Purpose
Compliant version of the Child and Adolescent Immunization Schedule by Medical Indication
Medical Indication
< < Back to Child & Adolescent Immunization Schedule by Medical Condition
¶ = Recommended for all age-eligible children who lack documentation of a complete vaccination series
§ = Not recommended for all children, but is recommended for some children based on increased risk for or severe outcomes from disease
» = Recommended for all age-eligible children, and additional doses may be necessary based on medical condition or other indications. See Notes.
| = Precaution: Might be indicated if benefit of protection outweighs risk of adverse reaction
± = Contraindicated or not recommended *Vaccinate after pregnancy, if indicated
• = No Guidance/Not Applicable
| Vaccine and other immunizing agents | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Pregnancy | Immunocompromised status (excluding HIV infection) | HIV infection CD4 percentage and counta | CSF leak or cochlear implant | Asplenia or persistent complement component deficiencies | Heart disease or chronic lung disease | Kidney failure, End-stage renal disease or on Dialysis |
Chronic liver disease | Diabetes | ||
| <15% or <200mm | ≥15% and ≥200/mm3 | |||||||||
RSV-mAb  (nirsevimab) |
• | 2nd RSV season » | 1 dose depending on maternal RSV vaccination status, See notes¶ |
2nd RSV season for chronic lung disease (See notes)» |
1 dose depending on maternal RSV vaccination status, See notes¶ | |||||
| Hepatitis B |
¶ | |||||||||
| Rotavirus |
• | | | | | ¶ | ||||||
| SCIDb± | ||||||||||
| DTaP/Tdap |
DTaP• | ¶ | ||||||||
| Tdap: 1 dose each pregnancy» | ||||||||||
| Hib |
• | See notes¶ | ¶ | See notes¶ | ¶ | |||||
| HSCT: 3 doses» | ||||||||||
| Pneumococcal |
• | » | ||||||||
| IPV |
| | ¶ | ||||||||
| COVID-19 |
¶ | See notes¶ | ¶ | |||||||
| IIV4 |
¶ | |||||||||
| LAIV4 |
± | | | | | |||||||
| Asthma, wheezing: 2–4 yearsc± | ||||||||||
| Measles, mumps, rubella |
*± | ± | ¶ | |||||||
| VAR |
*± | ± | ¶ | |||||||
| Hepatitis A |
¶ | |||||||||
| Human papillomavirus |
* | 3 dose series. See notes» | ¶ | |||||||
| Meningococcal ACWY |
¶ | » | ¶ | » | ¶ | |||||
| Meningococcal B |
| | • | » | • | ||||||
| RSV (Abrysvo) |
Seasonal administration, See notes¶ | • | ||||||||
| Dengue |
| | ± | | | § | ||||||
| Mpox |
See notes§ | § | ||||||||
- For additional information regarding HIV laboratory parameters and use of live vaccines, see the General Best Practice Guidelines for Immunization, “Altered Immunocompetence,” and Table 4-1 (footnote J).
- Severe Combined Immunodeficiency
- LAIV4 contraindicated for children 2–4 years of age with asthma or wheezing during the preceding 12 months
Content Source:
National Center for Immunization and Respiratory Diseases