diff --git a/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/SummaryUSContraceptive.pdf b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/SummaryUSContraceptive.pdf new file mode 100644 index 0000000..8fa1f60 Binary files /dev/null and b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/SummaryUSContraceptive.pdf differ diff --git a/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/summary-contraceptive.zip b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/summary-contraceptive.zip new file mode 100644 index 0000000..9f49085 Binary files /dev/null and b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/summary-contraceptive.zip differ diff --git a/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/us-mec-summary-chart-color-508.pdf b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/us-mec-summary-chart-color-508.pdf new file mode 100644 index 0000000..8078f89 Binary files /dev/null and b/other_reports/CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use/us-mec-summary-chart-color-508.pdf differ diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_chocr.html.gz b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_chocr.html.gz new file mode 100644 index 0000000..624fd94 Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_chocr.html.gz differ diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.txt b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.txt new file mode 100644 index 0000000..f092f6b --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.txt @@ -0,0 +1,2821 @@ +UNITED STATES + + +Recommended Child and Adolescent Immunization Schedule +for ages 18 years or younger + + +Vaccines and Other Immunizing Agents in the Child and Adolescent Immunization Schedule* + + +2025 + + +How to use the child and adolescent immunization +Respiratory syncytial virus monoclonal antibody (Nirsevimab) RSV-mAb Beyfortus +schedule +COVID-19 vaccine IvCOV-mRNA Comirnaty/Pfizer-BioNTech 1 2 3 4 5 6 +COVID-19 Vaccine += Determine Determine Assess need Review Review Review new or +ee ee recommended recommended for additional vaccine types, contraindications updated ACIP +: vaccine byage __ interval forcatch- recommended _ frequencies, and precautions guidance +1vCOV-aPS Novavax COVID-19 Vaccine (Table 1) up vaccination vaccines intervals, and for vaccine types (Addendum) +: - (Table 2) by medical considerations (Appendix) +Dengue vaccine DEN4CYD Dengvaxia condition or for special +Diphtheria, tetanus, and acellular pertussis vaccine DTaP Daptacel other indication — situations +Infanrix (Table 3) (Notes) +Haemophilus influenzae type b vaccine Hib (PRP-T) ActHIB +Hiberix +Hib (PRP-OMP) —— PedvaxHIB Recommended by the Advisory Committee on Immunization Practices (www.cdc.gov/acip/index. +Hepatitis A vaccine HepA Havrix html) and approved by the Centers for Disease Control and Prevention (www.cdc.gov), American +Vaqta Academy of Pediatrics (www.aap.org), American Academy of Family Physicians (www.aafp.org), +Hepatitis B vaccine HepB Engerix-B American College of Obstetricians and Gynecologists (www.acog.org), American College of Nurse- +; = Recombivax HB Midwives (www.midwife.org), American Academy of Physician Associates (www.aapa.org), and +Human papillomavirus vaccine nv Gardasil National Association of Pediatric Nurse Practitioners (www.napnap.org). +Influenza vaccine (inactivated: egg-based) IIV3 Multiple +Influenza vaccine (inactivated: cell-culture) ccllV3 Flucelvax Report +Influenza vaccine (live, attenuated) LAIV3 FluMist * Suspected cases of reportable vaccine-preventable diseases or outbreaks to your state or local health +Measles, mumps, and rubella vaccine MMR M-M-R II department +Priorix az bos ‘ . +ICT ts OeSTe TIE USC GON[SSIEW(CA NUN EIZET MenACWY-CRM Menveo ° pens Gabe pete pes . the Vaccine Adverse Event Reporting System (VAERS) at +MenACWY-TT MenQuadfi : ial +Meningococcal serogroup B vaccine MenB-4C Bexsero Questions or comments +MenB-FHbp Trumenba Contact www.cdc.gov/cdc-info or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 a.m.-8 p.m. ET, +Meningococcal serogroup A, B, C, W, Y vaccine MenACWY-TT/ Penbraya Monday through Friday, excluding holidays. +MenB-FHbp +nipexiogeine . . Mines siiinsss Download the CDC Vaccine Schedules app for providers at +Pneumococcal conjugate vaccine PCV15 Vaxneuvance ‘ i +PCV20 Previar20 ‘anja Www.cdc.gov/vaccines/hcp/imz-schedules/app.html +Pneumococcal polysaccharide vaccine PPSV23 Pneumovax 23 +Poliovirus vaccine (inactivated) IPV Ipol Helpful information +Respiratory syncytial virus vaccine RSV Abrysvo * Complete Advisory Committee on Immunization Practices (ACIP) recommendations: +Rotavirus vaccine RV1 Rotarix www.cdc.gov/acip-recs/hcp/vaccine-specific/index.html +RV5 RotaTeq ° ACIP Shared Clinical Decision-Making Recommendations: +Tetanus, diphtheria, and acellular pertussis vaccine Tdap Adacel www.cdc.gov/acip/vaccine-recommendations/shared-clinical-decision-making.html +Boostrix * General Best Practice Guidelines for Immunization (including contraindications and precautions): +Tetanus and diphtheria vaccine Td Tenivac www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html +. . iiras ¢ Vaccine information statements: +Varicella vaccine VAR Varivax + + +Combination vaccines (use combination vaccines instead of separate injections when appropriate) + + +Ps : hea : +DTaP, hepatitis B, and inactivated poliovirus vaccine DTaP-HepB-IPV Pediarix neal forthe aaa as betaine rie Scan QR code +DTaP i ‘ated DOloul ae PaWGhail 6 . DTaP-IPV/Hib p, | including case identification and outbreak response): for access to + +aP, inactivated poliovirus, and Haemophilus influenzae type b vaccine a /Hi entacel www.cdc.gov/surv-manual/php/ +DTaP and inactivated poliovirus vaccine DTaP-IPV Kinrix ienab +Quadracel +DTaP, inactivated poliovirus, Haemophilus influenzae type b, and DTaP-IPV-Hib- Vaxelis +hepatitis B vaccine HepB | | U.S. CENTERS FOR DISEASE +Measles, mumps, rubella, and varicella vaccine MMRV ProQuad CONTROL AND PREVENTION + +*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 identification purposes only and does not imply endorsement by the ACIP or CDC. + + +CS310020-E + + +11/21/2024 + + +www.cdc.gov/vaccines/hcp/vis/index.html + + +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). + + +Respiratory syncytial virus +(RSV-mAb [Nirsevimab]) + + +Hepatitis B (HepB) + + +Rotavirus (RV): RV1 (2-dose series), +RV5 (3-dose series) + + +Diphtheria, tetanus, acellular pertussis +(DTaP <7 yrs) + + +Haemophilus influenzae type b (Hib) + + +Pneumococcal conjugate +(PCV15, PCV20) + + +Inactivated poliovirus (IPV) + + +COVID-19 (1vCOV-mRNA, 1vCOV-aPS) + + +Influenza (IIV3, ccllV3) + + +Influenza (LAIV3) + + +Measles, mumps, rubella (MMR) + + +Varicella (VAR) + + +Hepatitis A (HepA) + + +Tetanus, diphtheria, acellular pertussis +(Tdap =7 yrs) + + +Human papillomavirus (HPV) + + +Meningococcal (MenACWY-CRM =2 mos, +MenACWY-TT =2years) + + +Meningococcal B +(MenB-4C, MenB-FHbp) + + +Respiratory syncytial virus vaccine +(RSV [Abrysvo]) + + +Dengue (DEN4CYD: 9-16 yrs) +Mpox + + +Range of recommended ages +for catch-up vaccination + + +Range of recommended ages +for all children + + +1 dose (8 through 19 months), See Notes + + +See Notes + + +See Notes + + +See Notes + + +Recommended vaccination can +begin in this age group + + +Range of recommended ages +for certain high-risk groups or +populations + + +See Notes + + +Seasonal administration +during pregnancy (See Notes) + + +Seropositive in endemic +dengue areas (See Notes) + + +No Guidance/ +Not Applicable + + +Recommended vaccination based +on shared clinical decision-making + + +Page 2 + + +Table 2 + + +Recommended Catch-up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More +than 1 Month Behind, United States, 2025 + + +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. + + +Vaccine +Hepatitis B + + +Rotavirus + + +Diphtheria, tetanus, and +acellular pertussis + + +Haemophilus influenzae +type b + + +Pneumococcal conjugate + + +Inactivated poliovirus + + +Measles, mumps, rubella +Varicella + +Hepatitis A +Meningococcal ACWY + + +Children and adolescents age 7 through 18 years + + +Meningococcal ACWY + + +Tetanus, diphtheria; +tetanus, diphtheria, and +acellular pertussis + + +Human papillomavirus + + +Hepatitis A +Hepatitis B +Inactivated poliovirus + + +Measles, mumps, rubella +Varicella + + +Dengue + + +Minimum Age for + + +Borel Dose 1 to Dose 2 + +Birth 4 weeks + +6 weeks 4 weeks + +Maximum age for first + +dose is 14 weeks, 6 days. + +6 weeks 4 weeks + +6 weeks No further doses needed +if first dose was administered at age +15 months or older. + +4 weeks + +if first dose was administered before +the 1st birthday. + +8 weeks (as final dose) + +if first dose was administered at age +12 through 14 months. + +6 weeks No further doses needed for healthy +children if first dose was administered +at age 24 months or older +4 weeks +if first dose was administered before +the 1st birthday +8 weeks (as final dose for healthy +children) +if first dose was administered at the +1st birthday or after + +6 weeks 4 weeks + +12 months 4 weeks + +12 months 3 months + +12 months 6 months + +2months MenACWY-CRM 8 weeks + +2 years MenACWY-TT + +Not applicable (N/A) 8 weeks + +7 years 4weeks + +9 years Routine dosing intervals are +recommended. + +N/A 6 months + +N/A 4 weeks + +N/A 4 weeks + +N/A 4 weeks + +N/A 3 months if younger than age 13 years. +4 weeks if age 13 years or older + +9 years 6 months + + +Children age 4 months through 6 years +Minimum Interval Between Doses +Dose 2 to Dose 3 +8 weeks and at least 16 weeks after first dose +minimum age for the final dose is 24 weeks + + +4 weeks +maximum age for final dose is 8 months, 0 days + + +4 weeks + + +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 first 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 final dose) + +if current age is younger than 12 months and first dose was administered at age 7 through 11 months; OR +if current age is 12 through 59 months and first dose was administered before the 1st birthday and second +dose was administered at younger than 15 months; OR + +if both doses were PedvaxHIB and were administered before the 1st birthday + + +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 final 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 + + +4 weeks + +if current age is <4 years + +6 months (as final dose) + +if current age is 4 years or older + + +See Notes + + +4 weeks + +if first dose of DTaP/DT was administered before the 1st birthday + +6 months (as final dose) + +if first dose of DTaP/DT or Tdap/Td was administered at or after the 1st birthday + + +8 weeks and at least 16 weeks after first dose + + +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. + + +6 months + + +Dose 3 to Dose 4 Dose 4 to Dose 5 + + +6 months + +A fifth dose is not necessary + +if the fourth dose was +administered at age 4 years or +older and at least 6 months +after dose 3 + + +6 months + + +8 weeks (as final dose) + +This dose only necessary + +for children age 12 through + +59 months who received 3 doses +before the 1st birthday. + + +8 weeks (as final 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. + + +6 months (minimum age 4 years +for final dose) + + +See Notes + + +6 months + +if first dose of DTaP/DT was +administered before the 1st +birthday + + +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. + + +Page 3 + + +aF-]e)(-"eM Recommended Child and Adolescent Immunization Schedule by Medical Indication, United States, 2025 + + +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. + + +HIV infection CD4 Asplenia or +Vaccine percentage and count? persistent Kidney failure, +and other Immunocompromised CSF leak or complement End-stage +immunizing (excluding HIV <15%or | =>15% and cochlear component Heart disease or renal disease Chronic liver +agents Pregnancy infection) <200/mm? | =200/mm? implant deficiencies chronic lung disease or on dialysis disease Diabetes + + +RSV-mAb 1 dose depending on maternal 1 dose depending on maternal + + +2nd RSV season 2nd RSV season for chronic +(nirsevimab) RSV vaccination status (See Notes) lung disease (See Notes) RSV vaccination status (See Notes) + + +Hepatitis B + + +Rotavirus + + +DTaP + + +DTaP/Td. +oe Tdap: 1 dose each pregnancy + + +Hib See Notes See Notes + + +Pneumococcal + + +IPV + + +Influenza Solid organ transplant: +inactivated 18yrs (See Notes) + + +LAIV3 +MMR +VAR + + +Hepatitis A + + +HPV 3-dose series (See Notes) + + +MenB +RSV (Abrysvo) Seasonal administration +¥ (See Notes) +Dengue +Mpox See Notes +Recommended for all age- Not recommended for all children, Recommended for all age-eligible Precaution: Might be Contraindicated or not No Guidance/ +eligible children who lack but recommended for some children, and additional doses may be indicated if benefit of recommended Not Applicable +documentation of a complete children based on increased risk for necessary based on medical condition protection outweighs *Vaccinate after pregnancy, +vaccination series or severe outcomes from disease or other indications. See Notes. risk of adverse reaction if indicated + + +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 b. Severe Combined Immunodeficiency +www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + + +c. LAIV3 contraindicated for children 2-4 years of age with +asthma or wheezing during the preceding 12 months + + +Page 4 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +For vaccination recommendations for persons ages +19 years or older, see the Recommended +Adult Immunization Schedule, 2025. + + +Additional information + + +¢ For calculating intervals between doses, 4 weeks = 28 days. +Intervals of >4 months are determined by calendar months. + + +e 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 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. + + +¢ Information on travel vaccination requirements and +recommendations is available at www.cdc.gov/travel/. + + +° For vaccination of persons with immunodeficiencies, see +Table 8-1, Vaccination of persons with primary and secondary +immunodeficiencies, 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, +Lynfield Ruth, Sawyer MH, eds. Red Book: 2021-2024 Report +of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: +American Academy of Pediatrics; 2021:72-86). + + +¢ For information about vaccination in the setting of a vaccine- +preventable disease outbreak, contact your +state or local health department. + + +¢ 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. + + +COVID-19 vaccination + + +(minimum age: 6 months [Moderna and Pfizer-BioNTech COVID-19 vaccines], 12 years [Novavax COVID-19 Vaccine]) + + +Routine vaccination +Age 6 months-4 years + + +All vaccine doses should be from the same manufacturer. +¢ Unvaccinated: + +-2 doses 2024-25 Moderna at 0, 4-8 weeks + +-3 doses 2024-25 Pfizer-BioNTech at 0, 3-8, and at least +8 weeks after dose 2 + +¢ Incomplete initial vaccination series before 2024-25 +vaccine with: + +- 1 dose Moderna: complete initial series with 1 dose +2024-25 Moderna 4-8 weeks after most recent dose + +-1 dose Pfizer-BioNTech: complete initial series with 2 doses +2024-25 Pfizer-BioNTech 8 weeks apart (administer dose 1 +3-8 weeks after most recent dose). + +- 2 doses Pfizer-BioNTech: complete initial series with 1 dose +2024-25 Pfizer-BioNTech at least 8 weeks after the most +recent dose. + +¢ Completed initial vaccination series before 2024-25 +vaccine with: + +-2 or more doses Moderna: 1 dose 2024-25 Moderna at +least 8 weeks after the most recent dose. + +-3 or more doses Pfizer-BioNTech: 1 dose 2024-25 Pfizer- +BioNTech at least 8 weeks after the most recent dose. + + +Age 5-11 years + +¢ Unvaccinated: 1 dose 2024-25 Moderna or Pfizer-BioNTech + +¢ Previously vaccinated before 2024-25 vaccine with 1 or +more doses Moderna or Pfizer-BioNTech: 1 dose 2024-25 +Moderna or Pfizer-BioNTech at least 8 weeks after the most +recent dose. + + +Age 12-18 years +¢ Unvaccinated: +- 1 dose 2024-25 Moderna or Pfizer-BioNTech +-2 doses 2024-25 Novavax at 0, 3-8 weeks +¢ Previously vaccinated before 2024-25 vaccine with: + +- 1 or more doses Moderna or Pfizer-BioNTech: 1 dose +2024-25 Moderna or Novavax or Pfizer-BioNTech at least +8 weeks after the most recent dose. + +- 1 dose Novavax: 1 dose 2024—25 Novavax 3-8 weeks after +most recent dose. If more than 8 weeks after most recent +dose, administer 1 dose 2024-25 Moderna or Novavax or +Pfizer-BioNTech. + +-2 or more doses Novavax: 1 dose 2024—25 Moderna or +Novavax or Pfizer-BioNTech at least 8 weeks after the most +recent dose. + + +Special situation +Persons who are moderately or severely immunocompromised. + + +Age 6 months-4 years + + +Use vaccine from the same manufacturer for all doses (initial +vaccination series and additional doses*). + + +¢ Unvaccinated: + +-4 doses (3-dose initial series 2024-25 Moderna at 0, +4 weeks, and at least 4 weeks after dose 2, followed by +1 dose 2024-25 Moderna 6 months later [minimum interval +2 months]).May administer additional doses.* + +-4 doses (3-dose initial series 2024-25 Pfizer-BioNTech +at 0, 3 weeks, and at least 8 weeks after dose 2, followed by +1 dose 2024-25 Pfizer-BioNTech 6 months later [minimum +interval 2 months]). May administer additional doses.* + + +¢ Incomplete initial 3-dose vaccination series before +2024-25 vaccine: + + +- Previous vaccination with Moderna + + +- 1 dose Moderna: complete initial series with 2 doses +2024-25 Moderna at least 4 weeks apart (administer dose 1 +4 weeks after most recent dose), followed by 1 dose 2024- +25 Moderna 6 months later (minimum interval 2 months). +May administer additional doses of Moderna.* + +-2 doses Moderna: complete initial series with 1 dose +2024-25 Moderna at least 4 weeks after most recent dose, +followed by 1 dose 2024-25 Moderna 6 months later +(minimum interval 2 months). May administer additional +doses of Moderna.* + +- Previous vaccination with Pfizer-BioNTech + + +-1 dose Pfizer-BioNTech: complete initial series with +2 doses 2024-25 Pfizer-BioNTech at least 8 weeks apart +(administer dose 1 3 weeks after most recent dose), +followed by 1 dose 2024-25 Pfizer-BioNTech 6 months later +(minimum interval 2 months). May administer additional +doses of Pfizer-BioNTech.* + +- 2 doses Pfizer-BioNTech: complete initial series with +1 dose 2024-25 Pfizer-BioNTech at least 8 weeks after +most recent dose, followed by 1 dose 2024-25 Pfizer- +BioNTech 6 months later (minimum interval 2 months). May +administer additional doses of Pfizer-BioNTech.* + + +Page 5 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +COVID-19 vaccination - continued + + +¢ Completed initial 3-dose vaccination series before + +2024-25 vaccine with: + +-3 or more doses Moderna: 2 doses 2024-25 Moderna +6 months apart (minimum interval 2 months). Administer +dose 1 at least 8 weeks after the most recent dose. May +administer additional doses of Moderna.* + +-3 or more doses Pfizer-BioNTech: 2 doses 2024-25 Pfizer- +BioNTech 6 months apart (minimum interval 2 months). +Administer dose 1 at least 8 weeks after the most recent +dose. May administer additional doses of Pfizer-BioNTech.* + + +Age 5-11 years + + +Use vaccine from the same manufacturer for all doses in the initial + + +vaccination series. + + +¢ Unvaccinated: + +-4 doses (3-dose initial series 2024-25 Moderna at 0, +4 weeks, and at least 4 weeks after dose 2, followed by +1 dose 2024-25 Moderna or Pfizer-BioNTech 6 months later +[minimum interval 2 months]). May administer additional +doses.* + +-4 doses (3-dose initial series 2024-25 Pfizer-BioNTech +at 0, 3 weeks, and at least 4 weeks after dose 2, followed by +1 dose 2024-25 Moderna or Pfizer-BioNTech 6 months later +[minimum interval 2 months]). May administer additional +doses.* + + +¢ Incomplete initial 3-dose vaccination series before +2024-25 vaccine: +- Previous vaccination with Moderna + +- 1 dose Moderna: complete initial series with 2 doses +2024-25 Moderna at least 4 weeks apart (administer dose +1 4 weeks after most recent dose), followed by 1 dose +2024-25 Moderna or Pfizer-BioNTech 6 months later +(minimum interval 2 months). May administer additional +doses of Moderna or Pfizer-BioNTech.* + +-2 doses Moderna: complete initial series with 1 dose +2024-25 Moderna at least 4 weeks after most recent +dose, followed by 1 dose 2024-25 Moderna or Pfizer- +BioNTech 6 months later (minimum interval 2 months). +May administer additional doses of Moderna or Pfizer- +BioNTech.* + + +- Previous vaccination with Pfizer-BioNTech + +- 1 dose Pfizer-BioNTech: complete initial series with +2 doses 2024-25 Pfizer-BioNTech at least 4 weeks +apart (administer dose 1 3 weeks after most recent +dose), followed by 1 dose 2024-25 Moderna or Pfizer- +BioNTech 6 months later (minimum interval 2 months). +May administer additional doses of Moderna or Pfizer- +BioNTech.* + +- 2 doses Pfizer-BioNTech: complete initial series with +1 dose 2024-25 Pfizer-BioNTech at least 4 weeks after +most recent dose, followed by 1 dose 2024-25 Moderna +or Pfizer-BioNTech 6 months later (minimum interval +2 months). May administer additional doses of Moderna or +Pfizer-BioNTech.* + + +¢ Completed initial 3-dose vaccination series before + + +2024-25 vaccine with: + +-3 or more doses Moderna or 3 or more doses Pfizer- +BioNTech: 2 doses 2024-25 Moderna or Pfizer-BioNTech +6 months apart (minimum interval 2 months). Administer +dose 1 at least 8 weeks after the most recent dose. May +administer additional doses of Moderna or Pfizer-BioNTech.* + + +Age 12-18 years + + +Use vaccine from the same manufacturer for all doses in the initial +vaccination series. + + +¢ Unvaccinated: + + +-4 doses (3-dose initial series Moderna at 0, 4 weeks, and +at least 4 weeks after dose 2, followed by 1 dose 2024-25 +Moderna or Novavax or Pfizer-BioNTech 6 months later +[minimum interval 2 months]). May administer additional +doses of Moderna or Novavax or Pfizer-BioNTech.* + +-4 doses (3-dose initial series Pfizer-BioNTech at 0, 3 weeks, +and at least 4 weeks after dose 2, followed by 1 dose 2024- +25 Moderna or Novavax or Pfizer-BioNTech 6 months later +[minimum interval 2 months]). May administer additional +doses of Moderna or Novavax or Pfizer-BioNTech.* + +-3 doses (2-dose initial series Novavax at 0, 3 weeks, +followed by 1 dose Moderna or Novavax or Pfizer-BioNTech +6 months later [minimum interval 2 months]). May +administer additional doses of Moderna or Novavax or +Pfizer-BioNTech.* + + +¢ Incomplete initial vaccination series before 2024-25 +vaccine: + + +- Previous vaccination with Moderna + +- 1 dose Moderna: complete initial series with 2 doses +2024-25 Moderna at least 4 weeks apart (administer dose 1 +4 weeks after most recent dose), followed by 1 dose 2024- +25 Moderna or Novavax or Pfizer-BioNTech 6 months later +(minimum interval 2 months). May administer additional +doses of Moderna or Novavax or Pfizer-BioNTech.* + +-2 doses Moderna: complete initial series with 1 dose +2024-25 Moderna at least 4 weeks after most recent dose, +followed by 1 dose 2024-25 Moderna or Novavax or Pfizer- +BioNTech 6 months later (minimum interval 2 months). +May administer additional doses of Moderna or Novavax or +Pfizer-BioNTech.* + +- Previous vaccination with Pfizer-BioNTech + +-1 dose Pfizer-BioNTech: complete initial series with +2 doses 2024-25 Pfizer-BioNTech at least 4 weeks apart +(administer dose 1 3 weeks after most recent dose), +followed by 1 dose 2024-25 Moderna or Novavax or Pfizer- +BioNTech 6 months later (minimum interval 2 months). +May administer additional doses of Moderna or Novavax or +Pfizer-BioNTech.* + +- 2 doses Pfizer-BioNTech: complete initial series with +1 dose 2024-25 Pfizer-BioNTech at least 4 weeks after +most recent dose, followed by 1 dose 2024-25 Moderna +or Novavax or Pfizer-BioNTech 6 months later (minimum +interval 2 months). May administer additional doses of +Moderna or Novavax or Pfizer-BioNTech.* + +- Previous vaccination with Novavax + +- 1 dose Novavax: complete initial series with 1 dose +2024-25 Novavax at least 3 weeks after most recent dose, +followed by 1 dose 2024-25 Moderna or Novavax or Pfizer- +BioNTech 6 months later (minimum interval 2 months). +May administer additional doses of Moderna or Novavax or +Pfizer-BioNTech.* + + +Page 6 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +COVID-19 vaccination - continued Dengue vaccination + + +¢ Completed initial 3-dose vaccination series before + +2024-25 vaccine with: + +-3 or more doses Moderna or 3 or more doses Pfizer- +BioNTech: 2 doses 2024-25 Moderna or Novavax or Pfizer- +BioNTech 6 months apart (minimum interval 2 months). +Administer dose 1 at least 8 weeks after the most recent +dose. May administer additional doses of Moderna or +Novavax or Pfizer-BioNTech.* + + +-2 or more doses Novavax: 2 doses 2024-25 Moderna or +Novavax or Pfizer-BioNTech 6 months apart (minimum +interval 2 months). Administer dose 1 at least 8 weeks after +the most recent dose. May administer additional doses of +Moderna or Novavax or Pfizer-BioNTech.* + + +*Additional doses of 2024-25 COVID-19 vaccine for +moderately or severely immunocompromised: based on +shared clinical decision-making and administered at least + +2 months after the most recent dose (see Table 2 at www. +cdc.gov/vaccines/covid-19/clinical-considerations/interim- +considerations-us.html#table-02.). For description of moderate +and severe immunocompromising conditions and treatment, +see www.cdc.gov/vaccines/covid-19/clinical-considerations/ +interim-considerations-us.html#immunocompromising- +conditions-treatment. + + +Unvaccinated persons have never received any COVID-19 +vaccine doses. 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. + + +For information about interchangeability of COVID-19 vaccines, +see www.cdc.gov/vaccines/covid-19/clinical-considerations/ +interim-considerations-us.html#Interchangeability. + + +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-201 9-covid-19/covid-19- +vaccines. + + +(minimum age: 9 years) + + +Routine vaccination + +¢ Age 9-16 years living in areas with endemic dengue AND +have laboratory confirmation of previous dengue infection +- 3-dose series administered at 0, 6, and 12 months + +e 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/ +index.html + +¢ 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 +¢ 5-dose series (3-dose primary series at age 2, 4, and 6 months, +followed by 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 4th 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 + +* Dose 5 is not necessary if dose 4 was administered at age +4 years or older and at least 6 months after dose 3. + +¢ For other catch-up guidance, see Table 2. + + +Special situations + +¢ Children younger than age 7 years with a contraindication +specific to the pertussis component of DTaP: May +administer Td for all recommended remaining doses in place +of DTaP. Encephalopathy within 7 days of vaccination when +not attributable to another identifiable cause is the only +contraindication specific to the pertussis component of DTaP. +For additional information, see www.cdc.gov/pertussis/hcp/ +vaccine-recommendations/td-offlabel.html. + +¢ Wound management in children younger 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 influenzae type b vaccination + + +(minimum age: 6 weeks) + + +Routine vaccination +¢ 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 +different Hib-containing vaccine should be used for the +booster dose. + + +¢ PedvaxHIB: 3-dose series (2-dose primary series at age 2 and +4 months, followed by a booster dose at age 12-15 months) + + +¢ American Indian and Alaska Native infants: Vaxelis and +PedvaxHIB preferred over other Hib vaccines for the primary +series. + + +Catch-up vaccination + +¢ Dose 1 at age 7-11 months: Administer dose 2 at least +4 weeks later and dose 3 (final dose) at age12—15 months or +8 weeks after dose 2 (whichever is later). + + +¢ Dose 1 at age 12-14 months: Administer dose 2 (final dose) +at least 8 weeks after dose 1. + + +° Dose 1 before age 12 months and dose 2 before age +15 months: Administer dose 3 (final dose) at least +8 weeks after dose 2. + + +¢ 2 doses of PedvaxHIB before age 12 months: Administer +dose 3 (final dose) at age12-59 months and at least 8 weeks +after dose 2. + + +¢ 1 dose administered at age 15 months or older: +No further doses needed + + +¢ Unvaccinated at age 15-59 months: Administer 1 dose. + + +¢ Previously unvaccinated children age 60 months or +older who are not considered high risk: Catch-up +vaccination not required. + + +For other catch-up guidance, see Table 2. Vaxelis can be used +for catch-up vaccination in children younger 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. + + +Page 7 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Haemophilus influenzae type b vaccination +- continued + + +Special situations +¢ 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. + + +¢ Hematopoietic stem cell transplant (HSCT): +- 3-dose series 4 weeks apart starting 6 to 12 months after +successful transplant, regardless of Hib vaccination history + + +¢ 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 + + +¢ Elective splenectomy: +Unvaccinated* persons age 15 months or older + + +- 1 dose (preferably at least 14 days before procedure) +¢ 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 + + +¢ Immunoglobulin deficiency, early component +complement deficiency, or early component complement +inhibitor use: +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 + + +¢ 2-dose series (minimum interval: 6 months) at age 12- +23 months + + +Catch-up vaccination + + +e Unvaccinated persons through age 18 years should +complete a 2-dose series (minimum interval: 6 months). + + +e Persons who previously received 1 dose at age 12 months or +older should receive dose 2 at least 6 months after dose 1. + + +e Adolescents age 18 years or older may receive HepA-HepB +(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 +¢ 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 +¢ Mother is HBsAg-negative +- 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) +- Infants who did not receive a birth dose should begin +the series as soon as possible (see Table 2 for minimum +intervals). +- Administration of 4 doses is permitted when a combination +vaccine containing HepB is used after the birth dose. +- Minimum intervals (see Table 2): when 4 doses +are administered, substitute “dose 4” for “dose 3” +in these calculations. +- Final (3rd or 4th) dose: age 6-18 months +(minimum age 24 weeks) + + +e 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 final dose. Do not +test before age 9 months. + + +Page 8 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Hepatitis B vaccination - continued + + +e 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 final dose. Do not test before age 9 months. + + +Catch-up vaccination + +e Unvaccinated persons should complete a 3-dose series at +0, 1-2, 6 months. See Table 2 for minimum intervals. + +e Adolescents age 11-15 years may use an alternative 2-dose +schedule with at least 4 months between doses (adult +formulation Recombivax HB only). + +e 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 + +- HepA-HepB (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). + + +Special situations +e Revaccination is generally not recommended for persons +with a normal immune status who were vaccinated as infants, +children, adolescents, or adults. +¢ 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/mmwr/volumes/67/rr/rr6701a1.htm. +*Note: PreHevbrio is 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 + + +e 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. + + +e 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) + + +¢ No additional dose recommended when any HPV +vaccine series of any valency has been completed using +recommended dosing intervals. + + +Special situations + +¢ Immunocompromising conditions, including HIV +infection: 3-dose series, even for those who initiate +vaccination at age 9 through 14 years. + + +¢ History of sexual abuse or assault: Start at age 9 years + + +¢ Pregnancy: Pregnancy testing not needed before +vaccination; HPV vaccination not recommended until +after pregnancy; no intervention needed if vaccinated +while pregnant + + +Influenza vaccination + + +(minimum age: 6 months [IIV3], 2 years [LAIV3],18 +years [recombinant influenza vaccine, RIV3]) + + +Routine vaccination +e Use any influenza vaccine appropriate for age and health +status annually: +- Age 6 months-8 years who have received fewer than +2 influenza vaccine doses before July 1, 2024, or whose +influenza 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 influenza vaccine doses before July 1, 2024: 1 dose. +- Age 9 years or older: 1 dose +- Age 18 years solid organ transplant recipients receiving +immunosuppressive medications: high-dose inactivated +(HD-IIV3) and adjuvanted inactivated (allV3) influenza +vaccines are acceptable options. No preference over other +age-appropriate IIV3 or RIV3. + + +e For the 2024-25 season, see www.cdc.gov/mmwr/ +volumes/73/rr/rr7305a1.htm. + + +¢ For the 2025-26 season, see the 2025-26 ACIP influenza +vaccine recommendations. + + +Special situations + +* Close contacts (e.g., household contacts) of severely +immunosuppressed persons who require a protected +environment: should not receive LAIV3. If LAIV3 is +given, they should avoid contact with, or caring for such +immunosuppressed persons for 7 days after vaccination. + + +Note: Persons with an egg allergy can receive any influenza +vaccine (egg-based or non-egg based) appropriate for age and +health status. + + +Page 9 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Measles, mumps, and rubella vaccination + + +(minimum age: 12 months for routine vaccination) + + +Routine vaccination +e 2-dose series at age 12-15 months, age 4-6 years + + +¢ 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 + +¢ Unvaccinated children and adolescents: 2-dose series at +least 4 weeks apart* + +¢ The maximum age for use of MMRV* is 12 years. + + +Special situations +¢ 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.* +- Children age 12 months or older: +- Unvaccinated: 2-dose series (separated by at least +4 weeks*) before departure +- Previously received 1 dose: administer dose 2 at least +4 weeks after dose 1* +¢ ln 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, MenQuadfi]), + + +10 years [MenACWY-TT/MenB-FHbp, Penbraya]) + + +Routine vaccination +* 2-dose series at age 11-12 years; 16 years + + +Catch-up vaccination + + +e Age 13-15 years: 1 dose now and booster at age 16-18 years +(minimum interval: 8 weeks) + + +¢ Age 16-18 years: 1 dose + + +Special situations + +Anatomic or functional asplenia (including sickle cell +disease), HIV infection, persistent complement +component deficiency, complement inhibitor + +(e.g., eculizumab, ravulizumab) use: + + +¢ 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 + + +¢ MenQuadfi + + +-Dose 1 at age 24 months or older: 2-dose series at least +8 weeks apart + + +Travel to countries with hyperendemic or epidemic +meningococcal disease, including countries in the African +meningitis belt or during the Hajj (www.cdc.gov/travel/): + + +¢ Children younger 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) + + +¢ Children age 2 years or older: 1 dose Menveo* +or MenQuadfi + + +First-year college students who live in residential housing +(if not previously vaccinated at age 16 years or older) or +military recruits: 1 dose Menveo* or MenQuadfi + + +Adolescent vaccination of children who received MenACWY +prior to age 10 years: + + +¢ Children for whom boosters are recommended because +of an ongoing increased risk of meningococcal disease +(e.g., those with complement component deficiency, HIV, +or asplenia): Follow the booster schedule for persons at +increased risk. + + +¢ 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). + + +Page 10 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Meningococcal serogroup B vaccination +(minimum age: 10 years [MenB-4C, Bexsero; MenB- + + +FHbp, Trumenba; MenACWY-TT/MenB-FHbp, +Penbraya)]) + + +Shared clinical decision-making +¢ Adolescents not at increased risk age 16-23 years + +(preferred age 16-18 years)* based on shared clinical + +decision-making. + +- Bexsero or Trumenba (use same brand for all doses): +2-dose series at least 6 months apart (if dose 2 is +administered earlier than 6 months, administer dose 3 +at least 4 months after dose 2) + + +*To optimize rapid protection (e.g., for students starting college +in less than 6 months), a 3-dose series (0, 1-2, 6 months) may be +administered. + + +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 deficiency, +complement inhibitor (e.g., eculizumab, ravulizumab) use. +- Bexsero or Trumenba (use same brand for all doses +including booster doses) 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 4th dose should be administered at +least 4 months after dose 3) + + +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. + + +Note: MenB vaccines may be administered simultaneously +with MenACWY vaccines if indicated, but at a different +anatomic site, if feasible. + + +Children age 10 years or older may receive a dose of Penbraya +(MenACWY-TT/MenB-FHbp) 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 + +¢ Age 18 years and at risk for mpox infection: complete +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 + + +¢ 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/mpox/hcp/vaccine- +considerations/vaccination-overview.html + + +Pneumococcal vaccination +(minimum age: 6 weeks [PCV15], [PCV 20]; 2 years + + +[PPSV23]) + + +Routine vaccination with PCV +e 4-dose series at 2, 4,6, 12-15 months + + +Catch-up vaccination with PCV + +¢ Healthy children ages 2-4 years with any incomplete* +PCV series: 1 dose PCV + +¢ 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. + + +Special situations + +Children and adolescents with cerebrospinal fluid 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 +e 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) +¢ 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. + + +Page 11 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Pneumococcal vaccination - continued + + +Age 6-18 years + +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.** + + +° 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. + + +¢ 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. + + +¢ 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 immunodeficiencies; +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 +e 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) +¢ 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 + +¢ 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.** + + +¢ 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. + + +¢ 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. + + +¢ 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. + + +Pregnancy: no recommendation for PCV or PPSV23 due to +limited data. Summary of existing data on pneumococcal +vaccination during pregnancy can be found at www.cdc.gov/ +mmwr/volumes/72/rr/rr7203a1.htm + + +For guidance on determining which pneumococcal vaccines a +patient needs and when, please refer to the mobile app, which +can be downloaded here: wcms-wp.cdc.gov/pneumococcal/ +hcp/vaccine-recommendations/app.html + + +*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 first. PCV15 and PPSV23 should not be +administered during the same visit. + + +Poliovirus vaccination + + +(minimum age: 6 weeks) + + +Routine vaccination + +e 4-dose series at ages 2, 4, 6-18 months, 4-6 years; administer +the final dose on or after age 4 years and at least 6 months +after the previous dose. + + +¢ 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 + +¢ In the first 6 months of life, use minimum ages and +intervals only for travel to a polio-endemic region +or during an outbreak. + + +e 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 specific 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: + +¢ 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. + +¢ Only trivalent OPV (tOPV) counts toward the +U.S. vaccination requirements. + +- Doses of OPV administered before April 1, 2016, should be +counted (unless specifically 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. + +¢ For other catch-up guidance, see Table 2. + + +Special situations + +¢ 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 + + +Page 12 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Respiratory syncytial virus immunization + + +(minimum age: birth [Nirsevimab, RSV-mAb, Beyfortus]) + + +Routine immunization +¢ 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 or mother received +RSV vaccine in previous pregnancy: administer 1 dose +nirsevimab within 1 week of birth—ideally during the birth +hospitalization. + +- Mother received RSV vaccine less than 14 days prior to +delivery: administer 1 dose nirsevimab within 1 week of +birth—ideally during the birth hospitalization. + +- 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 www.cdc.gov/vaccines/vpd/rsv/hcp/child-faqs.html) + + +¢ 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 or mother received +RSV vaccine in previous pregnancy: 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 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 + +¢ 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 fibrosis with either weight +for length <10th percentile or manifestation of severe +lung disease (e.g., previous hospitalization for pulmonary +exacerbation in the first year of life or abnormalities on +chest imaging that persist when stable)**: +- 1 dose nirsevimab shortly before start of second RSV + +season* + + +e Ages 8-19 months who are American Indian or +Alaska Native: 1 dose nirsevimab shortly before start of +second RSV season* + + +¢ Age-eligible and undergoing cardiac surgery with +cardiopulmonary bypass**: 1 additional dose of nirsevimab +after surgery. See www.accessdata.fda.gov/drugsatfda_docs/ +label/2023/761328s000Ibl.pdf + + +*Note: While the timing of the onset and duration of + +RSV season may vary, administration of nirsevimab is +recommended October through March in most of the +continental United States (optimally October through +November or within 1 week of birth). Providers in jurisdictions +with RSV seasonality that differs 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. + + +**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 + +¢ 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 Abrysvo. Administer RSV +vaccine regardless of previous RSV infection. + +- Either maternal RSV vaccination with Abrysvo or infant +immunization with nirsevimab (RSV monoclonal antibody) is +recommended to prevent severe respiratory syncytial virus +disease in infants. + + +¢ All other pregnant persons: RSV vaccine not recommended + + +e Subsequent pregnancies: additional doses not +recommended. No data are available to inform whether +additional doses are needed in subsequent pregnancies. +Infants born to pregnant persons who received RSV vaccine +during a previous pregnancy should receive nirsevimab. + + +*Note: Providers in jurisdictions with RSV seasonality that +differs from most of the continental United States (e.g., Alaska, +jurisdictions 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 +¢ Rotarix: 2-dose series at age 2 and 4 months + + +¢ RotaTeq: 3-dose series at age 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 Table 2. + + +Page 13 + + +| Notes | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Tetanus, diphtheria, and pertussis (Tdap) + + +vaccination (minimum age: 11 years for routine +vaccination, 7 years for catch-up vaccination) + + +Routine vaccination +e Age 11-12 years: 1 dose Tdap (adolescent booster) + + +¢ 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 + + +e Age 13-18 years who have not received Tdap: +1 dose Tdap (adolescent booster) + + +¢ Age 7-18 years not fully vaccinated* with DTaP: 1 dose +Tdap as part of the catch-up series (preferably the first dose); +if additional doses are needed, use Td or Tdap. + + +¢ 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 + + +¢ 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. + + +¢ For other catch-up guidance, see Table 2. + + +Special situations + +¢ 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. + + +¢ 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 +e 2-dose series at age 12-15 months, 4-6 years +¢ VAR or MMRV may be administered* + + +¢ 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 +¢ 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. + + +Page 14 + + +Appendix Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +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 Influenza with Vaccines: +Recommendations of the Advisory Committee on Immunization Practices—United States, 2024-25 Influenza Season | MMWR (cdc.gov), and Contraindications and Precautions for COVID-19 Vaccination + + +Vaccines and other + + +I a Contraindicated or Not Recommended’ Precautions” + +mmunizing Agents + +COVID-19 mRNA vaccines + Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of + Diagnosed non-severe allergy (e.g., urticaria beyond the injection site) to a +[Pfizer-BioNTech, Moderna] an mRNA COVID-19 vaccine? 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 inflammatory syndrome in children (MIS-C) or multisystem +inflammatory syndrome in adults (MIS-A) + ++ Moderate or severe acute illness, with or without fever + + +COVID-19 protein subunit + Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of + Diagnosed non-severe allergy (e.g., urticaria beyond the injection site) toa +vaccine a Novavax COVID-19 vaccine? component of Novavax COVID-19 vaccine?; or non-severe, immediate (onset +[Novavax] 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 inflammatory syndrome in children (MIS-C) or multisystem +inflammatory syndrome in adults (MIS-A) ++ Moderate or severe acute illness, with or without fever + + +Influenza, egg-based, + Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine + Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any +inactivated injectable (IIV3) (i.e., any egg-based IIV, ccllV, RIV, or LAIV of any valency) type of influenza vaccine + ++ Severe allergic reaction (e.g., anaphylaxis) to any vaccine component? (excluding egg) + Moderate or severe acute illness with or without fever +Influenza, cell culture-based + Severe allergic reaction (e.g., anaphylaxis) to any ccllV of any valency, or to any component? of ccllV3 + Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any +inactivated injectable (ccllV3) type of influenza vaccine +[Flucelvax] + 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 ccllV3, 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 + + +Influenza, recombinant + Severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency, or to any component? of RIV3 + Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any +injectable (RIV3) type of influenza vaccine +[Flublok] + Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous + + +dose of any egg-based IIV, ccllV, or LAIV of any valency. If using RIV3, 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 + + +Influenza, live attenuated + Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine + Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any +(LAIV3) (i.e., any egg-based IV, ccllV, RIV, or LAIV of any valency) type of influenza vaccine +[Flumist] + Severe allergic reaction (e.g., anaphylaxis) to any vaccine component? (excluding egg) - Asthma in persons age 5 years old or older ++ Children age 2-4 years with a history of asthma or wheezing + Persons with underlying medical conditions other than those listed under ++ Anatomic or functional asplenia contraindications that might predispose to complications after wild-type ++ Immunocompromised due to any cause including, but not limited to, medications and HIV infection influenza virus infection, e.g., chronic pulmonary, cardiovascular (except isolated ++ Close contacts or caregivers of severely immunosuppressed persons who require a protected environment hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders +- Pregnancy (including diabetes mellitus) ++ Cochlear implant + Moderate or severe acute illness with or without fever + + ++ Active communication between the cerebrospinal fluid (CSF) and the oropharynx, nasopharynx, nose, +ear or any other cranial CSF leak + ++ Children and adolescents receiving aspirin or salicylate-containing medications + ++ Received influenza antiviral medications oseltamivir or zanamivir within the previous 48 hours, +peramivir within the previous 5 days, or baloxavir within the previous 17 days + + +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 benefit 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. See package inserts and FDA EUA fact sheets for a full list of vaccine ingredients. mRNA COVID-19 vaccines contain polyethylene glycol (PEG). + +4. 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. + + +Page 15 + + +Appendix + + +Vaccines and other +Immunizing Agents + + +Dengue (DEN4CYD) + + +Diphtheria, tetanus, pertussis (DTaP) + + +raindicated or Not Recommended! + + ++ Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component? + ++ Severe immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, +long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised) + ++ Lack of laboratory confirmation of a previous dengue infection + + ++ Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component? ++ Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to another + + +identifiable cause within 7 days of admin + + +istration of previous dose of DTP or DTaP + + +Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +Precautions” + + ++ Pregnancy ++ HlV infection without evidence of severe immunosuppression ++ Moderate or severe acute illness with or without fever + + ++ 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 clarified and stabilized + ++ Moderate or severe acute illness with or without fever + + +Haemophilus influenzae type b (Hib) + + ++ Severe allergic reaction (e.g., anaphylaxis: ++ Younger than age 6 weeks + + +after a previous dose or to a vaccine component? + + ++ 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) + + +Hepatitis A-Hepatitis B vaccine (HepA-HepB) +[Twinrix] + + ++ Severe allergic reaction (e.g., anaphylaxis: ++ Pregnancy: PreHevbrio is not recommend +HepB is indicated* + + ++ Severe allergic reaction +yeast + + +‘e.g., anaphylaxis) + + +after a previous dose or to a vaccine component? including yeast +led due to lack of safety data in pregnant persons. Use other hepatitis B vaccines if + + +after a previous dose or to a vaccine component? including neomycin and + + ++ Moderate or severe acute illness with or without fever + + ++ 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 immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, +long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised) + + ++ Pregnancy + + ++ Family history of altered immunocompetence, unless verified clinically or by laboratory testing as immunocompetent + + ++ For MMRV only: HIV infection of any seve' + + +rity + + ++ Recent (<11 months) receipt of antibody-containing blood product (specific 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 + ++ If using MMRV, see Varicella/MMRV for additional precautions + + +Meningococcal ACWY (MenACWY) +MenACWY-CRM [Menveo] +MenACWY-TT [MenQuadfi] + + +Meningococcal B (MenB) +MenB-4C [Bexsero] +MenB-FHbp [Trumenba] + + ++ Severe allergic reaction (e.g., anaphylaxis: ++ For Men ACWY-CRM only: severe allergic + + +after a previous dose or to a vaccine component? +reaction to any diphtheria toxoid— or CRM197—containing vaccine + + ++ For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine + + ++ Severe allergic reaction (e.g., anaphylaxis + + +after a previous dose or to a vaccine component? + + ++ For MenACWY-CRM only: Preterm birth if younger than age 9 months ++ Moderate or severe acute illness with or without fever + + ++ 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: ++ Severe allergic reaction to a tetanus toxoi + + +after a previous dose or to a vaccine component? +d-containing vaccine + + ++ Moderate or severe acute illness, with or without fever + + +Mpox UJynneos] + + ++ 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 ++ Severe allergic reaction + + +e.g., anaphylaxis +e.g., anaphylaxis + + +after a previous dose or to a vaccine component? +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 ++ Severe combined immunodeficiency (SC ++ History of intussusception + + +after a previous dose or to a vaccine component? +ID) + + ++ Altered immunocompetence other than SCID + ++ Chronic gastrointestinal disease + ++ RV1 only: Spina bifida 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: ++ For Tdap only: Encephalopathy (e.g., com: + + +after a previous dose or to a vaccine component? +a, decreased level of consciousness, prolonged seizures) not attributable to + + +another identifiable 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) +Measles, mumps, rubella, and varicella +(MMRV) + + ++ Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component? ++ Severe immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, +long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised) + + ++ Pregnancy + + ++ Family history of altered immunocompetence, unless verified clinically or by laboratory testing as immunocompetent + + ++ For MMRV only: HIV infection of any seve + + +rity + + ++ Recent (<11 months) receipt of antibody-containing blood product (specific interval depends on product) + ++ Receipt of specific 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. + +2. When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit 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. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + +3. Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. Package inserts for U.S.-licensed vaccines are available at +www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states. + +4. For information on the pregnancy exposure registry for persons who were inadvertently vaccinated with PreHevbrio while pregnant, please visit www.prehevbrio.com/#safety. + +5. Full prescribing information for BEYFORTUS (nirsevimab-alip) www.accessdata.fda.gov/drugsatfda_docs/label/2023/761328sO000IbI.pdf. + + +Page 16 + + +MYolel-yale(¥laaM Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2025 + + +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 24, 2024. The following +recommendations have been adopted by the CDC Director and are now official. Links are provided if these recommendations have been published in Morbidity and Mortality Weekly Report (MMWR). + + +Vaccines Recommendations Effective Date of Recommendation* + + +No new vaccines or vaccine recommendations to report + + +*The effective date is the date when the CDC director adopted the recommendation and when the ACIP recommendation became official. Page 17 + + diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.xml b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.xml new file mode 100644 index 0000000..196053b --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_djvu.xml @@ -0,0 +1,18995 @@ + + + + + + + + + + + + + UNITED + STATES + + + + + + + + + Recommended + Child + and + Adolescent + Immunization + Schedule + + + for + ages + 18 + years + or + younger + + + + + + + + + Vaccines + and + Other + Immunizing + Agents + in + the + Child + and + Adolescent + Immunization + Schedule* + + + + + + + + + 2025 + + + + + + + + + How + to + use + the + child + and + adolescent + immunization + + + Respiratory + syncytial + virus + monoclonal + antibody + (Nirsevimab) + RSV-mAb + Beyfortus + + + schedule + + + COVID-19 + vaccine + IvCOV-mRNA + Comirnaty/Pfizer-BioNTech + 1 + 2 + 3 + 4 + 5 + 6 + + + COVID-19 + Vaccine + + + = + Determine + Determine + Assess + need + Review + Review + Review + new + or + + + ee + ee + recommended + recommended + for + additional + vaccine + types, + contraindications + updated + ACIP + + + : + vaccine + byage + __ + interval + forcatch- + recommended + _ + frequencies, + and + precautions + guidance + + + 1vCOV-aPS + Novavax + COVID-19 + Vaccine + (Table + 1) + up + vaccination + vaccines + intervals, + and + for + vaccine + types + (Addendum) + + + : + - + (Table + 2) + by + medical + considerations + (Appendix) + + + Dengue + vaccine + DEN4CYD + Dengvaxia + condition + or + for + special + + + Diphtheria, + tetanus, + and + acellular + pertussis + vaccine + DTaP + Daptacel + other + indication + — + situations + + + Infanrix + (Table + 3) + (Notes) + + + Haemophilus + influenzae + type + b + vaccine + Hib + (PRP-T) + ActHIB + + + Hiberix + + + Hib + (PRP-OMP) + —— + PedvaxHIB + Recommended + by + the + Advisory + Committee + on + Immunization + Practices + (www.cdc.gov/acip/index. + + + Hepatitis + A + vaccine + HepA + Havrix + html) + and + approved + by + the + Centers + for + Disease + Control + and + Prevention + (www.cdc.gov), + American + + + Vaqta + Academy + of + Pediatrics + (www.aap.org), + American + Academy + of + Family + Physicians + (www.aafp.org), + + + Hepatitis + B + vaccine + HepB + Engerix-B + American + College + of + Obstetricians + and + Gynecologists + (www.acog.org), + American + College + of + Nurse- + + + ; + = + Recombivax + HB + Midwives + (www.midwife.org), + American + Academy + of + Physician + Associates + (www.aapa.org), + and + + + Human + papillomavirus + vaccine + nv + Gardasil + National + Association + of + Pediatric + Nurse + Practitioners + (www.napnap.org). + + + Influenza + vaccine + (inactivated: + egg-based) + IIV3 + Multiple + + + Influenza + vaccine + (inactivated: + cell-culture) + ccllV3 + Flucelvax + Report + + + Influenza + vaccine + (live, + attenuated) + LAIV3 + FluMist + * + Suspected + cases + of + reportable + vaccine-preventable + diseases + or + outbreaks + to + your + state + or + local + health + + + Measles, + mumps, + and + rubella + vaccine + MMR + M-M-R + II + department + + + Priorix + az + bos + ‘ + . + + + ICT + ts + OeSTe + TIE + USC + GON[SSIEW(CA + NUN + EIZET + MenACWY-CRM + Menveo + ° + pens + Gabe + pete + pes + . + the + Vaccine + Adverse + Event + Reporting + System + (VAERS) + at + + + MenACWY-TT + MenQuadfi + : + ial + + + Meningococcal + serogroup + B + vaccine + MenB-4C + Bexsero + Questions + or + comments + + + MenB-FHbp + Trumenba + Contact + www.cdc.gov/cdc-info + or + 800-CDC-INFO + (800-232-4636), + in + English + or + Spanish, + 8 + a.m.-8 + p.m. + ET, + + + Meningococcal + serogroup + A, + B, + C, + W, + Y + vaccine + MenACWY-TT/ + Penbraya + Monday + through + Friday, + excluding + holidays. + + + MenB-FHbp + + + nipexiogeine + . + . + Mines + siiinsss + Download + the + CDC + Vaccine + Schedules + app + for + providers + at + + + Pneumococcal + conjugate + vaccine + PCV15 + Vaxneuvance + ‘ + i + + + PCV20 + Previar20 + ‘anja + Www.cdc.gov/vaccines/hcp/imz-schedules/app.html + + + Pneumococcal + polysaccharide + vaccine + PPSV23 + Pneumovax + 23 + + + Poliovirus + vaccine + (inactivated) + IPV + Ipol + Helpful + information + + + Respiratory + syncytial + virus + vaccine + RSV + Abrysvo + * + Complete + Advisory + Committee + on + Immunization + Practices + (ACIP) + recommendations: + + + Rotavirus + vaccine + RV1 + Rotarix + www.cdc.gov/acip-recs/hcp/vaccine-specific/index.html + + + RV5 + RotaTeq + ° + ACIP + Shared + Clinical + Decision-Making + Recommendations: + + + Tetanus, + diphtheria, + and + acellular + pertussis + vaccine + Tdap + Adacel + www.cdc.gov/acip/vaccine-recommendations/shared-clinical-decision-making.html + + + Boostrix + * + General + Best + Practice + Guidelines + for + Immunization + (including + contraindications + and + precautions): + + + Tetanus + and + diphtheria + vaccine + Td + Tenivac + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html + + + . + . + iiras + ¢ + Vaccine + information + statements: + + + Varicella + vaccine + VAR + Varivax + + + + + + + + + Combination + vaccines + (use + combination + vaccines + instead + of + separate + injections + when + appropriate) + + + + + + + + + Ps + : + hea + : + + + DTaP, + hepatitis + B, + and + inactivated + poliovirus + vaccine + DTaP-HepB-IPV + Pediarix + neal + forthe + aaa + as + betaine + rie + Scan + QR + code + + + DTaP + i + ‘ated + DOloul + ae + PaWGhail + 6 + . + DTaP-IPV/Hib + p, + | + including + case + identification + and + outbreak + response): + for + access + to + + + + + aP, + inactivated + poliovirus, + and + Haemophilus + influenzae + type + b + vaccine + a + /Hi + entacel + www.cdc.gov/surv-manual/php/ + + + DTaP + and + inactivated + poliovirus + vaccine + DTaP-IPV + Kinrix + ienab + + + Quadracel + + + DTaP, + inactivated + poliovirus, + Haemophilus + influenzae + type + b, + and + DTaP-IPV-Hib- + Vaxelis + + + hepatitis + B + vaccine + HepB + | + | + U.S. + CENTERS + FOR + DISEASE + + + Measles, + mumps, + rubella, + and + varicella + vaccine + MMRV + ProQuad + CONTROL + AND + PREVENTION + + + + + *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 + identification + purposes + only + and + does + not + imply + endorsement + by + the + ACIP + or + CDC. + + + + + + + + + CS310020-E + + + + + + + + + 11/21/2024 + + + + + + + + + www.cdc.gov/vaccines/hcp/vis/index.html + + + + + + + + + + + + + + + + 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). + + + + + + + + + Respiratory + syncytial + virus + + + (RSV-mAb + [Nirsevimab]) + + + + + + + + + Hepatitis + B + (HepB) + + + + + + + + + Rotavirus + (RV): + RV1 + (2-dose + series), + + + RV5 + (3-dose + series) + + + + + + + + + Diphtheria, + tetanus, + acellular + pertussis + + + (DTaP + <7 + yrs) + + + + + + + + + Haemophilus + influenzae + type + b + (Hib) + + + + + + + + + Pneumococcal + conjugate + + + (PCV15, + PCV20) + + + + + + + + + Inactivated + poliovirus + (IPV) + + + + + + + + + COVID-19 + (1vCOV-mRNA, + 1vCOV-aPS) + + + + + + + + + Influenza + (IIV3, + ccllV3) + + + + + + + + + Influenza + (LAIV3) + + + + + + + + + Measles, + mumps, + rubella + (MMR) + + + + + + + + + Varicella + (VAR) + + + + + + + + + Hepatitis + A + (HepA) + + + + + + + + + Tetanus, + diphtheria, + acellular + pertussis + + + (Tdap + =7 + yrs) + + + + + + + + + Human + papillomavirus + (HPV) + + + + + + + + + Meningococcal + (MenACWY-CRM + =2 + mos, + + + MenACWY-TT + =2years) + + + + + + + + + Meningococcal + B + + + (MenB-4C, + MenB-FHbp) + + + + + + + + + Respiratory + syncytial + virus + vaccine + + + (RSV + [Abrysvo]) + + + + + + + + + Dengue + (DEN4CYD: + 9-16 + yrs) + + + Mpox + + + + + + + + + Range + of + recommended + ages + + + for + catch-up + vaccination + + + + + + + + + Range + of + recommended + ages + + + for + all + children + + + + + + + + + 1 + dose + (8 + through + 19 + months), + See + Notes + + + + + + + + + See + Notes + + + + + + + + + See + Notes + + + + + + + + + See + Notes + + + + + + + + + Recommended + vaccination + can + + + begin + in + this + age + group + + + + + + + + + Range + of + recommended + ages + + + for + certain + high-risk + groups + or + + + populations + + + + + + + + + See + Notes + + + + + + + + + Seasonal + administration + + + during + pregnancy + (See + Notes) + + + + + + + + + Seropositive + in + endemic + + + dengue + areas + (See + Notes) + + + + + + + + + No + Guidance/ + + + Not + Applicable + + + + + + + + + Recommended + vaccination + based + + + on + shared + clinical + decision-making + + + + + + + + + Page + 2 + + + + + + + + + + + + + + + + Table + 2 + + + + + + + + + Recommended + Catch-up + Immunization + Schedule + for + Children + and + Adolescents + Who + Start + Late + or + Who + Are + More + + + than + 1 + Month + Behind, + United + States, + 2025 + + + + + + + + + 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. + + + + + + + + + Vaccine + + + Hepatitis + B + + + + + + + + + Rotavirus + + + + + + + + + Diphtheria, + tetanus, + and + + + acellular + pertussis + + + + + + + + + Haemophilus + influenzae + + + type + b + + + + + + + + + Pneumococcal + conjugate + + + + + + + + + Inactivated + poliovirus + + + + + + + + + Measles, + mumps, + rubella + + + Varicella + + + + + Hepatitis + A + + + Meningococcal + ACWY + + + + + + + + + Children + and + adolescents + age + 7 + through + 18 + years + + + + + + + + + Meningococcal + ACWY + + + + + + + + + Tetanus, + diphtheria; + + + tetanus, + diphtheria, + and + + + acellular + pertussis + + + + + + + + + Human + papillomavirus + + + + + + + + + Hepatitis + A + + + Hepatitis + B + + + Inactivated + poliovirus + + + + + + + + + Measles, + mumps, + rubella + + + Varicella + + + + + + + + + Dengue + + + + + + + + + Minimum + Age + for + + + + + + + + + Borel + Dose + 1 + to + Dose + 2 + + + + + Birth + 4 + weeks + + + + + 6 + weeks + 4 + weeks + + + + + Maximum + age + for + first + + + + + dose + is + 14 + weeks, + 6 + days. + + + + + 6 + weeks + 4 + weeks + + + + + 6 + weeks + No + further + doses + needed + + + if + first + dose + was + administered + at + age + + + 15 + months + or + older. + + + + + 4 + weeks + + + + + if + first + dose + was + administered + before + + + the + 1st + birthday. + + + + + 8 + weeks + (as + final + dose) + + + + + if + first + dose + was + administered + at + age + + + 12 + through + 14 + months. + + + + + 6 + weeks + No + further + doses + needed + for + healthy + + + children + if + first + dose + was + administered + + + at + age + 24 + months + or + older + + + 4 + weeks + + + if + first + dose + was + administered + before + + + the + 1st + birthday + + + 8 + weeks + (as + final + dose + for + healthy + + + children) + + + if + first + dose + was + administered + at + the + + + 1st + birthday + or + after + + + + + 6 + weeks + 4 + weeks + + + + + 12 + months + 4 + weeks + + + + + 12 + months + 3 + months + + + + + 12 + months + 6 + months + + + + + 2months + MenACWY-CRM + 8 + weeks + + + + + 2 + years + MenACWY-TT + + + + + Not + applicable + (N/A) + 8 + weeks + + + + + 7 + years + 4weeks + + + + + 9 + years + Routine + dosing + intervals + are + + + recommended. + + + + + N/A + 6 + months + + + + + N/A + 4 + weeks + + + + + N/A + 4 + weeks + + + + + N/A + 4 + weeks + + + + + N/A + 3 + months + if + younger + than + age + 13 + years. + + + 4 + weeks + if + age + 13 + years + or + older + + + + + 9 + years + 6 + months + + + + + + + + + Children + age + 4 + months + through + 6 + years + + + Minimum + Interval + Between + Doses + + + Dose + 2 + to + Dose + 3 + + + 8 + weeks + and + at + least + 16 + weeks + after + first + dose + + + minimum + age + for + the + final + dose + is + 24 + weeks + + + + + + + + + 4 + weeks + + + maximum + age + for + final + dose + is + 8 + months, + 0 + days + + + + + + + + + 4 + weeks + + + + + + + + + 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 + first + 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 + final + dose) + + + + + if + current + age + is + younger + than + 12 + months + and + first + dose + was + administered + at + age + 7 + through + 11 + months; + OR + + + if + current + age + is + 12 + through + 59 + months + and + first + dose + was + administered + before + the + 1st + birthday + and + second + + + dose + was + administered + at + younger + than + 15 + months; + OR + + + + + if + both + doses + were + PedvaxHIB + and + were + administered + before + the + 1st + birthday + + + + + + + + + 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 + final + 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 + + + + + + + + + 4 + weeks + + + + + if + current + age + is + <4 + years + + + + + 6 + months + (as + final + dose) + + + + + if + current + age + is + 4 + years + or + older + + + + + + + + + See + Notes + + + + + + + + + 4 + weeks + + + + + if + first + dose + of + DTaP/DT + was + administered + before + the + 1st + birthday + + + + + 6 + months + (as + final + dose) + + + + + if + first + dose + of + DTaP/DT + or + Tdap/Td + was + administered + at + or + after + the + 1st + birthday + + + + + + + + + 8 + weeks + and + at + least + 16 + weeks + after + first + dose + + + + + + + + + 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. + + + + + + + + + 6 + months + + + + + + + + + Dose + 3 + to + Dose + 4 + Dose + 4 + to + Dose + 5 + + + + + + + + + 6 + months + + + + + A + fifth + dose + is + not + necessary + + + + + if + the + fourth + dose + was + + + administered + at + age + 4 + years + or + + + older + and + at + least + 6 + months + + + after + dose + 3 + + + + + + + + + 6 + months + + + + + + + + + 8 + weeks + (as + final + dose) + + + + + This + dose + only + necessary + + + + + for + children + age + 12 + through + + + + + 59 + months + who + received + 3 + doses + + + before + the + 1st + birthday. + + + + + + + + + 8 + weeks + (as + final + 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. + + + + + + + + + 6 + months + (minimum + age + 4 + years + + + for + final + dose) + + + + + + + + + See + Notes + + + + + + + + + 6 + months + + + + + if + first + dose + of + DTaP/DT + was + + + administered + before + the + 1st + + + birthday + + + + + + + + + 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. + + + + + + + + + Page + 3 + + + + + + + + + + + + + + + + aF-]e)(-"eM + Recommended + Child + and + Adolescent + Immunization + Schedule + by + Medical + Indication, + United + States, + 2025 + + + + + + + + + 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. + + + + + + + + + HIV + infection + CD4 + Asplenia + or + + + Vaccine + percentage + and + count? + persistent + Kidney + failure, + + + and + other + Immunocompromised + CSF + leak + or + complement + End-stage + + + immunizing + (excluding + HIV + <15%or + | + =>15% + and + cochlear + component + Heart + disease + or + renal + disease + Chronic + liver + + + agents + Pregnancy + infection) + <200/mm? + | + =200/mm? + implant + deficiencies + chronic + lung + disease + or + on + dialysis + disease + Diabetes + + + + + + + + + RSV-mAb + 1 + dose + depending + on + maternal + 1 + dose + depending + on + maternal + + + + + + + + + 2nd + RSV + season + 2nd + RSV + season + for + chronic + + + (nirsevimab) + RSV + vaccination + status + (See + Notes) + lung + disease + (See + Notes) + RSV + vaccination + status + (See + Notes) + + + + + + + + + Hepatitis + B + + + + + + + + + Rotavirus + + + + + + + + + DTaP + + + + + + + + + DTaP/Td. + + + oe + Tdap: + 1 + dose + each + pregnancy + + + + + + + + + Hib + See + Notes + See + Notes + + + + + + + + + Pneumococcal + + + + + + + + + IPV + + + + + + + + + Influenza + Solid + organ + transplant: + + + inactivated + 18yrs + (See + Notes) + + + + + + + + + LAIV3 + + + MMR + + + VAR + + + + + + + + + Hepatitis + A + + + + + + + + + HPV + 3-dose + series + (See + Notes) + + + + + + + + + MenB + + + RSV + (Abrysvo) + Seasonal + administration + + + ¥ + (See + Notes) + + + Dengue + + + Mpox + See + Notes + + + Recommended + for + all + age- + Not + recommended + for + all + children, + Recommended + for + all + age-eligible + Precaution: + Might + be + Contraindicated + or + not + No + Guidance/ + + + eligible + children + who + lack + but + recommended + for + some + children, + and + additional + doses + may + be + indicated + if + benefit + of + recommended + Not + Applicable + + + documentation + of + a + complete + children + based + on + increased + risk + for + necessary + based + on + medical + condition + protection + outweighs + *Vaccinate + after + pregnancy, + + + vaccination + series + or + severe + outcomes + from + disease + or + other + indications. + See + Notes. + risk + of + adverse + reaction + if + indicated + + + + + + + + + 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 + b. + Severe + Combined + Immunodeficiency + + + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + + + + + + + + + c. + LAIV3 + contraindicated + for + children + 2-4 + years + of + age + with + + + asthma + or + wheezing + during + the + preceding + 12 + months + + + + + + + + + Page + 4 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + For + vaccination + recommendations + for + persons + ages + + + 19 + years + or + older, + see + the + Recommended + + + Adult + Immunization + Schedule, + 2025. + + + + + + + + + Additional + information + + + + + + + + + ¢ + For + calculating + intervals + between + doses, + 4 + weeks + = + 28 + days. + + + Intervals + of + >4 + months + are + determined + by + calendar + months. + + + + + + + + + e + 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 + 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. + + + + + + + + + ¢ + Information + on + travel + vaccination + requirements + and + + + recommendations + is + available + at + www.cdc.gov/travel/. + + + + + + + + + ° + For + vaccination + of + persons + with + immunodeficiencies, + see + + + Table + 8-1, + Vaccination + of + persons + with + primary + and + secondary + + + immunodeficiencies, + 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, + + + Lynfield + Ruth, + Sawyer + MH, + eds. + Red + Book: + 2021-2024 + Report + + + of + the + Committee + on + Infectious + Diseases. + 32nd + ed. + Itasca, + IL: + + + American + Academy + of + Pediatrics; + 2021:72-86). + + + + + + + + + ¢ + For + information + about + vaccination + in + the + setting + of + a + vaccine- + + + preventable + disease + outbreak, + contact + your + + + state + or + local + health + department. + + + + + + + + + ¢ + 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. + + + + + + + + + COVID-19 + vaccination + + + + + + + + + (minimum + age: + 6 + months + [Moderna + and + Pfizer-BioNTech + COVID-19 + vaccines], + 12 + years + [Novavax + COVID-19 + Vaccine]) + + + + + + + + + Routine + vaccination + + + Age + 6 + months-4 + years + + + + + + + + + All + vaccine + doses + should + be + from + the + same + manufacturer. + + + ¢ + Unvaccinated: + + + + + -2 + doses + 2024-25 + Moderna + at + 0, + 4-8 + weeks + + + + + -3 + doses + 2024-25 + Pfizer-BioNTech + at + 0, + 3-8, + and + at + least + + + 8 + weeks + after + dose + 2 + + + + + ¢ + Incomplete + initial + vaccination + series + before + 2024-25 + + + vaccine + with: + + + + + - + 1 + dose + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + 4-8 + weeks + after + most + recent + dose + + + + + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + 2 + doses + + + 2024-25 + Pfizer-BioNTech + 8 + weeks + apart + (administer + dose + 1 + + + 3-8 + weeks + after + most + recent + dose). + + + + + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + 1 + dose + + + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + + + + + ¢ + Completed + initial + vaccination + series + before + 2024-25 + + + vaccine + with: + + + + + -2 + or + more + doses + Moderna: + 1 + dose + 2024-25 + Moderna + at + + + least + 8 + weeks + after + the + most + recent + dose. + + + + + -3 + or + more + doses + Pfizer-BioNTech: + 1 + dose + 2024-25 + Pfizer- + + + BioNTech + at + least + 8 + weeks + after + the + most + recent + dose. + + + + + + + + + Age + 5-11 + years + + + + + ¢ + Unvaccinated: + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + + + + + ¢ + Previously + vaccinated + before + 2024-25 + vaccine + with + 1 + or + + + more + doses + Moderna + or + Pfizer-BioNTech: + 1 + dose + 2024-25 + + + Moderna + or + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + + + + + + + + + Age + 12-18 + years + + + ¢ + Unvaccinated: + + + - + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + + + -2 + doses + 2024-25 + Novavax + at + 0, + 3-8 + weeks + + + ¢ + Previously + vaccinated + before + 2024-25 + vaccine + with: + + + + + - + 1 + or + more + doses + Moderna + or + Pfizer-BioNTech: + 1 + dose + + + 2024-25 + Moderna + or + Novavax + or + Pfizer-BioNTech + at + least + + + 8 + weeks + after + the + most + recent + dose. + + + + + - + 1 + dose + Novavax: + 1 + dose + 2024—25 + Novavax + 3-8 + weeks + after + + + most + recent + dose. + If + more + than + 8 + weeks + after + most + recent + + + dose, + administer + 1 + dose + 2024-25 + Moderna + or + Novavax + or + + + Pfizer-BioNTech. + + + + + -2 + or + more + doses + Novavax: + 1 + dose + 2024—25 + Moderna + or + + + Novavax + or + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + + + + + + + + + Special + situation + + + Persons + who + are + moderately + or + severely + immunocompromised. + + + + + + + + + Age + 6 + months-4 + years + + + + + + + + + Use + vaccine + from + the + same + manufacturer + for + all + doses + (initial + + + vaccination + series + and + additional + doses*). + + + + + + + + + ¢ + Unvaccinated: + + + + + -4 + doses + (3-dose + initial + series + 2024-25 + Moderna + at + 0, + + + 4 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + 6 + months + later + [minimum + interval + + + 2 + months]).May + administer + additional + doses.* + + + + + -4 + doses + (3-dose + initial + series + 2024-25 + Pfizer-BioNTech + + + at + 0, + 3 + weeks, + and + at + least + 8 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Pfizer-BioNTech + 6 + months + later + [minimum + + + interval + 2 + months]). + May + administer + additional + doses.* + + + + + + + + + ¢ + Incomplete + initial + 3-dose + vaccination + series + before + + + 2024-25 + vaccine: + + + + + + + + + - + Previous + vaccination + with + Moderna + + + + + + + + + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + 1 + + + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + 2024- + + + 25 + Moderna + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna.* + + + + + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna.* + + + + + - + Previous + vaccination + with + Pfizer-BioNTech + + + + + + + + + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + apart + + + (administer + dose + 1 + 3 + weeks + after + most + recent + dose), + + + followed + by + 1 + dose + 2024-25 + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Pfizer-BioNTech.* + + + + + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + May + + + administer + additional + doses + of + Pfizer-BioNTech.* + + + + + + + + + Page + 5 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + COVID-19 + vaccination + - + continued + + + + + + + + + ¢ + Completed + initial + 3-dose + vaccination + series + before + + + + + 2024-25 + vaccine + with: + + + + + -3 + or + more + doses + Moderna: + 2 + doses + 2024-25 + Moderna + + + 6 + months + apart + (minimum + interval + 2 + months). + Administer + + + dose + 1 + at + least + 8 + weeks + after + the + most + recent + dose. + May + + + administer + additional + doses + of + Moderna.* + + + + + -3 + or + more + doses + Pfizer-BioNTech: + 2 + doses + 2024-25 + Pfizer- + + + BioNTech + 6 + months + apart + (minimum + interval + 2 + months). + + + Administer + dose + 1 + at + least + 8 + weeks + after + the + most + recent + + + dose. + May + administer + additional + doses + of + Pfizer-BioNTech.* + + + + + + + + + Age + 5-11 + years + + + + + + + + + Use + vaccine + from + the + same + manufacturer + for + all + doses + in + the + initial + + + + + + + + + vaccination + series. + + + + + + + + + ¢ + Unvaccinated: + + + + + -4 + doses + (3-dose + initial + series + 2024-25 + Moderna + at + 0, + + + 4 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses.* + + + + + -4 + doses + (3-dose + initial + series + 2024-25 + Pfizer-BioNTech + + + at + 0, + 3 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses.* + + + + + + + + + ¢ + Incomplete + initial + 3-dose + vaccination + series + before + + + 2024-25 + vaccine: + + + - + Previous + vaccination + with + Moderna + + + + + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + + + 1 + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + + + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna + or + Pfizer-BioNTech.* + + + + + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + + + dose, + followed + by + 1 + dose + 2024-25 + Moderna + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Pfizer- + + + BioNTech.* + + + + + + + + + - + Previous + vaccination + with + Pfizer-BioNTech + + + + + - + 1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + + + apart + (administer + dose + 1 + 3 + weeks + after + most + recent + + + dose), + followed + by + 1 + dose + 2024-25 + Moderna + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Pfizer- + + + BioNTech.* + + + + + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Moderna + + + or + Pfizer-BioNTech + 6 + months + later + (minimum + interval + + + 2 + months). + May + administer + additional + doses + of + Moderna + or + + + Pfizer-BioNTech.* + + + + + + + + + ¢ + Completed + initial + 3-dose + vaccination + series + before + + + + + + + + + 2024-25 + vaccine + with: + + + + + -3 + or + more + doses + Moderna + or + 3 + or + more + doses + Pfizer- + + + BioNTech: + 2 + doses + 2024-25 + Moderna + or + Pfizer-BioNTech + + + 6 + months + apart + (minimum + interval + 2 + months). + Administer + + + dose + 1 + at + least + 8 + weeks + after + the + most + recent + dose. + May + + + administer + additional + doses + of + Moderna + or + Pfizer-BioNTech.* + + + + + + + + + Age + 12-18 + years + + + + + + + + + Use + vaccine + from + the + same + manufacturer + for + all + doses + in + the + initial + + + vaccination + series. + + + + + + + + + ¢ + Unvaccinated: + + + + + + + + + -4 + doses + (3-dose + initial + series + Moderna + at + 0, + 4 + weeks, + and + + + at + least + 4 + weeks + after + dose + 2, + followed + by + 1 + dose + 2024-25 + + + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + + + + + -4 + doses + (3-dose + initial + series + Pfizer-BioNTech + at + 0, + 3 + weeks, + + + and + at + least + 4 + weeks + after + dose + 2, + followed + by + 1 + dose + 2024- + + + 25 + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + + + + + -3 + doses + (2-dose + initial + series + Novavax + at + 0, + 3 + weeks, + + + followed + by + 1 + dose + Moderna + or + Novavax + or + Pfizer-BioNTech + + + 6 + months + later + [minimum + interval + 2 + months]). + May + + + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + + + + + + + + + ¢ + Incomplete + initial + vaccination + series + before + 2024-25 + + + vaccine: + + + + + + + + + - + Previous + vaccination + with + Moderna + + + + + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + 1 + + + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + 2024- + + + 25 + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + + + + + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + + + + + - + Previous + vaccination + with + Pfizer-BioNTech + + + + + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + apart + + + (administer + dose + 1 + 3 + weeks + after + most + recent + dose), + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + + + + + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Moderna + + + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + (minimum + + + interval + 2 + months). + May + administer + additional + doses + of + + + Moderna + or + Novavax + or + Pfizer-BioNTech.* + + + + + - + Previous + vaccination + with + Novavax + + + + + - + 1 + dose + Novavax: + complete + initial + series + with + 1 + dose + + + 2024-25 + Novavax + at + least + 3 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + + + + + + + + + Page + 6 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + COVID-19 + vaccination + - + continued + Dengue + vaccination + + + + + + + + + ¢ + Completed + initial + 3-dose + vaccination + series + before + + + + + 2024-25 + vaccine + with: + + + + + -3 + or + more + doses + Moderna + or + 3 + or + more + doses + Pfizer- + + + BioNTech: + 2 + doses + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + apart + (minimum + interval + 2 + months). + + + Administer + dose + 1 + at + least + 8 + weeks + after + the + most + recent + + + dose. + May + administer + additional + doses + of + Moderna + or + + + Novavax + or + Pfizer-BioNTech.* + + + + + + + + + -2 + or + more + doses + Novavax: + 2 + doses + 2024-25 + Moderna + or + + + Novavax + or + Pfizer-BioNTech + 6 + months + apart + (minimum + + + interval + 2 + months). + Administer + dose + 1 + at + least + 8 + weeks + after + + + the + most + recent + dose. + May + administer + additional + doses + of + + + Moderna + or + Novavax + or + Pfizer-BioNTech.* + + + + + + + + + *Additional + doses + of + 2024-25 + COVID-19 + vaccine + for + + + moderately + or + severely + immunocompromised: + based + on + + + shared + clinical + decision-making + and + administered + at + least + + + + + 2 + months + after + the + most + recent + dose + (see + Table + 2 + at + www. + + + cdc.gov/vaccines/covid-19/clinical-considerations/interim- + + + considerations-us.html#table-02.). + For + description + of + moderate + + + and + severe + immunocompromising + conditions + and + treatment, + + + see + www.cdc.gov/vaccines/covid-19/clinical-considerations/ + + + interim-considerations-us.html#immunocompromising- + + + conditions-treatment. + + + + + + + + + Unvaccinated + persons + have + never + received + any + COVID-19 + + + vaccine + doses. + 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. + + + + + + + + + For + information + about + interchangeability + of + COVID-19 + vaccines, + + + see + www.cdc.gov/vaccines/covid-19/clinical-considerations/ + + + interim-considerations-us.html#Interchangeability. + + + + + + + + + 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-201 + 9-covid-19/covid-19- + + + vaccines. + + + + + + + + + (minimum + age: + 9 + years) + + + + + + + + + Routine + vaccination + + + + + ¢ + Age + 9-16 + years + living + in + areas + with + endemic + dengue + AND + + + have + laboratory + confirmation + of + previous + dengue + infection + + + - + 3-dose + series + administered + at + 0, + 6, + and + 12 + months + + + + + e + 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/ + + + index.html + + + + + ¢ + 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 + + + ¢ + 5-dose + series + (3-dose + primary + series + at + age + 2, + 4, + and + 6 + months, + + + followed + by + 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 + 4th + 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 + + + + + * + Dose + 5 + is + not + necessary + if + dose + 4 + was + administered + at + age + + + 4 + years + or + older + and + at + least + 6 + months + after + dose + 3. + + + + + ¢ + For + other + catch-up + guidance, + see + Table + 2. + + + + + + + + + Special + situations + + + + + ¢ + Children + younger + than + age + 7 + years + with + a + contraindication + + + specific + to + the + pertussis + component + of + DTaP: + May + + + administer + Td + for + all + recommended + remaining + doses + in + place + + + of + DTaP. + Encephalopathy + within + 7 + days + of + vaccination + when + + + not + attributable + to + another + identifiable + cause + is + the + only + + + contraindication + specific + to + the + pertussis + component + of + DTaP. + + + For + additional + information, + see + www.cdc.gov/pertussis/hcp/ + + + vaccine-recommendations/td-offlabel.html. + + + + + ¢ + Wound + management + in + children + younger + 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 + influenzae + type + b + vaccination + + + + + + + + + (minimum + age: + 6 + weeks) + + + + + + + + + Routine + vaccination + + + ¢ + 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 + + + different + Hib-containing + vaccine + should + be + used + for + the + + + booster + dose. + + + + + + + + + ¢ + PedvaxHIB: + 3-dose + series + (2-dose + primary + series + at + age + 2 + and + + + 4 + months, + followed + by + a + booster + dose + at + age + 12-15 + months) + + + + + + + + + ¢ + American + Indian + and + Alaska + Native + infants: + Vaxelis + and + + + PedvaxHIB + preferred + over + other + Hib + vaccines + for + the + primary + + + series. + + + + + + + + + Catch-up + vaccination + + + + + ¢ + Dose + 1 + at + age + 7-11 + months: + Administer + dose + 2 + at + least + + + 4 + weeks + later + and + dose + 3 + (final + dose) + at + age12—15 + months + or + + + 8 + weeks + after + dose + 2 + (whichever + is + later). + + + + + + + + + ¢ + Dose + 1 + at + age + 12-14 + months: + Administer + dose + 2 + (final + dose) + + + at + least + 8 + weeks + after + dose + 1. + + + + + + + + + ° + Dose + 1 + before + age + 12 + months + and + dose + 2 + before + age + + + 15 + months: + Administer + dose + 3 + (final + dose) + at + least + + + 8 + weeks + after + dose + 2. + + + + + + + + + ¢ + 2 + doses + of + PedvaxHIB + before + age + 12 + months: + Administer + + + dose + 3 + (final + dose) + at + age12-59 + months + and + at + least + 8 + weeks + + + after + dose + 2. + + + + + + + + + ¢ + 1 + dose + administered + at + age + 15 + months + or + older: + + + No + further + doses + needed + + + + + + + + + ¢ + Unvaccinated + at + age + 15-59 + months: + Administer + 1 + dose. + + + + + + + + + ¢ + Previously + unvaccinated + children + age + 60 + months + or + + + older + who + are + not + considered + high + risk: + Catch-up + + + vaccination + not + required. + + + + + + + + + For + other + catch-up + guidance, + see + Table + 2. + Vaxelis + can + be + used + + + for + catch-up + vaccination + in + children + younger + 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. + + + + + + + + + Page + 7 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Haemophilus + influenzae + type + b + vaccination + + + - + continued + + + + + + + + + Special + situations + + + ¢ + 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. + + + + + + + + + ¢ + Hematopoietic + stem + cell + transplant + (HSCT): + + + - + 3-dose + series + 4 + weeks + apart + starting + 6 + to + 12 + months + after + + + successful + transplant, + regardless + of + Hib + vaccination + history + + + + + + + + + ¢ + 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 + + + + + + + + + ¢ + Elective + splenectomy: + + + Unvaccinated* + persons + age + 15 + months + or + older + + + + + + + + + - + 1 + dose + (preferably + at + least + 14 + days + before + procedure) + + + ¢ + 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 + + + + + + + + + ¢ + Immunoglobulin + deficiency, + early + component + + + complement + deficiency, + or + early + component + complement + + + inhibitor + use: + + + 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 + + + + + + + + + ¢ + 2-dose + series + (minimum + interval: + 6 + months) + at + age + 12- + + + 23 + months + + + + + + + + + Catch-up + vaccination + + + + + + + + + e + Unvaccinated + persons + through + age + 18 + years + should + + + complete + a + 2-dose + series + (minimum + interval: + 6 + months). + + + + + + + + + e + Persons + who + previously + received + 1 + dose + at + age + 12 + months + or + + + older + should + receive + dose + 2 + at + least + 6 + months + after + dose + 1. + + + + + + + + + e + Adolescents + age + 18 + years + or + older + may + receive + HepA-HepB + + + (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 + + + ¢ + 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 + + + ¢ + Mother + is + HBsAg-negative + + + - + 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) + + + - + Infants + who + did + not + receive + a + birth + dose + should + begin + + + the + series + as + soon + as + possible + (see + Table + 2 + for + minimum + + + intervals). + + + - + Administration + of + 4 + doses + is + permitted + when + a + combination + + + vaccine + containing + HepB + is + used + after + the + birth + dose. + + + - + Minimum + intervals + (see + Table + 2): + when + 4 + doses + + + are + administered, + substitute + “dose + 4” + for + “dose + 3” + + + in + these + calculations. + + + - + Final + (3rd + or + 4th) + dose: + age + 6-18 + months + + + (minimum + age + 24 + weeks) + + + + + + + + + e + 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 + final + dose. + Do + not + + + test + before + age + 9 + months. + + + + + + + + + Page + 8 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Hepatitis + B + vaccination + - + continued + + + + + + + + + e + 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 + final + dose. + Do + not + test + before + age + 9 + months. + + + + + + + + + Catch-up + vaccination + + + + + e + Unvaccinated + persons + should + complete + a + 3-dose + series + at + + + 0, + 1-2, + 6 + months. + See + Table + 2 + for + minimum + intervals. + + + + + e + Adolescents + age + 11-15 + years + may + use + an + alternative + 2-dose + + + schedule + with + at + least + 4 + months + between + doses + (adult + + + formulation + Recombivax + HB + only). + + + + + e + 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 + + + + + - + HepA-HepB + (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). + + + + + + + + + Special + situations + + + e + Revaccination + is + generally + not + recommended + for + persons + + + with + a + normal + immune + status + who + were + vaccinated + as + infants, + + + children, + adolescents, + or + adults. + + + ¢ + 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/mmwr/volumes/67/rr/rr6701a1.htm. + + + *Note: + PreHevbrio + is + 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 + + + + + + + + + e + 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. + + + + + + + + + e + 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) + + + + + + + + + ¢ + No + additional + dose + recommended + when + any + HPV + + + vaccine + series + of + any + valency + has + been + completed + using + + + recommended + dosing + intervals. + + + + + + + + + Special + situations + + + + + ¢ + Immunocompromising + conditions, + including + HIV + + + infection: + 3-dose + series, + even + for + those + who + initiate + + + vaccination + at + age + 9 + through + 14 + years. + + + + + + + + + ¢ + History + of + sexual + abuse + or + assault: + Start + at + age + 9 + years + + + + + + + + + ¢ + Pregnancy: + Pregnancy + testing + not + needed + before + + + vaccination; + HPV + vaccination + not + recommended + until + + + after + pregnancy; + no + intervention + needed + if + vaccinated + + + while + pregnant + + + + + + + + + Influenza + vaccination + + + + + + + + + (minimum + age: + 6 + months + [IIV3], + 2 + years + [LAIV3],18 + + + years + [recombinant + influenza + vaccine, + RIV3]) + + + + + + + + + Routine + vaccination + + + e + Use + any + influenza + vaccine + appropriate + for + age + and + health + + + status + annually: + + + - + Age + 6 + months-8 + years + who + have + received + fewer + than + + + 2 + influenza + vaccine + doses + before + July + 1, + 2024, + or + whose + + + influenza + 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 + influenza + vaccine + doses + before + July + 1, + 2024: + 1 + dose. + + + - + Age + 9 + years + or + older: + 1 + dose + + + - + Age + 18 + years + solid + organ + transplant + recipients + receiving + + + immunosuppressive + medications: + high-dose + inactivated + + + (HD-IIV3) + and + adjuvanted + inactivated + (allV3) + influenza + + + vaccines + are + acceptable + options. + No + preference + over + other + + + age-appropriate + IIV3 + or + RIV3. + + + + + + + + + e + For + the + 2024-25 + season, + see + www.cdc.gov/mmwr/ + + + volumes/73/rr/rr7305a1.htm. + + + + + + + + + ¢ + For + the + 2025-26 + season, + see + the + 2025-26 + ACIP + influenza + + + vaccine + recommendations. + + + + + + + + + Special + situations + + + + + * + Close + contacts + (e.g., + household + contacts) + of + severely + + + immunosuppressed + persons + who + require + a + protected + + + environment: + should + not + receive + LAIV3. + If + LAIV3 + is + + + given, + they + should + avoid + contact + with, + or + caring + for + such + + + immunosuppressed + persons + for + 7 + days + after + vaccination. + + + + + + + + + Note: + Persons + with + an + egg + allergy + can + receive + any + influenza + + + vaccine + (egg-based + or + non-egg + based) + appropriate + for + age + and + + + health + status. + + + + + + + + + Page + 9 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Measles, + mumps, + and + rubella + vaccination + + + + + + + + + (minimum + age: + 12 + months + for + routine + vaccination) + + + + + + + + + Routine + vaccination + + + e + 2-dose + series + at + age + 12-15 + months, + age + 4-6 + years + + + + + + + + + ¢ + 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 + + + + + ¢ + Unvaccinated + children + and + adolescents: + 2-dose + series + at + + + least + 4 + weeks + apart* + + + + + ¢ + The + maximum + age + for + use + of + MMRV* + is + 12 + years. + + + + + + + + + Special + situations + + + ¢ + 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.* + + + - + Children + age + 12 + months + or + older: + + + - + Unvaccinated: + 2-dose + series + (separated + by + at + least + + + 4 + weeks*) + before + departure + + + - + Previously + received + 1 + dose: + administer + dose + 2 + at + least + + + 4 + weeks + after + dose + 1* + + + ¢ + ln + 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, + MenQuadfi]), + + + + + + + + + 10 + years + [MenACWY-TT/MenB-FHbp, + Penbraya]) + + + + + + + + + Routine + vaccination + + + * + 2-dose + series + at + age + 11-12 + years; + 16 + years + + + + + + + + + Catch-up + vaccination + + + + + + + + + e + Age + 13-15 + years: + 1 + dose + now + and + booster + at + age + 16-18 + years + + + (minimum + interval: + 8 + weeks) + + + + + + + + + ¢ + Age + 16-18 + years: + 1 + dose + + + + + + + + + Special + situations + + + + + Anatomic + or + functional + asplenia + (including + sickle + cell + + + disease), + HIV + infection, + persistent + complement + + + component + deficiency, + complement + inhibitor + + + + + (e.g., + eculizumab, + ravulizumab) + use: + + + + + + + + + ¢ + 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 + + + + + + + + + ¢ + MenQuadfi + + + + + + + + + -Dose + 1 + at + age + 24 + months + or + older: + 2-dose + series + at + least + + + 8 + weeks + apart + + + + + + + + + Travel + to + countries + with + hyperendemic + or + epidemic + + + meningococcal + disease, + including + countries + in + the + African + + + meningitis + belt + or + during + the + Hajj + (www.cdc.gov/travel/): + + + + + + + + + ¢ + Children + younger + 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) + + + + + + + + + ¢ + Children + age + 2 + years + or + older: + 1 + dose + Menveo* + + + or + MenQuadfi + + + + + + + + + First-year + college + students + who + live + in + residential + housing + + + (if + not + previously + vaccinated + at + age + 16 + years + or + older) + or + + + military + recruits: + 1 + dose + Menveo* + or + MenQuadfi + + + + + + + + + Adolescent + vaccination + of + children + who + received + MenACWY + + + prior + to + age + 10 + years: + + + + + + + + + ¢ + Children + for + whom + boosters + are + recommended + because + + + of + an + ongoing + increased + risk + of + meningococcal + disease + + + (e.g., + those + with + complement + component + deficiency, + HIV, + + + or + asplenia): + Follow + the + booster + schedule + for + persons + at + + + increased + risk. + + + + + + + + + ¢ + 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). + + + + + + + + + Page + 10 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Meningococcal + serogroup + B + vaccination + + + (minimum + age: + 10 + years + [MenB-4C, + Bexsero; + MenB- + + + + + + + + + FHbp, + Trumenba; + MenACWY-TT/MenB-FHbp, + + + Penbraya)]) + + + + + + + + + Shared + clinical + decision-making + + + ¢ + Adolescents + not + at + increased + risk + age + 16-23 + years + + + + + (preferred + age + 16-18 + years)* + based + on + shared + clinical + + + + + decision-making. + + + + + - + Bexsero + or + Trumenba + (use + same + brand + for + all + doses): + + + 2-dose + series + at + least + 6 + months + apart + (if + dose + 2 + is + + + administered + earlier + than + 6 + months, + administer + dose + 3 + + + at + least + 4 + months + after + dose + 2) + + + + + + + + + *To + optimize + rapid + protection + (e.g., + for + students + starting + college + + + in + less + than + 6 + months), + a + 3-dose + series + (0, + 1-2, + 6 + months) + may + be + + + administered. + + + + + + + + + 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 + deficiency, + + + complement + inhibitor + (e.g., + eculizumab, + ravulizumab) + use. + + + - + Bexsero + or + Trumenba + (use + same + brand + for + all + doses + + + including + booster + doses) + 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 + 4th + dose + should + be + administered + at + + + least + 4 + months + after + dose + 3) + + + + + + + + + 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. + + + + + + + + + Note: + MenB + vaccines + may + be + administered + simultaneously + + + with + MenACWY + vaccines + if + indicated, + but + at + a + different + + + anatomic + site, + if + feasible. + + + + + + + + + Children + age + 10 + years + or + older + may + receive + a + dose + of + Penbraya + + + (MenACWY-TT/MenB-FHbp) + 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 + + + + + ¢ + Age + 18 + years + and + at + risk + for + mpox + infection: + complete + + + 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 + + + + + + + + + ¢ + 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/mpox/hcp/vaccine- + + + considerations/vaccination-overview.html + + + + + + + + + Pneumococcal + vaccination + + + (minimum + age: + 6 + weeks + [PCV15], + [PCV + 20]; + 2 + years + + + + + + + + + [PPSV23]) + + + + + + + + + Routine + vaccination + with + PCV + + + e + 4-dose + series + at + 2, + 4,6, + 12-15 + months + + + + + + + + + Catch-up + vaccination + with + PCV + + + + + ¢ + Healthy + children + ages + 2-4 + years + with + any + incomplete* + + + PCV + series: + 1 + dose + PCV + + + + + ¢ + 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. + + + + + + + + + Special + situations + + + + + Children + and + adolescents + with + cerebrospinal + fluid + 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 + + + e + 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) + + + ¢ + 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. + + + + + + + + + Page + 11 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Pneumococcal + vaccination + - + continued + + + + + + + + + Age + 6-18 + years + + + + + 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.** + + + + + + + + + ° + 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. + + + + + + + + + ¢ + 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. + + + + + + + + + ¢ + 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 + immunodeficiencies; + + + 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 + + + e + 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) + + + ¢ + 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 + + + + + ¢ + 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.** + + + + + + + + + ¢ + 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. + + + + + + + + + ¢ + 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. + + + + + + + + + ¢ + 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. + + + + + + + + + Pregnancy: + no + recommendation + for + PCV + or + PPSV23 + due + to + + + limited + data. + Summary + of + existing + data + on + pneumococcal + + + vaccination + during + pregnancy + can + be + found + at + www.cdc.gov/ + + + mmwr/volumes/72/rr/rr7203a1.htm + + + + + + + + + For + guidance + on + determining + which + pneumococcal + vaccines + a + + + patient + needs + and + when, + please + refer + to + the + mobile + app, + which + + + can + be + downloaded + here: + wcms-wp.cdc.gov/pneumococcal/ + + + hcp/vaccine-recommendations/app.html + + + + + + + + + *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 + first. + PCV15 + and + PPSV23 + should + not + be + + + administered + during + the + same + visit. + + + + + + + + + Poliovirus + vaccination + + + + + + + + + (minimum + age: + 6 + weeks) + + + + + + + + + Routine + vaccination + + + + + e + 4-dose + series + at + ages + 2, + 4, + 6-18 + months, + 4-6 + years; + administer + + + the + final + dose + on + or + after + age + 4 + years + and + at + least + 6 + months + + + after + the + previous + dose. + + + + + + + + + ¢ + 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 + + + + + ¢ + In + the + first + 6 + months + of + life, + use + minimum + ages + and + + + intervals + only + for + travel + to + a + polio-endemic + region + + + or + during + an + outbreak. + + + + + + + + + e + 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 + specific + 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: + + + + + ¢ + 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. + + + + + ¢ + Only + trivalent + OPV + (tOPV) + counts + toward + the + + + U.S. + vaccination + requirements. + + + + + - + Doses + of + OPV + administered + before + April + 1, + 2016, + should + be + + + counted + (unless + specifically + 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. + + + + + ¢ + For + other + catch-up + guidance, + see + Table + 2. + + + + + + + + + Special + situations + + + + + ¢ + 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 + + + + + + + + + Page + 12 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Respiratory + syncytial + virus + immunization + + + + + + + + + (minimum + age: + birth + [Nirsevimab, + RSV-mAb, + Beyfortus]) + + + + + + + + + Routine + immunization + + + ¢ + 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 + or + mother + received + + + RSV + vaccine + in + previous + pregnancy: + administer + 1 + dose + + + nirsevimab + within + 1 + week + of + birth—ideally + during + the + birth + + + hospitalization. + + + + + - + Mother + received + RSV + vaccine + less + than + 14 + days + prior + to + + + delivery: + administer + 1 + dose + nirsevimab + within + 1 + week + of + + + birth—ideally + during + the + birth + hospitalization. + + + + + - + 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 + www.cdc.gov/vaccines/vpd/rsv/hcp/child-faqs.html) + + + + + + + + + ¢ + 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 + or + mother + received + + + RSV + vaccine + in + previous + pregnancy: + 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 + 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 + + + + + ¢ + 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 + fibrosis + with + either + weight + + + for + length + <10th + percentile + or + manifestation + of + severe + + + lung + disease + (e.g., + previous + hospitalization + for + pulmonary + + + exacerbation + in + the + first + year + of + life + or + abnormalities + on + + + chest + imaging + that + persist + when + stable)**: + + + - + 1 + dose + nirsevimab + shortly + before + start + of + second + RSV + + + + + season* + + + + + + + + + e + Ages + 8-19 + months + who + are + American + Indian + or + + + Alaska + Native: + 1 + dose + nirsevimab + shortly + before + start + of + + + second + RSV + season* + + + + + + + + + ¢ + Age-eligible + and + undergoing + cardiac + surgery + with + + + cardiopulmonary + bypass**: + 1 + additional + dose + of + nirsevimab + + + after + surgery. + See + www.accessdata.fda.gov/drugsatfda_docs/ + + + label/2023/761328s000Ibl.pdf + + + + + + + + + *Note: + While + the + timing + of + the + onset + and + duration + of + + + + + RSV + season + may + vary, + administration + of + nirsevimab + is + + + recommended + October + through + March + in + most + of + the + + + continental + United + States + (optimally + October + through + + + November + or + within + 1 + week + of + birth). + Providers + in + jurisdictions + + + with + RSV + seasonality + that + differs + 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. + + + + + + + + + **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 + + + + + ¢ + 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 + Abrysvo. + Administer + RSV + + + vaccine + regardless + of + previous + RSV + infection. + + + + + - + Either + maternal + RSV + vaccination + with + Abrysvo + or + infant + + + immunization + with + nirsevimab + (RSV + monoclonal + antibody) + is + + + recommended + to + prevent + severe + respiratory + syncytial + virus + + + disease + in + infants. + + + + + + + + + ¢ + All + other + pregnant + persons: + RSV + vaccine + not + recommended + + + + + + + + + e + Subsequent + pregnancies: + additional + doses + not + + + recommended. + No + data + are + available + to + inform + whether + + + additional + doses + are + needed + in + subsequent + pregnancies. + + + Infants + born + to + pregnant + persons + who + received + RSV + vaccine + + + during + a + previous + pregnancy + should + receive + nirsevimab. + + + + + + + + + *Note: + Providers + in + jurisdictions + with + RSV + seasonality + that + + + differs + from + most + of + the + continental + United + States + (e.g., + Alaska, + + + jurisdictions + 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 + + + ¢ + Rotarix: + 2-dose + series + at + age + 2 + and + 4 + months + + + + + + + + + ¢ + RotaTeq: + 3-dose + series + at + age + 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 + Table + 2. + + + + + + + + + Page + 13 + + + + + + + + + + + + + + + + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Tetanus, + diphtheria, + and + pertussis + (Tdap) + + + + + + + + + vaccination + (minimum + age: + 11 + years + for + routine + + + vaccination, + 7 + years + for + catch-up + vaccination) + + + + + + + + + Routine + vaccination + + + e + Age + 11-12 + years: + 1 + dose + Tdap + (adolescent + booster) + + + + + + + + + ¢ + 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 + + + + + + + + + e + Age + 13-18 + years + who + have + not + received + Tdap: + + + 1 + dose + Tdap + (adolescent + booster) + + + + + + + + + ¢ + Age + 7-18 + years + not + fully + vaccinated* + with + DTaP: + 1 + dose + + + Tdap + as + part + of + the + catch-up + series + (preferably + the + first + dose); + + + if + additional + doses + are + needed, + use + Td + or + Tdap. + + + + + + + + + ¢ + 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 + + + + + + + + + ¢ + 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. + + + + + + + + + ¢ + For + other + catch-up + guidance, + see + Table + 2. + + + + + + + + + Special + situations + + + + + ¢ + 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. + + + + + + + + + ¢ + 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 + + + e + 2-dose + series + at + age + 12-15 + months, + 4-6 + years + + + ¢ + VAR + or + MMRV + may + be + administered* + + + + + + + + + ¢ + 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 + + + ¢ + 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. + + + + + + + + + Page + 14 + + + + + + + + + + + + + + + + Appendix + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + 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 + Influenza + with + Vaccines: + + + Recommendations + of + the + Advisory + Committee + on + Immunization + Practices—United + States, + 2024-25 + Influenza + Season + | + MMWR + (cdc.gov), + and + Contraindications + and + Precautions + for + COVID-19 + Vaccination + + + + + + + + + Vaccines + and + other + + + + + + + + + I + a + Contraindicated + or + Not + Recommended’ + Precautions” + + + + + mmunizing + Agents + + + + + COVID-19 + mRNA + vaccines + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + component + of + + + Diagnosed + non-severe + allergy + (e.g., + urticaria + beyond + the + injection + site) + to + a + + + [Pfizer-BioNTech, + Moderna] + an + mRNA + COVID-19 + vaccine? + 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 + inflammatory + syndrome + in + children + (MIS-C) + or + multisystem + + + inflammatory + syndrome + in + adults + (MIS-A) + + + + + + + Moderate + or + severe + acute + illness, + with + or + without + fever + + + + + + + + + COVID-19 + protein + subunit + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + component + of + + + Diagnosed + non-severe + allergy + (e.g., + urticaria + beyond + the + injection + site) + toa + + + vaccine + a + Novavax + COVID-19 + vaccine? + component + of + Novavax + COVID-19 + vaccine?; + or + non-severe, + immediate + (onset + + + [Novavax] + 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 + inflammatory + syndrome + in + children + (MIS-C) + or + multisystem + + + inflammatory + syndrome + in + adults + (MIS-A) + + + + + Moderate + or + severe + acute + illness, + with + or + without + fever + + + + + + + + + Influenza, + egg-based, + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + previous + dose + of + any + influenza + vaccine + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + inactivated + injectable + (IIV3) + (i.e., + any + egg-based + IIV, + ccllV, + RIV, + or + LAIV + of + any + valency) + type + of + influenza + vaccine + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + vaccine + component? + (excluding + egg) + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + Influenza, + cell + culture-based + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + ccllV + of + any + valency, + or + to + any + component? + of + ccllV3 + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + inactivated + injectable + (ccllV3) + type + of + influenza + vaccine + + + [Flucelvax] + + + 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 + ccllV3, + 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 + + + + + + + + + Influenza, + recombinant + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + RIV + of + any + valency, + or + to + any + component? + of + RIV3 + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + injectable + (RIV3) + type + of + influenza + vaccine + + + [Flublok] + + + Persons + with + a + history + of + severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + + + + + + + + + dose + of + any + egg-based + IIV, + ccllV, + or + LAIV + of + any + valency. + If + using + RIV3, + 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 + + + + + + + + + Influenza, + live + attenuated + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + previous + dose + of + any + influenza + vaccine + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + (LAIV3) + (i.e., + any + egg-based + IV, + ccllV, + RIV, + or + LAIV + of + any + valency) + type + of + influenza + vaccine + + + [Flumist] + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + vaccine + component? + (excluding + egg) + - + Asthma + in + persons + age + 5 + years + old + or + older + + + + + Children + age + 2-4 + years + with + a + history + of + asthma + or + wheezing + + + Persons + with + underlying + medical + conditions + other + than + those + listed + under + + + + + Anatomic + or + functional + asplenia + contraindications + that + might + predispose + to + complications + after + wild-type + + + + + Immunocompromised + due + to + any + cause + including, + but + not + limited + to, + medications + and + HIV + infection + influenza + virus + infection, + e.g., + chronic + pulmonary, + cardiovascular + (except + isolated + + + + + Close + contacts + or + caregivers + of + severely + immunosuppressed + persons + who + require + a + protected + environment + hypertension), + renal, + hepatic, + neurologic, + hematologic, + or + metabolic + disorders + + + - + Pregnancy + (including + diabetes + mellitus) + + + + + Cochlear + implant + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + + + + + + + + + Active + communication + between + the + cerebrospinal + fluid + (CSF) + and + the + oropharynx, + nasopharynx, + nose, + + + ear + or + any + other + cranial + CSF + leak + + + + + + + Children + and + adolescents + receiving + aspirin + or + salicylate-containing + medications + + + + + + + Received + influenza + antiviral + medications + oseltamivir + or + zanamivir + within + the + previous + 48 + hours, + + + peramivir + within + the + previous + 5 + days, + or + baloxavir + within + the + previous + 17 + days + + + + + + + + + 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 + benefit + 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. + See + package + inserts + and + FDA + EUA + fact + sheets + for + a + full + list + of + vaccine + ingredients. + mRNA + COVID-19 + vaccines + contain + polyethylene + glycol + (PEG). + + + + + 4. + 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. + + + + + + + + + Page + 15 + + + + + + + + + + + + + + + + Appendix + + + + + + + + + Vaccines + and + other + + + Immunizing + Agents + + + + + + + + + Dengue + (DEN4CYD) + + + + + + + + + Diphtheria, + tetanus, + pertussis + (DTaP) + + + + + + + + + raindicated + or + Not + Recommended! + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + vaccine + component? + + + + + + + Severe + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + + + + + + + Lack + of + laboratory + confirmation + of + a + previous + dengue + infection + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + vaccine + component? + + + + + Encephalopathy + (e.g., + coma, + decreased + level + of + consciousness, + prolonged + seizures) + not + attributable + to + another + + + + + + + + + identifiable + cause + within + 7 + days + of + admin + + + + + + + + + istration + of + previous + dose + of + DTP + or + DTaP + + + + + + + + + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + Precautions” + + + + + + + + + + + Pregnancy + + + + + HlV + infection + without + evidence + of + severe + immunosuppression + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + + + + + + + + + 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 + clarified + and + stabilized + + + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + + + + + + + Haemophilus + influenzae + type + b + (Hib) + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + Younger + than + age + 6 + weeks + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + + + + + + + + + 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) + + + + + + + + + Hepatitis + A-Hepatitis + B + vaccine + (HepA-HepB) + + + [Twinrix] + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + Pregnancy: + PreHevbrio + is + not + recommend + + + HepB + is + indicated* + + + + + + + + + + + Severe + allergic + reaction + + + yeast + + + + + + + + + ‘e.g., + anaphylaxis) + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + including + yeast + + + led + due + to + lack + of + safety + data + in + pregnant + persons. + Use + other + hepatitis + B + vaccines + if + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + including + neomycin + and + + + + + + + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + + + + + + + + + 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 + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + + + + + + + + + + + Pregnancy + + + + + + + + + + + Family + history + of + altered + immunocompetence, + unless + verified + clinically + or + by + laboratory + testing + as + immunocompetent + + + + + + + + + + + For + MMRV + only: + HIV + infection + of + any + seve' + + + + + + + + + rity + + + + + + + + + + + Recent + (<11 + months) + receipt + of + antibody-containing + blood + product + (specific + 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 + + + + + + + If + using + MMRV, + see + Varicella/MMRV + for + additional + precautions + + + + + + + + + Meningococcal + ACWY + (MenACWY) + + + MenACWY-CRM + [Menveo] + + + MenACWY-TT + [MenQuadfi] + + + + + + + + + Meningococcal + B + (MenB) + + + MenB-4C + [Bexsero] + + + MenB-FHbp + [Trumenba] + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + For + Men + ACWY-CRM + only: + severe + allergic + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + reaction + to + any + diphtheria + toxoid— + or + CRM197—containing + vaccine + + + + + + + + + + + For + MenACWY-TT + only: + severe + allergic + reaction + to + a + tetanus + toxoid-containing + vaccine + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + + + + + + + + + For + MenACWY-CRM + only: + Preterm + birth + if + younger + than + age + 9 + months + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + + + + + + + + + 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: + + + + + Severe + allergic + reaction + to + a + tetanus + toxoi + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + d-containing + vaccine + + + + + + + + + + + Moderate + or + severe + acute + illness, + with + or + without + fever + + + + + + + + + Mpox + UJynneos] + + + + + + + + + + + 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 + + + + + Severe + allergic + reaction + + + + + + + + + e.g., + anaphylaxis + + + e.g., + anaphylaxis + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + 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 + + + + + Severe + combined + immunodeficiency + (SC + + + + + History + of + intussusception + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + ID) + + + + + + + + + + + Altered + immunocompetence + other + than + SCID + + + + + + + Chronic + gastrointestinal + disease + + + + + + + RV1 + only: + Spina + bifida + 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: + + + + + For + Tdap + only: + Encephalopathy + (e.g., + com: + + + + + + + + + after + a + previous + dose + or + to + a + vaccine + component? + + + a, + decreased + level + of + consciousness, + prolonged + seizures) + not + attributable + to + + + + + + + + + another + identifiable + 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) + + + Measles, + mumps, + rubella, + and + varicella + + + (MMRV) + + + + + + + + + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + vaccine + component? + + + + + Severe + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + + + + + + + + + + + Pregnancy + + + + + + + + + + + Family + history + of + altered + immunocompetence, + unless + verified + clinically + or + by + laboratory + testing + as + immunocompetent + + + + + + + + + + + For + MMRV + only: + HIV + infection + of + any + seve + + + + + + + + + rity + + + + + + + + + + + Recent + (<11 + months) + receipt + of + antibody-containing + blood + product + (specific + interval + depends + on + product) + + + + + + + Receipt + of + specific + 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. + + + + + 2. + When + a + precaution + is + present, + vaccination + should + generally + be + deferred + but + might + be + indicated + if + the + benefit + 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. + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + + + + + 3. + Vaccination + providers + should + check + FDA-approved + prescribing + information + for + the + most + complete + and + updated + information, + including + contraindications, + warnings, + and + precautions. + Package + inserts + for + U.S.-licensed + vaccines + are + available + at + + + www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states. + + + + + 4. + For + information + on + the + pregnancy + exposure + registry + for + persons + who + were + inadvertently + vaccinated + with + PreHevbrio + while + pregnant, + please + visit + www.prehevbrio.com/#safety. + + + + + 5. + Full + prescribing + information + for + BEYFORTUS + (nirsevimab-alip) + www.accessdata.fda.gov/drugsatfda_docs/label/2023/761328sO000IbI.pdf. + + + + + + + + + Page + 16 + + + + + + + + + + + + + + + + MYolel-yale(¥laaM + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + + + + + + + + + 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 + 24, + 2024. + The + following + + + recommendations + have + been + adopted + by + the + CDC + Director + and + are + now + official. + Links + are + provided + if + these + recommendations + have + been + published + in + Morbidity + and + Mortality + Weekly + Report + (MMWR). + + + + + + + + + Vaccines + Recommendations + Effective + Date + of + Recommendation* + + + + + + + + + No + new + vaccines + or + vaccine + recommendations + to + report + + + + + + + + + *The + effective + date + is + the + date + when + the + CDC + director + adopted + the + recommendation + and + when + the + ACIP + recommendation + became + official. + Page + 17 + + + + + + + + + diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr.html b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr.html new file mode 100644 index 0000000..a8da404 --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr.html @@ -0,0 +1,18272 @@ + + + + + + + + + + +
+
+

+ + UNITED + STATES + +

+
+
+

+ + Recommended + Child + and + Adolescent + Immunization + Schedule + + + for + ages + 18 + years + or + younger + +

+
+
+

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

+
+
+

+ + 2025 + +

+
+
+
+

+ + How + to + use + the + child + and + adolescent + immunization + + + Respiratory + syncytial + virus + monoclonal + antibody + (Nirsevimab) + RSV-mAb + Beyfortus + + + schedule + + + COVID-19 + vaccine + IvCOV-mRNA + Comirnaty/Pfizer-BioNTech + 1 + 2 + 3 + 4 + 5 + 6 + + + COVID-19 + Vaccine + + + = + Determine + Determine + Assess + need + Review + Review + Review + new + or + + + ee + ee + recommended + recommended + for + additional + vaccine + types, + contraindications + updated + ACIP + + + : + vaccine + byage + __ + interval + forcatch- + recommended + _ + frequencies, + and + precautions + guidance + + + 1vCOV-aPS + Novavax + COVID-19 + Vaccine + (Table + 1) + up + vaccination + vaccines + intervals, + and + for + vaccine + types + (Addendum) + + + : + - + (Table + 2) + by + medical + considerations + (Appendix) + + + Dengue + vaccine + DEN4CYD + Dengvaxia + condition + or + for + special + + + Diphtheria, + tetanus, + and + acellular + pertussis + vaccine + DTaP + Daptacel + other + indication + — + situations + + + Infanrix + (Table + 3) + (Notes) + + + Haemophilus + influenzae + type + b + vaccine + Hib + (PRP-T) + ActHIB + + + Hiberix + + + Hib + (PRP-OMP) + —— + PedvaxHIB + Recommended + by + the + Advisory + Committee + on + Immunization + Practices + (www.cdc.gov/acip/index. + + + Hepatitis + A + vaccine + HepA + Havrix + html) + and + approved + by + the + Centers + for + Disease + Control + and + Prevention + (www.cdc.gov), + American + + + Vaqta + Academy + of + Pediatrics + (www.aap.org), + American + Academy + of + Family + Physicians + (www.aafp.org), + + + Hepatitis + B + vaccine + HepB + Engerix-B + American + College + of + Obstetricians + and + Gynecologists + (www.acog.org), + American + College + of + Nurse- + + + ; + = + Recombivax + HB + Midwives + (www.midwife.org), + American + Academy + of + Physician + Associates + (www.aapa.org), + and + + + Human + papillomavirus + vaccine + nv + Gardasil + National + Association + of + Pediatric + Nurse + Practitioners + (www.napnap.org). + + + Influenza + vaccine + (inactivated: + egg-based) + IIV3 + Multiple + + + Influenza + vaccine + (inactivated: + cell-culture) + ccllV3 + Flucelvax + Report + + + Influenza + vaccine + (live, + attenuated) + LAIV3 + FluMist + * + Suspected + cases + of + reportable + vaccine-preventable + diseases + or + outbreaks + to + your + state + or + local + health + + + Measles, + mumps, + and + rubella + vaccine + MMR + M-M-R + II + department + + + Priorix + az + bos + ‘ + . + + + ICT + ts + OeSTe + TIE + USC + GON[SSIEW(CA + NUN + EIZET + MenACWY-CRM + Menveo + ° + pens + Gabe + pete + pes + . + the + Vaccine + Adverse + Event + Reporting + System + (VAERS) + at + + + MenACWY-TT + MenQuadfi + : + ial + + + Meningococcal + serogroup + B + vaccine + MenB-4C + Bexsero + Questions + or + comments + + + MenB-FHbp + Trumenba + Contact + www.cdc.gov/cdc-info + or + 800-CDC-INFO + (800-232-4636), + in + English + or + Spanish, + 8 + a.m.-8 + p.m. + ET, + + + Meningococcal + serogroup + A, + B, + C, + W, + Y + vaccine + MenACWY-TT/ + Penbraya + Monday + through + Friday, + excluding + holidays. + + + MenB-FHbp + + + nipexiogeine + . + . + Mines + siiinsss + Download + the + CDC + Vaccine + Schedules + app + for + providers + at + + + Pneumococcal + conjugate + vaccine + PCV15 + Vaxneuvance + ‘ + i + + + PCV20 + Previar20 + ‘anja + Www.cdc.gov/vaccines/hcp/imz-schedules/app.html + + + Pneumococcal + polysaccharide + vaccine + PPSV23 + Pneumovax + 23 + + + Poliovirus + vaccine + (inactivated) + IPV + Ipol + Helpful + information + + + Respiratory + syncytial + virus + vaccine + RSV + Abrysvo + * + Complete + Advisory + Committee + on + Immunization + Practices + (ACIP) + recommendations: + + + Rotavirus + vaccine + RV1 + Rotarix + www.cdc.gov/acip-recs/hcp/vaccine-specific/index.html + + + RV5 + RotaTeq + ° + ACIP + Shared + Clinical + Decision-Making + Recommendations: + + + Tetanus, + diphtheria, + and + acellular + pertussis + vaccine + Tdap + Adacel + www.cdc.gov/acip/vaccine-recommendations/shared-clinical-decision-making.html + + + Boostrix + * + General + Best + Practice + Guidelines + for + Immunization + (including + contraindications + and + precautions): + + + Tetanus + and + diphtheria + vaccine + Td + Tenivac + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html + + + . + . + iiras + ¢ + Vaccine + information + statements: + + + Varicella + vaccine + VAR + Varivax + +

+
+
+

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

+
+
+

+ + Ps + : + hea + : + + + DTaP, + hepatitis + B, + and + inactivated + poliovirus + vaccine + DTaP-HepB-IPV + Pediarix + neal + forthe + aaa + as + betaine + rie + Scan + QR + code + + + DTaP + i + ‘ated + DOloul + ae + PaWGhail + 6 + . + DTaP-IPV/Hib + p, + | + including + case + identification + and + outbreak + response): + for + access + to + +

+ +

+ + aP, + inactivated + poliovirus, + and + Haemophilus + influenzae + type + b + vaccine + a + /Hi + entacel + www.cdc.gov/surv-manual/php/ + + + DTaP + and + inactivated + poliovirus + vaccine + DTaP-IPV + Kinrix + ienab + + + Quadracel + + + DTaP, + inactivated + poliovirus, + Haemophilus + influenzae + type + b, + and + DTaP-IPV-Hib- + Vaxelis + + + hepatitis + B + vaccine + HepB + | + | + U.S. + CENTERS + FOR + DISEASE + + + Measles, + mumps, + rubella, + and + varicella + vaccine + MMRV + ProQuad + CONTROL + AND + PREVENTION + +

+ +

+ + *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 + identification + purposes + only + and + does + not + imply + endorsement + by + the + ACIP + or + CDC. + +

+
+
+

+ + CS310020-E + +

+
+
+
+

+ + 11/21/2024 + +

+
+
+

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

+
+
+
+ +
+
+

+ + 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). + +

+
+
+

+ + Respiratory + syncytial + virus + + + (RSV-mAb + [Nirsevimab]) + +

+
+
+

+ + Hepatitis + B + (HepB) + +

+
+
+

+ + Rotavirus + (RV): + RV1 + (2-dose + series), + + + RV5 + (3-dose + series) + +

+
+
+

+ + Diphtheria, + tetanus, + acellular + pertussis + + + (DTaP + <7 + yrs) + +

+
+
+

+ + Haemophilus + influenzae + type + b + (Hib) + +

+
+
+

+ + Pneumococcal + conjugate + + + (PCV15, + PCV20) + +

+
+
+

+ + Inactivated + poliovirus + (IPV) + +

+
+
+

+ + COVID-19 + (1vCOV-mRNA, + 1vCOV-aPS) + +

+
+
+

+ + Influenza + (IIV3, + ccllV3) + +

+
+
+

+ + Influenza + (LAIV3) + +

+
+
+

+ + Measles, + mumps, + rubella + (MMR) + +

+
+
+

+ + Varicella + (VAR) + +

+
+
+

+ + Hepatitis + A + (HepA) + +

+
+
+

+ + Tetanus, + diphtheria, + acellular + pertussis + + + (Tdap + =7 + yrs) + +

+
+
+

+ + Human + papillomavirus + (HPV) + +

+
+
+

+ + Meningococcal + (MenACWY-CRM + =2 + mos, + + + MenACWY-TT + =2years) + +

+
+
+

+ + Meningococcal + B + + + (MenB-4C, + MenB-FHbp) + +

+
+
+

+ + Respiratory + syncytial + virus + vaccine + + + (RSV + [Abrysvo]) + +

+
+
+

+ + Dengue + (DEN4CYD: + 9-16 + yrs) + + + Mpox + +

+
+
+

+ + Range + of + recommended + ages + + + for + catch-up + vaccination + +

+
+
+

+ + Range + of + recommended + ages + + + for + all + children + +

+
+
+
+
+

+ + 1 + dose + (8 + through + 19 + months), + See + Notes + +

+
+
+

+ + See + Notes + +

+
+
+

+ + See + Notes + +

+
+
+

+ + See + Notes + +

+
+
+

+ + Recommended + vaccination + can + + + begin + in + this + age + group + +

+
+
+

+ + Range + of + recommended + ages + + + for + certain + high-risk + groups + or + + + populations + +

+
+
+
+
+
+

+ + See + Notes + +

+
+
+

+ + Seasonal + administration + + + during + pregnancy + (See + Notes) + +

+
+
+

+ + Seropositive + in + endemic + + + dengue + areas + (See + Notes) + +

+
+
+

+ + No + Guidance/ + + + Not + Applicable + +

+
+
+

+ + Recommended + vaccination + based + + + on + shared + clinical + decision-making + +

+
+
+

+ + Page + 2 + +

+
+
+ +
+
+

+ + Table + 2 + +

+
+
+

+ + Recommended + Catch-up + Immunization + Schedule + for + Children + and + Adolescents + Who + Start + Late + or + Who + Are + More + + + than + 1 + Month + Behind, + United + States, + 2025 + +

+
+
+

+ + 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. + +

+
+
+
+

+ + Vaccine + + + Hepatitis + B + +

+
+
+

+ + Rotavirus + +

+
+
+

+ + Diphtheria, + tetanus, + and + + + acellular + pertussis + +

+
+
+

+ + Haemophilus + influenzae + + + type + b + +

+
+
+

+ + Pneumococcal + conjugate + +

+
+
+

+ + Inactivated + poliovirus + +

+
+
+

+ + Measles, + mumps, + rubella + + + Varicella + +

+ +

+ + Hepatitis + A + + + Meningococcal + ACWY + +

+
+
+

+ + Children + and + adolescents + age + 7 + through + 18 + years + +

+
+
+

+ + Meningococcal + ACWY + +

+
+
+

+ + Tetanus, + diphtheria; + + + tetanus, + diphtheria, + and + + + acellular + pertussis + +

+
+
+

+ + Human + papillomavirus + +

+
+
+

+ + Hepatitis + A + + + Hepatitis + B + + + Inactivated + poliovirus + +

+
+
+

+ + Measles, + mumps, + rubella + + + Varicella + +

+
+
+

+ + Dengue + +

+
+
+

+ + Minimum + Age + for + +

+
+
+

+ + Borel + Dose + 1 + to + Dose + 2 + +

+ +

+ + Birth + 4 + weeks + +

+ +

+ + 6 + weeks + 4 + weeks + +

+ +

+ + Maximum + age + for + first + +

+ +

+ + dose + is + 14 + weeks, + 6 + days. + +

+ +

+ + 6 + weeks + 4 + weeks + +

+ +

+ + 6 + weeks + No + further + doses + needed + + + if + first + dose + was + administered + at + age + + + 15 + months + or + older. + +

+ +

+ + 4 + weeks + +

+ +

+ + if + first + dose + was + administered + before + + + the + 1st + birthday. + +

+ +

+ + 8 + weeks + (as + final + dose) + +

+ +

+ + if + first + dose + was + administered + at + age + + + 12 + through + 14 + months. + +

+ +

+ + 6 + weeks + No + further + doses + needed + for + healthy + + + children + if + first + dose + was + administered + + + at + age + 24 + months + or + older + + + 4 + weeks + + + if + first + dose + was + administered + before + + + the + 1st + birthday + + + 8 + weeks + (as + final + dose + for + healthy + + + children) + + + if + first + dose + was + administered + at + the + + + 1st + birthday + or + after + +

+ +

+ + 6 + weeks + 4 + weeks + +

+ +

+ + 12 + months + 4 + weeks + +

+ +

+ + 12 + months + 3 + months + +

+ +

+ + 12 + months + 6 + months + +

+ +

+ + 2months + MenACWY-CRM + 8 + weeks + +

+ +

+ + 2 + years + MenACWY-TT + +

+ +

+ + Not + applicable + (N/A) + 8 + weeks + +

+ +

+ + 7 + years + 4weeks + +

+ +

+ + 9 + years + Routine + dosing + intervals + are + + + recommended. + +

+ +

+ + N/A + 6 + months + +

+ +

+ + N/A + 4 + weeks + +

+ +

+ + N/A + 4 + weeks + +

+ +

+ + N/A + 4 + weeks + +

+ +

+ + N/A + 3 + months + if + younger + than + age + 13 + years. + + + 4 + weeks + if + age + 13 + years + or + older + +

+ +

+ + 9 + years + 6 + months + +

+
+
+

+ + Children + age + 4 + months + through + 6 + years + + + Minimum + Interval + Between + Doses + + + Dose + 2 + to + Dose + 3 + + + 8 + weeks + and + at + least + 16 + weeks + after + first + dose + + + minimum + age + for + the + final + dose + is + 24 + weeks + +

+
+
+

+ + 4 + weeks + + + maximum + age + for + final + dose + is + 8 + months, + 0 + days + +

+
+
+

+ + 4 + weeks + +

+
+
+

+ + 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 + first + 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 + final + dose) + +

+ +

+ + if + current + age + is + younger + than + 12 + months + and + first + dose + was + administered + at + age + 7 + through + 11 + months; + OR + + + if + current + age + is + 12 + through + 59 + months + and + first + dose + was + administered + before + the + 1st + birthday + and + second + + + dose + was + administered + at + younger + than + 15 + months; + OR + +

+ +

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

+
+
+

+ + 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 + final + 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 + +

+
+
+

+ + 4 + weeks + +

+ +

+ + if + current + age + is + <4 + years + +

+ +

+ + 6 + months + (as + final + dose) + +

+ +

+ + if + current + age + is + 4 + years + or + older + +

+
+
+

+ + See + Notes + +

+
+
+

+ + 4 + weeks + +

+ +

+ + if + first + dose + of + DTaP/DT + was + administered + before + the + 1st + birthday + +

+ +

+ + 6 + months + (as + final + dose) + +

+ +

+ + if + first + dose + of + DTaP/DT + or + Tdap/Td + was + administered + at + or + after + the + 1st + birthday + +

+
+
+

+ + 8 + weeks + and + at + least + 16 + weeks + after + first + dose + +

+
+
+

+ + 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. + +

+
+
+

+ + 6 + months + +

+
+
+
+

+ + Dose + 3 + to + Dose + 4 + Dose + 4 + to + Dose + 5 + +

+
+
+

+ + 6 + months + +

+ +

+ + A + fifth + dose + is + not + necessary + +

+ +

+ + if + the + fourth + dose + was + + + administered + at + age + 4 + years + or + + + older + and + at + least + 6 + months + + + after + dose + 3 + +

+
+
+

+ + 6 + months + +

+
+
+

+ + 8 + weeks + (as + final + dose) + +

+ +

+ + This + dose + only + necessary + +

+ +

+ + for + children + age + 12 + through + +

+ +

+ + 59 + months + who + received + 3 + doses + + + before + the + 1st + birthday. + +

+
+
+

+ + 8 + weeks + (as + final + 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. + +

+
+
+

+ + 6 + months + (minimum + age + 4 + years + + + for + final + dose) + +

+
+
+

+ + See + Notes + +

+
+
+
+

+ + 6 + months + +

+ +

+ + if + first + dose + of + DTaP/DT + was + + + administered + before + the + 1st + + + birthday + +

+
+
+

+ + 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. + +

+
+
+

+ + Page + 3 + +

+
+
+ +
+
+

+ + aF-]e)(-"eM + Recommended + Child + and + Adolescent + Immunization + Schedule + by + Medical + Indication, + United + States, + 2025 + +

+
+
+

+ + 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. + +

+
+
+

+ + HIV + infection + CD4 + Asplenia + or + + + Vaccine + percentage + and + count? + persistent + Kidney + failure, + + + and + other + Immunocompromised + CSF + leak + or + complement + End-stage + + + immunizing + (excluding + HIV + <15%or + | + =>15% + and + cochlear + component + Heart + disease + or + renal + disease + Chronic + liver + + + agents + Pregnancy + infection) + <200/mm? + | + =200/mm? + implant + deficiencies + chronic + lung + disease + or + on + dialysis + disease + Diabetes + +

+
+
+

+ + RSV-mAb + 1 + dose + depending + on + maternal + 1 + dose + depending + on + maternal + +

+
+
+

+ + 2nd + RSV + season + 2nd + RSV + season + for + chronic + + + (nirsevimab) + RSV + vaccination + status + (See + Notes) + lung + disease + (See + Notes) + RSV + vaccination + status + (See + Notes) + +

+
+
+

+ + Hepatitis + B + +

+
+
+
+
+

+ + Rotavirus + +

+
+
+

+ + DTaP + +

+
+
+

+ + DTaP/Td. + + + oe + Tdap: + 1 + dose + each + pregnancy + +

+
+
+

+ + Hib + See + Notes + See + Notes + +

+
+
+
+

+ + Pneumococcal + +

+
+
+
+
+

+ + IPV + +

+
+
+

+ + Influenza + Solid + organ + transplant: + + + inactivated + 18yrs + (See + Notes) + +

+
+
+
+

+ + LAIV3 + + + MMR + + + VAR + +

+
+
+

+ + Hepatitis + A + +

+
+
+

+ + HPV + 3-dose + series + (See + Notes) + +

+
+
+
+

+ + MenB + + + RSV + (Abrysvo) + Seasonal + administration + + + ¥ + (See + Notes) + + + Dengue + + + Mpox + See + Notes + + + Recommended + for + all + age- + Not + recommended + for + all + children, + Recommended + for + all + age-eligible + Precaution: + Might + be + Contraindicated + or + not + No + Guidance/ + + + eligible + children + who + lack + but + recommended + for + some + children, + and + additional + doses + may + be + indicated + if + benefit + of + recommended + Not + Applicable + + + documentation + of + a + complete + children + based + on + increased + risk + for + necessary + based + on + medical + condition + protection + outweighs + *Vaccinate + after + pregnancy, + + + vaccination + series + or + severe + outcomes + from + disease + or + other + indications. + See + Notes. + risk + of + adverse + reaction + if + indicated + +

+
+
+
+

+ + 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 + b. + Severe + Combined + Immunodeficiency + + + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + +

+
+
+

+ + c. + LAIV3 + contraindicated + for + children + 2-4 + years + of + age + with + + + asthma + or + wheezing + during + the + preceding + 12 + months + +

+
+
+

+ + Page + 4 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + For + vaccination + recommendations + for + persons + ages + + + 19 + years + or + older, + see + the + Recommended + + + Adult + Immunization + Schedule, + 2025. + +

+
+
+

+ + Additional + information + +

+
+
+

+ + ¢ + For + calculating + intervals + between + doses, + 4 + weeks + = + 28 + days. + + + Intervals + of + >4 + months + are + determined + by + calendar + months. + +

+
+
+

+ + e + 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 + 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. + +

+
+
+

+ + ¢ + Information + on + travel + vaccination + requirements + and + + + recommendations + is + available + at + www.cdc.gov/travel/. + +

+
+
+

+ + ° + For + vaccination + of + persons + with + immunodeficiencies, + see + + + Table + 8-1, + Vaccination + of + persons + with + primary + and + secondary + + + immunodeficiencies, + 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, + + + Lynfield + Ruth, + Sawyer + MH, + eds. + Red + Book: + 2021-2024 + Report + + + of + the + Committee + on + Infectious + Diseases. + 32nd + ed. + Itasca, + IL: + + + American + Academy + of + Pediatrics; + 2021:72-86). + +

+
+
+

+ + ¢ + For + information + about + vaccination + in + the + setting + of + a + vaccine- + + + preventable + disease + outbreak, + contact + your + + + state + or + local + health + department. + +

+
+
+

+ + ¢ + 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. + +

+
+
+
+

+ + COVID-19 + vaccination + +

+
+
+

+ + (minimum + age: + 6 + months + [Moderna + and + Pfizer-BioNTech + COVID-19 + vaccines], + 12 + years + [Novavax + COVID-19 + Vaccine]) + +

+
+
+

+ + Routine + vaccination + + + Age + 6 + months-4 + years + +

+
+
+
+

+ + All + vaccine + doses + should + be + from + the + same + manufacturer. + + + ¢ + Unvaccinated: + +

+ +

+ + -2 + doses + 2024-25 + Moderna + at + 0, + 4-8 + weeks + +

+ +

+ + -3 + doses + 2024-25 + Pfizer-BioNTech + at + 0, + 3-8, + and + at + least + + + 8 + weeks + after + dose + 2 + +

+ +

+ + ¢ + Incomplete + initial + vaccination + series + before + 2024-25 + + + vaccine + with: + +

+ +

+ + - + 1 + dose + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + 4-8 + weeks + after + most + recent + dose + +

+ +

+ + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + 2 + doses + + + 2024-25 + Pfizer-BioNTech + 8 + weeks + apart + (administer + dose + 1 + + + 3-8 + weeks + after + most + recent + dose). + +

+ +

+ + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + 1 + dose + + + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + +

+ +

+ + ¢ + Completed + initial + vaccination + series + before + 2024-25 + + + vaccine + with: + +

+ +

+ + -2 + or + more + doses + Moderna: + 1 + dose + 2024-25 + Moderna + at + + + least + 8 + weeks + after + the + most + recent + dose. + +

+ +

+ + -3 + or + more + doses + Pfizer-BioNTech: + 1 + dose + 2024-25 + Pfizer- + + + BioNTech + at + least + 8 + weeks + after + the + most + recent + dose. + +

+
+
+

+ + Age + 5-11 + years + +

+ +

+ + ¢ + Unvaccinated: + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + +

+ +

+ + ¢ + Previously + vaccinated + before + 2024-25 + vaccine + with + 1 + or + + + more + doses + Moderna + or + Pfizer-BioNTech: + 1 + dose + 2024-25 + + + Moderna + or + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + +

+
+
+

+ + Age + 12-18 + years + + + ¢ + Unvaccinated: + + + - + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + + + -2 + doses + 2024-25 + Novavax + at + 0, + 3-8 + weeks + + + ¢ + Previously + vaccinated + before + 2024-25 + vaccine + with: + +

+ +

+ + - + 1 + or + more + doses + Moderna + or + Pfizer-BioNTech: + 1 + dose + + + 2024-25 + Moderna + or + Novavax + or + Pfizer-BioNTech + at + least + + + 8 + weeks + after + the + most + recent + dose. + +

+ +

+ + - + 1 + dose + Novavax: + 1 + dose + 2024—25 + Novavax + 3-8 + weeks + after + + + most + recent + dose. + If + more + than + 8 + weeks + after + most + recent + + + dose, + administer + 1 + dose + 2024-25 + Moderna + or + Novavax + or + + + Pfizer-BioNTech. + +

+ +

+ + -2 + or + more + doses + Novavax: + 1 + dose + 2024—25 + Moderna + or + + + Novavax + or + Pfizer-BioNTech + at + least + 8 + weeks + after + the + most + + + recent + dose. + +

+
+
+
+

+ + Special + situation + + + Persons + who + are + moderately + or + severely + immunocompromised. + +

+
+
+

+ + Age + 6 + months-4 + years + +

+
+
+
+

+ + Use + vaccine + from + the + same + manufacturer + for + all + doses + (initial + + + vaccination + series + and + additional + doses*). + +

+
+
+

+ + ¢ + Unvaccinated: + +

+ +

+ + -4 + doses + (3-dose + initial + series + 2024-25 + Moderna + at + 0, + + + 4 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + 6 + months + later + [minimum + interval + + + 2 + months]).May + administer + additional + doses.* + +

+ +

+ + -4 + doses + (3-dose + initial + series + 2024-25 + Pfizer-BioNTech + + + at + 0, + 3 + weeks, + and + at + least + 8 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Pfizer-BioNTech + 6 + months + later + [minimum + + + interval + 2 + months]). + May + administer + additional + doses.* + +

+
+
+

+ + ¢ + Incomplete + initial + 3-dose + vaccination + series + before + + + 2024-25 + vaccine: + +

+
+
+

+ + - + Previous + vaccination + with + Moderna + +

+
+
+

+ + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + 1 + + + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + 2024- + + + 25 + Moderna + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna.* + +

+ +

+ + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna.* + +

+ +

+ + - + Previous + vaccination + with + Pfizer-BioNTech + +

+
+
+

+ + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + apart + + + (administer + dose + 1 + 3 + weeks + after + most + recent + dose), + + + followed + by + 1 + dose + 2024-25 + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Pfizer-BioNTech.* + +

+ +

+ + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 8 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + May + + + administer + additional + doses + of + Pfizer-BioNTech.* + +

+
+
+

+ + Page + 5 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + COVID-19 + vaccination + - + continued + +

+
+
+

+ + ¢ + Completed + initial + 3-dose + vaccination + series + before + +

+ +

+ + 2024-25 + vaccine + with: + +

+ +

+ + -3 + or + more + doses + Moderna: + 2 + doses + 2024-25 + Moderna + + + 6 + months + apart + (minimum + interval + 2 + months). + Administer + + + dose + 1 + at + least + 8 + weeks + after + the + most + recent + dose. + May + + + administer + additional + doses + of + Moderna.* + +

+ +

+ + -3 + or + more + doses + Pfizer-BioNTech: + 2 + doses + 2024-25 + Pfizer- + + + BioNTech + 6 + months + apart + (minimum + interval + 2 + months). + + + Administer + dose + 1 + at + least + 8 + weeks + after + the + most + recent + + + dose. + May + administer + additional + doses + of + Pfizer-BioNTech.* + +

+
+
+

+ + Age + 5-11 + years + +

+
+
+

+ + Use + vaccine + from + the + same + manufacturer + for + all + doses + in + the + initial + +

+
+
+

+ + vaccination + series. + +

+
+
+

+ + ¢ + Unvaccinated: + +

+ +

+ + -4 + doses + (3-dose + initial + series + 2024-25 + Moderna + at + 0, + + + 4 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses.* + +

+ +

+ + -4 + doses + (3-dose + initial + series + 2024-25 + Pfizer-BioNTech + + + at + 0, + 3 + weeks, + and + at + least + 4 + weeks + after + dose + 2, + followed + by + + + 1 + dose + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses.* + +

+
+
+

+ + ¢ + Incomplete + initial + 3-dose + vaccination + series + before + + + 2024-25 + vaccine: + + + - + Previous + vaccination + with + Moderna + +

+ +

+ + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + + + 1 + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + + + 2024-25 + Moderna + or + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna + or + Pfizer-BioNTech.* + +

+ +

+ + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + + + dose, + followed + by + 1 + dose + 2024-25 + Moderna + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Pfizer- + + + BioNTech.* + +

+
+
+

+ + - + Previous + vaccination + with + Pfizer-BioNTech + +

+ +

+ + - + 1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + + + apart + (administer + dose + 1 + 3 + weeks + after + most + recent + + + dose), + followed + by + 1 + dose + 2024-25 + Moderna + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Pfizer- + + + BioNTech.* + +

+ +

+ + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Moderna + + + or + Pfizer-BioNTech + 6 + months + later + (minimum + interval + + + 2 + months). + May + administer + additional + doses + of + Moderna + or + + + Pfizer-BioNTech.* + +

+
+
+

+ + ¢ + Completed + initial + 3-dose + vaccination + series + before + +

+
+
+

+ + 2024-25 + vaccine + with: + +

+ +

+ + -3 + or + more + doses + Moderna + or + 3 + or + more + doses + Pfizer- + + + BioNTech: + 2 + doses + 2024-25 + Moderna + or + Pfizer-BioNTech + + + 6 + months + apart + (minimum + interval + 2 + months). + Administer + + + dose + 1 + at + least + 8 + weeks + after + the + most + recent + dose. + May + + + administer + additional + doses + of + Moderna + or + Pfizer-BioNTech.* + +

+
+
+

+ + Age + 12-18 + years + +

+
+
+

+ + Use + vaccine + from + the + same + manufacturer + for + all + doses + in + the + initial + + + vaccination + series. + +

+
+
+

+ + ¢ + Unvaccinated: + +

+
+
+

+ + -4 + doses + (3-dose + initial + series + Moderna + at + 0, + 4 + weeks, + and + + + at + least + 4 + weeks + after + dose + 2, + followed + by + 1 + dose + 2024-25 + + + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + +

+ +

+ + -4 + doses + (3-dose + initial + series + Pfizer-BioNTech + at + 0, + 3 + weeks, + + + and + at + least + 4 + weeks + after + dose + 2, + followed + by + 1 + dose + 2024- + + + 25 + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + [minimum + interval + 2 + months]). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + +

+ +

+ + -3 + doses + (2-dose + initial + series + Novavax + at + 0, + 3 + weeks, + + + followed + by + 1 + dose + Moderna + or + Novavax + or + Pfizer-BioNTech + + + 6 + months + later + [minimum + interval + 2 + months]). + May + + + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + +

+
+
+
+

+ + ¢ + Incomplete + initial + vaccination + series + before + 2024-25 + + + vaccine: + +

+
+
+

+ + - + Previous + vaccination + with + Moderna + +

+ +

+ + - + 1 + dose + Moderna: + complete + initial + series + with + 2 + doses + + + 2024-25 + Moderna + at + least + 4 + weeks + apart + (administer + dose + 1 + + + 4 + weeks + after + most + recent + dose), + followed + by + 1 + dose + 2024- + + + 25 + Moderna + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + + + (minimum + interval + 2 + months). + May + administer + additional + + + doses + of + Moderna + or + Novavax + or + Pfizer-BioNTech.* + +

+ +

+ + -2 + doses + Moderna: + complete + initial + series + with + 1 + dose + + + 2024-25 + Moderna + at + least + 4 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + +

+ +

+ + - + Previous + vaccination + with + Pfizer-BioNTech + +

+ +

+ + -1 + dose + Pfizer-BioNTech: + complete + initial + series + with + + + 2 + doses + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + apart + + + (administer + dose + 1 + 3 + weeks + after + most + recent + dose), + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + +

+ +

+ + - + 2 + doses + Pfizer-BioNTech: + complete + initial + series + with + + + 1 + dose + 2024-25 + Pfizer-BioNTech + at + least + 4 + weeks + after + + + most + recent + dose, + followed + by + 1 + dose + 2024-25 + Moderna + + + or + Novavax + or + Pfizer-BioNTech + 6 + months + later + (minimum + + + interval + 2 + months). + May + administer + additional + doses + of + + + Moderna + or + Novavax + or + Pfizer-BioNTech.* + +

+ +

+ + - + Previous + vaccination + with + Novavax + +

+ +

+ + - + 1 + dose + Novavax: + complete + initial + series + with + 1 + dose + + + 2024-25 + Novavax + at + least + 3 + weeks + after + most + recent + dose, + + + followed + by + 1 + dose + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + later + (minimum + interval + 2 + months). + + + May + administer + additional + doses + of + Moderna + or + Novavax + or + + + Pfizer-BioNTech.* + +

+
+
+

+ + Page + 6 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + COVID-19 + vaccination + - + continued + Dengue + vaccination + +

+
+
+

+ + ¢ + Completed + initial + 3-dose + vaccination + series + before + +

+ +

+ + 2024-25 + vaccine + with: + +

+ +

+ + -3 + or + more + doses + Moderna + or + 3 + or + more + doses + Pfizer- + + + BioNTech: + 2 + doses + 2024-25 + Moderna + or + Novavax + or + Pfizer- + + + BioNTech + 6 + months + apart + (minimum + interval + 2 + months). + + + Administer + dose + 1 + at + least + 8 + weeks + after + the + most + recent + + + dose. + May + administer + additional + doses + of + Moderna + or + + + Novavax + or + Pfizer-BioNTech.* + +

+
+
+

+ + -2 + or + more + doses + Novavax: + 2 + doses + 2024-25 + Moderna + or + + + Novavax + or + Pfizer-BioNTech + 6 + months + apart + (minimum + + + interval + 2 + months). + Administer + dose + 1 + at + least + 8 + weeks + after + + + the + most + recent + dose. + May + administer + additional + doses + of + + + Moderna + or + Novavax + or + Pfizer-BioNTech.* + +

+
+
+

+ + *Additional + doses + of + 2024-25 + COVID-19 + vaccine + for + + + moderately + or + severely + immunocompromised: + based + on + + + shared + clinical + decision-making + and + administered + at + least + +

+ +

+ + 2 + months + after + the + most + recent + dose + (see + Table + 2 + at + www. + + + cdc.gov/vaccines/covid-19/clinical-considerations/interim- + + + considerations-us.html#table-02.). + For + description + of + moderate + + + and + severe + immunocompromising + conditions + and + treatment, + + + see + www.cdc.gov/vaccines/covid-19/clinical-considerations/ + + + interim-considerations-us.html#immunocompromising- + + + conditions-treatment. + +

+
+
+

+ + Unvaccinated + persons + have + never + received + any + COVID-19 + + + vaccine + doses. + 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. + +

+
+
+

+ + For + information + about + interchangeability + of + COVID-19 + vaccines, + + + see + www.cdc.gov/vaccines/covid-19/clinical-considerations/ + + + interim-considerations-us.html#Interchangeability. + +

+
+
+

+ + 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-201 + 9-covid-19/covid-19- + + + vaccines. + +

+
+
+

+ + (minimum + age: + 9 + years) + +

+
+
+

+ + Routine + vaccination + +

+ +

+ + ¢ + Age + 9-16 + years + living + in + areas + with + endemic + dengue + AND + + + have + laboratory + confirmation + of + previous + dengue + infection + + + - + 3-dose + series + administered + at + 0, + 6, + and + 12 + months + +

+ +

+ + e + 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/ + + + index.html + +

+ +

+ + ¢ + 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 + + + ¢ + 5-dose + series + (3-dose + primary + series + at + age + 2, + 4, + and + 6 + months, + + + followed + by + 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 + 4th + 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 + +

+ +

+ + * + Dose + 5 + is + not + necessary + if + dose + 4 + was + administered + at + age + + + 4 + years + or + older + and + at + least + 6 + months + after + dose + 3. + +

+ +

+ + ¢ + For + other + catch-up + guidance, + see + Table + 2. + +

+
+
+

+ + Special + situations + +

+ +

+ + ¢ + Children + younger + than + age + 7 + years + with + a + contraindication + + + specific + to + the + pertussis + component + of + DTaP: + May + + + administer + Td + for + all + recommended + remaining + doses + in + place + + + of + DTaP. + Encephalopathy + within + 7 + days + of + vaccination + when + + + not + attributable + to + another + identifiable + cause + is + the + only + + + contraindication + specific + to + the + pertussis + component + of + DTaP. + + + For + additional + information, + see + www.cdc.gov/pertussis/hcp/ + + + vaccine-recommendations/td-offlabel.html. + +

+ +

+ + ¢ + Wound + management + in + children + younger + 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 + influenzae + type + b + vaccination + +

+
+
+
+

+ + (minimum + age: + 6 + weeks) + +

+
+
+

+ + Routine + vaccination + + + ¢ + 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 + + + different + Hib-containing + vaccine + should + be + used + for + the + + + booster + dose. + +

+
+
+

+ + ¢ + PedvaxHIB: + 3-dose + series + (2-dose + primary + series + at + age + 2 + and + + + 4 + months, + followed + by + a + booster + dose + at + age + 12-15 + months) + +

+
+
+

+ + ¢ + American + Indian + and + Alaska + Native + infants: + Vaxelis + and + + + PedvaxHIB + preferred + over + other + Hib + vaccines + for + the + primary + + + series. + +

+
+
+

+ + Catch-up + vaccination + +

+ +

+ + ¢ + Dose + 1 + at + age + 7-11 + months: + Administer + dose + 2 + at + least + + + 4 + weeks + later + and + dose + 3 + (final + dose) + at + age12—15 + months + or + + + 8 + weeks + after + dose + 2 + (whichever + is + later). + +

+
+
+

+ + ¢ + Dose + 1 + at + age + 12-14 + months: + Administer + dose + 2 + (final + dose) + + + at + least + 8 + weeks + after + dose + 1. + +

+
+
+

+ + ° + Dose + 1 + before + age + 12 + months + and + dose + 2 + before + age + + + 15 + months: + Administer + dose + 3 + (final + dose) + at + least + + + 8 + weeks + after + dose + 2. + +

+
+
+

+ + ¢ + 2 + doses + of + PedvaxHIB + before + age + 12 + months: + Administer + + + dose + 3 + (final + dose) + at + age12-59 + months + and + at + least + 8 + weeks + + + after + dose + 2. + +

+
+
+

+ + ¢ + 1 + dose + administered + at + age + 15 + months + or + older: + + + No + further + doses + needed + +

+
+
+

+ + ¢ + Unvaccinated + at + age + 15-59 + months: + Administer + 1 + dose. + +

+
+
+

+ + ¢ + Previously + unvaccinated + children + age + 60 + months + or + + + older + who + are + not + considered + high + risk: + Catch-up + + + vaccination + not + required. + +

+
+
+

+ + For + other + catch-up + guidance, + see + Table + 2. + Vaxelis + can + be + used + + + for + catch-up + vaccination + in + children + younger + 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. + +

+
+
+

+ + Page + 7 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Haemophilus + influenzae + type + b + vaccination + + + - + continued + +

+
+
+

+ + Special + situations + + + ¢ + 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. + +

+
+
+
+

+ + ¢ + Hematopoietic + stem + cell + transplant + (HSCT): + + + - + 3-dose + series + 4 + weeks + apart + starting + 6 + to + 12 + months + after + + + successful + transplant, + regardless + of + Hib + vaccination + history + +

+
+
+

+ + ¢ + 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 + +

+
+
+
+
+

+ + ¢ + Elective + splenectomy: + + + Unvaccinated* + persons + age + 15 + months + or + older + +

+
+
+

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

+
+
+
+
+
+

+ + ¢ + Immunoglobulin + deficiency, + early + component + + + complement + deficiency, + or + early + component + complement + + + inhibitor + use: + + + 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 + +

+
+
+

+ + ¢ + 2-dose + series + (minimum + interval: + 6 + months) + at + age + 12- + + + 23 + months + +

+
+
+

+ + Catch-up + vaccination + +

+
+
+

+ + e + Unvaccinated + persons + through + age + 18 + years + should + + + complete + a + 2-dose + series + (minimum + interval: + 6 + months). + +

+
+
+

+ + e + Persons + who + previously + received + 1 + dose + at + age + 12 + months + or + + + older + should + receive + dose + 2 + at + least + 6 + months + after + dose + 1. + +

+
+
+

+ + e + Adolescents + age + 18 + years + or + older + may + receive + HepA-HepB + + + (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 + + + ¢ + 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 + + + ¢ + Mother + is + HBsAg-negative + + + - + 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) + + + - + Infants + who + did + not + receive + a + birth + dose + should + begin + + + the + series + as + soon + as + possible + (see + Table + 2 + for + minimum + + + intervals). + + + - + Administration + of + 4 + doses + is + permitted + when + a + combination + + + vaccine + containing + HepB + is + used + after + the + birth + dose. + + + - + Minimum + intervals + (see + Table + 2): + when + 4 + doses + + + are + administered, + substitute + “dose + 4” + for + “dose + 3” + + + in + these + calculations. + + + - + Final + (3rd + or + 4th) + dose: + age + 6-18 + months + + + (minimum + age + 24 + weeks) + +

+
+
+
+

+ + e + 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 + final + dose. + Do + not + + + test + before + age + 9 + months. + +

+
+
+
+

+ + Page + 8 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Hepatitis + B + vaccination + - + continued + +

+
+
+

+ + e + 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 + final + dose. + Do + not + test + before + age + 9 + months. + +

+
+
+

+ + Catch-up + vaccination + +

+ +

+ + e + Unvaccinated + persons + should + complete + a + 3-dose + series + at + + + 0, + 1-2, + 6 + months. + See + Table + 2 + for + minimum + intervals. + +

+ +

+ + e + Adolescents + age + 11-15 + years + may + use + an + alternative + 2-dose + + + schedule + with + at + least + 4 + months + between + doses + (adult + + + formulation + Recombivax + HB + only). + +

+ +

+ + e + 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 + +

+ +

+ + - + HepA-HepB + (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). + +

+
+
+

+ + Special + situations + + + e + Revaccination + is + generally + not + recommended + for + persons + + + with + a + normal + immune + status + who + were + vaccinated + as + infants, + + + children, + adolescents, + or + adults. + + + ¢ + 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/mmwr/volumes/67/rr/rr6701a1.htm. + + + *Note: + PreHevbrio + is + 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 + +

+
+
+

+ + e + 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. + +

+
+
+

+ + e + 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) + +

+
+
+

+ + ¢ + No + additional + dose + recommended + when + any + HPV + + + vaccine + series + of + any + valency + has + been + completed + using + + + recommended + dosing + intervals. + +

+
+
+

+ + Special + situations + +

+ +

+ + ¢ + Immunocompromising + conditions, + including + HIV + + + infection: + 3-dose + series, + even + for + those + who + initiate + + + vaccination + at + age + 9 + through + 14 + years. + +

+
+
+

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

+
+
+

+ + ¢ + Pregnancy: + Pregnancy + testing + not + needed + before + + + vaccination; + HPV + vaccination + not + recommended + until + + + after + pregnancy; + no + intervention + needed + if + vaccinated + + + while + pregnant + +

+
+
+

+ + Influenza + vaccination + +

+
+
+

+ + (minimum + age: + 6 + months + [IIV3], + 2 + years + [LAIV3],18 + + + years + [recombinant + influenza + vaccine, + RIV3]) + +

+
+
+
+

+ + Routine + vaccination + + + e + Use + any + influenza + vaccine + appropriate + for + age + and + health + + + status + annually: + + + - + Age + 6 + months-8 + years + who + have + received + fewer + than + + + 2 + influenza + vaccine + doses + before + July + 1, + 2024, + or + whose + + + influenza + 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 + influenza + vaccine + doses + before + July + 1, + 2024: + 1 + dose. + + + - + Age + 9 + years + or + older: + 1 + dose + + + - + Age + 18 + years + solid + organ + transplant + recipients + receiving + + + immunosuppressive + medications: + high-dose + inactivated + + + (HD-IIV3) + and + adjuvanted + inactivated + (allV3) + influenza + + + vaccines + are + acceptable + options. + No + preference + over + other + + + age-appropriate + IIV3 + or + RIV3. + +

+
+
+

+ + e + For + the + 2024-25 + season, + see + www.cdc.gov/mmwr/ + + + volumes/73/rr/rr7305a1.htm. + +

+
+
+

+ + ¢ + For + the + 2025-26 + season, + see + the + 2025-26 + ACIP + influenza + + + vaccine + recommendations. + +

+
+
+

+ + Special + situations + +

+ +

+ + * + Close + contacts + (e.g., + household + contacts) + of + severely + + + immunosuppressed + persons + who + require + a + protected + + + environment: + should + not + receive + LAIV3. + If + LAIV3 + is + + + given, + they + should + avoid + contact + with, + or + caring + for + such + + + immunosuppressed + persons + for + 7 + days + after + vaccination. + +

+
+
+

+ + Note: + Persons + with + an + egg + allergy + can + receive + any + influenza + + + vaccine + (egg-based + or + non-egg + based) + appropriate + for + age + and + + + health + status. + +

+
+
+

+ + Page + 9 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Measles, + mumps, + and + rubella + vaccination + +

+
+
+
+

+ + (minimum + age: + 12 + months + for + routine + vaccination) + +

+
+
+

+ + Routine + vaccination + + + e + 2-dose + series + at + age + 12-15 + months, + age + 4-6 + years + +

+
+
+

+ + ¢ + 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 + +

+ +

+ + ¢ + Unvaccinated + children + and + adolescents: + 2-dose + series + at + + + least + 4 + weeks + apart* + +

+ +

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

+
+
+

+ + Special + situations + + + ¢ + 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.* + + + - + Children + age + 12 + months + or + older: + + + - + Unvaccinated: + 2-dose + series + (separated + by + at + least + + + 4 + weeks*) + before + departure + + + - + Previously + received + 1 + dose: + administer + dose + 2 + at + least + + + 4 + weeks + after + dose + 1* + + + ¢ + ln + 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, + MenQuadfi]), + +

+
+
+

+ + 10 + years + [MenACWY-TT/MenB-FHbp, + Penbraya]) + +

+
+
+

+ + Routine + vaccination + + + * + 2-dose + series + at + age + 11-12 + years; + 16 + years + +

+
+
+

+ + Catch-up + vaccination + +

+
+
+

+ + e + Age + 13-15 + years: + 1 + dose + now + and + booster + at + age + 16-18 + years + + + (minimum + interval: + 8 + weeks) + +

+
+
+

+ + ¢ + Age + 16-18 + years: + 1 + dose + +

+
+
+

+ + Special + situations + +

+ +

+ + Anatomic + or + functional + asplenia + (including + sickle + cell + + + disease), + HIV + infection, + persistent + complement + + + component + deficiency, + complement + inhibitor + +

+ +

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

+
+
+

+ + ¢ + 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 + +

+
+
+

+ + ¢ + MenQuadfi + +

+
+
+

+ + -Dose + 1 + at + age + 24 + months + or + older: + 2-dose + series + at + least + + + 8 + weeks + apart + +

+
+
+

+ + Travel + to + countries + with + hyperendemic + or + epidemic + + + meningococcal + disease, + including + countries + in + the + African + + + meningitis + belt + or + during + the + Hajj + (www.cdc.gov/travel/): + +

+
+
+

+ + ¢ + Children + younger + 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) + +

+
+
+

+ + ¢ + Children + age + 2 + years + or + older: + 1 + dose + Menveo* + + + or + MenQuadfi + +

+
+
+
+

+ + First-year + college + students + who + live + in + residential + housing + + + (if + not + previously + vaccinated + at + age + 16 + years + or + older) + or + + + military + recruits: + 1 + dose + Menveo* + or + MenQuadfi + +

+
+
+

+ + Adolescent + vaccination + of + children + who + received + MenACWY + + + prior + to + age + 10 + years: + +

+
+
+

+ + ¢ + Children + for + whom + boosters + are + recommended + because + + + of + an + ongoing + increased + risk + of + meningococcal + disease + + + (e.g., + those + with + complement + component + deficiency, + HIV, + + + or + asplenia): + Follow + the + booster + schedule + for + persons + at + + + increased + risk. + +

+
+
+

+ + ¢ + 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). + +

+
+
+

+ + Page + 10 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Meningococcal + serogroup + B + vaccination + + + (minimum + age: + 10 + years + [MenB-4C, + Bexsero; + MenB- + +

+
+
+

+ + FHbp, + Trumenba; + MenACWY-TT/MenB-FHbp, + + + Penbraya)]) + +

+
+
+

+ + Shared + clinical + decision-making + + + ¢ + Adolescents + not + at + increased + risk + age + 16-23 + years + +

+ +

+ + (preferred + age + 16-18 + years)* + based + on + shared + clinical + +

+ +

+ + decision-making. + +

+ +

+ + - + Bexsero + or + Trumenba + (use + same + brand + for + all + doses): + + + 2-dose + series + at + least + 6 + months + apart + (if + dose + 2 + is + + + administered + earlier + than + 6 + months, + administer + dose + 3 + + + at + least + 4 + months + after + dose + 2) + +

+
+
+

+ + *To + optimize + rapid + protection + (e.g., + for + students + starting + college + + + in + less + than + 6 + months), + a + 3-dose + series + (0, + 1-2, + 6 + months) + may + be + + + administered. + +

+
+
+

+ + 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 + deficiency, + + + complement + inhibitor + (e.g., + eculizumab, + ravulizumab) + use. + + + - + Bexsero + or + Trumenba + (use + same + brand + for + all + doses + + + including + booster + doses) + 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 + 4th + dose + should + be + administered + at + + + least + 4 + months + after + dose + 3) + +

+
+
+

+ + 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. + +

+
+
+

+ + Note: + MenB + vaccines + may + be + administered + simultaneously + + + with + MenACWY + vaccines + if + indicated, + but + at + a + different + + + anatomic + site, + if + feasible. + +

+
+
+

+ + Children + age + 10 + years + or + older + may + receive + a + dose + of + Penbraya + + + (MenACWY-TT/MenB-FHbp) + 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 + +

+ +

+ + ¢ + Age + 18 + years + and + at + risk + for + mpox + infection: + complete + + + 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 + +

+
+
+

+ + ¢ + 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/mpox/hcp/vaccine- + + + considerations/vaccination-overview.html + +

+
+
+

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

+
+
+
+

+ + [PPSV23]) + +

+
+
+

+ + Routine + vaccination + with + PCV + + + e + 4-dose + series + at + 2, + 4,6, + 12-15 + months + +

+
+
+

+ + Catch-up + vaccination + with + PCV + +

+ +

+ + ¢ + Healthy + children + ages + 2-4 + years + with + any + incomplete* + + + PCV + series: + 1 + dose + PCV + +

+ +

+ + ¢ + 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. + +

+
+
+

+ + Special + situations + +

+ +

+ + Children + and + adolescents + with + cerebrospinal + fluid + 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 + + + e + 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) + + + ¢ + 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. + +

+
+
+

+ + Page + 11 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Pneumococcal + vaccination + - + continued + +

+
+
+

+ + Age + 6-18 + years + +

+ +

+ + 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.** + +

+
+
+

+ + ° + 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. + +

+
+
+

+ + ¢ + 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. + +

+
+
+

+ + ¢ + 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 + immunodeficiencies; + + + 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 + + + e + 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) + + + ¢ + 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 + +

+ +

+ + ¢ + 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.** + +

+
+
+

+ + ¢ + 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. + +

+
+
+

+ + ¢ + 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. + +

+
+
+

+ + ¢ + 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. + +

+
+
+

+ + Pregnancy: + no + recommendation + for + PCV + or + PPSV23 + due + to + + + limited + data. + Summary + of + existing + data + on + pneumococcal + + + vaccination + during + pregnancy + can + be + found + at + www.cdc.gov/ + + + mmwr/volumes/72/rr/rr7203a1.htm + +

+
+
+

+ + For + guidance + on + determining + which + pneumococcal + vaccines + a + + + patient + needs + and + when, + please + refer + to + the + mobile + app, + which + + + can + be + downloaded + here: + wcms-wp.cdc.gov/pneumococcal/ + + + hcp/vaccine-recommendations/app.html + +

+
+
+

+ + *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 + first. + PCV15 + and + PPSV23 + should + not + be + + + administered + during + the + same + visit. + +

+
+
+

+ + Poliovirus + vaccination + +

+
+
+

+ + (minimum + age: + 6 + weeks) + +

+
+
+
+

+ + Routine + vaccination + +

+ +

+ + e + 4-dose + series + at + ages + 2, + 4, + 6-18 + months, + 4-6 + years; + administer + + + the + final + dose + on + or + after + age + 4 + years + and + at + least + 6 + months + + + after + the + previous + dose. + +

+
+
+

+ + ¢ + 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 + +

+ +

+ + ¢ + In + the + first + 6 + months + of + life, + use + minimum + ages + and + + + intervals + only + for + travel + to + a + polio-endemic + region + + + or + during + an + outbreak. + +

+
+
+

+ + e + 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 + specific + 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: + +

+ +

+ + ¢ + 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. + +

+ +

+ + ¢ + Only + trivalent + OPV + (tOPV) + counts + toward + the + + + U.S. + vaccination + requirements. + +

+ +

+ + - + Doses + of + OPV + administered + before + April + 1, + 2016, + should + be + + + counted + (unless + specifically + 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. + +

+ +

+ + ¢ + For + other + catch-up + guidance, + see + Table + 2. + +

+
+
+

+ + Special + situations + +

+ +

+ + ¢ + 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 + +

+
+
+

+ + Page + 12 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Respiratory + syncytial + virus + immunization + +

+
+
+

+ + (minimum + age: + birth + [Nirsevimab, + RSV-mAb, + Beyfortus]) + +

+
+
+
+

+ + Routine + immunization + + + ¢ + 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 + or + mother + received + + + RSV + vaccine + in + previous + pregnancy: + administer + 1 + dose + + + nirsevimab + within + 1 + week + of + birth—ideally + during + the + birth + + + hospitalization. + +

+ +

+ + - + Mother + received + RSV + vaccine + less + than + 14 + days + prior + to + + + delivery: + administer + 1 + dose + nirsevimab + within + 1 + week + of + + + birth—ideally + during + the + birth + hospitalization. + +

+ +

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

+
+
+

+ + ¢ + 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 + or + mother + received + + + RSV + vaccine + in + previous + pregnancy: + 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 + 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 + +

+ +

+ + ¢ + 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 + fibrosis + with + either + weight + + + for + length + <10th + percentile + or + manifestation + of + severe + + + lung + disease + (e.g., + previous + hospitalization + for + pulmonary + + + exacerbation + in + the + first + year + of + life + or + abnormalities + on + + + chest + imaging + that + persist + when + stable)**: + + + - + 1 + dose + nirsevimab + shortly + before + start + of + second + RSV + +

+ +

+ + season* + +

+
+
+

+ + e + Ages + 8-19 + months + who + are + American + Indian + or + + + Alaska + Native: + 1 + dose + nirsevimab + shortly + before + start + of + + + second + RSV + season* + +

+
+
+

+ + ¢ + Age-eligible + and + undergoing + cardiac + surgery + with + + + cardiopulmonary + bypass**: + 1 + additional + dose + of + nirsevimab + + + after + surgery. + See + www.accessdata.fda.gov/drugsatfda_docs/ + + + label/2023/761328s000Ibl.pdf + +

+
+
+

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

+ +

+ + RSV + season + may + vary, + administration + of + nirsevimab + is + + + recommended + October + through + March + in + most + of + the + + + continental + United + States + (optimally + October + through + + + November + or + within + 1 + week + of + birth). + Providers + in + jurisdictions + + + with + RSV + seasonality + that + differs + 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. + +

+
+
+

+ + **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 + +

+ +

+ + ¢ + 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 + Abrysvo. + Administer + RSV + + + vaccine + regardless + of + previous + RSV + infection. + +

+ +

+ + - + Either + maternal + RSV + vaccination + with + Abrysvo + or + infant + + + immunization + with + nirsevimab + (RSV + monoclonal + antibody) + is + + + recommended + to + prevent + severe + respiratory + syncytial + virus + + + disease + in + infants. + +

+
+
+

+ + ¢ + All + other + pregnant + persons: + RSV + vaccine + not + recommended + +

+
+
+

+ + e + Subsequent + pregnancies: + additional + doses + not + + + recommended. + No + data + are + available + to + inform + whether + + + additional + doses + are + needed + in + subsequent + pregnancies. + + + Infants + born + to + pregnant + persons + who + received + RSV + vaccine + + + during + a + previous + pregnancy + should + receive + nirsevimab. + +

+
+
+

+ + *Note: + Providers + in + jurisdictions + with + RSV + seasonality + that + + + differs + from + most + of + the + continental + United + States + (e.g., + Alaska, + + + jurisdictions + 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 + + + ¢ + Rotarix: + 2-dose + series + at + age + 2 + and + 4 + months + +

+
+
+

+ + ¢ + RotaTeq: + 3-dose + series + at + age + 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 + Table + 2. + +

+
+
+

+ + Page + 13 + +

+
+
+ +
+
+

+ + | + Notes + | + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Tetanus, + diphtheria, + and + pertussis + (Tdap) + +

+
+
+

+ + vaccination + (minimum + age: + 11 + years + for + routine + + + vaccination, + 7 + years + for + catch-up + vaccination) + +

+
+
+
+

+ + Routine + vaccination + + + e + Age + 11-12 + years: + 1 + dose + Tdap + (adolescent + booster) + +

+
+
+

+ + ¢ + 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 + +

+
+
+

+ + e + Age + 13-18 + years + who + have + not + received + Tdap: + + + 1 + dose + Tdap + (adolescent + booster) + +

+
+
+

+ + ¢ + Age + 7-18 + years + not + fully + vaccinated* + with + DTaP: + 1 + dose + + + Tdap + as + part + of + the + catch-up + series + (preferably + the + first + dose); + + + if + additional + doses + are + needed, + use + Td + or + Tdap. + +

+
+
+

+ + ¢ + 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 + +

+
+
+

+ + ¢ + 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. + +

+
+
+

+ + ¢ + For + other + catch-up + guidance, + see + Table + 2. + +

+
+
+

+ + Special + situations + +

+ +

+ + ¢ + 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. + +

+
+
+

+ + ¢ + 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 + + + e + 2-dose + series + at + age + 12-15 + months, + 4-6 + years + + + ¢ + VAR + or + MMRV + may + be + administered* + +

+
+
+

+ + ¢ + 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 + + + ¢ + 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. + +

+
+
+

+ + Page + 14 + +

+
+
+ +
+
+

+ + Appendix + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + 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 + Influenza + with + Vaccines: + + + Recommendations + of + the + Advisory + Committee + on + Immunization + Practices—United + States, + 2024-25 + Influenza + Season + | + MMWR + (cdc.gov), + and + Contraindications + and + Precautions + for + COVID-19 + Vaccination + +

+
+
+

+ + Vaccines + and + other + +

+
+
+
+

+ + I + a + Contraindicated + or + Not + Recommended’ + Precautions” + +

+ +

+ + mmunizing + Agents + +

+ +

+ + COVID-19 + mRNA + vaccines + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + component + of + + + Diagnosed + non-severe + allergy + (e.g., + urticaria + beyond + the + injection + site) + to + a + + + [Pfizer-BioNTech, + Moderna] + an + mRNA + COVID-19 + vaccine? + 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 + inflammatory + syndrome + in + children + (MIS-C) + or + multisystem + + + inflammatory + syndrome + in + adults + (MIS-A) + +

+ +

+ + + + Moderate + or + severe + acute + illness, + with + or + without + fever + +

+
+
+
+

+ + COVID-19 + protein + subunit + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + component + of + + + Diagnosed + non-severe + allergy + (e.g., + urticaria + beyond + the + injection + site) + toa + + + vaccine + a + Novavax + COVID-19 + vaccine? + component + of + Novavax + COVID-19 + vaccine?; + or + non-severe, + immediate + (onset + + + [Novavax] + 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 + inflammatory + syndrome + in + children + (MIS-C) + or + multisystem + + + inflammatory + syndrome + in + adults + (MIS-A) + + + + + Moderate + or + severe + acute + illness, + with + or + without + fever + +

+
+
+
+
+

+ + Influenza, + egg-based, + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + previous + dose + of + any + influenza + vaccine + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + inactivated + injectable + (IIV3) + (i.e., + any + egg-based + IIV, + ccllV, + RIV, + or + LAIV + of + any + valency) + type + of + influenza + vaccine + +

+ +

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + vaccine + component? + (excluding + egg) + + + Moderate + or + severe + acute + illness + with + or + without + fever + + + Influenza, + cell + culture-based + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + ccllV + of + any + valency, + or + to + any + component? + of + ccllV3 + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + inactivated + injectable + (ccllV3) + type + of + influenza + vaccine + + + [Flucelvax] + + + 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 + ccllV3, + 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 + +

+
+
+
+

+ + Influenza, + recombinant + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + RIV + of + any + valency, + or + to + any + component? + of + RIV3 + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + injectable + (RIV3) + type + of + influenza + vaccine + + + [Flublok] + + + Persons + with + a + history + of + severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + +

+
+
+

+ + dose + of + any + egg-based + IIV, + ccllV, + or + LAIV + of + any + valency. + If + using + RIV3, + 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 + +

+
+
+
+

+ + Influenza, + live + attenuated + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + previous + dose + of + any + influenza + vaccine + + + Guillain-Barré + syndrome + (GBS) + within + 6 + weeks + after + a + previous + dose + of + any + + + (LAIV3) + (i.e., + any + egg-based + IV, + ccllV, + RIV, + or + LAIV + of + any + valency) + type + of + influenza + vaccine + + + [Flumist] + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + to + any + vaccine + component? + (excluding + egg) + - + Asthma + in + persons + age + 5 + years + old + or + older + + + + + Children + age + 2-4 + years + with + a + history + of + asthma + or + wheezing + + + Persons + with + underlying + medical + conditions + other + than + those + listed + under + + + + + Anatomic + or + functional + asplenia + contraindications + that + might + predispose + to + complications + after + wild-type + + + + + Immunocompromised + due + to + any + cause + including, + but + not + limited + to, + medications + and + HIV + infection + influenza + virus + infection, + e.g., + chronic + pulmonary, + cardiovascular + (except + isolated + + + + + Close + contacts + or + caregivers + of + severely + immunosuppressed + persons + who + require + a + protected + environment + hypertension), + renal, + hepatic, + neurologic, + hematologic, + or + metabolic + disorders + + + - + Pregnancy + (including + diabetes + mellitus) + + + + + Cochlear + implant + + + Moderate + or + severe + acute + illness + with + or + without + fever + +

+
+
+

+ + + + Active + communication + between + the + cerebrospinal + fluid + (CSF) + and + the + oropharynx, + nasopharynx, + nose, + + + ear + or + any + other + cranial + CSF + leak + +

+ +

+ + + + Children + and + adolescents + receiving + aspirin + or + salicylate-containing + medications + +

+ +

+ + + + Received + influenza + antiviral + medications + oseltamivir + or + zanamivir + within + the + previous + 48 + hours, + + + peramivir + within + the + previous + 5 + days, + or + baloxavir + within + the + previous + 17 + days + +

+
+
+
+

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

+ +

+ + 4. + 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. + +

+
+
+

+ + Page + 15 + +

+
+
+ +
+
+
+

+ + Appendix + +

+
+
+

+ + Vaccines + and + other + + + Immunizing + Agents + +

+
+
+

+ + Dengue + (DEN4CYD) + +

+
+
+

+ + Diphtheria, + tetanus, + pertussis + (DTaP) + +

+
+
+

+ + raindicated + or + Not + Recommended! + +

+
+
+

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

+ +

+ + + + Severe + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + +

+ +

+ + + + Lack + of + laboratory + confirmation + of + a + previous + dengue + infection + +

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + vaccine + component? + + + + + Encephalopathy + (e.g., + coma, + decreased + level + of + consciousness, + prolonged + seizures) + not + attributable + to + another + +

+
+
+

+ + identifiable + cause + within + 7 + days + of + admin + +

+
+
+

+ + istration + of + previous + dose + of + DTP + or + DTaP + +

+
+
+

+ + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + Precautions” + +

+
+
+

+ + + + Pregnancy + + + + + HlV + infection + without + evidence + of + severe + immunosuppression + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + +

+
+
+

+ + + + 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 + clarified + and + stabilized + +

+ +

+ + + + Moderate + or + severe + acute + illness + with + or + without + fever + +

+
+
+
+

+ + Haemophilus + influenzae + type + b + (Hib) + +

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + Younger + than + age + 6 + weeks + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + +

+
+
+

+ + + + 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) + +

+
+
+

+ + Hepatitis + A-Hepatitis + B + vaccine + (HepA-HepB) + + + [Twinrix] + +

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + Pregnancy: + PreHevbrio + is + not + recommend + + + HepB + is + indicated* + +

+
+
+

+ + + + Severe + allergic + reaction + + + yeast + +

+
+
+

+ + ‘e.g., + anaphylaxis) + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + including + yeast + + + led + due + to + lack + of + safety + data + in + pregnant + persons. + Use + other + hepatitis + B + vaccines + if + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + including + neomycin + and + +

+
+
+

+ + + + Moderate + or + severe + acute + illness + with + or + without + fever + +

+
+
+

+ + + + 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 + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + +

+
+
+

+ + + + Pregnancy + +

+
+
+

+ + + + Family + history + of + altered + immunocompetence, + unless + verified + clinically + or + by + laboratory + testing + as + immunocompetent + +

+
+
+

+ + + + For + MMRV + only: + HIV + infection + of + any + seve' + +

+
+
+

+ + rity + +

+
+
+

+ + + + Recent + (<11 + months) + receipt + of + antibody-containing + blood + product + (specific + 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 + +

+ +

+ + + + If + using + MMRV, + see + Varicella/MMRV + for + additional + precautions + +

+
+
+
+

+ + Meningococcal + ACWY + (MenACWY) + + + MenACWY-CRM + [Menveo] + + + MenACWY-TT + [MenQuadfi] + +

+
+
+

+ + Meningococcal + B + (MenB) + + + MenB-4C + [Bexsero] + + + MenB-FHbp + [Trumenba] + +

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis: + + + + + For + Men + ACWY-CRM + only: + severe + allergic + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + + + reaction + to + any + diphtheria + toxoid— + or + CRM197—containing + vaccine + +

+
+
+

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

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + +

+
+
+

+ + + + For + MenACWY-CRM + only: + Preterm + birth + if + younger + than + age + 9 + months + + + + + Moderate + or + severe + acute + illness + with + or + without + fever + +

+
+
+

+ + + + 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: + + + + + Severe + allergic + reaction + to + a + tetanus + toxoi + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + + + d-containing + vaccine + +

+
+
+

+ + + + Moderate + or + severe + acute + illness, + with + or + without + fever + +

+
+
+
+

+ + Mpox + UJynneos] + +

+
+
+

+ + + + 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 + + + + + Severe + allergic + reaction + +

+
+
+

+ + e.g., + anaphylaxis + + + e.g., + anaphylaxis + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + + + 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 + + + + + Severe + combined + immunodeficiency + (SC + + + + + History + of + intussusception + +

+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + + + ID) + +

+
+
+

+ + + + Altered + immunocompetence + other + than + SCID + +

+ +

+ + + + Chronic + gastrointestinal + disease + +

+ +

+ + + + RV1 + only: + Spina + bifida + 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: + + + + + For + Tdap + only: + Encephalopathy + (e.g., + com: + +

+
+
+
+

+ + after + a + previous + dose + or + to + a + vaccine + component? + + + a, + decreased + level + of + consciousness, + prolonged + seizures) + not + attributable + to + +

+
+
+

+ + another + identifiable + 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) + + + Measles, + mumps, + rubella, + and + varicella + + + (MMRV) + +

+
+
+

+ + + + Severe + allergic + reaction + (e.g., + anaphylaxis) + after + a + previous + dose + or + to + a + vaccine + component? + + + + + Severe + immunodeficiency + (e.g., + hematologic + and + solid + tumors, + receipt + of + chemotherapy, + congenital + immunodeficiency, + + + long-term + immunosuppressive + therapy + or + patients + with + HIV + infection + who + are + severely + immunocompromised) + +

+
+
+

+ + + + Pregnancy + +

+
+
+

+ + + + Family + history + of + altered + immunocompetence, + unless + verified + clinically + or + by + laboratory + testing + as + immunocompetent + +

+
+
+

+ + + + For + MMRV + only: + HIV + infection + of + any + seve + +

+
+
+

+ + rity + +

+
+
+

+ + + + Recent + (<11 + months) + receipt + of + antibody-containing + blood + product + (specific + interval + depends + on + product) + +

+ +

+ + + + Receipt + of + specific + 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. + +

+ +

+ + 2. + When + a + precaution + is + present, + vaccination + should + generally + be + deferred + but + might + be + indicated + if + the + benefit + 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. + www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. + +

+ +

+ + 3. + Vaccination + providers + should + check + FDA-approved + prescribing + information + for + the + most + complete + and + updated + information, + including + contraindications, + warnings, + and + precautions. + Package + inserts + for + U.S.-licensed + vaccines + are + available + at + + + www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states. + +

+ +

+ + 4. + For + information + on + the + pregnancy + exposure + registry + for + persons + who + were + inadvertently + vaccinated + with + PreHevbrio + while + pregnant, + please + visit + www.prehevbrio.com/#safety. + +

+ +

+ + 5. + Full + prescribing + information + for + BEYFORTUS + (nirsevimab-alip) + www.accessdata.fda.gov/drugsatfda_docs/label/2023/761328sO000IbI.pdf. + +

+
+
+

+ + Page + 16 + +

+
+
+ +
+
+

+ + MYolel-yale(¥laaM + Recommended + Child + and + Adolescent + Immunization + Schedule + for + Ages + 18 + Years + or + Younger, + United + States, + 2025 + +

+
+
+

+ + 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 + 24, + 2024. + The + following + + + recommendations + have + been + adopted + by + the + CDC + Director + and + are + now + official. + Links + are + provided + if + these + recommendations + have + been + published + in + Morbidity + and + Mortality + Weekly + Report + (MMWR). + +

+
+
+
+

+ + Vaccines + Recommendations + Effective + Date + of + Recommendation* + +

+
+
+

+ + No + new + vaccines + or + vaccine + recommendations + to + report + +

+
+
+
+
+

+ + *The + effective + date + is + the + date + when + the + CDC + director + adopted + the + recommendation + and + when + the + ACIP + recommendation + became + official. + Page + 17 + +

+
+
+ + \ No newline at end of file diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_pageindex.json.gz b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_pageindex.json.gz new file mode 100644 index 0000000..3154b74 Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_pageindex.json.gz differ diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_searchtext.txt.gz b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_searchtext.txt.gz new file mode 100644 index 0000000..06e45bc Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_hocr_searchtext.txt.gz differ diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_page_numbers.json b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_page_numbers.json new file mode 100644 index 0000000..d6e275f --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_page_numbers.json @@ -0,0 +1,127 @@ +{ + "identifier": "cdc-0-18yrs-immunization-schedule-2025", + "format-version": "2", + "archive-hocr-tools-version": "1.1.54", + "confidence": 76, + "pages": [ + { + "leafNum": 0, + "confidence": null, + "pageNumber": "", + "pageProb": null, + "wordConf": null + }, + { + "leafNum": 1, + "confidence": 74, + "pageNumber": "2", + "pageProb": 64, + "wordConf": 95 + }, + { + "leafNum": 2, + "confidence": 76, + "pageNumber": "3", + "pageProb": 66, + "wordConf": 95 + }, + { + "leafNum": 3, + "confidence": 75, + "pageNumber": "4", + "pageProb": 65, + "wordConf": 95 + }, + { + "leafNum": 4, + "confidence": 76, + "pageNumber": "5", + "pageProb": 66, + "wordConf": 90 + }, + { + "leafNum": 5, + "confidence": 77, + "pageNumber": "6", + "pageProb": 67, + "wordConf": 94 + }, + { + "leafNum": 6, + "confidence": 77, + "pageNumber": "7", + "pageProb": 67, + "wordConf": 95 + }, + { + "leafNum": 7, + "confidence": 75, + "pageNumber": "8", + "pageProb": 65, + "wordConf": 96 + }, + { + "leafNum": 8, + "confidence": 79, + "pageNumber": "9", + "pageProb": 69, + "wordConf": 94 + }, + { + "leafNum": 9, + "confidence": 77, + "pageNumber": "10", + "pageProb": 67, + "wordConf": 93 + }, + { + "leafNum": 10, + "confidence": 76, + "pageNumber": "11", + "pageProb": 66, + "wordConf": 96 + }, + { + "leafNum": 11, + "confidence": 77, + "pageNumber": "12", + "pageProb": 67, + "wordConf": 96 + }, + { + "leafNum": 12, + "confidence": 79, + "pageNumber": "13", + "pageProb": 69, + "wordConf": 96 + }, + { + "leafNum": 13, + "confidence": 73, + "pageNumber": "14", + "pageProb": 63, + "wordConf": 96 + }, + { + "leafNum": 14, + "confidence": 77, + "pageNumber": "15", + "pageProb": 67, + "wordConf": 93 + }, + { + "leafNum": 15, + "confidence": 75, + "pageNumber": "16", + "pageProb": 65, + "wordConf": 96 + }, + { + "leafNum": 16, + "confidence": 76, + "pageNumber": "17", + "pageProb": 66, + "wordConf": 95 + } + ] +} \ No newline at end of file diff --git a/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_scandata.xml b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_scandata.xml new file mode 100644 index 0000000..a511bf9 --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/CDC 0-18yrs Immunization Schedule 2025_scandata.xml @@ -0,0 +1,249 @@ + + + + 300 + cdc-0-18yrs-immunization-schedule-2025 + 17 + 5 + + + + Title + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + true + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 2 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 3 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 4 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 5 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 6 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 7 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 8 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 9 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 10 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 11 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 12 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 13 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 14 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 15 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 16 + + + Normal + true + 3301 + 2550 + + 0 + 0 + 3301 + 2550 + + 300 + 17 + + + \ No newline at end of file diff --git a/other_reports/Vaccine Schedule 2025/__ia_thumb.jpg b/other_reports/Vaccine Schedule 2025/__ia_thumb.jpg new file mode 100644 index 0000000..0e394b6 Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/__ia_thumb.jpg differ diff --git a/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025.zip b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025.zip new file mode 100644 index 0000000..d7065ce Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025.zip differ diff --git a/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_archive.torrent b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_archive.torrent new file mode 100644 index 0000000..fb1acec --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_archive.torrent @@ -0,0 +1,5 @@ +d8:announce36:http://bt1.archive.org:6969/announce13:announce-listll36:http://bt1.archive.org:6969/announceel36:http://bt2.archive.org:6969/announceee7:comment710:This content hosted at the Internet Archive at https://archive.org/details/cdc-0-18yrs-immunization-schedule-2025 +Files may have changed, which prevents torrents from downloading correctly or completely; please check for an updated torrent at https://archive.org/download/cdc-0-18yrs-immunization-schedule-2025/cdc-0-18yrs-immunization-schedule-2025_archive.torrent +Note: retrieval usually requires a client that supports webseeding (GetRight style). +Note: many Internet Archive torrents contain a 'pad file' directory. This directory and the files within it may be erased once retrieval completes. +Note: the file cdc-0-18yrs-immunization-schedule-2025_meta.xml contains metadata about this torrent's contents.10:created by15:ia_make_torrent13:creation datei1739215741e4:infod11:collectionsl50:org.archive.cdc-0-18yrs-immunization-schedule-2025e5:filesld5:crc328:a0fc57116:lengthi1087499e3:md532:c6343b5c5e1056ea961fe471760f7b055:mtime10:17392143344:pathl52:CDC 0-18yrs Immunization Schedule 2025_chocr.html.gze4:sha140:50c4d56e62d1ca2583cb570d4211f99268fd1703ed5:crc328:16ee52de6:lengthi83578e3:md532:ffc37fc0d51ca1d277ae01ed2c49bf235:mtime10:17392143914:pathl47:CDC 0-18yrs Immunization Schedule 2025_djvu.txte4:sha140:9e0fa20bad3c82096fb1ab91c3014f969d30c2baed5:crc328:3c08c1ed6:lengthi1010014e3:md532:c772bb89b99966abebf4dae42ac2cc675:mtime10:17392143604:pathl47:CDC 0-18yrs Immunization Schedule 2025_djvu.xmle4:sha140:2977fca5031eb2b49df472e81b34d2b50bd0a95aed5:crc328:6d46415c6:lengthi1905789e3:md532:a39a1f838b1e6525f9acc8f21e74239a5:mtime10:17392143484:pathl48:CDC 0-18yrs Immunization Schedule 2025_hocr.htmle4:sha140:6374225b2b28cf5222949c44db5b0ecc079f8d26ed5:crc328:a0e524906:lengthi230e3:md532:6f3412b944c0ddcc2010a0b4343c39c45:mtime10:17392143684:pathl61:CDC 0-18yrs Immunization Schedule 2025_hocr_pageindex.json.gze4:sha140:5debd866ece51fa5dba9308816a8c8086aa7dfafed5:crc328:5c32246e6:lengthi19412e3:md532:13e2401b88c1d004162af1509f9741615:mtime10:17392143824:pathl61:CDC 0-18yrs Immunization Schedule 2025_hocr_searchtext.txt.gze4:sha140:27c8c77da3b137f941f1bbdb4f0c3d771d643842ed5:crc328:fcf7f8856:lengthi2967e3:md532:e59fa1d801b6803bc7fbf744fe92a0145:mtime10:17392144194:pathl56:CDC 0-18yrs Immunization Schedule 2025_page_numbers.jsone4:sha140:b5623b0fe80f96dbec239a5dd5e60fadb6b1b0d7ed5:crc328:c9fd9f9a6:lengthi6256e3:md532:a84f760234331337adfaa328fd898ea75:mtime10:17392144194:pathl51:CDC 0-18yrs Immunization Schedule 2025_scandata.xmle4:sha140:2ae0c6cd92ac5decba573f6e9d39d94440a40230ed5:crc328:ac53c15e6:lengthi11728e3:md532:02075f77504c61ff284729499fb3c8e65:mtime10:17392144474:pathl14:__ia_thumb.jpge4:sha140:80b23faaa963f611bfaeaecf04ac8e34d2a1047aed5:crc328:641289006:lengthi20480e3:md532:e1bcf7f9a47f420172ebe89bbaca41fe5:mtime10:17392157384:pathl50:cdc-0-18yrs-immunization-schedule-2025_meta.sqlitee4:sha140:d1170ad730a7bdaeee73eb63736fe46e84eecd41ed5:crc328:909b29596:lengthi1789e3:md532:3ede1237b0393f97a34f87d27f824a775:mtime10:17392144194:pathl47:cdc-0-18yrs-immunization-schedule-2025_meta.xmle4:sha140:c33976bcda3ae81953e9ee1327e687c12ace845cee4:name38:cdc-0-18yrs-immunization-schedule-202512:piece lengthi524288e6:pieces160:[ 8#kt`0J|NĉVĹC WnuNlD\vq=JE j5]!_{9a!l҂C}NP.,Mkb}j0^fG@X;']> F&HέT9I3e6:locale2:en5:title38:cdc-0-18yrs-immunization-schedule-20258:url-listl29:https://archive.org/download/40:http://ia600808.us.archive.org/34/items/40:http://ia800808.us.archive.org/34/items/ee \ No newline at end of file diff --git a/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_files.xml b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_files.xml new file mode 100644 index 0000000..c860a65 --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_files.xml @@ -0,0 +1,145 @@ + + + + tesseract 5.3.0-6-g76ae + lang-eng;two-pass-disabled;pass-dpi-disabled;autonomous-mode-disabled;binarisation-method-otsu + 0.0.21 + Latin + 1.0000 + en + 1.0000 + chOCR + CDC 0-18yrs Immunization Schedule 2025_jp2.zip + 1739214334 + 1087499 + c6343b5c5e1056ea961fe471760f7b05 + a0fc5711 + 50c4d56e62d1ca2583cb570d4211f99268fd1703 + + + DjVuTXT + CDC 0-18yrs Immunization Schedule 2025_djvu.xml + 1739214391 + 83578 + ffc37fc0d51ca1d277ae01ed2c49bf23 + 16ee52de + 9e0fa20bad3c82096fb1ab91c3014f969d30c2ba + + + Djvu XML + CDC 0-18yrs Immunization Schedule 2025_hocr.html + 1739214360 + 1010014 + c772bb89b99966abebf4dae42ac2cc67 + 3c08c1ed + 2977fca5031eb2b49df472e81b34d2b50bd0a95a + + + 1.3.0 + 1.1.56 + lang-eng;two-pass-disabled;pass-dpi-disabled;autonomous-mode-disabled;binarisation-method-otsu + 0.0.21 + Latin + 1.0000 + en + 1.0000 + hOCR + CDC 0-18yrs Immunization Schedule 2025_chocr.html.gz + 1739214348 + 1905789 + a39a1f838b1e6525f9acc8f21e74239a + 6d46415c + 6374225b2b28cf5222949c44db5b0ecc079f8d26 + + + 1.1.0 + 1.1.56 + OCR Page Index + CDC 0-18yrs Immunization Schedule 2025_hocr.html + 1739214368 + 230 + 6f3412b944c0ddcc2010a0b4343c39c4 + a0e52490 + 5debd866ece51fa5dba9308816a8c8086aa7dfaf + + + 1.2.0 + 1.1.56 + 44 + 21 + 46 + 71 + 78 + 117 + 86 + 95 + 515 + 11193 + OCR Search Text + CDC 0-18yrs Immunization Schedule 2025_hocr.html + 1739214382 + 19412 + 13e2401b88c1d004162af1509f974161 + 5c32246e + 27c8c77da3b137f941f1bbdb4f0c3d771d643842 + + + 1.0.5 + 1.1.54 + 76 + Page Numbers JSON + CDC 0-18yrs Immunization Schedule 2025_hocr.html + 1739214419 + 2967 + e59fa1d801b6803bc7fbf744fe92a014 + fcf7f885 + b5623b0fe80f96dbec239a5dd5e60fadb6b1b0d7 + + + Scandata + CDC 0-18yrs Immunization Schedule 2025_djvu.xml + 1739214419 + 6256 + a84f760234331337adfaa328fd898ea7 + c9fd9f9a + 2ae0c6cd92ac5decba573f6e9d39d94440a40230 + + + 1739214447 + 11728 + 02075f77504c61ff284729499fb3c8e6 + ac53c15e + 80b23faaa963f611bfaeaecf04ac8e34d2a1047a + Item Tile + + + bdea1589633fd7681e3ba0afe90e9fbde5ce2e11 + 1739215741 + 3680 + 77645b4b26c290f9a12a3b881475a615 + 83b16191 + fc38fd3a59e575f5f46f14dbe5d3410929efc375 + Archive BitTorrent + + + Metadata + 38db6eea0797da53502b0ad6f99f3f78 + md5 + + + 1739215738 + 20480 + e1bcf7f9a47f420172ebe89bbaca41fe + 64128900 + d1170ad730a7bdaeee73eb63736fe46e84eecd41 + Metadata + + + 1739214419 + 1789 + 3ede1237b0393f97a34f87d27f824a77 + 909b2959 + c33976bcda3ae81953e9ee1327e687c12ace845c + Metadata + + diff --git a/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.sqlite b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.sqlite new file mode 100644 index 0000000..cf54ef1 Binary files /dev/null and b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.sqlite differ diff --git a/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.xml b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.xml new file mode 100644 index 0000000..79ed38a --- /dev/null +++ b/other_reports/Vaccine Schedule 2025/cdc-0-18yrs-immunization-schedule-2025_meta.xml @@ -0,0 +1,35 @@ + + + cdc-0-18yrs-immunization-schedule-2025 + texts + opensource + U.S. Centers for Disease Control and Prevention + 2024-11-21 + <p class="p1" style="margin:0px;font-size:13px;line-height:normal;font-family:'Helvetica Neue';">Recommended child and adolescent immunization schedule for ages 18 years or younger.</p> + eng + Internet Archive HTML5 Uploader 1.7.0 + CDC + vaccines + immunizations + public health + preventive care + NCIRD + ACIP + CDC 0-18yrs Immunization Schedule 2025 + jaredleighton@gmail.com + 2025-02-10 19:01:20 + 2025-02-10 19:01:20 + [curator]validator@archive.org[/curator][date]20250210190207[/date][comment]checked for malware[/comment] + http://archive.org/details/cdc-0-18yrs-immunization-schedule-2025 + ark:/13960/s24w2bmtvsg + 300 + tesseract 5.3.0-6-g76ae + -l eng + 0.0.21 + Latin + 1.0000 + en + 1.0000 + 76 + 1.0.5 +