yrs and vaccinate older teens on a catch-up basis; for children age 7yrs and older; use tetanus toxoid-containing vaccine.
diphtheria, then boost every 10yrs with Td. Td and Tdap instead. ••Guillain-Barré syndrome (GBS) within 6wks after previous
acellular ••Make special efforts to give Tdap to children and teens who are ••Children as young as age 7yrs and dose of tetanus toxoid-containing vaccine.
pertussis) 1) in contact with infants younger than age 12m and, 2) healthcare teens who are unvaccinated or ••For all pertussis-containing vaccines: Progressive or unstable
workers with direct patient contact. behind schedule should complete neurologic disorder, uncontrolled seizures, or progressive
Give IM ••Give Tdap to pregnant adolescents during each pregnancy (preferred a primary Td series (3 doses, with encephalopathy until a treatment regimen has been established
during the early part of gestational weeks 27 through 36wks), an interval of 1–2m between dose and the condition has stabilized.
regardless of interval since prior Td or Tdap. #1 and #2, and an interval of 6–12m
between dose #2 and #3); substitute
Tdap for any dose in the series,
preferably as dose #1.
••Tdap should be given regardless of
interval since previous Td.

This document was adapted from the vaccine recommendations of the This table is revised periodically. Visit IAC’s website at www.immunize. For the purposes of calculating intervals between doses, 4 weeks =
Advisory Committee on Immunization Practices (ACIP) and also Best org/childrules to make sure you have the most current version. 28 days. Intervals of 4 months or greater are determined by
Practices Guidance of the ACIP. To view the full vaccine recom- calendar months.
mendations, visit CDC’s website at www.cdc.gov/vaccines/hcp/ACIP-
recs/index.html or, for the complete guidance document, visit www. A vaccine series does not need to be restarted, regardless of
cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html the time that has elapsed between doses.

Technical content reviewed by the Centers for Disease Control and Prevention
IMMUNIZATION ACTION COALITION Saint Paul, Minnesota • 651-647-9009 • www.immunize.org • www.vaccineinformation.org www.immunize.org/catg.d/p2010.pdf • Item #P2010 (4/19)
Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 2 OF 6

Vaccine name Schedule for routine vaccination and other guidelines Contraindications and precautions
and route (any vaccine can be given with another, unless otherwise noted) Schedule for catch-up vaccination and related issues (mild illness is not a contraindication)

Rotavirus ••Rotarix (RV1): Give at ages 2m, 4m. ••Do not begin series in infants older than age 14wks 6d. Contraindications
(RV) ••RotaTeq (RV5): Give at ages 2m, 4m, 6m. ••Intervals between doses may be as short as 4wks. ••Previous severe allergic reaction (e.g.,
Give orally ••May give dose #1 as early as age 6wks. ••If prior vaccination included use of different or anaphylaxis) to this vaccine or to any of
••Give final dose no later than age 8m–0d. unknown brand(s), a total of 3 doses should be given. its components. If allergy to latex, use
RV5.
••History of intussusception.
••Diagnosis of severe combined immuno-
deficiency (SCID).
Precautions
••Moderate or severe acute illness, with or
without fever.
••Altered immunocompetence other than
SCID.
••Chronic gastrointestinal disease.
••For RV1 only, spina bifida or bladder
exstrophy.

Hib ••ActHib (PRP-T), Hiberix, or Pentacel: Give at age 2m, 4m, 6m, 12–15m All Hib vaccines: Contraindications
(Haemophilus (booster dose). ••If dose #1 was given at 12–14m, give booster in 8wks. ••Previous severe allergic reaction
influenzae type b) ••PedvaxHIB (containing PRP-OMP): Give at age 2m, 4m, 12–15m ••Give only 1 dose to unvaccinated children ages (e.g., anaphylaxis) to this vaccine
(booster dose). 15–59m. or to any of its components.
Give IM
••Dose #1 of Hib vaccine should not be given earlier than age 6wks. ActHib: ••Age younger than 6wks.
••Give final dose (booster dose) no earlier than age 12m and a minimum ••Dose #2 and #3 may be given 4wks after previous Precaution
of 8wks after the previous dose. dose. Moderate or severe acute illness, with or
••Hib vaccines are interchangeable; however, if different brands of Hib ••If dose #1 was given at age 7–11m, only 3 doses are without fever.
vaccines are administered for dose #1 and dose #2, a total of 3 doses needed; #2 is given at least 4wks after #1, then final
is necessary to complete the primary series in infants, followed by a dose at age 12–15m (wait at least 8wks after dose #2).
booster after age 12m. PedvaxHIB:
••For vaccination of children 12 through 59m who are immunocompro- ••Dose #2 may be given 4wks after #1.
mised (immunoglobulin deficiency, complement component Recipients of hematopoietic stem cell transplant should
deficiency, HIV infection, receipt of chemotherapy or radiation therapy receive 3 doses of Hib vaccine at least 4wks apart
for cancer) or asplenic: if previously received no doses or only 1 dose beginning 6–12m after transplant, regardless of Hib
before age 12m, give 2 additional doses at least 8wks apart; if vaccination history.
previously received 2 or more doses before age 12m, give 1 additional
dose.
••Hib is not routinely given to healthy children age 5yrs and older.
••1 dose of Hib vaccine should be administered to children age 5yrs and
older who have anatomic
or functional asplenia (including sickle cell disease) and who have not
received a primary series and booster dose or at least 1 dose of Hib
vaccine after age 14m.
••1 dose of Hib vaccine should be administered to unvaccinated persons
5 through 18yrs of age with HIV infection.

Immunization Action Coalition • www.immunize.org/catg.d/p2010.pdf • (4/19)

Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 3 OF 6

Schedule for routine vaccination and Schedule for catch-up

Vaccine name Contraindications and precautions
other guidelines (any vaccine can be given vaccination and related
and route (mild illness is not a contraindication)
with another, unless otherwise noted) issues
Varicella ••Give dose #1 at age 12–15m. ••If younger than age 13yrs, Contraindications
(Var) ••Give dose #2 at age 4–6yrs. Dose #2 of space dose #1 and #2 at ••Previous severe allergic reaction (e.g., anaphylaxis) to this vaccine or to any of its components.
(Chickenpox) Var or MMRV may be given earlier if at least 3m apart. If age 13yrs ••Pregnancy or possibility of pregnancy within 4wks.
least 3m since dose #1. If dose #2 was or older, space at least ••Severe immunodeficiency (e.g., hematologic and solid tumors; receiving chemotherapy; congenital
Give Subcut
given at least 4wks after dose #1, it can 4wks apart. immunodeficiency; long-term immunosuppressive therapy, or severely symptomatic HIV).
be accepted as valid. ••May use as postexposure ••Family history of congenital or hereditary immunodeficiency in first-degree relatives (e.g., parents and
••Give a 2nd dose to all older children/ prophylaxis if given within 5d. siblings), unless the immune competence of the potential vaccine recipient has been substantiated
teens with history of only 1 dose. ••If Var and either LAIV, MMR, clinically or verified by a laboratory test.
••MMRV may be used in children age and/or yellow fever vaccine ••Children on high-dose immunosuppressive therapy or who are immunocompromised because of
12m through 12yrs (see note below). are not given on the same malignancy and primary or acquired immunodeficiency, including HIV/AIDS (although vaccination
day, space them at least 28d may be considered if CD4+ T-lymphocyte percentages are 15% or greater in children age 1 through
apart. (If yellow fever 8yrs or 200 cells/µL in children age 9yrs and older).
vaccine, space by 30d.) Precautions
••Moderate or severe acute illness, with or without fever.
••If blood, plasma, and/or immune globulin (IG or VZIG) were given in past 11m, see ACIP’s Best
Practices Guidance1 regarding time to wait before vaccinating.
••Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24hrs before vaccination, if
possible; delay resumption of these antiviral drugs for 14d after vaccination.
••Use of aspirin or aspirin-containing products.
••For MMRV only, personal or family (i.e., sibling or parent) history of seizures.
NOTE: For the first dose of MMR and varicella given at age 12–47m, NOTE: For patients with humoral immunodeficiency or leukemia, see ACIP recommendations at
either MMR and Var or MMRV may be used. Unless the parent or www.cdc.gov/mmwr/pdf/rr/rr5604.pdf.
caregiver expresses a preference for MMRV, CDC recommends that
MMR MMR and Var be used for the first doses in this age group.
Contraindications
(Measles, ••Previous severe allergic reaction (e.g., anaphylaxis) to this vaccine or to any of its components.
mumps, ••Give dose #1 at age 12–15m. ••If MMR and either LAIV, Var, ••Pregnancy or possibility of pregnancy within 4wks.
rubella) ••Give MMR at age 6–11m if traveling and/or yellow fever vaccine ••Severe immunodeficiency (e.g., hematologic and solid tumors; receiving chemotherapy; congenital
internationally; revaccinate with 2 doses are not given on the same immunodeficiency; long-term immunosuppressive therapy, or severely symptomatic HIV).
Give Subcut of MMR at age 12–15m and at least day, space them at least 28d ••Family history of congenital or hereditary immunodeficiency in first-degree relatives (e.g., parents and
4wks later. The dose given at younger apart. (If yellow fever vac- siblings), unless the immune competence of the potential vaccine recipient has been substantiated
than 12m does not count toward the cine, space by 30d.) clinically or verified by a laboratory test.
2-dose series. ••When using MMR for both NOTE: HIV infection is NOT a contraindication to MMR for children who are not severely immunocom-
••Give dose #2 at age 4–6yrs. Dose #2 doses, minimum interval is promised (see ACIP recommendations at www.cdc.gov/mmwr/pdf/rr/rr6204.pdf).
may be given earlier if at least 4wks 4wks.
Precautions
since dose #1. For MMRV: dose #2 may ••When using MMRV for both
••Moderate or severe acute illness, with or without fever.
be given earlier if at least 3m since dose doses, minimum interval
••If blood, plasma, and/or immune globulin (IG or VZIG) were given in past 11m, see ACIP’s Best Prac-
#1. is 3m. tices Guidance1 regarding time to wait before vaccinating.
••Give a 2nd dose to all older children and ••May use as postexposure ••History of thrombocytopenia or thrombocytopenic purpura.
teens with history of only 1 dose. measles prophylaxis if given ••For MMRV only, personal or family (i.e., sibling or parent) history of seizures.
••MMRV may be used in children age 12m within 3d. ••Need for tuberculin skin testing (TST) or interferon-gamma release assay (IGRA) testing. If TST or
through 12yrs (see note above). IGRA needed, give TST or IGRA before or on same day as MMR, or give TST or IGRA 4wks following MMR.

Immunization Action Coalition • www.immunize.org/catg.d/p2010.pdf • (4/19)

Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 4 OF 6

Vaccine name Schedule for routine vaccination and other guidelines Contraindications and precautions
and route (any vaccine can be given with another, unless otherwise Schedule for catch-up vaccination and related issues (mild illness is not a contraindication)
noted)
Pneumococcal ••Give at ages 2m, 4m, 6m, 12–15m (booster dose). ••When children are behind on PCV13 schedule, minimum interval Contraindication
conjugate ••Dose #1 may be given as early as age 6wks. for doses given to children younger than age 12m is 4wks; for Previous severe allergic reaction (e.g.,
(PCV13) ••For age 24 through 59m and healthy: If unvaccinated or any doses given at 12m and older, it is 8wks. anaphylaxis) to a PCV vaccine, to any
Prevnar 13 incomplete schedule of 3 doses of PCV 13 was received ••For age 7 through 11m: If history of 0 doses, give 2 doses of of its components, or to any diphtheria
previously, give 1 supplemental dose of PCV13 PCV13, 4wks apart, with a 3rd dose at age 12–15m; if history of 1 toxoid-containing vaccine.
Give IM at least 8 wks after the most recent dose. or 2 doses, give 1 dose of PCV13 with a 2nd dose at age 12–15m at Precaution
••For high-risk** children ages 2 through 5 yrs: Give 2 doses at least 8wks later. Moderate or severe acute illness, with
least 8 wks apart if they previously received an incomplete ••For age 12 through 23m: If unvaccinated or history of 1 dose or without fever.
schedule of fewer than 3 doses; give 1 dose at least 8 wks after before age 12m, give 2 doses of PCV13 8wks apart; if history of 1
the most recent dose if they previously received 3 doses. dose at or after age 12m or 2 or 3 doses before age 12m, give 1
••For high-risk** children: All recommended PCV13 doses should dose of PCV13 at least 8wks after most recent dose.
be given prior to PPSV vaccination. ••For age 2 through 5yrs and at high risk**: If unvaccinated or any
••PCV13 is not routinely given to healthy children age 5yrs and incomplete schedule of 1 or 2 doses, give 2 doses of PCV13, 1 at
older. least 8wks after the most recent dose and another dose at least
8wks later; if any incomplete series of 3 doses, give 1 supplemen-
tal dose of PCV13 at least 8wks after the most recent dose.
** High-risk
For both PCV13 and PPSV23, those with sickle cell ••For children ages 6 through 18yrs with functional or anatomic
disease; anatomic or functional asplenia; chronic asplenia (including sickle cell disease), HIV infection or other
cardiac, pulmonary, or renal disease; diabetes; immunocompromising condition, cochlear implant, or CSF leak,
cerebrospinal fluid leaks; HIV infection; immuno- give 1 dose of PCV13 if no previous history of PCV13.
suppression; diseases associated with immuno-
suppressive and/or radiation therapy; solid organ
transplantation; or who have or will have a
cochlear implant.
For PPSPV23 only in children ages 6–18yrs, alcohol-
Pneumococcal ism and/or chronic liver disease. Contraindication
polysaccharide Previous severe allergic reaction (e.g.,
(PPSV23) ••Give 1 dose at least 8wks after final dose of PCV13 to high-risk** anaphylaxis) to this vaccine or to any
Pneumovax 23 children age 2yrs and older. of its components.
Give IM or Subcut ••For children who have sickle cell disease, functional or anatomic Precaution
asplenia, HIV infection, or other immunocompromising Moderate or severe acute illness, with
condition, give a 2nd dose of PPSV 5 yrs after previous PPSV. or without fever.
(See ACIP pneumococcal recommendations at www.cdc.gov/
mmwr/pdf/rr/rr5911.pdf.)

Human ••Give a 2-dose series of HPV to girls and boys at age 11–12yrs on ••With the exception of immunocompromised persons, or persons Contraindication
papillomavirus a 0, 6–12m schedule. (May give as early as age 9yrs.) with autoimmune disease, a 2-dose schedule may be followed Previous severe allergic reaction (e.g.,
(HPV) ••Give a 3-dose series of HPV to girls and boys age 15yrs or older for all persons initiating the HPV vaccine series before age 15yrs. anaphylaxis) to this vaccine or to any
Give IM or who are immunocompromised or have autoimmune disease ••A 3-dose schedule must be followed for all persons initiating the of its components.
on a 0, 1–2, 6m schedule. (May give as early as age 9yrs.) series at age 15yrs or older, as well as for immunocompromised Precautions
••Give a 3-dose series of HPV to all older girls/women (through persons or persons with autoimmune disease ages 9 through ••Moderate or severe acute illness, with or
age 26yrs) and boys/men (through age 21yrs) who were not 26yrs. without fever.
previously vaccinated. ••Minimum intervals between doses: 2-dose schedule: 5m; 3-dose
••Other guidance: Pregnancy is neither a contraindication nor a schedule: 4wks between #1 and #2; 12wks between #2 and #3
precaution to HPV vaccine. and 5m between #1 and #3.

Immunization Action Coalition • www.immunize.org/catg.d/p2010.pdf • (4/19)

Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 5 OF 6

Vaccine name Schedule for routine vaccination and other guidelines Schedule for catch-up vaccination Contraindications and precautions
and route (any vaccine can be given with another, unless otherwise and related issues (mild illness is not a contraindication)
noted)

Hepatitis A ••Give 2 doses spaced 6–18m apart to all children at age ••Minimum interval between doses is Contraindication
(HepA) 1yr (12–23m). 6m. Previous severe allergic reaction (e.g., anaphylaxis) to this vaccine or to
Give IM ••Vaccinate all previously unvaccinated children and ••Children who are not fully vaccinated any of its components.
adolescents age 2yrs and older who by age 2yrs can be vaccinated at a Precautions
– Want to be protected from HAV infection and lack a subsequent visit. ••Moderate or severe acute illness, with or without fever.
specific risk factor. ••Administer 2 doses at least 6m apart
– Live in areas where vaccination programs target older to previously unvaccinated persons
children. who live in areas where vaccination
– Are homeless. programs target older children, or who
– Have chronic liver disease, clotting factor disorder, are at increased risk for infection.
or are adolescent males who have sex with other males. ••Give 1 dose as postexposure prophy-
– Use illicit drugs (injectable or non-injectable). laxis to incompletely vaccinated
– Anticipate close personal contact with an international children and teens age 12m and older
adoptee from a country of high or intermediate who have recently (during the past
endemicity during the first 60d following the adoptee’s ar- 2wks) been exposed to hepatitis A
rival in the U.S. virus. For children younger than 12
months, use IG (0.1 mL/kg), rather
• Give 1 dose to children age 6–11m who travel anywhere
than vaccine, for postexposure
outside the U.S., most, but not all of Western Europe, New
prophylaxis.
Zealand, Australia, Canada, or Japan. This dose does not
count toward the routine 2-dose series given at age 1yr.

Inactivated polio ••Give to children at ages 2m, 4m, 6–18m, 4–6yrs. ••The final dose should be given on or Contraindication
(IPV) ••May give dose #1 as early as age 6wks. after the 4th birthday and at least 6m Previous severe allergic reaction (e.g., anaphylaxis) to this vaccine or to
••Not routinely recommended for U.S. residents age 18yrs from the previous dose. any of its components.
Give Subcut or
and older (except certain travelers). For information on ••If dose #3 is given after 4th birthday, Precautions
IM
polio vaccination for international travelers, see wwwnc. dose #4 is not needed if dose #3 is ••Moderate or severe acute illness, with or without fever.
cdc.gov/travel/diseases. given at least 6m after dose #2. ••Pregnancy.

Influenza ••Vaccinate all children and teens age 6m and Contraindications

older. ••History of severe allergic reaction (e.g., anaphylaxis) to this vaccine (except egg) or after a previous dose of any influe nza
Inactivated
••For children age 6m through 8yrs, give 2 doses of vaccine.
influenza*
age-appropriate vaccine, spaced 4 wks apart, ••For LAIV only: Age younger that 2yrs; pregnancy; immunosuppression (including that caused by medications or HIV); for
vaccine (IIV)
who 1) are first-time vaccinees, or 2) have children and teens ages 6m through 18yrs, current aspirin or salicylate-containing medication; for children age 2 through
Give IM received only one lifetime dose previous to this 4yrs, wheezing or asthma within the past 12m, per healthcare provider statement. Receipt of specific antivirals (i.e.,
* includes current season (season runs July to June) amantadine, rimantadine, zanamivir, oseltamivir, or peramivir) 48hrs before vaccination. Avoid use of these antiviral drugs
recombinant ••For IIV in children age 6–35m: Give one of the for 14d after vaccination.
influenza vaccine following: Fluarix 0.5 mL dose, FluLaval 0.5 mL NOTE: People with egg allergy of any severity can receive any recommended and age-appropriate influenza vaccine (i.e., any
(RIV) for teens ages dose, or Fluzone 0.25 mL dose. IIV, RIV, or LAIV) that is otherwise appropriate for their health status. People having had a previous severe reaction to egg s
18yrs and older ••For IIV in children age 3yrs and older: Give 0.5 involving symptoms other than hives should be administered vaccine in a medical setting (e.g., a health department or
mL dose of any age-appropriate influenza physician office) and should be supervised by a healthcare provider who is able to recognize and manage severe allergic
Live attenuated vaccine. conditions.
influenza vaccine ••For teens age 18yrs and older: recombinant Precautions
(LAIV) influenza vaccine (RIV) may also be used. ••Moderate or severe acute illness, with or without fever.
Give NAS ••Other guidance: Children with functional or ••History of Guillain-Barré syndrome (GBS) within 6wks of a previous influenza vaccination.
anatomic asplenia, complement deficiency, ••For children/teens who experience only hives with exposure to eggs, give any age-appropriate influenza vaccine.
(intranasally) ••For LAIV only: Chronic pulmonary (including asthma in children age 5yrs and older), cardiovascular (except hypertension),
cochlear implant, or CSF leak should not receive
LAIV. renal, hepatic, neurological/neuromuscular, hematologic or metabolic (including diabetes) disorders.

Immunization Action Coalition • www.immunize.org/catg.d/p2010.pdf • (4/19)

Summary of Recommendations for Child/Teen Immunization (Age birth through 18 years) PAGE 6 OF 6

Contraindications
Vaccine name and Schedule for routine vaccination and other guidelines Schedule for catch-up vaccination and precautions
route (any vaccine can be given with another, unless otherwise noted) and related issues (mild illness is not
a contraindication)

Meningococcal ••Give a 2-dose series of MenACWY with dose #1 at age 11–12yrs and dose #2 at age 16yrs. ••If previously vaccinated and risk of Contraindication
conjugate, quadriva- ••If unvaccinated at 11–12yrs, give dose #1 at age 13 through 15yrs. Give dose #2 at 16 through 18yrs meningococcal disease persists, revaccinate Previous severe
lent (MenACWY) with a minimum interval of at least 8wks between doses. with MenACWY in 3yrs (if previous dose allergic reaction
Menactra and ••If unvaccinated at 11 through 15yrs, give dose #1 at 16 through 18yrs. given when younger than age 7yrs) or in 5 (e.g., anaphylaxis)
Menveo ••For college students, give 1 (initial) dose to unvaccinated first-year students age 19 through 21yrs yrs (if previous dose given at age 7yrs or to this vaccine
who live in a residence hall; give dose #2 if most recent dose given when younger than age 16yrs. older). Then, give additional booster doses or to any of its
Give IM every 5 yrs if risk continues. components.
••Give Menveo to children age 2–18m with persistent complement component deficiency, HIV
infection, or anatomic/functional asplenia; give at ages 2, 4, 6, 12–15m. ••Minimum ages: 2m Menveo; 9m Menactra. Precaution
••For unvaccinated or partially vaccinated children age 7–23m with persistent complement component ••If using Menactra in a high-risk child, it Moderate or severe
deficiency: 1) if age 7–23m and using Menveo, give a 2-dose series at least 3m apart with dose #2 should be given before or at the same visit acute illness, with or
given after age 12m or, 2) if age 9–23m and using Menactra, give a 2-dose series at least 3m apart. as DTaP is administered. without fever.
Give either brand of MenACWY to unvaccinated children age 24m and older with persistent
complement component deficiency or anatomic or functional asplenia; give 2 doses, 2m apart.
If Menactra is given, it must be separated by 4wks from the final dose of PCV13.
••Give age-appropriate series of meningococcal conjugate vaccine (brand must be licensed for age of
child) to 1) children age 2m and older at risk during a community outbreak attributable to a vaccine
serogroup and 2) children age 2m and older traveling to or living in countries with hyperendemic
or epidemic meningococcal disease. Prior receipt of MenHibrix is not sufficient for children traveling
to the meningitis belt or the Hajj.

Meningococcal ••Teens age 16 through 18yrs may be vaccinated routinely as a Category B recommendation (provider-patient discussion). Give 2 doses of either
serogroup B (MenB) MenB vaccine: Bexsero, spaced 1m apart; Trumenba, spaced 6m apart. MenB brands are not interchangeable.
Bexsero and ••For children age 10yrs and older with persistent complement component deficiencies, functional or anatomic asplenia, including sickle cell disease,
Trumenba or who are at risk during a community outbreak of serotype B, give either 2 doses of Bexsero, 1m apart, or 3 doses of Trumenba on a 0, 1–2, and 6m
schedule. MenB brands are not interchangeable.
Give IM ••MenB vaccine may be given concomitantly with MenACWY vaccine.

Immunization Action Coalition • www.immunize.org/catg.d/p2010.pdf • (4/19)