What vaccines are age-restricted?

Age Restrictions for Vaccines

Several vaccines have specific age restrictions, with some having minimum age requirements and others having maximum age cutoffs beyond which they should not be administered. 1

Vaccines with Minimum Age Requirements

Birth to 6 Weeks

• Hepatitis B (HepB): Minimum age: birth 1, 2
  • First dose typically given at birth
  • Series must be completed by 6-18 months

6 Weeks Minimum Age

• Rotavirus (Rota): Minimum age: 6 weeks 1, 3

  • First dose must be administered between 6-12 weeks
  • Do not start series after 12 weeks of age

• DTaP (Diphtheria, Tetanus, acellular Pertussis): Minimum age: 6 weeks 1, 2

• Haemophilus influenzae type b (Hib): Minimum age: 6 weeks 1, 2

• Pneumococcal Conjugate Vaccine (PCV): Minimum age: 6 weeks 1, 2

• Inactivated Poliovirus Vaccine (IPV): Minimum age: 6 weeks 1, 2

6 Months Minimum Age

• Influenza vaccine (TIV): Minimum age: 6 months 1, 2
  • Children under 9 years receiving for the first time need two doses

12 Months Minimum Age

• MMR (Measles, Mumps, Rubella): Minimum age: 12 months 1, 2

• Varicella: Minimum age: 12 months 1, 2

• Hepatitis A (HepA): Minimum age: 12 months 1, 2

2 Years Minimum Age

• Pneumococcal Polysaccharide Vaccine (PPV): Minimum age: 2 years 1

• Meningococcal Polysaccharide Vaccine (MPSV4): Minimum age: 2 years 1

5 Years Minimum Age

• Live Attenuated Influenza Vaccine (LAIV): Minimum age: 5 years 1

9-11 Years Minimum Age

• HPV Vaccine: Minimum age: 9 years 1, 4

  • Routinely recommended at age 11-12 years
  • Can be started as early as age 9

• Tdap: Minimum age: 10 years for BOOSTRIX® and 11 years for ADACEL™ 1

Vaccines with Maximum Age Restrictions

Rotavirus Vaccine

• Maximum age for first dose: 12 weeks 1, 5
• Maximum age for final dose: 32 weeks 1
• Critical restriction: Do not administer after these age cutoffs due to insufficient safety and efficacy data 1, 3

HPV Vaccine

• Maximum age: 26 years for routine recommendation 1
  • For females: Recommended through age 26 if not previously vaccinated
  • For males: Routinely recommended through age 21, may be given through age 26
  • For men who have sex with men and immunocompromised persons: Recommended through age 26 1

Zoster Vaccine

• While licensed for use in persons aged 50 years or older, ACIP recommends beginning vaccination at age 60 years 1

Common Pitfalls and Caveats

1. Rotavirus vaccine age restrictions are absolute:

   • Missing the window for starting rotavirus vaccine (after 12 weeks) means the series cannot be initiated
   • No doses should be given after 32 weeks of age 1, 5

2. Catch-up vaccination:

   • For most vaccines, if a series is started late or interrupted, there's no need to restart
   • Continue from where the series was interrupted, respecting minimum intervals between doses 1

3. Minimum intervals between doses must be respected:

   • Administering doses too close together may result in suboptimal immune response 2

4. Special populations may have different recommendations:

   • Children with certain medical conditions may need additional doses or different schedules 1
   • American Indian/Alaska Native children may benefit from specific Hib vaccine formulations 2

5. Live vaccines in immunocompromised patients:

   • Live vaccines (MMR, varicella, LAIV) are generally contraindicated in severely immunocompromised individuals 1

Understanding these age restrictions is crucial for ensuring optimal vaccine efficacy and safety while maximizing protection against preventable diseases.