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  » Immunization Schedules  »  Reccomended Childhood Immunization Schedule, United States

Regular checkups at your pediatrician's office or local health clinic are an important way to keep children healthy.

By making sure that your child gets immunized on time, you can provide the best available defense against many dangerous childhood diseases. Immunizations protect children against: hepatitis B, polio, measles, mumps, rubella (German measles), pertussis (whooping cough), diphtheria, tetanus (lockjaw), Haemophilus influenzae type b, pneumococcal infections, and chickenpox. All of these immunizations need to be given before children are 2 years old in order for them to be protected during their most vulnerable period. Are your child's immunizations up-to-date?

The chart below includes immunization recommendations from the American Academy of Pediatrics. Remember to keep track of your child's immunizations -- it's the only way you can be sure your child is up-to-date. Also, check with your pediatrician or health clinic at each visit to find out if your child needs any booster shots or if any new vaccines have been recommended since this schedule was prepared.

If you don't have a pediatrician, call your local health department. Public health clinics usually have supplies of vaccine and may give shots free.

2002 Immunization Schedule

Vaccines Commonly Used in the United States

Name of Vaccine Route of Administration Primary Immunization Schedule Booster Schedule Contraindications Side Effects
IM 2 months,
4 months,
6 months
15-18 months, 4-6 years CNS disease, history of screaming, high fever or seizures after previous DPT Tenderness at injection site, redness at sites, or swelling
TD (Tetanus/Diphtheria) IM   Every 10 years after age 15   Urticaria, anaphylactic reactions
Trivalent Oral Polio Virus
Vaccine (Sabine Vaccine)
PO 2 months,
4 months
18 months and 4-5 years Pregnancy
Rarely, paralytic disease in recipients or contacts
Inactivated Polio Virus
Vaccine (Salk Vaccine)
PO 2 months,
4 months,
16-18 months
Every 5 years Pregnancy Local irritation at injection site
SC 15 months Either at school entry (4-6 yrs) as recommended by the Advisory Committee on Immunization Practices (ACIP) or at junior high school (11-12 yrs) as recommended by the American Association of Pediatrics (AAP) Pregnancy, febrile illness, recently received immune serum globulin (ISG) Immunodeficiency
Irritation at injection site; generalized rash 10-14 days after injection. Fever after 5-12 days
Haemophilus influenzae
SC 2 months,
4 months,
6 months
15 months or older Pregnancy Local irritation at injection site; fever
Hepatitis B
Plasma Derived (HBIG) or Recombinant DNA
IM Babies born to HbsAg-positive mothers should receive HBIG at birth Series of 3 doses protection for 5 years 1 month and 6 months after first injection Only plasma-derived vaccine should be used for immunosuppressed patients Arthralgia, neurological reactions
*DPT, topV, and MMR may be administered simultaneously.
In high risk areas, children can receive the first dose at 12 months. In epidemics, children 6 months and older should be immunized. In these, cases, the school doses are given as described.

1. 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 4 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 8 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 1-2 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).

2. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at age 15-18 months. Tetanus and diphtheria toxoids (Td) is recommended at age 11-12 years if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine. Subsequent routine Td boosters are recommended every 10 years.

3. 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.

4. 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, 6-18 months, and 4-6 years.

5. Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4-6 years but may be administered during any visit, provided at least 4 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.

6. 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 4 weeks apart.

7. Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for all children age 2-23 months. It is also recommended for certain children age 24-59 months. Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain high-risk groups. 2000;49(RR-9):1-35.

8. 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. 1999;48(RR-12):1-37.

9. Influenza vaccine. Influenza vaccine is recommended annually for children age > 6 months 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 aged <12 years should receive vaccine in a dosage appropriate for their age (0.25 mL if age 6-35 months or 0.5 mL if age >3 years). Children aged <8 years who are receiving influenza vaccine for the first time should receive two doses separated by at least 4 weeks.