Childhood Immunization Schedule, United States, 2009
to download/view the schedule
This schedule indicates the recommended ages for routine
administration of currently licensed childhood vaccines, as of 2009 for children through age 18 years. Any dose not
given at the recommended age should be given at any subsequent visit
when indicated and feasible. Additional vaccines may be licensed
and recommended during the year. Licensed combination vaccines may
be used whenever any components of the combination are indicated and
the vaccine's other components are not contraindicated. Providers
should consult the manufacturers' package inserts for detailed
- Hepatitis B vaccine (Hep B). All infants should receive
the first dose of hepatitis B vaccine soon after birth and
before hospital discharge; the first dose may also be given by
age 2 months if the infant's mother is HBsAg-negative. Only
monovalent hepatitis B vaccine can be used for the birth dose.
Monovalent or combination vaccine containing Hep B may be used
to complete the series; four doses of vaccine may be
administered if combination vaccine is used. The second dose
should be given at least four weeks after the first dose, except
for Hib-containing vaccine which cannot be administered before
age 6 weeks. The third dose should be given at least 16 weeks
after the first dose and at least eight weeks after the second
dose. The last dose in the vaccination series (third or fourth
dose) should not be administered before age 6 months.
Infants born to HBsAg-positive mothers should
receive hepatitis B vaccine and 0.5 mL hepatitis B immune
globulin (HBIG) within 12 hours of birth at separate sites. The
second dose is recommended at age 1 to 2 months and the
vaccination series should be completed (third or fourth dose) at
age 6 months.
Infants born to mothers whose HBsAg status is unknown
should receive the first dose of the hepatitis B vaccine series
within 12 hours of birth. Maternal blood should be drawn at the
time of delivery to determine the mother's HBsAg status; if the
HBsAg test is positive, the infant should receive HBIG as soon
as possible (no later than age 1 week).
- Diphtheria and tetanus toxoids and acellular pertussis
vaccine (DTaP). The fourth dose of DTaP may be administered
as early as age 12 months, provided six months have elapsed
since the third dose and the child is unlikely to return at age
15 to 18 months. Tetanus and diphtheria toxoids (Td) is
recommended at age 11 to 12 years if at least five years have
elapsed since the last dose of tetanus and diphtheria toxoid-containing
vaccine. Subsequent routine Td boosters are recommended every 10
- Haemophilus influenzae type b (Hib) conjugate
vaccine. Three Hib conjugate vaccines are licensed for
infant use. If PRP-OMP (PedvaxHIB® or ComVax® [Merck]) is
administered at ages 2 and 4 months, a dose at age 6 months is
not required. DTaP/Hib combination products should not be used
for primary immunization in infants at ages 2, 4 or 6 months,
but can be used as boosters following any Hib vaccine.
- Inactivated polio vaccine (IPV). An all-IPV schedule is
recommended for routine childhood polio vaccination in the
United States. All children should receive four doses of IPV at
ages 2 months, 4 months, 6 to 18 months and 4 to 6 years.
- Measles, mumps, and rubella vaccine (MMR). The second
dose of MMR is recommended routinely at age 4 to 6 years but may
be administered during any visit, provided at least four weeks
have elapsed since the first dose and that both doses are
administered beginning at or after age 12 months. Those who have
not previously received the second dose should complete the
schedule by the 11-12 year old visit.
- Varicella vaccine. Varicella vaccine is recommended at
any visit at or after age 12 months for susceptible children,
i.e. those who lack a reliable history of chickenpox.
Susceptible persons aged > 13 years should receive two doses,
given at least four weeks apart.
- Pneumococcal vaccine. The heptavalent pneumococcal
conjugate vaccine (PCV) is recommended for all children age 2 to
23 months. It is also recommended for certain children age 24 to
59 months. Pneumococcal polysaccharide vaccine (PPV) is
recommended in addition to PCV for certain high-risk groups. See
- Hepatitis A vaccine. Hepatitis A vaccine is recommended
for use in selected states and regions, and for certain
high-risk groups; consult your local public health authority.
See MMWR 1999;48(RR-12);1-37.
- Influenza vaccine. Influenza vaccine is recommended
annually for children age 6 months and older with certain risk
factors (including but not limited to asthma, cardiac disease,
sickle cell disease, HIV, diabetes; see MMWR
2001;50(RR-4);1-44), and can be administered to all others
wishing to obtain immunity. Children 12 years and younger should
receive vaccine in a dosage appropriate for their age (0.25 mL
if age 6-35 months or 0.5 mL if aged ³ 3 years). Children 8
years and younger or who are receiving influenza vaccine for the
first time should receive two doses separated by at least four
For additional information about vaccines, vaccine supply and
contraindications for immunization, please visit the National
Immunization Program Website at www.cdc.gov/nip
or call the National Immunization Hotline at 1-800-232-2522
(English) or 1-800-232-0233 (Spanish).
Approved by the Advisory Committee on Immunization Practices (www.cdc.gov/nip/acip),
the American Academy of Pediatrics (www.aap.org),
and the American Academy of Family Physicians (www.aafp.org).