Complete Vaccination Series Recommended by Age 18
According to the Advisory Committee on Immunization Practices (ACIP), all children and adolescents should complete specific vaccine series by age 18 to ensure protection against preventable diseases that impact morbidity, mortality, and quality of life. 1
Core Vaccines Required by Age 18
- DTaP/Tdap: 5 doses of DTaP (diphtheria, tetanus, and acellular pertussis) with the final dose at age 4-6 years, followed by 1 dose of Tdap at age 11-12 years 1
- Polio (IPV): 4 doses with the final dose at age 4-6 years 1
- MMR: 2 doses of measles, mumps, and rubella vaccine with the first dose at 12-15 months and the second dose at 4-6 years 1
- Hepatitis B: 3-dose series typically completed in infancy 1
- Varicella: 2 doses with the first dose at 12-15 months and the second dose at 4-6 years 1
- Hepatitis A: 2-dose series with the first dose at 12-23 months and the second dose 6 months later 1
- Meningococcal (MenACWY): 2 doses with the first dose at age 11-12 years and the second dose at age 16 years 1
- HPV: 2-dose series if started before age 15 years (doses at 0 and 6-12 months) or 3-dose series if started at age 15-18 years (doses at 0,1-2, and 6 months) 2, 3
- Influenza: Annual vaccination 1
Additional Vaccines for Specific Risk Groups
- Meningococcal B (MenB): 2 or 3 doses for persons aged ≥10 years with complement deficiency, those who use complement inhibitors, persons with asplenia, microbiologists, or during outbreaks 1
- Haemophilus influenzae type b (Hib): Complete series in infancy; catch-up vaccination not recommended for previously unvaccinated children aged ≥5 years without high-risk conditions 1
- Pneumococcal vaccines: Complete series in infancy; additional doses may be needed for children with certain medical conditions 1
Key Vaccination Timing Considerations
- DTaP: Dose 5 is not necessary if dose 4 was administered at age ≥4 years AND at least 6 months after dose 3 1
- HPV: Starting the series at ages 11-12 years is associated with better completion rates compared to later initiation 4, 3
- Catch-up vaccination: All children and adolescents aged 2-18 years who have not previously received Hepatitis A vaccine should complete a 2-dose series 1
Common Pitfalls to Avoid
- Delaying HPV vaccination: Initiating the HPV vaccine series at the recommended age of 11-12 years leads to better completion rates and stronger immune response 3, 5
- Missing the second MenACWY dose: The booster dose at age 16 is critical for continued protection during the period of highest risk 1, 6
- Assuming vaccination is complete after childhood series: Adolescent vaccines (Tdap, MenACWY, HPV) are essential components of the complete vaccination schedule 1
- Overlooking annual influenza vaccination: This should be administered every year, ideally before the start of flu season 1
Special Considerations
- Immunocompromised individuals: May require modified schedules or additional doses of certain vaccines 1
- Catch-up schedules: Children who fall behind on vaccinations should follow ACIP catch-up schedules to complete their series as quickly as possible 1
- Vaccine documentation: Maintaining accurate records of all vaccines received is essential for ensuring complete vaccination 1