2003 Immunization Schedule
"Recommended by the American Academy of Pediatrics"
Regular checkups at your pediatrician's office or local health clinic
are an important way to keep children healthy.
By making sure that your child gets immunized on time, you can provide
the best available defense against many dangerous childhood diseases.
Immunizations protect children against: hepatitis B, polio, measles, mumps,
rubella (German measles), pertussis (whooping cough), diphtheria, tetanus
(lockjaw), Haemophilus influenzae type b, pneumococcal infections, and
chickenpox. All of these immunizations need to be given before children
are 2 years old in order for them to be protected during their most vulnerable
period. Are your child's immunizations up-to-date?
The chart below includes immunization recommendations from the American
Academy of Pediatrics. Remember to keep track of your child's immunizations
-- it's the only way you can be sure your child is up-to-date. Also,
check with your pediatrician or health clinic at each visit to find out
if your child needs any booster shots or if any new vaccines have been
recommended since this schedule was prepared.
If you don't have a pediatrician, call your local health department.
Public health clinics usually have supplies of vaccine and may give shots free.
1. Hepatitis B vaccine (HepB). All infants should receive the first dose of hepatitis B vaccine soon
after birth and before hospital discharge; the first dose may also be
given by age 2 months if the infant’s mother is HBsAg-negative.
Only monovalent HepB can be used for the birth dose. Monovalent or combination
vaccine containing HepB may be used to complete the series. Four doses
of vaccine may be administered when a birth dose is given. The second
dose should be given at least 4 weeks after the first dose, except for
combination vaccines which cannot be administeredbefore age 6 weeks. The
third dose should be given at least 16 weeks after the first dose and
at least 8 weeks after the second dose. The last dose in the vaccination
series (third or fourth dose) should not be administered before age 6 months.
Infants born to HBsAg-positive mothersshould receive HepB and 0.5 mL Hepatitis
B Immune Globulin (HBIG) within 12 hours of birth at separate sites. The
second dose is recommended at age 1-2 months. The last dose in the vaccination
series should not be administered before age 6 months. These infants should
be tested for HBsAg and anti-HBs at 9-15 months of age.Infants born to
mothers whose HBsAg status is unknownshould receive the first dose of
the HepB series within 12 hours of birth. Maternal blood should be drawn
as soon as possible to determine the mother's HBsAg status; if the
HBsAg test is positive, the infant should receive HBIG as soon as possible
(no later than age 1 week). The second dose is recommended at age 1-2
months. The last dose in the vaccination series should not be administered
before age 6 months.
2. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). The fourth dose of DTaP may be administered as early as age 12 months,
provided 6 months have elapsed since the third dose and the child is unlikely
to return at age 15-18 months. Tetanus and diphtheria toxoids (Td)is recommended
at age 11-12 years if at least 5 years have elapsed since the last dose
of tetanus and diphtheria toxoid-containing vaccine. Subsequent routine
Td boosters are recommended every 10years.
3.Haemophilus influenzaetype b (Hib) conjugate vaccine.Three Hib conjugate vaccines are licensed for infant use. If PRP-OMP (PedvaxHIB®or
ComVax®[Merck]) is administered at ages 2 and 4 months, a dose at
age 6 months is not required. DTaP/Hib combination products should notbe
used for primary immunization in infants at ages 2, 4 or 6 months, but
can be used as boosters following any Hib vaccine.
4. Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended routinely at age 4-6 years but may
be administered during any visit, provided at least 4 weeks have elapsed
since the first dose and that both doses are administered beginning at
or after age 12 months. Those who have not previously received the second
dose should completethe schedule by the 11-12 year old visit.
5. Varicella vaccine.Varicella vaccine is recommended at any visit at or after age 12 months
for susceptible children, i.e. those who lack a reliable history of chickenpox.
Susceptible persons aged =13 years should receive two doses, given at
least 4 weeks apart.
6. Pneumococcal vaccine. The heptavalent pneumococcal conjugatevaccine(PCV)is recommended for all
children age 2-23 months. It is also recommended for certain children
age 24-59 months. Pneumococcal polysaccharide vaccine (PPV)is recommended
in addition to PCV for certain high-risk groups. See MMWR2000;49(RR-9);1-38.
7. Hepatitis A vaccine.Hepatitis A vaccine is recommended for children and adolescents in selected
states and regions, and for certain high-risk groups; consult your local
public health authority. Children and adolescents in these states, regions,
and high risk groups who have not been immunized against hepatitis A can
begin the hepatitis A vaccination series during any visit. The two doses
in the series should be administered at least 6 months apart. See
8. Influenza vaccine. Influenza vaccine is recommended annually for children age =6 months with
certain risk factors (including but not limited toasthma, cardiac disease,
sickle cell disease, HIV, diabetes, and household members of persons in
groups at high risk; see MMWR 2002;51(RR-3);1-31), and can be administered
to all others wishing to obtain immunity. In addition, healthy children
age 6-23 months are encouraged to receive influenza vaccine if feasible
because children in this age group are at substantially increased risk
for influenza-related hospitalizations. Children aged =12 years should
receive vaccine in a dosage appropriate for their age (0.25 mL if age
6-35months or 0.5 mL if aged =3 years). Children aged =8 years who are
receiving influenza vaccine for the first time should receive two doses
separated byat least
For additional information about vaccines, including precautions and contraindications
for immunization and vaccine shortages, please visit the National Immunization
Program Website at
www.cdc.gov/nip or call the National Immunization Information Hotlineat 800-232-2522 (English)
or 800-232-0233 (Spanish).
Approved by the Advisory Committee on Immunization Practices (www.cdc.gov/nip/acip),
the American Academy of Pediatrics (www.aap.org), and the American Academy of Family Physicians (www.aafp.org).