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Recommended and Minimum Ages and Intervals Between Doses of Routinely Recommended Vaccines

 

Vaccine and dose number

Recommended age for this dose

Minimum age for this dose

Recommended interval to next dose

Minimum interval to next dose

     

Hepatitis B (HepB)-1

Birth

Birth

1-4 months

4 weeks

HepB-2

1-2 months

4 weeks

2-17 months

8 weeks

HepB-3

6-18 months

24 weeks

 

 

     

Diphtheria-tetanus-acellular pertussis (DTaP)-1

2 months

6 weeks

2 months

4 weeks

DPT-2

4 months

10 weeks

2 months

4 weeks

DPT-3

6 months

14 weeks

6-12 months

6 months

DPT-4

15-18 months

12 months

3 years

6 months

DPT-5

4-6 years

4 Years

 

 

     

Haemophilus influenzae type b (Hib)-1

2 months

6 weeks

2 months

4 weeks

Hib-2

4 months

10 weeks

2 months

4 weeks

Hib-3

6 months

14 weeks

6-9 months

8 weeks

Hib-4

12-15 months

12 months

 

 

     

Inactivated poliovirus (IPV)-1

2 months

6 weeks

2 months

4 weeks

IPV-2

4 months

10 weeks

2-14 months

4 weeks

IPV-3

6-18 months

14 weeks

3-5 years

4 weeks

IPV-4

4-6 years

18 weeks

 

 

     

Pneumococcal conjugate (PCV)-1

2 months

6 weeks

2 months

4 weeks

PCV-2

4 months

10 weeks

2 months

4 weeks

PCV-3

6 months

14 weeks

6 months

8 weeks

PCV-4

12-15 months

12 months

 

 

     

Measles-mumps-rubella (MMR)-1

12-15 months

12 months

3-5 years

4 weeks

MMR-2

4-6 years

13 months

 

 

     

Varicella (Var)-1

12-15 months

12 months

3-5 years

12 weeks

Var-2

4-6 years

15 months

 

 

     

Hepatitis A (HepA)-1

12-23 months

12 months

6-18 months

6 months

HepA-2

18-41 months

18 months

 

 

 

 

 

 

Influenza, Inactivated (TIV)10

6-59 months

6 months

1 month

4 weeks

 

 

 

 

Influenza, Live attenuated (LAIV)

 

2 years

1 month

4 weeks

 

 

 

 

Meningococcal Conjugate (MCV)

11-12 years

2 years

5 years

5 years

 

 

 

 

Meningococcal Polysaccharide (MPSV)-1

 

2 years

 

 

MPSV-2

 

7 years

 

 

 

 

 

 

Tetanus-diphtheria (Td)

11-12 years

7 years

10 years

5 years

 

 

 

 

Tetanus-diphtheria-acellular pertussis (Tdap)

>11 years

10 years

 

 

 

 

 

 

Pneumococcal polysaccharide (PPV)-1

 

2 years

5 years

5 years

PPV-2

 

7 years

 

 

     

Human papillomavirus (HPV)-1

11-12 years

9 years

2 months

4 weeks

HPV-2

11-12 years

109 months

4 months

12 weeks

HPV-3

11-12 years

114 months

 

 

     

Rotavirus (Rota)-1

2 months

6 weeks

2 months

4 weeks

Rota-2

4 months

10 weeks

2 months

4 weeks

Rota-3

6 months

14 weeks

 

 

 

 

 

 

Zoster

60 years

60 years

 

 

 

 

1.         Use of licensed combination vaccines is preferred over separate injections of their equivalent component vaccines. (CDC. Combination vaccines for childhood immunization recommendations of the Advisory Committee on Immunization Practices [ACIP], the American Academy of Pediatrics [AAP], and the American Academy of Family Physicians [AAFP]. MMWR 1999;48[No. RR-5]). When administering combination vaccines, the minimum age

for administration is the oldest age for any of the individual components; the minimum interval between doses is equal to the greatest interval of any of the individual components.

 

2.         Combination vaccines containing the Hepatitis B component are available (HepB-Hib, DTaP-HepB-IPV, HepA-HepB). These vaccines should not be administered to infants younger than 6 weeks of age because of the other components (i.e., Hib, DTaP, IPV, and HepA).

 

3.         HepB-3 should be administered at least 8 weeks after HepB-2 and at least 16 weeks after HepB-1, and it should not be administered before age 24 weeks.

 

4.         Calendar months.

 

5.         The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3.

 

6.         For Hib and PCV, children receiving the first dose of vaccine at age 7 months of age or older require fewer doses to complete the series (CDC. Recommended childhood and adolescent immunization schedule – United States, 2006. MMWR 2005; 54 [Nos. 51 & 52]:Q1-Q4).

 

7.         If PRP-OMP (Pedvax-Hib®, Merck Vaccine Division), was administered at 2 and 4 months of age a dose at 6 months of age is not required.

 

8.         Combination measles-mumps-rubella-varicella (MMRV) vaccine can be used for children 12 months through 12 years of age. Also see footnote 9.

 

9.         The minimum interval from Var-1 to Var-2 for persons beginning the series at 13 years or older is 4 weeks.

 

10.       One dose of influenza vaccine per season is recommended for most people. Children younger than 9 years of age who are receiving influenza vaccine for the first time, or received only 1 dose the previous season (if it was their first vaccination season) should receive 2 doses this season.

 

11.       The minimum age for inactivated influenza vaccine varies by vaccine manufacturer. Only Fluzone (manufactured by sanofi pasteur) is approved for children 6-35 months of age. The minimum age for Fluvirin (manufactured by Novartis) is 4 years. For Fluarix and FluLaval (manufactured by GlaxoSmithKline) and Afluria (manufactured by CSL Ltd), the minimum age is 18 years.

 

12.       Some experts recommend a second dose of MPSV-3 years after the first dose for people at increased risk for meningococcal disease.

 

13.       A second dose of meningococcal vaccine is recommended for people previously vaccinated with MPSV who remain at high risk for meningococcal disease. MCV is preferred when revaccinating persons aged 2-55 years, but a second dose of MPSV is acceptable. (CDC. Prevention and Control of Meningococcal Disease Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2005; 54: No. RR-7.)

 

14.       Only one dose of Tdap is recommended. Subsequent doses should be administered as Td. If vaccination to prevent tetanus and/or diphtheria disease is required for children 7 through 9 years of age, Td should be administered (minimum age for Td is 7 years). For one brand of Tdap the minimum age is 11 years. The preferred interval between Tdap and a previous dose of Td is 5 years. In persons who have received a primary series of tetanus-toxoid containing vaccine, for management of a tetanus-prone wound, the minimum interval after a previous dose of any tetanus-containing vaccine is 5 years.

 

15.       A second dose of PPV is recommended for persons at highest risk for serious pneumococcal infection and those who are likely to have a rapid decline in pneumococcal antibody concentration. Revaccination 3 years after the previous dose can be considered for children at highest risk for severe pneumococcal infection who would be younger than 10 years of age at the time of revaccination. (CDC. Prevention of pneumococcal disease recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1997;46[No. RR-8]).

 

16.       HPV is approved only for females 9-26 years of age.

 

17.       HPV-3 should be administered at least 12 weeks after HPV-2 and at least 24 weeks after HPV-1, and it should not be administered before 114 months of age.

 

18.       The first dose of Rota must be administered at 6-12 weeks of age. The vaccine series should not be started at 13 weeks of age or older. Rota should not be administered to children 33 weeks of age or older regardless of the number of doses received between 6 and 32 weeks of age.

 

19.       Herpes zoster vaccine is approved as a single dose for persons 60 years and older with a history of varicella.

 


Adapted from Table 1, ACIP General Recommendations on Immunization: MMWR 2006;55(No. RR-15) February 2008

 

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