Catch-Up Immunization Schedule for Children

Source: Centers for Disease Control and Prevention.
Available at: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm. Accessed on 1/2010.

*The tables provide 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 chart appropriate for the child's age.

1. Hepatitis B vaccine (HepB).
   • Administer the 3-dose series to those not previously vaccinated.
   • A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB® is licensed for children aged 11 through 15 years.
2. Rotavirus vaccine (Rota).
   • The maximum age for the first dose is 14 weeks 6 days. Vaccination should not be initiated for infants aged 15 weeks 0 days or older.
   • The maximum age for the final dose in the series is 8 months 0 days.
   • If Rotarix was administered for the first and second doses, a third dose is not indicated.
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP).
   • The fifth dose is not necessary if the fourth dose was administered at age 4 years or older.
4. Haemophilus influenzae type b conjugate vaccine (Hib).
   • Hib vaccine is not generally recommended for persons aged 5 years or older. No efficacy data are available on which to base a recommendation concerning use of Hib vaccine for older children and adults. However, studies suggest good immunogenicity in persons who have sickle cell disease, leukemia, or HIV infection, or who have had a splenectomy; administering 1 dose of Hib vaccine to these persons who have not previously received Hib vaccine is not contraindicated.
   • If the first 2 doses were PRP-OMP (PedvaxHIB® or Comvax®), and administered at age 11 months or younger, the third (and final) dose should be administered at age 12 through 15 months and at least 8 weeks after the second dose.
   • If the first dose was administered at age 7 through 11 months, administer the second dose at least 4 weeks later and a final dose at age 12 through 15 months.
5. Pneumococcal vaccine (PCV).
   • Administer 1 dose of pneumococcal conjugate vaccine (PCV) to all healthy children aged 24 through 59 months who have not received at least 1 dose of PCV on or after age 12 months.
   • For children aged 24 through 59 months with underlying medical conditions, administer 1 dose of PCV if 3 doses were received previously or administer 2 doses of PCV at least 8 weeks apart if fewer than 3 doses were received previously.
   • Administer pneumococcal polysaccharide vaccine (PPSV) to children aged 2 years or older with certain underlying medical conditions, including a cochlear implant, at least 8 weeks after the last dose of PCV. See MMWR 1997;46(No. RR-8)
6. Inactivated poliovirus vaccine (IPV).
   • The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose.
   • A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6 months following the previous dose.
   • In the first 6 months of life, minimum age and minimum intervals are only recommended if the person is at risk for imminent exposure to circulating poliovirus (i.e., travel to a polio-endemic region or during an outbreak).
7. Measles, mumps, and rubella vaccine (MMR).
   • Administer the second dose routinely at age 4 through 6 years. However, the second dose may be administered before age 4, provided at least 28 days have elapsed since the first dose.
   • If not previously vaccinated, administer 2 doses with at least 28 days between doses.
8. Varicella vaccine (VAR).
   • Administer the second dose routinely at age 4 through 6 years. However, the second dose may be administered before age 4, provided at least 3 months have elapsed since the first dose.
   • For persons aged 12 months through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.
   • For persons aged 13 years and older, the minimum interval between doses is 28 days.
9. Hepatitis A vaccine (HepA).
   • HepA is recommended for children aged older than 23 months who live in areas where vaccination programs target older children, who are at increased risk of infection, or for whom immunity against hepatitis A is desired.
10. Tetanus and diphtheria toxoids vaccine (Td) and tetanus and diphtheriatoxoids and acellular pertussis vaccine (Tdap).
    • Doses of DTaP are counted as part of the Td/Tdap series
    • Tdap should be substituted for a single dose of Td in the catch-up series or as a booster for children aged 10 through 18 years; use Td for other doses.
11. Human papillomavirus vaccine (HPV).
    • Administer the series to females at age 13 through 18 years if not previously vaccinated.
    • Use recommended routine dosing intervals for series catch-up (i.e., the second and third doses should be administered at 1 to 2 and 6 months after the first dose). The minimum interval between the second and third doses is 12 weeks, and the third dose should be given at least 24 weeks after the first dose.