What is the recommended vaccine schedule for children and adults?

Recommended Vaccine Schedules for Children and Adults

The American Academy of Pediatrics (AAP) recommends a comprehensive vaccination schedule for all infants, children, and adults, with specific timing for each vaccine to maximize protection against vaccine-preventable diseases and reduce morbidity and mortality. 1

Childhood Vaccination Schedule (0-18 years)

Birth to 6 Months

• Hepatitis B (HepB): First dose within 24 hours of birth, second dose at 1-2 months, third dose at 6-18 months 1, 2
• Rotavirus (RV): First dose at 2 months, second dose at 4 months, must start by 12 weeks of age and complete by 32 weeks 1
• Diphtheria, Tetanus, acellular Pertussis (DTaP): First dose at 2 months, second dose at 4 months, third dose at 6 months 1
• Haemophilus influenzae type b (Hib): First dose at 2 months, second dose at 4 months, third dose at 6 months (if using PRP-OMP [PedvaxHIB], third dose may not be required) 1
• Pneumococcal conjugate (PCV): First dose at 2 months, second dose at 4 months, third dose at 6 months 1
• Inactivated Poliovirus (IPV): First dose at 2 months, second dose at 4 months 1

6-18 Months

• Influenza: Annual vaccination starting at 6 months; children under 8 years receiving influenza vaccine for the first time should receive two doses separated by at least 4 weeks 1, 3
• IPV: Third dose at 6-18 months 1

12-15 Months

• MMR (Measles, Mumps, Rubella): First dose at 12-15 months 1, 3
• Varicella: First dose at 12-15 months 1, 3
• Hepatitis A (HepA): First dose at 12 months 1, 3
• Hib: Final booster dose at 12-15 months 1
• PCV: Final dose at 12-15 months 1

15-18 Months

• DTaP: Fourth dose at 15-18 months 1

4-6 Years

• DTaP: Fifth and final dose in the series 1, 3
• IPV: Fourth and final dose 1, 3
• MMR: Second dose 3
• Varicella: Second dose 3

11-12 Years

• Tdap: One dose 1
• Human papillomavirus (HPV): Two-dose series 1, 3
• Meningococcal conjugate (MenACWY): First dose 1, 3

16 Years

• MenACWY: Second dose (booster) 1
• Meningococcal B (MenB): Two-dose series may be administered based on clinical discretion for ages 16-23 years 1, 4

Adult Vaccination Schedule

• Influenza: Annual vaccination 1
• Tdap/Td: Tdap once, then Td or Tdap booster every 10 years 1
• HPV: Recommended through age 26 if not adequately vaccinated previously 1
• Pneumococcal: Based on age and risk factors 1
• Hepatitis A and B: For those not previously vaccinated and at risk 1
• MMR: For adults born after 1957 without evidence of immunity 1
• Varicella: For adults without evidence of immunity 1

Special Considerations

Pregnant Women

• Tdap: One dose during each pregnancy, preferably between 27-36 weeks gestation 1, 4
• Influenza: Recommended during flu season 1

Catch-up Vaccination

• For children and adolescents who start late or are >1 month behind, follow catch-up schedules to bring them current with recommended vaccines 1, 4
• A vaccine series does not need to be restarted, regardless of the time elapsed between doses 1

High-Risk Groups

• Children with specific medical conditions may require additional vaccines or modified schedules 4
• Hemodialysis patients require higher doses of certain vaccines, such as hepatitis B 2
• Children with asplenia, complement deficiencies, or HIV infection have specific recommendations for meningococcal vaccination 4

Common Pitfalls in Vaccine Administration

1. Missing opportunities for simultaneous administration: When multiple vaccines are due, they should be given during the same visit 1
2. Restarting vaccine series unnecessarily: A series never needs to be restarted, regardless of time elapsed between doses 1
3. Not following catch-up schedules: Children who are behind should be brought up-to-date as quickly as possible following minimum interval guidelines 1
4. Delaying vaccines without medical indication: This leaves children vulnerable to preventable diseases 5
5. Improper storage or administration technique: Can reduce vaccine efficacy 2

Vaccination Coverage and Importance

National vaccination coverage by age 24 months is at least 90% for poliovirus vaccine, MMR, hepatitis B, and varicella, although MMR coverage is below 90% in 20 states 5. Only 1.3% of children born in 2015 and 2016 had received no vaccinations by their second birthday 5. Maintaining high vaccination rates is crucial for preventing outbreaks of vaccine-preventable diseases.