Recommended Child and Adolescent Immunization Schedule for

How to use the child and adolescent immunization

schedule

Recommended by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/acip)

and approved by the Centers for Disease Control and Prevention (www.cdc.gov), American Academy

of Pediatrics (www.aap.org), American Academy of Family Physicians (www.aafp.org), American

College of Obstetricians and Gynecologists (www.acog.org), American College of Nurse-Midwives

(www.midwife.org), American Academy of Physician Associates (www.aapa.org), and National

Association of Pediatric Nurse Practitioners (www.napnap.org).

Vaccines and Other Immunizing Agents in the Child and Adolescent Immunization Schedule*

Monoclonal antibody Abbreviation(s) Trade name(s)

Respiratory syncytial virus monoclonal antibody (Nirsevimab) RSV-mAb Beyfortus™

Vaccine Abbreviation(s) Trade name(s)

COVID-19 1vCOV-mRNA Comirnaty®/Pzer-

BioNTech COVID-19

Vaccine

Spikevax®/Moderna

COVID-19 Vaccine

1vCOV-aPS Novavax COVID-19

Vaccine

Dengue vaccine DEN4CYD Dengvaxia®

Diphtheria, tetanus, and acellular pertussis vaccine DTaP Daptacel®

Infanrix®

Haemophilus inuenzae type b vaccine Hib (PRP-T)

Hib (PRP-OMP)

ActHIB®

Hiberix®

PedvaxHIB®

Hepatitis A vaccine HepA Havrix®

Vaqta®

Hepatitis B vaccine HepB Engerix-B®

Recombivax HB®

Human papillomavirus vaccine HPV Gardasil 9®

Inuenza vaccine (inactivated) IIV4 Multiple

Inuenza vaccine (live, attenuated) LAIV4 FluMist® Quadrivalent

Measles, mumps, and rubella vaccine MMR M-M-R II®

Priorix®

Meningococcal serogroups A, C, W, Y vaccine MenACWY-CRM Menveo®

MenACWY-TT MenQuad®

Meningococcal serogroup B vaccine MenB-4C Bexsero®

MenB-FHbp Trumenba®

Meningococcal serogroup A, B, C, W, Y vaccine MenACWY-TT/

MenB-FHbp

Penbraya™

Mpox vaccine Mpox Jynneos®

Pneumococcal conjugate vaccine PCV15

PCV20

Vaxneuvance™

Prevnar 20®

Pneumococcal polysaccharide vaccine PPSV23 Pneumovax 23®

Poliovirus vaccine (inactivated) IPV Ipol®

Respiratory syncytial virus vaccine RSV Abrysvo™

Rotavirus vaccine RV1

RV5

Rotarix®

RotaTeq®

Tetanus, diphtheria, and acellular pertussis vaccine Tdap Adacel®

Boostrix®

Tetanus and diphtheria vaccine Td Tenivac®

Tdvax™

Varicella vaccine VAR Varivax®

Combination vaccines (use combination vaccines instead of separate injections when appropriate)

DTaP, hepatitis B, and inactivated poliovirus vaccine DTaP-HepB-IPV Pediarix®

DTaP, inactivated poliovirus, and Haemophilus inuenzae type b vaccine DTaP-IPV/Hib Pentacel®

DTaP and inactivated poliovirus vaccine DTaP-IPV Kinrix®

Quadracel®

DTaP, inactivated poliovirus, Haemophilus inuenzae type b, and

hepatitis B vaccine

DTaP-IPV-Hib-

HepB

Vaxelis®

Measles, mumps, rubella, and varicella vaccine MMRV ProQuad®

* Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to vaccine series for

extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit.

The use of trade names is for identication purposes only and does not imply endorsement by the ACIP or CDC.

Report

y Suspected cases of reportable vaccine-preventable diseases or outbreaks to your state or local health

department

y Clinically signicant adverse events to the Vaccine Adverse Event Reporting System (VAERS) at

www.vaers.hhs.gov or 800-822-7967

Questions or comments

Contact www.cdc.gov/cdc-info or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 a.m.–8 p.m. ET,

Monday through Friday, excluding holidays

Helpful information

y Complete Advisory Committee on Immunization Practices (ACIP) recommendations:

www.cdc.gov/vaccines/hcp/acip-recs/index.html

y ACIP Shared Clinical Decision-Making Recommendations:

www.cdc.gov/vaccines/acip/acip-scdm-faqs.html

y General Best Practice Guidelines for Immunization (including contraindications and precautions):

www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html

y Vaccine information statements:

www.cdc.gov/vaccines/hcp/vis/index.html

y Manual for the Surveillance of Vaccine-Preventable Diseases

(including case identication and outbreak response):

www.cdc.gov/vaccines/pubs/surv-manual

Determine

recommended

vaccine by age

(Table1)

Determine

recommended

interval for catch-

up vaccination

(Table2)

Assess need

for additional

recommended

vaccines

by medical

condition or

other indication

(Table3)

Review

vaccine types,

frequencies,

intervals, and

considerations

for special

situations

(Notes)

Review

contraindications

and precautions

for vaccine types

(Appendix)

Review new or

updated ACIP

guidance

(Addendum)

Download the CDC Vaccine Schedules app for providers at

www.cdc.gov/vaccines/schedules/hcp/schedule-app.html

CS310020-D

06/27/2024

Scan QR code

for access to

online schedule

Recommended Child and Adolescent Immunization Schedule

for ages 18 years or younger

UNITED STATES

2024

These recommendations must be read with the notes that follow. For those who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars.

To determine minimum intervals between doses, see the catch-up schedule (Table 2).

Vaccine and other immunizing agents Birth 1 mo 2 mos 4 mos 6 mos 9 mos 12 mos 15 mos 18 mos 19–23 mos 2–3 yrs 4–6 yrs 7–10 yrs 11–12 yrs 13–15 yrs 16 yrs 17–18 yrs

Respiratory syncytial virus

(RSV-mAb [Nirsevimab])

1 dose depending on maternal

RSV vaccination status, See Notes

1 dose (8 through 19 months), See Notes

Hepatitis B (HepB) 1

dose ----- 2

dose ----- ---------------------------- 3

dose ----------------------------

Rotavirus (RV): RV1 (2-dose series),

RV5 (3-dose series)

dose 2

dose See Notes

Diphtheria, tetanus, acellular pertussis

(DTaP <7 yrs)

dose 2

dose 3

dose ----- 4

dose ------ 5

dose

Haemophilus inuenzae type b (Hib) 1

dose 2

dose See Notes

or 4

dose,

--

See Notes



Pneumococcal conjugate

(PCV15, PCV20)

dose 2

dose 3

dose ----- 4

dose -----

Inactivated poliovirus

(IPV <18yrs)

dose 2

dose ---------------------------- 3

dose ---------------------------- 4

dose

See

Notes

COVID-19 (1vCOV-mRNA, 1vCOV-aPS) 1 or more doses of updated (2023–2024 Formula) vaccine (See Notes)

Inuenza (IIV4) Annual vaccination 1 or 2 doses Annual vaccination 1 dose only

Inuenza (LAIV4)

Annual vaccination

1 or 2 doses

Annual vaccination 1 dose only

Measles, mumps, rubella (MMR) See Notes ----- 1

dose ----- 2

dose

Varicella (VAR) ----- 1

dose ----- 2

dose

Hepatitis A (HepA) See Notes 2-dose series, See Notes

Tetanus, diphtheria, acellular pertussis

(Tdap ≥7 yrs)

1 dose

Human papillomavirus (HPV)

See

Notes

Meningococcal (MenACWY-CRM ≥2 mos,

MenACWY-TT ≥2years)

See Notes 1

dose 2

dose

Meningococcal B

(MenB-4C, MenB-FHbp)

See Notes

Respiratory syncytial virus vaccine

(RSV [Abrysvo])

Seasonal administration

during pregnancy, See Notes

Dengue (DEN4CYD; 9-16 yrs)

Seropositive in endemic

dengue areas (See Notes)

Mpox

oror



Range of recommended

ages for all children



Range of recommended ages

for catch-up vaccination



Range of recommended ages

for certain high-risk groups



Recommended vaccination

can begin in this age group



Recommended vaccination based

on shared clinical decision-making



No recommendation/

not applicable

Table 1

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

The table below provides catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed. 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. Always use this table in conjunction with Table 1 and the Notes that follow.

Children age 4 months through 6 years

Vaccine Minimum Age for

Dose 1

Minimum Interval Between Doses

Dose 1 to Dose 2 Dose 2 to Dose 3 Dose 3 to Dose 4 Dose 4 to Dose 5

Hepatitis B Birth 4 weeks 8 weeks and at least 16 weeks after rst dose

minimum age for the nal dose is 24 weeks

Rotavirus 6 weeks

Maximum age for rst

dose is 14weeks, 6 days.

4 weeks 4 weeks

maximum age for nal dose is 8 months, 0 days

Diphtheria, tetanus, and

acellular pertussis

6 weeks 4 weeks 4 weeks 6 months 6 months

A fifth dse is nt necessry

if the furth dse ws

dministered t ge 4 yers r

lder nd t lest 6 mnths fter

dse 3

Haemophilus inuenzae

typeb

6 weeks No further doses needed

if rst dose was administered at age 15

months or older.

4 weeks

if rst dose was administered before the

birthday.

8 weeks (as nal dose)

if rst dose was administered at age

12through 14 months.

No further doses needed

if previous dose was administered at age 15 months or older

4 weeks

if current age is younger than 12 months and rst dose was administered at younger than age 7 months and

at least 1 previous dose was PRP-T (ActHib®, Pentacel®, Hiberix®), Vaxelis® or unknown

8 weeks and age 12 through 59 months (as nal dose)

if current age is younger than 12 months and rst dose was administered at age 7 through 11 months; OR

if current age is 12 through 59 months and rst dose was administered before the 1

birthday and second

dose was administered at younger than 15 months; OR

if both doses were PedvaxHIB® and were administered before the 1st birthday

8 weeks (as nal dose)

This dose only necessary

for children age 12 through

59months who received

3doses before the

birthday.

Pneumococcal conjugate 6 weeks No further doses needed for healthy

children if rst dose was administered at

age 24 months or older

4 weeks

if rst dose was administered before the

birthday

8 weeks (as nal dose for healthy

children)

if rst dose was administered at the

birthday or after

No further doses needed

for healthy children if previous dose was administered at age 24 months or older

4 weeks

if current age is younger than 12 months and previous dose was administered at <7 months old

8 weeks (as nal dose for healthy children)

if previous dose was administered between 7–11 months (wait until at least 12 months old); OR

if current age is 12 months or older and at least 1 dose was administered before age 12 months

8 weeks (as nal dose)

This dose is only necessary

for children age 12 through

59 months regardless of risk,

or age 60 through 71 months

with any risk, who received 3

doses before age 12 months.

Inactivated poliovirus 6 weeks 4 weeks 4 weeks

if current age is <4 years

6 months (as nal dose)

if current age is 4 years or older

6 months (minimum age 4

years for nal dose)

Measles, mumps, rubella 12 months 4 weeks

Varicella 12 months 3 months

Hepatitis A 12 months 6 months

Meningococcal ACWY 2 months MenACWY-CRM

2 years MenACWY-TT

8 weeks See Notes See Notes

Children and adolescents age 7 through 18 years

Meningococcal ACWY Not applicable (N/A) 8 weeks

Tetanus, diphtheria;

tetanus, diphtheria, and

acellular pertussis

7 years 4 weeks 4 weeks

if rst dose of DTaP/DT was administered before the 1

birthday

6 months (as nal dose)

if rst dose of DTaP/DT or Tdap/Td was administered at or after the 1

birthday

6 months

if rst dose of DTaP/DT was

administered before the 1

birthday

Human papillomavirus 9 years Routine dosing intervals are

recommended.

Hepatitis A N/A 6 months

Hepatitis B N/A 4 weeks 8 weeks and at least 16 weeks after rst dose

Inactivated poliovirus N/A 4 weeks 6 months

A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6months

after the previous dose.

A fourth dose of IPV is

indicated if all previous doses

were administered at <4

years OR if the third dose was

administered <6 months after

the second dose.

Measles, mumps, rubella N/A 4 weeks

Varicella N/A 3 months if younger than age 13 years.

4 weeks if age 13 years or older

Dengue 9 years 6 months 6 months

Table 2

Recommended Catch-up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More

than 1 Month Behind, United States, 2024

Always use this table in conjunction with Table 1 and the Notes that follow. Medical conditions are often not mutually exclusive. If multiple conditions are present, refer to guidance in all relevant

columns. See Notes for medical conditions not listed.

Vaccine

and other

immunizing

agents Pregnancy

Immunocompromised

(excluding HIV

infection)

HIV infection CD4

percentage and count

CSF leak or

cochlear

implant

Asplenia or

persistent

complement

component

deciencies

Heart disease or

chronic lung disease

Kidney failure,

End-stage

renal disease

or on Dialysis

Chronic liver

disease Diabetes

<15% or

<200mm

≥15% and

≥200mm

RSV-mAb

(nirsevimab)

2nd RSV season

1 dose depending on maternal

RSV vaccination status, See Notes

2nd RSV season for chronic

lung disease (See Notes)

1 dose depending on maternal

RSV vaccination status, See Notes

Hepatitis B

Rotavirus

SCID

DTaP/Tdap

DTaP

Tdap: 1 dose each pregnancy

Hib See Notes See Notes

HSCT: 3 doses

Pneumococcal

IPV

COVID-19 See Notes

IIV4

LAIV4

Asthma, wheezing: 2–4 years

MMR *

VAR *

Hepatitis A

HPV * 3 dose series. See Notes

MenACWY

MenB

RSV (Abrysvo)

Seasonal administration,

See Notes

Dengue

Mpox See Notes



Recommended for all age-

eligible children who lack

documentation of a complete

vaccination series



Not recommended for all children,

but is recommended for some

children based on increased risk for

or severe outcomes from disease



Recommended for all age-eligible

children, and additional doses may be

necessary based on medical condition

or other indications. See Notes.



Precaution: Might be

indicated if benet of

protection outweighs

risk of adverse reaction



Contraindicated or not

recommended

*Vaccinate after pregnancy,

if indicated



No Guidance/

Not Applicable

Table 3

Recommended Child and Adolescent Immunization Schedule by Medical Indication, United States, 2024

a. For additional information regarding HIV laboratory parameters and use of live vaccines, see the General Best Practice Guidelines for Immunization,

“Altered Immunocompetence,” at www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.html and Table 4-1 (footnote J) at

www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html.

b. Severe Combined Immunodeciency

c. LAIV4 contraindicated for children 2–4 years of age with

asthma or wheezing during the preceding 12 months

For vaccination recommendations for persons ages

19 years or older, see the Recommended

Adult Immunization Schedule, 2024.

Additional information

y For calculating intervals between doses, 4 weeks = 28 days.

Intervals of ≥4 months are determined by calendar months.

y Within a number range (e.g., 12–18), a dash (–) should

be read as “through.”

y Vaccine doses administered ≤4 days before the minimum

age or interval are considered valid. Doses of any vaccine

administered ≥5 days earlier than the minimum age or

minimum interval should not be counted as valid and

should be repeated as age appropriate. The repeat

dose should be spaced after the invalid dose by the

recommended minimum interval. For further details,

see Table 3-2, Recommended and minimum ages and

intervals between vaccine doses, in General Best Practice

Guidelines for Immunization at www.cdc.gov/vaccines/hcp/

acip-recs/general-recs/timing.html.

y Information on travel vaccination requirements and

recommendations is available at www.cdc.gov/travel/.

y For vaccination of persons with immunodeciencies, see

Table 8-1, Vaccination of persons with primary and secondary

immunodeciencies, in General Best Practice Guidelines for

Immunization at www.cdc.gov/vaccines/hcp/acip-recs/

general-recs/immunocompetence.html, and Immunization in

Special Clinical Circumstances (In: Kimberlin DW, Barnett ED,

Lyneld Ruth, Sawyer MH, eds. Red Book: 2021–2024 Report

of the Committee on Infectious Diseases. 32

ed. Itasca, IL:

American Academy of Pediatrics; 2021:72–86).

y For information about vaccination in the setting of a vaccine-

preventable disease outbreak, contact your

state or local health department.

y The National Vaccine Injury Compensation Program (VICP)

is a no-fault alternative to the traditional legal system for

resolving vaccine injury claims. All vaccines included in

the child and adolescent vaccine schedule are covered by

VICP except dengue, PPSV23, RSV, Mpox and COVID-19

vaccines. Mpox and COVID-19 vaccines are covered by the

Countermeasures Injury Compensation Program (CICP). For

more information, see www.hrsa.gov/vaccinecompensation

or www.hrsa.gov/cicp.

Special situations

Persons who are moderately or severely immunocompromised**

Age 6 months–4 years

y Unvaccinated:

- 3-dose series of updated (2023–2024 Formula) Moderna at

0, 4, 8 weeks

- 3-dose series of updated (2023–2024 Formula) Pzer-

BioNTech at 0, 3, 11 weeks.

y Previously vaccinated* with 1 dose of any Moderna:

2-dose series of updated (2023–2024 Formula) Moderna at

0, 4 weeks (minimum interval between previous Moderna and

dose 1: 4 weeks).

y Previously vaccinated* with 2 doses of any Moderna:

1 dose of updated (2023–2024 Formula) Moderna at least

4 weeks after the most recent dose.

y Previously vaccinated* with 3 or more doses of any

Moderna: 1 dose of updated (2023–2024 Formula) Moderna

at least 8 weeks after the most recent dose.

y Previously vaccinated* with 1 dose of any Pzer-

BioNTech: 2-dose series of updated (2023–2024 Formula)

Pzer-BioNTech at 0, 8 weeks (minimum interval between

previous Pzer-BioNTech and dose 1: 3 weeks).

y Previously vaccinated* with 2 or more doses of any Pzer-

BioNTech: 1 dose of updated (2023–2024 Formula) Pzer-

BioNTech at least 8 weeks after the most recent dose.

Age 5–11 years

y Unvaccinated:

- 3-dose series of updated (2023–2024 Formula) Moderna

at 0, 4, 8 weeks

- 3-dose series updated (2023–2024 Formula) Pzer-BioNTech

at 0, 3, 7 weeks.

y Previously vaccinated* with 1 dose of any Moderna:

2-dose series of updated (2023–2024 Formula) Moderna at

0, 4 weeks (minimum interval between previous Moderna and

dose 1: 4 weeks).

y Previously vaccinated* with 2 doses of any Moderna:

1 dose of updated (2023–2024 Formula) Moderna at least

4 weeks after the most recent dose.

y Previously vaccinated* with 1 dose of any Pzer-

BioNTech: 2-dose series of updated (2023–2024 Formula)

Pzer-BioNTech at 0, 4 weeks (minimum interval between

previous Pzer-BioNTech and dose 1: 3 weeks)

y Previously vaccinated* with 2 doses of any Pzer-

BioNTech: 1 dose of 2023–2024 Pzer-BioNTech at least

4 weeks after the most recent dose.

COVID-19 vaccination

(minimum age: 6 months [Moderna and Pzer-

BioNTech COVID-19 vaccines], 12 years [Novavax

COVID-19 Vaccine])

Routine vaccination

Age 6 months–4 years

y Unvaccinated:

- 2-dose series of updated (2023–2024 Formula) Moderna at

0, 4-8 weeks

- 3-dose series of updated (2023–2024 Formula) Pzer-

BioNTech at 0, 3-8, 11-16 weeks

y Previously vaccinated* with 1 dose of any Moderna:

1 dose of updated (2023–2024 Formula) Moderna 4-8 weeks

after the most recent dose.

y Previously vaccinated* with 2 or more doses of any

Moderna: 1 dose of updated (2023–2024 Formula) Moderna

at least 8 weeks after the most recent dose.

y Previously vaccinated* with 1 dose of any Pzer-

BioNTech: 2-dose series of updated (2023–2024 Formula)

Pzer-BioNTech at 0, 8 weeks (minimum interval between

previous Pzer-BioNTech and dose 1: 3-8 weeks).

y Previously vaccinated* with 2 or more doses of any Pzer-

BioNTech: 1 dose of updated (2023–2024 Formula) Pzer-

BioNTech at least 8 weeks after the most recent dose.

Age 5–11 years

y Unvaccinated: 1 dose of updated (2023–2024 Formula)

Moderna or Pzer-BioNTech vaccine.

y Previously vaccinated* with 1 or more doses of Moderna

or Pzer-BioNTech: 1 dose of updated (2023–2024 Formula)

Moderna or Pzer-BioNTech at least 8 weeks after the most

recent dose.

Age 12–18 years

y Unvaccinated:

- 1 dose of updated (2023–2024 Formula) Moderna or Pzer-

BioNTech vaccine

- 2-dose series of updated (2023–2024 Formula) Novavax at

0, 3-8 weeks

y Previously vaccinated* with any COVID-19 vaccine(s):

1 dose of any updated (2023–2024 Formula) COVID-19

vaccine at least 8 weeks after the most recent dose.

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

y Previously vaccinated* with 3 or more doses of any

Moderna or Pzer-BioNTech: 1 dose of updated

(2023–2024 Formula) Moderna or Pzer-BioNTech at least

8 weeks after the most recent dose.

Age 12–18 years

y Unvaccinated:

- 3-dose series of updated (2023–2024 Formula) Moderna at

0, 4, 8 weeks

- 3-dose series of updated (2023–2024 Formula) Pzer-

BioNTech at 0, 3, 7 weeks

- 2-dose series of updated (2023–2024 Formula) Novavax at

0, 3 weeks

y Previously vaccinated* with 1 dose of any Moderna:

2-dose series of updated (2023–2024 Formula) Moderna at

0, 4 weeks (minimum interval between previous Moderna

dose and dose 1: 4 weeks).

y Previously vaccinated* with 2 doses of any Moderna:

1 dose of updated (2023–2024 Formula) Moderna at least

4 weeks after the most recent dose.

y Previously vaccinated* with 1 dose of any Pzer-

BioNTech: 2-dose series of updated (2023–2024 Formula)

Pzer-BioNTech at 0, 4 weeks (minimum interval between

previous Pzer-BioNTech dose and dose 1: 3 weeks).

y Previously vaccinated* with 2 doses of any Pzer-

BioNTech: 1 dose of updated (2023–2024 Formula) Pzer-

BioNTech at least 4 weeks after the most recent dose.

y Previously vaccinated* with 3 or more doses of any

Moderna or Pzer-BioNTech: 1 dose of any updated

(2023–2024 Formula) COVID-19 vaccine at least 8 weeks

after the most recent dose.

y Previously vaccinated* with 1 or more doses of Janssen

or Novavax or with or without dose(s) of any Original

monovalent or bivalent COVID-19 vaccine: 1 dose of any

updated (2023–2024 Formula) COVID-19 vaccine at least

8 weeks after the most recent dose.

There is no preferential recommendation for the use of

one COVID-19 vaccine over another when more than one

recommended age-appropriate vaccine is available.

Administer an age-appropriate COVID-19 vaccine product for

each dose. For information about transition from age 4 years

to age 5 years or age 11 years to age 12 years during COVID-19

vaccination series, see Tables 1 and 2 at www.cdc.gov/vaccines/

covid-19/clinical-considerations/interim-considerations-us.

html#covid-vaccines.

Current COVID-19 schedule and dosage formulation available

at www.cdc.gov/covidschedule. For more information on

Emergency Use Authorization (EUA) indications for COVID-19

vaccines, see www.fda.gov/emergency-preparedness-and-

response/coronavirus-disease-2019-covid-19/covid-19-vaccines

*Note: Previously vaccinated is dened as having received any

Original monovalent or bivalent COVID-19 vaccine (Janssen,

Moderna, Novavax, Pzer-BioNTech) prior to the updated

2023–2024 formulation.

**Note: Persons who are moderately or severely

immunocompromised have the option to receive one

additional dose of updated (2023–2024 Formula) COVID-19

vaccine at least 2 months following the last recommended

updated (2023 –2024 Formula) COVID-19 vaccine dose.

Further additional updated (2023–2024 Formula) COVID-19

vaccine dose(s) may be administered, informed by the clinical

judgement of a healthcare provider and personal preference

and circumstances. Any further additional doses should be

administered at least 2 months after the last updated

(2023–2024 Formula) COVID-19 vaccine dose. Moderately or

severely immunocompromised children 6 months–4 years of

age should receive homologous updated (2023–2024 Formula)

mRNA vaccine dose(s) if they receive additional doses.

Dengue vaccination

(minimum age: 9 years)

Routine vaccination

y Age 9–16 years living in areas with endemic dengue AND

have laboratory conrmation of previous dengue infection

- 3-dose series administered at 0, 6, and 12 months

y Endemic areas include Puerto Rico, American Samoa, US

Virgin Islands, Federated States of Micronesia, Republic of

Marshall Islands, and the Republic of Palau. For updated

guidance on dengue endemic areas and pre-vaccination

laboratory testing see www.cdc.gov/mmwr/volumes/70/rr/

rr7006a1.htm?s_cid=rr7006a1_w and www.cdc.gov/dengue/

vaccine/hcp/index.html

y Dengue vaccine should not be administered to children

traveling to or visiting endemic dengue areas.

Diphtheria, tetanus, and pertussis (DTaP)

vaccination (minimum age: 6 weeks [4 years

for Kinrix® or Quadracel®])

Routine vaccination

y 5-dose series (3-dose primary series at age 2, 4, and 6 months,

followed by a booster doses at ages 15–18 months and

4–6 years

- Prospectively: Dose 4 may be administered as early as age

12months if at least 6 months have elapsed since dose 3.

- Retrospectively: A 4

dose that was inadvertently

administered as early as age 12 months may be counted if at

least 4 months have elapsed since dose 3.

Catch-up vaccination

y Dose 5 is not necessary if dose 4 was administered at age

4years or older and at least 6 months after dose 3.

y For other catch-up guidance, see Table 2.

Special situations

y Wound management in children less than age 7 years with

history of 3 or more doses of tetanus-toxoid-containing

vaccine: For all wounds except clean and minor wounds,

administer DTaP if more than 5 years since last dose of

tetanus-toxoid-containing vaccine. For detailed information,

see www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.htm.

Haemophilus inuenzae type b vaccination

(minimum age: 6 weeks)

Routine vaccination

y ActHIB®, Hiberix®, Pentacel®, or Vaxelis®: 4-dose series

(3-dose primary series at age 2, 4, and 6 months, followed by

a booster dose* at age 12–15 months)

- *Vaxelis® is not recommended for use as a booster dose.

A dierent Hib-containing vaccine should be used for the

booster dose.

y PedvaxHIB®: 3-dose series (2-dose primary series at age

2 and 4 months, followed by a booster dose at age 12–15

months)

Catch-up vaccination

y Dose 1 at age 7–11 months: Administer dose 2 at least

4 weeks later and dose 3 (nal dose) at age12–15 months or

8weeks after dose 2 (whichever is later).

y Dose 1 at age 12–14 months: Administer dose 2 (nal dose)

at least 8weeks after dose 1.

y Dose 1 before age 12 months and dose 2 before age

15 months: Administer dose 3 (nal dose) at least

8weeks after dose 2.

y 2 doses of PedvaxHIB® before age 12 months:

Administer dose 3 (nal dose) at age12–59 months and

at least 8weeks after dose 2.

y 1 dose administered at age 15 months or older:

No further doses needed

y Unvaccinated at age 15–59 months: Administer 1 dose.

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Notes

y Previously unvaccinated children age 60 months or

older who are not considered high risk: Do not

require catch-up vaccination

For other catch-up guidance, see Table 2. Vaxelis® can be used

for catch-up vaccination in children less than age 5 years.

Follow the catch-up schedule even if Vaxelis® is used for one

or more doses. For detailed information on use of Vaxelis® see

www.cdc.gov/mmwr/volumes/69/wr/mm6905a5.htm.

Special situations

y Chemotherapy or radiation treatment:

Age 12–59 months

- Unvaccinated or only 1 dose before age 12 months: 2doses,

8weeks apart

- 2 or more doses before age 12 months: 1 dose at least

8weeks after previous dose

Doses administered within 14 days of starting therapy or

during therapy should be repeated at least 3 months

after therapy completion.

y Hematopoietic stem cell transplant (HSCT):

- 3-dose series 4 weeks apart starting 6 to 12 months after

successful transplant, regardless of Hib vaccination history

y Anatomic or functional asplenia (including

sickle cell disease):

Age 12–59 months

- Unvaccinated or only 1 dose before age 12 months:

2 doses, 8weeks apart

- 2 or more doses before age 12 months:

1 dose at least 8weeks after previous dose

Unvaccinated* persons age 5 years or older

- 1 dose

y Elective splenectomy:

Unvaccinated* persons age 15 months or older

- 1 dose (preferably at least 14 days before procedure)

y HIV infection:

Age 12–59 months

- Unvaccinated or only 1 dose before age 12 months:

2doses, 8weeks apart

- 2 or more doses before age 12 months:

1 dose at least 8weeks after previous dose

Unvaccinated* persons age 5–18 years

- 1 dose

y Immunoglobulin deciency, early component

complement deciency:

Age 12–59 months

- Unvaccinated or only 1 dose before age 12 months:

2doses, 8weeks apart

- 2 or more doses before age 12 months:

1 dose at least 8weeks after previous dose

* Unvaccinated = Less than routine series (through age

14months) OR no doses (age 15 months or older)

Hepatitis A vaccination

(minimum age: 12 months for routine vaccination)

Routine vaccination

y 2-dose series (minimum interval: 6 months) at

age 12–23 months

Catch-up vaccination

y Unvaccinated persons through age 18 years should complete

a 2-dose series (minimum interval: 6 months).

y Persons who previously received 1 dose at age 12 months or

older should receive dose 2 at least 6 months after dose 1.

y Adolescents age 18 years or older may receive the combined

HepA and HepB vaccine, Twinrix®, as a 3-dose series (0, 1, and

6months) or 4-dose series (3 doses at 0, 7, and 21–30 days,

followed by a booster dose at 12 months).

International travel

y Persons traveling to or working in countries with high or

intermediate endemic hepatitis A (www.cdc.gov/travel/):

- Infants age 6–11 months: 1 dose before departure;

revaccinate with 2 doses (separated by at least 6 months)

between age 12–23 months.

- Unvaccinated age 12 months or older: Administer dose 1

as soon as travel is considered.

Hepatitis B vaccination

(minimum age: birth)

Routine vaccination

y 3-dose series at age 0, 1–2, 6–18 months (use monovalent

HepB vaccine for doses administered before age 6 weeks)

- Birth weight ≥2,000 grams: 1 dose within 24 hours of birth

if medically stable

- Birth weight <2,000 grams: 1 dose at chronological age

1 month or hospital discharge (whichever is earlier and

even if weight is still <2,000 grams).

y Infants who did not receive a birth dose should begin the

series as soon as possible (see Table 2 for minimum intervals).

y Administration of 4 doses is permitted when a combination

vaccine containing HepB is used after the birth dose.

y Minimum intervals (see Table 2): when 4 doses

are administered, substitute “dose 4” for “dose 3”

in these calculations

y Final (3rd or 4th) dose: age 6–18 months

(minimum age 24 weeks)

y Mother is HBsAg-positive

- Birth dose (monovalent HepB vaccine only): administer

HepB vaccine and hepatitis B immune globulin (HBIG)

(in separate limbs) within 12 hours of birth, regardless

of birth weight.

- Birth weight <2000 grams: administer 3 additional doses

of HepB vaccine beginning at age 1 month (total of 4 doses)

- Final (3rd or 4th) dose: administer at age 6 months

(minimum age 24 weeks)

- Test for HBsAg and anti-HBs at age 9–12 months. If HepB

series is delayed, test 1–2 months after nal dose. Do not

test before age 9 months.

y Mother is HBsAg-unknown

If other evidence suggestive of maternal hepatitis B infection

exists (e.g., presence of HBV DNA, HBeAg-positive, or mother

known to have chronic hepatitis B infection), manage infant

as if mother is HBsAg-positive

- Birth dose (monovalent HepB vaccine only):

 Birth weight ≥2,000 grams: administer HepB vaccine

within 12 hours of birth. Determine mother’s HBsAg status

as soon as possible. If mother is determined to be HBsAg-

positive, administer HBIG as soon as possible (in separate

limb), but no later than 7 days of age.

 Birth weight <2,000 grams: administer HepB vaccine

and HBIG (in separate limbs) within 12 hours of birth.

Administer 3 additional doses of HepB vaccine beginning

at age 1 month (total of 4 doses)

- Final (3rd or 4th) dose: administer at age 6 months

(minimum age 24 weeks)

- If mother is determined to be HBsAg-positive or if status

remains unknown, test for HBsAg and anti-HBs at

age 9–12 months. If HepB series is delayed, test 1–2 months

after nal dose. Do not test before age 9 months.

Catch-up vaccination

y Unvaccinated persons should complete a 3-dose series at

0, 1–2, 6 months. See Table 2 for minimum intervals

y Adolescents age 11–15 years may use an alternative

2-dose schedule with at least 4 months between doses

(adult formulation Recombivax HB® only).

y Adolescents age 18 years may receive:

- Heplisav-B®: 2-dose series at least 4 weeks apart

- PreHevbrio®: 3-dose series at 0, 1, and 6 months

- Combined HepA and HepB vaccine, Twinrix®: 3-dose series

(0, 1, and 6 months) or 4-dose series (3 doses at 0, 7, and

21–30 days, followed by a booster dose at 12 months).

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Special situations

y Revaccination is not generally recommended for persons

with a normal immune status who were vaccinated as infants,

children, adolescents, or adults.

y Post-vaccination serology testing and revaccination

(if anti-HBs <10mlU/mL) is recommended for certain

populations, including:

- Infants born to HBsAg-positive mothers

- Persons who are predialysis or on maintenance dialysis

- Other immunocompromised persons

- For detailed revaccination recommendations, see www.cdc.

gov/vaccines/hcp/acip-recs/vacc-specic/hepb.html.

Note: Heplisav-B and PreHevbrio are not recommended in

pregnancy due to lack of safety data in pregnant persons

Human papillomavirus vaccination

(minimum age: 9 years)

Routine and catch-up vaccination

y HPV vaccination routinely recommended at age 11–12 years

(can start at age 9 years) and catch-up HPV vaccination

recommended for all persons through age 18 years if not

adequately vaccinated

y 2- or 3-dose series depending on age at initial vaccination:

- Age 9–14 years at initial vaccination: 2-dose series at 0,

6–12 months (minimum interval: 5 months; repeat dose if

administered too soon)

- Age 15 years or older at initial vaccination: 3-dose series

at 0, 1–2 months, 6 months (minimum intervals: dose 1 to

dose 2: 4 weeks / dose 2 to dose 3: 12 weeks / dose 1 to dose

3: 5months; repeat dose if administered too soon)

y No additional dose recommended when any HPV

vaccine series of any valency has been completed using

recommended dosing intervals.

Special situations

y Immunocompromising conditions, including HIV

infection: 3-dose series, even for those who initiate

vaccination at age 9 through 14 years.

y History of sexual abuse or assault: Start at age 9 years

y Pregnancy: Pregnancy testing not needed before

vaccination; HPV vaccination not recommended

until after pregnancy; no intervention needed if

vaccinated while pregnant

Inuenza vaccination

(minimum age: 6 months [IIV], 2 years [LAIV4],

18years [recombinant inuenza vaccine, RIV4])

Routine vaccination

y Use any inuenza vaccine appropriate for age and health

status annually:

- Age 6 months–8 years who have received fewer than

2 inuenza vaccine doses before July 1, 2023, or whose

inuenza vaccination history is unknown: 2 doses, separated

by at least 4 weeks. Administer dose 2 even if the child turns

9 years between receipt of dose 1 and dose 2.

- Age 6 months–8 years who have received at least 2

inuenza vaccine doses before July 1, 2023: 1 dose

- Age 9 years or older: 1 dose

y For the 2023-2024 season, see www.cdc.gov/mmwr/

volumes/72/rr/rr7202a1.htm.

y For the 2024–25 season, see the 2024–25 ACIP inuenza

vaccine recommendations.

Special situations

y Close contacts (e.g., household contacts) of severely

immunosuppressed persons who require a protected

environment: should not receive LAIV4. If LAIV4 is given,

they should avoid contact with for such immunosuppressed

persons for 7 days after vaccination.

Note: Persons with an egg allergy can receive any inuenza

vaccine (egg-based and non-egg-based) appropriate for age

and health status.

Measles, mumps, and rubella vaccination

(minimum age: 12 months for routine vaccination)

Routine vaccination

y 2-dose series at age 12–15 months, age 4–6 years

y MMR or MMRV* may be administered

Note: For dose 1 in children age 12–47 months, it is

recommended to administer MMR and varicella vaccines

separately. MMRV* may be used if parents or caregivers

express a preference.

Catch-up vaccination

y Unvaccinated children and adolescents: 2-dose series

at least 4 weeks apart*

y The maximum age for use of MMRV* is 12 years.

Special situations

y International travel

- Infants age 6–11 months: 1 dose before departure;

revaccinate with 2-dose series at age 12–15 months

(12 months for children in high-risk areas) and dose 2

as early as 4 weeks later.*

- Unvaccinated children age 12 months or older:

2-dose series at least 4 weeks apart before departure*

y In mumps outbreak settings, for information about

additional doses of MMR (including 3rd dose of MMR), see

www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm

*Note: If MMRV is used, the minimum interval between MMRV

doses is 3 months

Meningococcal serogroup A,C,W,Y vaccination

(minimum age: 2 months [MenACWY-CRM, Menveo],

2 years [MenACWY-TT, MenQuad]), 10 years

[MenACWY-TT/MenB-FHbp, Penbraya])

Routine vaccination

y 2-dose series at age 11–12 years; 16 years

Catch-up vaccination

y Age 13–15 years: 1 dose now and booster at age 16–18 years

(minimum interval: 8 weeks)

y Age 16–18 years: 1 dose

Special situations

Anatomic or functional asplenia (including sickle cell

disease), HIV infection, persistent complement

component deciency, complement inhibitor

(e.g., eculizumab, ravulizumab) use:

y Menveo®*

- Dose 1 at age 2 months: 4-dose series (additional 3 doses

at age 4, 6, and 12 months)

- Dose 1 at age 3–6 months: 3- or 4-dose series (dose 2

[and dose 3 if applicable] at least 8 weeks after previous

dose until a dose is received at age 7 months or older,

followed by an additional dose at least 12 weeks later

and after age 12 months)

- Dose 1 at age 7–23 months: 2-dose series (dose 2 at least

12weeks after dose 1 and after age 12 months)

- Dose 1 at age 24 months or older: 2-dose series

at least 8weeks apart

y MenQuad®

- Dose 1 at age 24 months or older: 2-dose series at least

8 weeks apart

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Travel to countries with hyperendemic or epidemic

meningococcal disease, including countries in the African

meningitis belt or during the Hajj (www.cdc.gov/travel/):

y Children less than age 24 months:

- Menveo®* (age 2–23 months)

 Dose 1 at age 2 months: 4-dose series (additional 3 doses at

age 4, 6, and 12 months)

 Dose 1 at age 3–6 months: 3- or 4-dose series (dose 2

[and dose 3 if applicable] at least 8 weeks after previous

dose until a dose is received at age 7 months or older,

followed by an additional dose at least 12 weeks later

and after age 12 months)

 Dose 1 at age 7–23 months: 2-dose series (dose 2 at least

12 weeks after dose 1 and after age 12 months)

y Children age 2 years or older: 1 dose Menveo®*

or MenQuad®

First-year college students who live in residential housing

(if not previously vaccinated at age 16 years or older) or

military recruits:

y 1 dose Menveo®* or MenQuad®

Adolescent vaccination of children who received MenACWY

prior to age 10 years:

y Children for whom boosters are recommended because

of an ongoing increased risk of meningococcal disease

(e.g., those with complement component deciency, HIV,

or asplenia): Follow the booster schedule for persons at

increased risk.

y Children for whom boosters are not recommended

(e.g., a healthy child who received a single dose for travel

to a country where meningococcal disease is endemic):

Administer MenACWY according to the recommended

adolescent schedule with dose 1 at age 11–12 years and

dose 2 at age 16 years.

* Menveo has two formulations: lyophilized and liquid. The liquid

formulation should not be used before age 10 years. See www.

cdc.gov/vaccines/vpd/mening/downloads/menveo-single-vial-

presentation.pdf.

Note: For MenACWY booster dose recommendations for

groups listed under “Special situations” and in an outbreak

setting and additional meningococcal vaccination information,

see www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm.

Children age 10 years or older may receive a single dose of

Penbraya™ as an alternative to separate administration of

MenACWY and MenB when both vaccines would be given

on the same clinic day (see “Meningococcal serogroup B

vaccination” section below for more information).

Meningococcal serogroup B vaccination

(minimum age: 10 years [MenB-4C, Bexsero®;

MenB-FHbp, Trumenba®; MenACWY-TT/MenB-FHbp,

Penbraya™])

Shared clinical decision-making

y Adolescents not at increased risk age 16–23 years

(preferred age 16–18 years) based on shared

clinical decision-making:

- Bexsero®: 2-dose series at least 1 month apart

- Trumenba®: 2-dose series at least 6 months apart (if dose 2

is administered earlier than 6 months, administer a 3

dose

at least 4 months after dose 2)

For additional information on shared clinical decision-making

for MenB, see www.cdc.gov/vaccines/hcp/admin/downloads/

isd-job-aid-scdm-mening-b-shared-clinical-decision-making.pdf

Special situations

Anatomic or functional asplenia (including sickle cell

disease), persistent complement component deciency,

complement inhibitor (e.g., eculizumab, ravulizumab) use:

y Bexsero®: 2-dose series at least 1 month apart

y Trumenba®: 3-dose series at 0, 1–2, 6 months (if dose 2

was administered at least 6 months after dose 1, dose 3

not needed; if dose 3 is administered earlier than 4 months

after dose 2, a 4

dose should be administered at least

4 months after dose 3)

Note: Bexsero® and Trumenba® are not interchangeable;

the same product should be used for all doses in a series.

For MenB booster dose recommendations for groups listed

under “Special situations” and in an outbreak setting and

additional meningococcal vaccination information, see

www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm.

Children age 10 years or older may receive a dose of Penbraya™

as an alternative to separate administration of MenACWY and

MenB when both vaccines would be given on the same clinic

day. For age-eligible children not at increased risk, if Penbraya™

is used for dose 1 MenB, MenB-FHbp (Trumenba) should be

administered for dose 2 MenB. For age-eligible children at

increased risk of meningococcal disease, Penbraya™ may be

used for additional MenACWY and MenB doses (including

booster doses) if both would be given on the same clinic

day and at least 6 months have elapsed since most recent

Penbraya™ dose.

Mpox vaccination

(minimum age: 18 years [Jynneos®])

Special situations

y Age 18 years and at risk for Mpox infection: 2-dose series,

28 days apart.

Risk factors for Mpox infection include:

- Persons who are gay, bisexual, and other MSM, transgender

or nonbinary people who in the past 6 months have had:

 A new diagnosis of at least 1 sexually transmitted disease

 More than 1 sex partner

 Sex at a commercial sex venue

 Sex in association with a large public event in a geographic

area where Mpox transmission is occurring

- Persons who are sexual partners of the persons described

above

- Persons who anticipate experiencing any of the situations

described above

y Pregnancy: There is currently no ACIP recommendation

for Jynneos use in pregnancy due to lack of safety data in

pregnant persons. Pregnant persons with any risk factor

described above may receive Jynneos.

For detailed information, see: www.cdc.gov/vaccines/acip/

meetings/downloads/slides-2023-10-25-26/04-MPOX-Rao-508.pdf

Pneumococcal vaccination

(minimum age: 6 weeks [PCV15], [PCV 20]; 2 years

[PPSV23])

Routine vaccination with PCV

y 4-dose series at 2, 4, 6, 12–15 months

Catch-up vaccination with PCV

y Healthy children ages 2–4 years with any incomplete*

PCV series: 1 dose PCV

y For other catch-up guidance, see Table 2.

Note: For children without risk conditions, PCV20 is not

indicated if they have received 4 doses of PCV13 or PCV15 or

another age appropriate complete PCV series.

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Special situations

Children and adolescents with cerebrospinal uid leak;

chronic heart disease; chronic kidney disease (excluding

maintenance dialysis and nephrotic syndrome); chronic

liver disease; chronic lung disease (including moderate

persistent or severe persistent asthma); cochlear implant;

or diabetes mellitus:

Age 2–5 years

y Any incomplete* PCV series with:

- 3 PCV doses: 1 dose PCV (at least 8 weeks after the most

recent PCV dose)

- Less than 3 PCV doses: 2 doses PCV (at least 8 weeks after

the most recent dose and administered at least 8 weeks

apart)

y Completed recommended PCV series but have not received

PPSV23

- Previously received at least 1 dose of PCV20: no further PCV

or PPSV23 doses needed

- Not previously received PCV20: administer 1 dose PCV20 OR

1 dose PPSV23 administer at least 8 weeks after the most

recent PCV dose.

Age 6–18 years

y Not previously received any dose of PCV13, PCV15, or PCV20:

administer 1 dose of PCV15 or PCV20. If PCV15 is used and no

previous receipt of PPSV23, administer 1 dose of PPSV23 at

least 8 weeks after the PCV15 dose.**

y Received PCV before age 6 years but have not received

PPSV23

- Previously received at least 1 dose of PCV20: no further PCV

or PPSV23 doses needed

- Not previously received PCV20: 1 dose PCV20 OR 1 dose

PPSV23 administer at least 8 weeks after the most recent

PCV dose.

y Received PCV13 only at or after age 6 years: administer 1 dose

PCV20 OR 1 dose PPSV23 at least 8 weeks after the most

recent PCV13 dose.

y Received 1 dose PCV13 and 1 dose PPSV23 at or after age

6 years: no further doses of any PCV or PPSV23 indicated.

Children and adolescents on maintenance dialysis, or

with immunocompromising conditions such as nephrotic

syndrome; congenital or acquired asplenia or splenic

dysfunction; congenital or acquired immunodeciencies;

diseases and conditions treated with immunosuppressive

drugs or radiation therapy, including malignant

neoplasms, leukemias, lymphomas, Hodgkin disease, and

solid organ transplant; HIV infection; or sickle cell disease

or other hemoglobinopathies:

Age 2–5 years

y Any incomplete* PCV series:

- 3 PCV doses: 1 dose PCV (at least 8 weeks after the most

recent PCV dose)

- Less than 3 PCV doses: 2 doses PCV (at least 8 weeks after the

most recent dose and administered at least 8 weeks apart)

y Completed recommended PCV series but have not received

PPSV23

- Previously received at least 1 dose of PCV20: no further PCV

or PPSV23 doses needed

- Not previously received PCV20: administer 1 dose PCV20 OR

1 dose PPSV23 at least 8 weeks after the most recent PCV

dose. If PPSV23 is used, administer 1 dose of PCV20 or dose

2 PPSV23 at least 5 years after dose 1 PPSV23.

Age 6–18 years

y Not previously received any dose of PCV13, PCV15, or PCV20:

administer 1 dose of PCV15 or 1 dose of PCV20. If PCV15 is

used and no previous receipt of PPSV23, administer 1 dose of

PPSV23 at least 8 weeks after the PCV15 dose.**

y Received PCV before age 6 years but have not received

PPSV23

- Previously received at least 1 dose of PCV20: no additional

dose of PCV or PPSV23

- Not previously received PCV20: administer 1 dose PCV20 OR

1 dose PPSV23 at least 8 weeks after the most recent PCV

dose. If PPSV23 is used, administer either PCV20 or dose 2

PPSV23 at least 5 years after dose 1 PPSV23.

y Received PCV13 only at or after age 6 years: administer 1 dose

PCV20 OR 1 dose PPSV23 at least 8 weeks after the most

recent PCV13 dose. If PPSV23 is used, administer 1 dose of

PCV20 or dose 2 PPSV23 at least 5 years after dose 1 PPSV23.

y Received 1 dose PCV13 and 1 dose PPSV23 at or after age

6 years: administer 1 dose PCV20 OR 1 dose PPSV23 at least

8 weeks after the most recent PCV13 dose and at least 5 years

after dose 1 PPSV23.

*Incomplete series = Not having received all doses in either the

recommended series or an age-appropriate catch-up series.

See Table 2 in ACIP pneumococcal recommendations at

stacks.cdc.gov/view/cdc/133252

**When both PCV15 and PPSV23 are indicated, administer

all doses of PCV15 rst. PCV15 and PPSV23 should not be

administered during the same visit.

For guidance on determining which pneumococcal vaccines

a patient needs and when, please refer to the mobile app,

which can be downloaded here: www.cdc.gov/vaccines/vpd/

pneumo/hcp/pneumoapp.html

Poliovirus vaccination

(minimum age: 6 weeks)

Routine vaccination

y 4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer

the nal dose on or after age 4 years and at least 6 months

after the previous dose.

y 4 or more doses of IPV can be administered before age 4 years

when a combination vaccine containing IPV is used. However,

a dose is still recommended on or after age 4 years and at

least 6 months after the previous dose.

Catch-up vaccination

y In the rst 6 months of life, use minimum ages and

intervals only for travel to a polio-endemic region

or during an outbreak.

y Adolescents age 18 years known or suspected to be

unvaccinated or incompletely vaccinated: administer

remaining doses (1, 2, or 3 IPV doses) to complete a 3-dose

primary series.* Unless there are specic reasons to believe

they were not vaccinated, most persons aged 18 years or

older born and raised in the United States can assume they

were vaccinated against polio as children.

Series containing oral poliovirus vaccine (OPV), either mixed

OPV-IPV or OPV-only series:

y Total number of doses needed to complete the series is the

same as that recommended for the U.S. IPV schedule. See

www.cdc.gov/mmwr/volumes/66/wr/mm6601a6.htm?s_%20

cid=mm6601a6_w.

y Only trivalent OPV (tOPV) counts toward the

U.S. vaccination requirements.

- Doses of OPV administered before April 1, 2016,

should be counted (unless specically noted as

administered during a campaign).

- Doses of OPV administered on or after April 1, 2016,

should not be counted.

- For guidance to assess doses documented as “OPV,” see

www.cdc.gov/mmwr/volumes/66/wr/mm6606a7.htm?s_

cid=mm6606a7_w.

y For other catch-up guidance, see Table 2.

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Special situations

y Adolescents aged 18 years at increased risk of exposure to

poliovirus and completed primary series*: may administer

one lifetime IPV booster

*Note: Complete primary series consist of at least 3 doses

of IPV or trivalent oral poliovirus vaccine (tOPV) in any

combination.

For detailed information, see: www.cdc.gov/vaccines/vpd/

polio/hcp/recommendations.html

Respiratory syncytial virus immunization

(minimum age: birth [Nirsevimab, RSV-mAb

(Beyfortus™)

Routine immunization

y Infants born October – March in most of the continental

United States*

- Mother did not receive RSV vaccine OR mother’s RSV

vaccination status is unknown: administer 1 dose nirsevimab

within 1 week of birth in hospital or outpatient setting

- Mother received RSV vaccine less than 14 days prior to

delivery: administer 1 dose nirsevimab within 1 week of

birth in hospital or outpatient setting

- Mother received RSV vaccine at least 14 days prior to

delivery: nirsevimab not needed but can be considered in

rare circumstances at the discretionof healthcare providers

(see special populations and situations at

www.cdc.gov/vaccines/vpd/rsv/hcp/child-faqs.html)

y Infants born April–September in most of the continental

United States*

- Mother did not receive RSV vaccine OR mother’s RSV

vaccination status is unknown: administer 1 dose nirsevimab

shortly before start of RSV season*

- Mother received RSV vaccine less than 14 days prior to

delivery: administer 1 dose nirsevimab shortly before start of

RSV season*

- Mother received RSV vaccine at least 14 days prior to

delivery: nirsevimab not needed but can be considered

in rare circumstances at the discretionof healthcare

providers(see special populations and situations at

www.cdc.gov/vaccines/vpd/rsv/hcp/child-faqs.html)

Infants with prolonged birth hospitalization** (e.g., for

prematurity) discharged October through March should be

immunized shortly before or promptly afterdischarge.

Special situations

y Ages 8–19 months with chronic lung disease of

prematurity requiring medical support (e.g.,

chronic corticosteroid therapy, diuretic therapy, or

supplemental oxygen) any time during the 6-month

period before the start of the second RSV season; severe

immunocompromise; cystic brosis with either weight

for length <10th percentile or manifestation of severe

lung disease (e.g., previous hospitalization for pulmonary

exacerbation in the rst year of life or abnormalities on

chest imaging that persist when stable)**:

- 1 dose nirsevimab shortly before start of second RSV

season*

y Ages 8–19 months who are American Indian or Alaska

Native:

- 1 dose nirsevimab shortly before start of second RSV

season*

y Age-eligible and undergoing cardiac surgery with

cardiopulmonary bypass**: 1 additional dose of nirsevimab

after surgery. For additional details see special populations

and situations at www.cdc.gov/vaccines/vpd/rsv/hcp/child-

faqs.html

*Note: While the timing of the onset and duration of RSV

season may vary, nirsevimab may be administered October

through March in most of the continental United States.

Providers in jurisdictions with RSV seasonality that diers from

most of the continental United States (e.g., Alaska, jurisdiction

with tropical climate) should follow guidance from public

health authorities (e.g., CDC, health departments) or regional

medical centers on timing of administration based on local

RSV seasonality. Although optimal timing of administration is

just before the start of the RSV season, nirsevimab may also

be administered during the RSV season to infants and children

who are age-eligible.

**Note: Nirsevimab can be administered to children who are

eligible to receive palivizumab. Children who have received

nirsevimab should not receive palivizumab for the same RSV

season.

For further guidance, see www.cdc.gov/mmwr/volumes/72/

wr/mm7234a4.htm and www.cdc.gov/vaccines/vpd/rsv/hcp/

child-faqs.html

Respiratory syncytial virus vaccination

(RSV [Abrysvo™])

Routine vaccination

y Pregnant at 32 weeks 0 days through 36 weeks and 6 days

gestation from September through January in most of the

continental United States*: 1 dose RSV vaccine (Abrysvo™).

Administer RSV vaccine regardless of previous RSV infection.

- Either maternal RSV vaccination or infant immunization with

nirsevimab (RSV monoclonal antibody) is recommended to

prevent respiratory syncytial virus lower respiratory tract

infection in infants.

y All other pregnant persons: RSV vaccine not recommended.

There is currently no ACIP recommendation for RSV vaccination

in subsequent pregnancies. No data are available to inform

whether additional doses are needed in later pregnancies.

*Note: Providers in jurisdictions with RSV seasonality that

diers from most of the continental United States (e.g., Alaska,

jurisdiction with tropical climate) should follow guidance from

public health authorities (e.g., CDC, health departments) or

regional medical centers on timing of administration based on

local RSV seasonality.

Rotavirus vaccination

(minimum age: 6 weeks)

Routine vaccination

y Rotarix®: 2-dose series at age 2 and 4 months

y RotaTeq®: 3-dose series at age 2, 4, and 6 months

y If any dose in the series is either RotaTeq® or unknown,

default to 3-dose series.

Catch-up vaccination

y Do not start the series on or after age 15 weeks, 0 days.

y The maximum age for the nal dose is 8 months, 0 days.

y For other catch-up guidance, see Table 2.

Notes

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

11/16/2023 Centers for Disease Control and Prevention

Recommended Child and Adolescent Immunization Schedule, United States, 2024

Tetanus, diphtheria, and pertussis (Tdap)

vaccination

(minimum age: 11 years for routine vaccination,

7years for catch-up vaccination)

Routine vaccination

y Age 11–12 years: 1 dose Tdap (adolescent booster)

y Pregnancy: 1 dose Tdap during each pregnancy, preferably in

early part of gestational weeks 27–36.

Note: Tdap may be administered regardless of the interval

since the last tetanus- and diphtheria-toxoid-containing

vaccine.

Catch-up vaccination

y Age 13–18 years who have not received Tdap:

1 dose Tdap (adolescent booster)

y Age 7–18 years not fully vaccinated

with DTaP: 1dose

Tdap as part of the catch-up series (preferably the rst dose);

if additional doses are needed, use Td or Tdap.

y Tdap administered at age 7–10 years:

- Age 7–9 years who receive Tdap should receive the

adolescent Tdap booster dose at age 11–12 years.

- Age 10 years who receive Tdap do not need the adolescent

Tdap booster dose at age 11–12 years.

y DTaP inadvertently administered on or after age 7 years:

- Age 7–9 years: DTaP may count as part of catch-up series.

Administer adolescent Tdap booster dose at age 11–12 years.

- Age 10–18 years: Count dose of DTaP as the adolescent

Tdap booster dose.

y For other catch-up guidance, see Table 2.

Special situations

y Wound management in persons age 7 years or older with

history of 3 or more doses of tetanus-toxoid-containing

vaccine: For clean and minor wounds, administer Tdap or

Td if more than 10 years since last dose of tetanus-toxoid-

containing vaccine; for all other wounds, administer Tdap

or Td if more than 5 years since last dose of tetanus-toxoid-

containing vaccine. Tdap is preferred for persons age 11 years

or older who have not previously received Tdap or whose

Tdap history is unknown. If a tetanus-toxoid-containing

vaccine is indicated for a pregnant adolescent, use Tdap.

y For detailed information, see www.cdc.gov/mmwr/

volumes/69/wr/mm6903a5.htm.

*Fully vaccinated = 5 valid doses of DTaP OR 4 valid doses of

DTaP if dose 4 was administered at age 4 years or older

Varicella vaccination

(minimum age: 12 months)

Routine vaccination

y 2-dose series at age 12–15 months, 4–6 years

y VAR or MMRV may be administered*

y Dose 2 may be administered as early as 3 months after dose 1

(a dose inadvertently administered after at least 4 weeks

may be counted as valid)

*Note: For dose 1 in children age 12–47 months, it is

recommended to administer MMR and varicella vaccines

separately. MMRV may be used if parents or caregivers

express a preference.

Catch-up vaccination

y Ensure persons age 7–18 years without evidence of immunity

(see MMWR at www.cdc.gov/mmwr/pdf/rr/rr5604.pdf)

have a 2-dose series:

- Age 7–12 years: Routine interval: 3 months

(a dose inadvertently administered after at least

4 weeks may be counted as valid)

- Age 13 years and older: Routine interval: 4–8weeks

(minimum interval: 4 weeks)

- The maximum age for use of MMRV is 12 years.

Vaccines and other

Immunizing Agents

Contraindicated or Not Recommended

Precautions

COVID-19 mRNA vaccines

[Pzer-BioNTech, Moderna]

• Severeallergic reaction (e.g., anaphylaxis) after a previous dose or to a component of

an mRNA COVID-19 vaccine

• Diagnosed non-severe allergy (e.g., urticaria beyond the injection site) to a

component of an mRNA COVID-19 vaccine

; or non-severe, immediate (onset

less than 4 hours) allergic reaction after administration of a previous dose of

an mRNA COVID-19 vaccine

• Myocarditis or pericarditis within 3 weeks after a dose ofany COVID-19 vaccine

• Multisystem inammatory syndrome in children (MIS-C) or multisystem

inammatory syndrome in adults (MIS-A)

• Moderate or severe acute illness, with or without fever

COVID-19 protein subunit

vaccine

[Novavax]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of

a Novavax COVID-19 vaccine

• Diagnosed non-severe allergy (e.g., urticaria beyond the injection site) to a

component of Novavax COVID-19 vaccine

; or non-severe, immediate (onset

less than 4 hours) allergic reaction after administration of a previous dose of

a Novavax COVID-19 vaccine

• Myocarditis or pericarditis within 3 weeks after a dose ofany COVID-19 vaccine

• Multisystem inammatory syndrome in children (MIS-C) or multisystem

inammatory syndrome in adults (MIS-A)

• Moderate or severe acute illness, with or without fever

Inuenza, egg-based,

inactivated injectable (IIV4)

• Severe allergic reaction (e.g., anaphylaxis) after previous dose of any inuenza vaccine

(i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)

• Severe allergic reaction (e.g., anaphylaxis) to any vaccine component

(excluding egg)

• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any

type of inuenza vaccine

• Moderate or severe acute illness with or without fever

Inuenza, cell culture-based

inactivated injectable (ccIIV4)

[Flucelvax Quadrivalent]

• Severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency, or to any component

of ccIIV4 • Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any

type of inuenza vaccine

• Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous

dose of any egg-based IIV, RIV, or LAIV of any valency. If using ccIV4, administer in

medical setting under supervision of health care provider who can recognize and

manage severe allergic reactions. May consult an allergist.

• Moderate or severe acute illness with or without fever

Inuenza, recombinant

injectable (RIV4)

[Flublok Quadrivalent]

• Severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency, or to any component

of RIV4 • Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any

type of inuenza vaccine

• Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous

dose of any egg-based IIV, ccIIV, or LAIV of any valency. If using RIV4, administer in

medical setting under supervision of health care provider who can recognize and

manage severe allergic reactions. May consult an allergist.

• Moderate or severe acute illness with or without fever

Inuenza, live attenuated

(LAIV4)

[Flumist Quadrivalent]

• Severe allergic reaction (e.g., anaphylaxis) after previous dose of any inuenza vaccine

(i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)

• Severe allergic reaction (e.g., anaphylaxis) to any vaccine component

(excluding egg)

• Children age 2–4 years with a history of asthma or wheezing

• Anatomic or functional asplenia

• Immunocompromised due to any cause including, but not limited to, medications and HIV infection

• Close contacts or caregivers of severely immunosuppressed persons who require a protected environment

• Pregnancy

• Cochlear implant

• Active communication between the cerebrospinal uid (CSF) and the oropharynx, nasopharynx, nose,

ear or any other cranial CSF leak

• Children and adolescents receiving aspirin or salicylate-containing medications

• Received inuenza antiviral medications oseltamivir or zanamivir within the previous 48 hours,

peramivir within the previous 5 days, or baloxavir within the previous 17 days

• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any

type of inuenza vaccine

• Asthma in persons age 5 years old or older

• Persons with underlying medical conditions other than those listed under

contraindications that might predispose to complications after wild-type

inuenza virus infection, e.g., chronic pulmonary, cardiovascular (except isolated

hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders

(including diabetes mellitus)

• Moderate or severe acute illness with or without fever

1. When a contraindication is present, a vaccine shouldNOTbe administered. Kroger A, Bahta L, Hunter P.ACIP General Best Practice Guidelines for Immunization.

2. When a precaution is present, vaccination should generally be deferred but might be indicated if the benet of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P.ACIP General Best

Practice Guidelines for Immunization.

3. Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. SeePackage inserts for U.S.-licensed vaccines.

4. Seepackage insertsandFDA EUA fact sheetsfor a full list of vaccine ingredients. mRNA COVID-19 vaccines contain polyethylene glycol (PEG).

Guide to Contraindications and Precautions to Commonly Used Vaccines

Adapted from Table 4-1 inAdvisory Committee on Immunization Practices (ACIP) General Best Practice Guidelines for Immunization:Contraindication and Precautions, Prevention and Control of Seasonal Inuenza with Vaccines:

Recommendations of the Advisory Committee on Immunization Practices—United States, 2023–24 Inuenza Season | MMWR (cdc.gov), Contraindications and Precautions for COVID-19 Vaccination, and Contraindications and

Precautions for JYNNEOS Vaccination

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Appendix

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Appendix

Vaccines and other

Immunizing Agents

Contraindicated or Not Recommended

Precautions

Dengue (DEN4CYD) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe immunodeciency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeciency,

long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)

• Lack of laboratory conrmation of a previous Dengue infection

• Pregnancy

• HIV infection without evidence of severe immunosuppression

• Moderate or severe acute illness with or without fever

Diphtheria, tetanus, pertussis (DTaP) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• For DTaP only: Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to

another identiable cause within 7 days of administration of previous dose of DTP or DTaP

• Guillain-Barré syndrome (GBS) within 6 weeks after previous dose of tetanus-toxoid–containing vaccine

• History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria-toxoid–containing

or tetanus-toxoid–containing vaccine; defer vaccination until at least 10 years have elapsed since the last

tetanus-toxoid-containing vaccine

• For DTaP only: Progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy,

progressive encephalopathy; defer DTaP until neurologic status claried and stabilized

• Moderate or severe acute illness with or without fever

Haemophilus inuenzae type b (Hib) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Less than age 6 weeks

• Moderate or severe acute illness with or without fever

Hepatitis A (HepA) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

including neomycin • Moderate or severe acute illness with or without fever

Hepatitis B (HepB) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

including yeast

• Pregnancy: Heplisav-B and PreHevbrio are not recommended due to lack of safety data in pregnant persons. Use other hepatitis

B vaccines if HepB is indicated

• Moderate or severe acute illness with or without fever

Hepatitis A-Hepatitis B vaccine (HepA-HepB)

[Twinrix]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

including neomycin and

yeast

• Moderate or severe acute illness with or without fever

Human papillomavirus (HPV) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Pregnancy: HPV vaccination not recommended.

• Moderate or severe acute illness with or without fever

Measles, mumps, rubella (MMR)

Measles, mumps, rubella, and varicella

(MMRV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe immunodeciency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeciency,

long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)

• Pregnancy

• Family history of altered immunocompetence, unless veried clinically or by laboratory testing as immunocompetent

• Recent (≤11 months) receipt of antibody-containing blood product (specic interval depends on product)

• History of thrombocytopenia or thrombocytopenic purpura

• Need for tuberculin skin testing or interferon-gamma release assay (IGRA) testing

• Moderate or severe acute illness with or without fever

• For MMRV only: Personal or family (i.e., sibling or parent) history of seizures of any etiology

Meningococcal ACWY (MenACWY)

MenACWY-CRM [Menveo]

MenACWY-TT [MenQuad]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• For Men ACWY-CRM only: severe allergic reaction to any diphtheria toxoid—or CRM197—containing vaccine

• For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine

• For MenACWY-CRM only: Preterm birth if less than age 9 months

• Moderate or severe acute illness with or without fever

Meningococcal B (MenB)

MenB-4C [Bexsero]

MenB-FHbp [Trumenba]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Pregnancy

• For MenB-4C only: Latex sensitivity

• Moderate or severe acute illness with or without fever

Meningococcal ABCWY

(MenACWY-TT/MenB-FHbp) [Penbraya]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe allergic reaction to a tetanus toxoid-containing vaccine

• Moderate or severe acute illness, with or without fever

Mpox [Jynneos] • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Moderate or severe acute illness, with or without fever

Pneumococcal conjugate (PCV) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe allergic reaction (e.g., anaphylaxis) to any diphtheria-toxoid-containing vaccine or its component

• Moderate or severe acute illness with or without fever

Pneumococcal polysaccharide (PPSV23) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Moderate or severe acute illness with or without fever

Poliovirus vaccine, inactivated (IPV) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Pregnancy

• Moderate or severe acute illness with or without fever

RSV monoclonal antibody (RSV-mAb) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Moderate or severe acute illness with or without fever

Respiratory syncytial virus vaccine (RSV) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Moderate or severe acute illness with or without fever

Rotavirus (RV)

RV1 [Rotarix]

RV5 [RotaTeq]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe combined immunodeciency (SCID)

• History of intussusception

• Altered immunocompetence other than SCID

• Chronic gastrointestinal disease

• RV1 only: Spina bida or bladder exstrophy

• Moderate or severe acute illness with or without fever

Tetanus, diphtheria, and acellular pertussis

(Tdap)

Tetanus, diphtheria (Td)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• For Tdap only: Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to

another identiable cause within 7 days of administration of previous dose of DTP, DTaP, or Tdap

• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus-toxoid–containing vaccine

• History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria-toxoid–containing

or tetanus-toxoid–containing vaccine; defer vaccination until at least 10 years have elapsed since the last

tetanus-toxoid–containing vaccine

• For Tdap only: Progressive or unstable neurological disorder, uncontrolled seizures, or progressive

encephalopathy until a treatment regimen has been established and the condition has stabilized

• Moderate or severe acute illness with or without fever

Varicella (VAR) • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component

• Severe immunodeciency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeciency,

long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)

• Pregnancy

• Family history of altered immunocompetence, unless veried clinically or by laboratory testing as immunocompetent

• Recent (≤11 months) receipt of antibody-containing blood product (specic interval depends on product)

• Receipt of specic antiviral drugs (acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination (avoid

use of these antiviral drugs for 14 days after vaccination)

• Use of aspirin or aspirin-containing products

• Moderate or severe acute illness with or without fever

• If using MMRV, see MMR/MMRV for additional precautions

1. When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html

Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html

www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states.

4. For information on the pregnancy exposure registries for persons who were inadvertently vaccinated with Heplisav-B or PreHevbrio while pregnant, please visit heplisavbpregnancyregistry.com or www.prehevbrio.com/#safety.

5. Full prescribing information for BEYFORTUS (nirsevimab-alip) www.accessdata.fda.gov/drugsatfda_docs/label/2023/761328s000lbl.pdf

Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2024

Addendum

Vaccines Recommendations Eective Date of Recommendation*

COVID-19 (Moderna,

Pzer-BioNTech, Novavax)

• ACIP recommends 2024-2025 COVID-19 vaccines as authorized or approved by FDA in persons ≥6 months of age. June 27, 2024

Inuenza • ACIP rearms the recommendation for routine annual inuenza vaccination of all persons aged ≥6 months who do not

have contraindications.

• ACIP recommends high-dose inactivated (HD-IIV3) and adjuvanted inactivated (aIIV3) inuenza vaccines as acceptable options for

inuenza vaccination of solid organ transplant recipients aged 18 through 64 years who are on immunosuppressive medication

regimens, without a preference over other age-appropriate IIV3s or RIV3.

June 27, 2024

Vaxelis (DTaP-IPV-Hib-HepB) • ACIP recommends DTaP-IPV-Hib-HepB (Vaxelis®) should be included with PRP-OMP (PedvaxHIB®) in the preferential recommendation

for American Indian and Alaska Native infants based on the Haemophilus inuenzae type b (Hib) component.

June 26, 2024

In addition to the recommendations presented in the previous sections of this immunization schedule, ACIP has approved the following recommendations by majority vote since October 26, 2023. The following

recommendations have been adopted by the CDC Director and are now ocial. Links are provided if these recommendations have been published in Morbidity and Mortality Weekly Report (MMWR).

*The eective date is the date when the CDC director adopted the recommendation and when the ACIP recommendation became ocial.