- Consult relevant ACIP statements for detailed recommendations (www.cdc.gov/vaccines/hcp/acip-recs/index.html). - When a vaccine is not administered at the recommended age, administer at a subsequent visit. - Use combination vaccines instead of separate injections when appropriate. - Report clinically significant adverse events to the Vaccine Adverse Event Reporting System (VAERS) online (www.vaers.hhs.gov) or by telephone (800-822-7967). - Report suspected cases of reportable vaccine-preventable diseases to your state or local health department. - For information about precautions and contraindications, see www.
cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. These recommendations must be read with the footnotes that follow. For those who fall behind or start late, provide catch-up vaccination at the earliest opportunity as indicated by the green bars in Figure 1.
To determine minimum intervals between doses, see the catch-up schedule (Figure 2). School entry and adolescent vaccine age groups are shaded in gray.

# NOTE:
The above recommendations must be read along with the footnotes of this schedule.  The figure 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 Figure 1 and the footnotes that follow.

# Additional information
- For information on contraindications and precautions for the use of a vaccine, consult the General Best Practice Guidelines for Immunization and relevant ACIP statements, at www.cdc.gov/vaccines/hcp/acip-recs/index.html. - For calculating intervals between doses, 4 weeks = 28 days. Intervals of >4 months are determined by calendar months.
- Within a number range (e.g., 12-18), a dash (-) should be read as "through. "
- 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 interval or minimum age 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  Give HepB vaccine within 12 hours of birth, regardless of birth weight.  For infants 2,000 grams as soon as possible, but no later than 7 days of age. Routine Series: - A complete series is 3 doses at 0, 1-2, and 6-18 months. (Monovalent HepB vaccine should be used for doses given before age 6 weeks.)
- Infants who did not receive a birth dose should begin the series as soon as feasible (see Figure 2). - Administration of 4 doses is permitted when a combination vaccine containing HepB is used after the birth dose. - Minimum age for the final (3rd or 4th) dose: 24 weeks. - Minimum Intervals: Dose 1 to Dose 2: 4 weeks / Dose 2 to Dose 3: 8 weeks / Dose 1 to Dose 3: 16 weeks. (When 4 doses are given, substitute "Dose 4" for "Dose 3" in these calculations.)

# Catch-up vaccination:
- Unvaccinated persons should complete a 3-dose series at 0, 1-2, and 6 months. - Adolescents 11-15 years of age may use an alternative 2-dose schedule, with at least 4 months between doses (adult formulation Recombivax HB only). - For other catch-up guidance, see Figure 2.

# Rotavirus vaccines. (minimum age: 6 weeks)
Routine vaccination: Rotarix: 2-dose series at 2 and 4 months. RotaTeq: 3-dose series at 2, 4, and 6 months. If any dose in the series is either RotaTeq or unknown, default to 3-dose series.

# Catch-up vaccination:
- Do not start the series on or after age 15 weeks, 0 days. - The maximum age for the final dose is 8 months, 0 days. - For other catch-up guidance, see Figure 2.

# Diphtheria, tetanus, and acellular pertussis (DTaP)
vaccine. (minimum age: 6 weeks ) Routine vaccination:
- 5-dose series at 2, 4, 6, and 15-18 months, and 4-6 years.  Prospectively: A 4th dose may be given as early as age 12 months if at least 6 months have elapsed since the 3rd dose.  Retrospectively: A 4th dose that was inadvertently given as early as 12 months may be counted if at least 4 months have elapsed since the 3rd dose.

# Catch-up vaccination:
- The 5th dose is not necessary if the 4th dose was administered at 4 years or older. - For other catch-up guidance, see Figure 2. (minimum age: 6 weeks) Routine vaccination:
- ActHIB, Hiberix, or Pentacel: 4-dose series at 2, 4, 6, and 12-15 months. - PedvaxHIB: 3-dose series at 2, 4, and 12-15 months.

# Catch-up vaccination:
- 1st dose at 7-11 months: Give 2nd dose at least 4 weeks later and 3rd (final) dose at 12-15 months or 8 weeks after 2nd dose (whichever is later). - 1st dose at 12-14 months: Give 2nd (final) dose at least 8 weeks after 1st dose. - 1st dose before 12 months and 2nd dose before 15 months: Give 3rd (final) dose 8 weeks after 2nd dose. - 2 doses of PedvaxHIB before 12 months: Give 3rd (final) dose at 12-59 months and at least 8 weeks after 2nd dose. - Unvaccinated at 15-59 months: 1 dose.
- For other catch-up guidance, see Figure 2. Special Situations:
- Chemotherapy or radiation treatment 12-59 months  Unvaccinated or only 1 dose before 12 months: Give 2 doses, 8 weeks apart  2 or more doses before 12 months: Give 1 dose, at least 8 weeks after previous dose. Doses given within 14 days of starting therapy or during therapy should be repeated at least 3 months after therapy completion.
- Hematopoietic stem cell transplant (HSCT) - 3-dose series with doses 4 weeks apart starting 6 to 12 months after successful transplant (regardless of Hib vaccination history). - Anatomic or functional asplenia (including sickle cell disease) 12-59 months  Unvaccinated or only 1 dose before 12 months: Give 2 doses, 8 weeks apart.  2 or more doses before 12 months: Give 1 dose, at least 8 weeks after previous dose.

# Unimmunized- persons 5 years or older  Give 1 dose - Elective splenectomy
Unimmunized- persons 15 months or older  Give 1 dose (preferably at least 14 days before procedure).
- HIV infection 12-59 months  Unvaccinated or only 1 dose before 12 months: Give 2 doses 8 weeks apart.  2 or more doses before 12 months: Give 1 dose, at least 8 weeks after previous dose. - Any incomplete- schedules with:  3 PCV13 doses: 1 dose of PCV13 (at least 8 weeks after any prior PCV13 dose).  <3 PCV13 doses: 2 doses of PCV13, 8 weeks after the most recent dose and given 8 weeks apart. - No history of PPSV23: 1 dose of PPSV23 (at least 8 weeks after any prior PCV13 dose) and a 2nd dose of PPSV23 5 years later. Age 6-18 years:
- No history of either PCV13 or PPSV23: 1 dose of PCV13, 2 doses of PPSV23 (1st dose of PPSV23 administered 8 weeks after PCV13 and 2nd dose of PPSV23 administered at least 5 years after the 1st dose of PPSV23). - Any PCV13 but no PPSV23: 2 doses of PPSV23 (1st dose of PPSV23 to be given 8 weeks after the most recent dose of PCV13 and 2nd dose of PPSV23 administered at least 5 years after the 1st dose of PPSV23).
- PPSV23 but no PCV13: 1 dose of PCV13 at least 8 weeks after the most recent PPSV23 dose and a 2nd dose of PPSV23 to be given 5 years after the 1st dose of PPSV23 and at least 8 weeks after a dose of PCV13. Chronic liver disease, alcoholism: Age 6-18 years:
- No history of PPSV23: 1 dose of PPSV23 (at least 8 weeks after any prior PCV13 dose). *Incomplete schedules are any schedules where PCV13 doses have not been completed according to ACIP recommended catch-up schedules. The total number and timing of doses for complete PCV13 series are dictated by the age at first vaccination. See Tables 8 and 9 in the ACIP pneumococcal vaccine recommendations (www.cdc.gov/mmwr/pdf/rr/ rr5911.pdf ) for complete schedule details.

# Inactivated poliovirus vaccine (IPV). (minimum age: 6 weeks) Routine vaccination:
- 4-dose series at ages 2, 4, 6-18 months, and 4-6 years.
Administer the final dose on or after the 4th birthday and at least 6 months after the previous dose.

# Catch-up vaccination:
- In the first 6 months of life, use minimum ages and intervals only for travel to a polio-endemic region or during an outbreak. - If 4 or more doses were given before the 4th birthday, give 1 more dose at age 4-6 years and at least 6 months after the previous dose. - A 4th dose is not necessary if the 3rd dose was given on or after the 4th birthday and at least 6 months after the previous dose. (minimum age: 12 months for routine vaccination) Routine vaccination:
- 2-dose series at 12-15 months and 4-6 years.
- The 2nd dose may be given as early as 4 weeks after the 1st dose.

# Catch-up vaccination:
- Unvaccinated children and adolescents: 2 doses at least 4 weeks apart.

# International travel:
- Infants 6-11 months: 1 dose before departure.
Revaccinate with 2 doses at 12-15 months (12 months for children in high-risk areas) and 2nd dose as early as 4 weeks later. - Unvaccinated children 12 months and older: 2 doses at least 4 weeks apart before departure.

# Mumps outbreak:
- Persons 12 months who previously received 2 doses of mumps-containing vaccine and are identified by public health authorities to be at increased risk during a mumps outbreak should receive a dose of mumps-virus containing vaccine.

# Varicella (VAR) vaccine. (minimum age: 12 months) Routine vaccination:
- 2-dose series: 12-15 months and 4-6 years.
- The 2nd dose may be given as early as 3 months after the 1st dose (a dose given after a 4-week interval may be counted).

# Catch-up vaccination:
- who are not at increased risk.
- Bexsero: 2 doses at least 1 month apart.
- Trumenba: 2 doses at least 6 months apart. If the 2nd dose is given earlier than 6 months, give a 3rd dose at least 4 months after the 2nd. Special populations and situations: Anatomic or functional asplenia, sickle cell disease, persistent complement component deficiency (including eculizumab use), serogroup B meningococcal disease outbreak - Bexsero: 2-dose series at least 1 month apart.
- Trumenba: 3-dose series at 0, 1-2, and 6 months.
Note: Bexsero and Trumenba are not interchangeable. For additional meningococcal vaccination information, see meningococcal MMWR publications at: www.cdc.gov/vaccines/hcp/acip-recs/vaccspecific/mening.html.

# Tetanus, diphtheria, and acellular pertussis
(Tdap) vaccine. (minimum age: 11 years for routine vaccinations, 7 years for catch-up vaccination) Routine vaccination:
- Adolescents 11-12 years of age: 1 dose.
- Pregnant adolescents: 1 dose during each pregnancy (preferably during the early part of gestational weeks 27-36). - Tdap may be administered regardless of the interval since the last tetanus-and diphtheriatoxoid-containing vaccine.

# Catch-up vaccination:
- Adolescents 13-18 who have not received Tdap:
1 dose, followed by a Td booster every 10 years. - Persons aged 7-18 years not fully immunized with DTaP: 1 dose of Tdap as part of the catch-up series (preferably the first dose). If additional doses are needed, use Td.
- Children 7-10 years who receive Tdap inadvertently or as part of the catch-up series may receive the routine Tdap dose at 11-12 years. - DTaP inadvertently given after the 7th birthday:  Child 7-10: DTaP may count as part of catch-up series. Routine Tdap dose at 11-12 may be given.  Adolescent 11-18: Count dose of DTaP as the adolescent Tdap booster.
For other catch-up guidance, see Figure 2.

# Human papillomavirus (HPV) vaccine (minimum age: 9 years) Routine and catch-up vaccination:
- Routine vaccination for all adolescents at 11-12 years (can start at age 9) and through age 18 if not previously adequately vaccinated. Number of doses dependent on age at initial vaccination:  Age 9-14 years at initiation: 2-dose series at 0 and 6-12 months. Minimum interval: 5 months (repeat a dose given too soon at least 12 weeks after the invalid dose and at least 5 months after the 1st dose).  Age 15 years or older at initiation: 3-dose series at 0, 1-2 months, and 6 months. Minimum intervals: 4 weeks between 1st and 2nd dose; 12 weeks between 2nd and 3rd dose; 5 months between 1st and 3rd dose (repeat dose(s) given too soon at or after the minimum interval since the most recent dose). - Persons who have completed a valid series with any HPV vaccine do not need any additional doses.

# Special situations:
- History of sexual abuse or assault: Begin series at age 9 years. - Immunocompromised- (including HIV) aged 9-26 years: 3-dose series at 0, 1-2 months, and 6 months.