Purpose
Guide health care providers in determining recommended vaccines for specific medical or other indications.
How to use the schedule
To make vaccination recommendations, healthcare providers should:
- Determine recommended vaccine by age (Table 1 – By Age)
- Determine recommended interval for catch-up vaccination (Table 2 – Catch-up)
- Assess need for additional recommended vaccines by medical condition or other indication (Table 3 - By Medical Indication)
- Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Medical Indication
| Recommended for all age-eligible children who lack documentation of a complete vaccination series | Not recommended for all children, but 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 |
Always use this table in conjunction with Table 1 and the Notes that follow. Medical conditions are often not mutually exclusive. If multiple conditions are present, refer to guidance in all relevant columns. See Notes for medical conditions not listed.
| 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 | |||||||||
| Influenza inactivated |
Solid organ transplant: 18yrs (See Notes) | |||||||||
| LAIV3 |
||||||||||
| Asthma, wheezing: 2–4 yearsc |
||||||||||
| MMR |
* | |||||||||
| VAR |
* | |||||||||
| Hepatitis A |
||||||||||
| HPV |
* | 3-dose series. (See Notes) | ||||||||
| MenACWY |
||||||||||
| MenB |
||||||||||
| 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
- LAIV3 contraindicated for children 2–4 years of age with asthma or wheezing during the preceding 12 months.
To make vaccination recommendations, healthcare providers should:
- Determine recommended vaccine by age (Table 1 – By Age)
- Determine recommended interval for catch-up vaccination (Table 2 – Catch-up)
- Assess need for additional recommended vaccines by medical condition or other indication (Table 3 - By Medical Indication)
- Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Additional Information
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).
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)