Catch-up Immunization Schedule for Children and Adolescents

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 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 given at <7 months old 8 weeks (as final dose for healthy children) if previous dose given 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

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

To make vaccination recommendations, healthcare providers should:

1. Determine recommended vaccine by age (Table 1 – By Age)
2. Determine recommended interval for catch-up vaccination (Table 2 - Catch-up)
3. Assess need for additional recommended vaccines by medical condition or other indication (Table 3 – By Medical Indication)
4. Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)
5. Review contraindications and precautions for vaccine types (Appendix)
6. Review new or updated ACIP guidance (Addendum)

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).

The comprehensive summary of the ACIP recommended changes made to the child and adolescent immunization schedule can be found in the January 11, 2024 MMWR.

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)