Purpose
Guide health care providers in determining recommended catch-up schedule for children/adolescents whose vaccination is delayed.
How to use the schedule
To make vaccination recommendations, healthcare providers should:
- Determine recommended vaccine by age (Table 1 – By Age)
- Determine recommended interval for catch-up vaccination (Table 2 - Catch-up)
- Assess need for additional recommended vaccines by medical condition or other indication (Table 3 – By Medical Indication)
- Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Vaccine Catch-Up Guidance
CDC has developed catch-up guidance job aids to assist healthcare providers in interpreting Table 2 in the child and adolescent immunization schedule.
Download the Schedule
Children age 4 months through 6 years
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 | Minimum Age for Dose 1 | Minimum Interval Between Doses | |||
|---|---|---|---|---|---|
| Dose 1 to Dose 2 | Dose 2 to Dose 3 | Dose 3 to Dose 4 | Dose 4 to Dose 5 | ||
Hepatitis B  |
Birth | 4 weeks | 8 weeks and at least 16 weeks after first dose. Minimum age for the final dose is 24 weeks | ||
| Rotavirus |
6 weeks Maximum age for first dose is 14 weeks, 6 days. | 4 weeks | 4 weeks Maximum age for final dose is 8 months, 0 days | ||
| Diphtheria, tetanus, and acellular pertussis |
6 weeks | 4 weeks | 4 weeks | 6 months | 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 |
| Haemophilus influenzae type b |
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. |
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 |
8 weeks (as final dose) This dose only necessary for children age 12 through 59 months who received 3 doses before the 1st birthday. | |
| Pneumococcal conjugate |
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 |
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 |
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. | |
| Inactivated poliovirus |
6 weeks | 4 weeks | 4 weeks
if current age is <4 years
6 months (as final dose)
if current age is 4 years or older |
6 months (minimum age 4 years for final dose) | |
| Measles, mumps, rubella |
12 months | 4 weeks | |||
| Varicella |
12 months | 3 months | |||
| Hepatitis A |
12 months | 6 months | |||
| Meningococcal ACWY |
2 months MenACWY-CRM 2 years MenACWY-TT | 8 weeks | See Notes | See Notes | |
Children and adolescents age 7 through 18 years
| Vaccine | Minimum Age for Dose 1 | Minimum Interval Between Doses | |||
|---|---|---|---|---|---|
| Dose 1 to Dose 2 | Dose 2 to Dose 3 | Dose 3 to Dose 4 | |||
| Meningococcal ACWY |
Not Applicable (N/A) | 8 weeks | |||
| Tetanus, diphtheria; tetanus, diphtheria, and acellular pertussis |
7 years | 4 weeks | 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 |
6 months if first dose of DTaP/DT was administered before the 1st birthday |
|
| Human papillomavirus |
9 years | Routine dosing intervals are recommended. | |||
| Hepatitis A |
N/A | 6 months | |||
| Hepatitis B |
N/A | 4 weeks | 8 weeks and at least 16 weeks after first dose. | ||
| Inactivated poliovirus |
N/A | 4 weeks | 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. |
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. | |
| Measles, mumps, rubella |
N/A | 4 weeks | |||
| Varicella |
N/A | 3 months if younger than age 13 years.
4 weeks if age 13 years or older |
|||
| Dengue |
9 years | 6 months | 6 months | ||
- Determine recommended vaccine by age (Table 1 – By Age)
- Determine recommended interval for catch-up vaccination (Table 2 - Catch-up)
- Assess need for additional recommended vaccines by medical condition or other indication (Table 3 – By Medical Indication)
- Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Additional Information
Recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American College of Nurse-Midwives (ACNM), American Academy of Physician Associates (AAPA), and National Association of Pediatric Nurse Practitioners (NAPNAP).
Report
- Suspected cases of reportable vaccine-preventable diseases or outbreaks to your state or local health department
- Clinically significant adverse events to the Vaccine Adverse Event Reporting System (VAERS) at www.vaers.hhs.gov or (800-822-7967)
Questions or comments
Contact www.cdc.gov/cdc-info or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 a.m.–8 p.m. ET, Monday through Friday, excluding holidays.
Helpful information
- Complete Advisory Committee on Immunization Practices (ACIP) recommendations
- ACIP Shared Clinical Decision-Making Recommendations
- General Best Practice Guidelines for Immunization (including contraindications and precautions)
- Vaccine information statements
- Manual for the Surveillance of Vaccine-Preventable Diseases (including case identification and outbreak response)
Content Source:
National Center for Immunization and Respiratory Diseases