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Recommended Childhood and Adolescent Immunization Schedules−−United States, 2012 COMMITTEE ON INFECTIOUS DISEASES Pediatrics 2012;129;385 DOI: 10.

1542/peds.2011-3630

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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2012 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.

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2011-3630 PEDIATRICS (ISSN Numbers: Print.2011-3630 doi:10. All authors have filed conflict of interest statements with the American Academy of Pediatrics. 2012 385 . Copyright © 2012 by the American Academy of Pediatrics cine and hepatitis B immune globulin to infants weighing <2000 g and for infants weighing ≥2000 g who are born to hepatitis B surface antigen-positive mothers. a schedule for children 7 through 18 years of age (Fig 2). Number 2. repetition between footnotes has been eliminated. Any conflicts have been resolved through a process approved by the Board of Directors. An adult immunization schedule also is updated and published each year (www. mumps. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.pediatrics. All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed. These schedules are revised annually to reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration and include the following changes from last year:  Clarification is provided for administration of hepatitis B vacwww.1542/peds. the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.cdc. February 2012 Downloaded from pediatrics. Guidance is provided on contraindications to the use of live-attenuated influenza vaccine.  Hepatitis A footnotes have been clarified to emphasize administra- tion of the second dose 6 to 18 months after the first dose. and rubella vaccine in infants 6 through 11 months of age who are traveling internationally has been added.  Clarification is provided for Tdap vaccine use for children 7 through 10 years who are not fully immunized with the childhood DTaP series. and a catch-up schedule for children and adolescents who start late or fall >1 month behind (Fig 3). 2012 COMMITTEE ON INFECTIOUS DISEASES This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. Because of the increasing complexity of the vaccine schedule and the limited amount of space for footnotes. not as stand-alone schedules.org/cgi/doi/10. Three schedules are provided: a schedule for children 0 through 6 years of age (Fig 1). 0031-4005. A new yellow and purple bar has been added to the “Recommended PEDIATRICS Volume 129. Online.  Guidance for the use of Haemophilus influenzae type b vaccine in people 5 years of age and older has been added to the catchup schedule. The 2012 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics. Providers are advised to use all 3 schedules and their respective footnotes together.gov/vaccines).  Influenza vaccine footnotes have been updated to clarify vaccine dosing for children 6 months through 8 years of age for the 2011– 2012 season. Clarification is provided for timing of doses after administration of the birth dose of hepatitis B vaccine.org by guest on February 3. or retired at or before that time.1542/peds. revised.FROM THE AMERICAN ACADEMY OF PEDIATRICS Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of all Children POLICY STATEMENT Recommended Childhood and Adolescent Immunization Schedules—United States.aappublications.  Guidance for the use of measles. 1098-4275). and the American Academy of Family Physicians.

Pickering.vaers. Red Book: 2012 Report of the Committee on Infectious Diseases. 2012 . MD Yvonne A.  Human papillomavirus vaccine footnotes have been updated to include a routine recommendation for vaccination of males with quadrivalent human papillomavirus vaccine (Gardasil). 29th ed. In press 386 FROM THE AMERICAN ACADEMY OF PEDIATRICS Downloaded from pediatrics. interim recommendations resulting from vaccine shortages. Brady. Long SS.aapredbook. Douglas Pratt. MD – Red Book Associate Editor Sarah S.org). Dele Davies. DO – Red Book Online Associate Editor David W. Maldonado. MD Gordon E. MD – National Vaccine Program Office Joan Robinson. Glode. Orenstein. Kimberlin DW. MD – National Vaccine Program Office Richard L. The MCV4 purple bar has been extended in the “Recommended immunization schedule for persons aged 0 through 6 years” to reflect licensure of MCV4-D (Menactra) use in children as young as 9 months. MD H. MD – Pediatric Infectious Diseases Society EX OFFICIO  Inactivated poliovirus vaccine footnotes have been updated to note that inactivated polio vaccine is not routinely recommended for US residents 18 years of age or older. MD Mary P. Information on new vaccine releases. MD Theoklis E.gov or by calling 800822-7967. Chairperson Carrie L. Cody Meissner. MD Mary Anne Jackson.htm. Elk Grove Village. MD – Red Book Editor CONSULTANT Lorry G. vaccine supplies. Kimberlin. MD – Canadian Paediatric Society Jane Seward.org/news/vaccstatus.immunization schedule for persons aged 0 through 6 years” to reflect hepatitis A vaccine recommendations for children 2 years of age and older. Willoughby. MD – National Institutes of Health Lucia Lee. MD – Red Book Associate Editor H. 2011–2012 Michael T. MD – Red Book Associate Editor Henry H. Schutze. MD – American Thoracic Society Geoffrey Simon. Tan. MD Walter A. Edwards. MPH REFERENCE 1. Pickering LK. including recommendations for children with high-risk conditions. Murray. MD Kathryn M.  Guidance for routine administration of a booster dose of either meningococcal vaccine (MCV4) is provided. American Academy of Pediatrics. MD STAFF Jennifer Frantz. MD – Visual Red Book Associate Editor Larry K.gov/vaccines/pubs/ ACIP-list. MD. Bernstein.aapredbook. MD – Centers for Disease Control and Prevention Bruce Gellin.aappublications.gov/vaccines/pubs/ ACIP-list. Long. how to obtain and complete a Vaccine Adverse Event Reporting System form can be obtained on the Internet at www. Baker CJ. Guidance about Carol J. Baker. MD – Food and Drug Administration R. MD Harry L. IL: American Academy of Pediatrics. eds. Additional information can be found in the Red Book1 and at Red Book Online (www.cdc. MPH – Centers for Disease Control & Prevention Jeffrey R. Starke.htm.org by guest on February 3. MD Rodney E. MD Dennis L.hhs. Statements from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that contain details of recommendations for individual vaccines. MD LIAISONS Marc A. Rubin. Byington. are available at www. 2012. Gorman. shtml and www. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System. MBBS. Keyserling. COMMITTEE ON INFECTIOUS DISEASES. Read. Zaoutis. MD – Committee on Practice Ambulatory Medicine Tina Q. Fischer. and statements on specific vaccines can be found at www.cdc. Guidance is provided for administration of MCV4 to children at increased risk of meningococcal disease. MD – Food and Drug Administration Jennifer S.

Inactivated poliovirus vaccine (IPV). (Minimum age: 6 weeks for pneumococcal conjugate not completely vaccinated for their age. mumps. These children should be revaccinated with 2 doses of MMR vaccine. mumps. when indicated and feasible. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 12 months) MMWR previously unvaccinated.cdc. and MMWR pdf.FIGURE 1 Recommended immunization schedule for persons aged 0 through 6 years—United States. vaccine starting as soon as feasible (Figure 3). 4. (Minimum age: birth) At birth: 7. quadrivalent (MCV4). 8. single supplemental dose of 13-valent PCV (PCV13) is recommended for: — — Children aged 60 through 71 months with underlying medical conditions.gov/vaccines/pubs/acip-list. available at http://www. for further guidance. rubella8 Varicella MMR VAR HepA series 9 Hepatitis A Meningococcal MCV4 — See footnote 11 Range of recommended ages for all children and certain high-risk groups This schedule includes recommendations in effect as of December 23. it can be accepted as valid. Clinically significant adverse events that follow vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS) online (http://www. Influenza vaccines.org by guest on February 3. Meningococcal conjugate vaccines. including a cochlear implant. the American Academy of Pediatrics (http://www. See MMWR 2010:59(No.htm. cdc. and Vaccines for Children Program resolution No. Hepatitis A (HepA) vaccine.cdc. Any dose not administered at the recommended age should be administered at a subsequent visit. Pneumococcal vaccines.pdf.org). 11. 5. (Minimum age: 6 weeks) a dose at age 6 months is not indicated. 0 days or older. — vaccine recommendations. pertussis3 Haemophilus influenzae type b e Pneumococcal 7 5 6 4 DTaP DTaP Range of recommended ages for certain high-risk groups Hib PCV IPV Hib PCV IPV Influenza (yearly) MMR VAR Dose 1 10 See footnote See footnote 8 PCV PPSV IPV Inactivated poliovirus Influenza 9 10 11 Measles. 3. older with certain underlying medical conditions. (Minimum age: 6 months for trivalent inactivated influenza vaccine to 2 months after receiving the last dose of the series. 10. RR-11). available at http://www. least 8 weeks apart.hhs.vaers. 6. internationally. This schedule is approved by the Advisory Committee on Immunization Practices (http://www. 1. 2011. weeks after the first dose. available online at http://www. 2012 .gov/vaccines/recs/acip). Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations. (Minimum age: 6 weeks for both RV-1 [Rotarix] and RV-5 [Rota Teq]) 0 days for the final dose in the series.cdc. Rotavirus (RV) vaccines.org).aafp. 6/11-1.aappublications. (Minimum age: 6 weeks) months have elapsed since the third dose.gov) or by telephone (800-822-7967). Vaccine Hepatitis B Rotavirus2 1 Age Birth HepB 1 month 19–23 2 4 6 9 12 15 18 months months months months months months months months HepB RV DTaP RV DTaP Hib PCV IPV RV2 DTaP Hib 4 See footnote 3 2–3 years 4–6 years HepB Range of recommended ages for all children Diphtheria. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine.aap. Varicella (VAR) vaccine. Vaccination should not be initiated for infants aged 15 weeks. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines.gov/vaccines/programs/vfc/downloads/resolutions/06-11mening-mcv.pdf. and the American Academy of Family Physicians (http://www. for whom immunity against hepatitis A virus infection is desired. (Minimum age: 6 weeks) MMWR pdf. (Minimum age: 12 months) have elapsed since the first dose. at least 6 months after the previous dose. 2. tetanus. (Minimum age: 12 months) have elapsed since the first dose. Hepatitis B (HepB) vaccine. Downloaded from pediatrics.gov/mmwr/pdf/rr/rr5911. and rubella (MMR) vaccine. or 3) children who have any other underlying medical conditions that predispose them MMWR — Doses after the birth dose: vaccine should be used for doses administered before age 6 weeks. 2012. (Minimum age: 9 months 9. Measles. including revaccination guidelines.

2012 .org). and 1 dose every 5 years thereafter. the American Academy of Pediatrics (http://www. rubella Varicella This schedule includes recommendations in effect as of December 23. Downloaded from pediatrics. available at http://www.aappublications. (Figure 3). Varicella (VAR) vaccine. and rubella (MMR) vaccine. or cerebral spinal fluid leak. quadrivalent (MCV4). mumps. For MMWR http://www. cdc. Hepatitis A (HepA) vaccine. 2. and Vaccines for Children Program resolution No. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations.gov/mmwr/pdf/rr/rr5908. 6. where vaccination programs target older children. pertussis 2 3 Meningococcal Influenza Pneumococcal 6 7 5 Range of recomended ages for catch-up immunization Inactivated poliovirus 10 8 9 Complete 3-dose series 2-dose Series Complete 2-Dose series Complete 2-dose series Range of recommended ages for certain high-risk groups Measles. Human papillomavirus (HPV) vaccines (HPV4 [Gardasil] and HPV2 [Cervarix]).gov/vaccines/pubs/acip-list. who are at increased risk for infection. Pneumococcal vaccines (pneumococcal conjugate vaccine [PCV] and pneumococcal polysaccharide vaccine [PPSV]).pdf. and the American Academy of Family Physicians (http://www.org by guest on February 3.cdc. Clinically significant adverse events that follow vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS) online (http://www. 10. MMWR vaccinated or the second dose if only 1 dose has been administered. Vaccine Age 1 7–10 years 1 dose (if indicated) See footnote2 See footnote3 11–12 years 1 dose 3 doses Dose 1 Influenza (yearly) See footnote5 Complete 2-dose series Complete 3-dose series 13–18 years 1 dose (if indicated) Complete 3-dose series Booster at age 16 years Range of recommended ages for all children Tetanus. including those with asthma or any other underlying medical conditions that predispose them to influenza complications.cdc.gov/vaccines/recs/acip). children aged 7 through 10 years. Refer to the catch-up schedule if additional doses or older with certain underlying medical conditions. dose. or for whom immunity against hepatitis A virus infection is desired. condition. 1.pdf. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. 6/11-1. Measles.vaers. the first dose.gov) or by telephone (800-822-7967). with persistent complement component deficiency or anatomic/functional asplenia. See MMWR 2010:59(No. A single revaccination should be administered after 5 years to children with anatomic/ functional asplenia or an immunocompromising condition.FIGURE 2 Recommended immunization schedule for persons aged 7 through 18 years—United States. 5.org).gov/mmwr/pdf/rr/rr5911. attenuated influenza vaccine [LAIV]). Hepatitis B (HepB) vaccine. 2011. Meningococcal conjugate vaccines.hhs. Influenza vaccines (trivalent inactivated influenza vaccine [TIV] and live.cdc. including a cochlear implant. (Minimum a dose followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter. Any dose not administered at the recommended age should be administered at a subsequent visit. — — vaccine recommendations. 2012. administered at age 16 through 18 years with a minimum interval of at least 8 weeks after the preceding dose. 4. Inactivated poliovirus vaccine (IPV).aap. RR-11). available online at http://www. See MMWR 7. MMWR pdf. available at http://www.cdc. 8. cochlear implant. when indicated and feasible. mumps. for further guidelines. diphtheria.pdf. it can be accepted as valid. 3.gov/vaccines/programs/vfc/downloads/resolutions/06-11mening-mcv. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. 9. should not be used for some persons. (Minimum age: 9 years) MMWR pdf.htm. This schedule is approved by the Advisory Committee on Immunization Practices (http://www.aafp.

8. Inactivated poliovirus vaccine (IPV). 0 days for the final dose in the series. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. rubella7 Varicella8 5 6 weeks 9 months 12 months 12 months 4 weeks 8 weeks6 4 weeks 3 months if person is younger than age 13 years 4 weeks5 6 months5 4 weeks if person is aged 13 years or older 1. and rubella (MMR) vaccine.FIGURE 3 Catch-up immunization schedule for persons aged 4 months through 18 years who start late or who are more than 1 month behind—United States. mumps. (Minimum age: 6 weeks for pneumococcal conjugate vacister 1 dose of PCV if 3 doses of PCV were received previously. 3. Rotavirus (RV) vaccines (RV-1 [Rotarix] and RV-5 [Rota Teq]). 5. mumps.gov/vaccines) or by telephone ( ). 2012.pdf. See MMWR 2010:59(No. Always use this table in conjunction with the accompanying childhood and adolescent immunization schedules (Figures 1 and 2) and their respective footnotes. Pneumococcal vaccines. 6. diphtheria. Vaccination should not be initiated for infants aged 15 weeks.gov) or by telephone (800-822-7967). Clinically significant adverse events that follow vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS) online (http://www. is available from CDC online (http://www. 7. with underlying medical conditions. mumps. the third (and final) dose should be administered at age 12 through 15 months and at least 8 weeks after the second dose. 10. Varicella (VAR) vaccine. (Minimum age: 9 months through 18 years”) for further guidance. Meningococcal conjugate vaccines.. Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Tdap vaccine should be substituted for a single dose of Td vaccine an adolescent Tdap vaccine dose should not be given. 9. Downloaded from pediatrics. pertussis9 10 4 weeks 7 years9 9 years 12 months 4 weeks if first dose administered at younger than age 12 months 6 months if first dose administered at younger than age 12 months 6 months if first dose administered at 12 months or older Routine dosing intervals are recommended10 6 months 4 weeks 8 weeks (and at least 16 weeks after first dose) Inactivated poliovirus Meningococcal6 Measles. age 13 through 18 years if patient is not previously vaccinated.hhs. Tetanus and diphtheria toxoids (Td) and tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccines.cdc.vaers. Human papillomavirus (HPV) vaccines (HPV4 [Gardasil] and HPV2 [Cervarix]). tetanus. diphtheria/tetanus. Measles. 4.aappublications. age 11 months or younger. 2. See age-specific schedules for details. Persons aged 4 months through 6 years Vaccine Minimum age for dose 1 Minimum interval between doses Dose 1 to dose 2 4 weeks Rotavirus Diphtheria. travel to a polio-endemic region or during an outbreak). Haemophilus influenzae type b (Hib) conjugate vaccine. conditions. pertussis2 1 Dose 2 to dose 3 8 weeks 4 weeks1 4 weeks 4 weeks3 if current age is younger than 12 months Dose 3 to dose 4 Dose 4 to dose 5 6 weeks 6 weeks 4 weeks 4 weeks 4 weeks if first dose administered at younger than age 12 months 6 months 8 weeks (as final dose) This dose only necessary for children aged 12 months through 59 months who received 3 doses before age 12 months 6 months2 Haemophilus influenzae type b 3 6 weeks 8 weeks (as final dose) No further doses needed if first dose administered at age 15 months or older 8 weeks (as final dose)3 if current age is 12 months or older and first dose administered at younger than age 12 months and second dose administered at younger than 15 months No further doses needed if previous dose administered at age 15 months or older 4 weeks if first dose administered at younger than age 12 months 4 weeks if current age is younger than 12 months 8 weeks (as final dose) This dose only necessary for children aged 12 months through 59 months who received 3 doses before age 12 months or for children at high risk who received 3 doses at any age 8 weeks (as final dose for healthy children) Pneumococcal 6 weeks if first dose administered at age 12 months or older or 8 weeks (as final dose for healthy children) if current age is 12 months or older No further doses needed for healthy children if first dose administered at No further doses needed for healthy children if previous dose administered at Inactivated poliovirus5 Meningococcal6 Measles. mended if the person is at risk for imminent exposure to circulating poliovirus (i. DTaP vaccine series. A vaccine series does not need to be restarted. or administer 2 doses of PCV at least 8 weeks apart if fewer than 3 doses of PCV were received previously. available at http://www. 0 days or older. quadrivalent (MCV4). 2012 . The figure below provides catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed.cdc. older and at least 6 months after the previous dose. anatomic/functional asplenia. Additional information.gov/mmwr/ pdf/rr/rr5911. including precautions and contraindications for vaccination. RR-11).org by guest on February 3.e. rubella7 Varicella8 6 weeks 9 months 12 months 12 months 12 months 4 weeks 8 weeks6 4 weeks 3 months 6 months 4 weeks 6 months5 final dose Persons aged 7 through 18 years Tetanus.

Online ISSN: 1098-4275. 60007. Downloaded from pediatrics. Elk Grove Village.org/site/misc/reprints. Illinois.ht ml This article.org by guest on February 3. A monthly publication.1542/peds.Recommended Childhood and Adolescent Immunization Schedules−−United States.385 DOI: 10. 2012 COMMITTEE ON INFECTIOUS DISEASES Pediatrics 2012.2011-3630 Updated Information & Services Subspecialty Collections including high resolution figures.aappublications. 141 Northwest Point Boulevard. can be found at: http://pediatrics. published.aappublications.aappublications.129. along with others on similar topics.aappublications. Print ISSN: 0031-4005.aappublications. Copyright © 2012 by the American Academy of Pediatrics.org/site/misc/Permissions. All rights reserved. PEDIATRICS is owned. and trademarked by the American Academy of Pediatrics.full.xhtml Permissions & Licensing Reprints PEDIATRICS is the official journal of the American Academy of Pediatrics. tables) or in its entirety can be found online at: http://pediatrics. 2012 . appears in the following collection(s): Infectious Disease & Immunity http://pediatrics.xh tml Information about ordering reprints can be found online: http://pediatrics. it has been published continuously since 1948.org/content/129/2/385.org/cgi/collection/infectious _disease Information about reproducing this article in parts (figures.