For vaccination recommendations for persons ages
19 years or older, see the Recommended
Adult Immunization Schedule, 2023.
Additional information
y Consult relevant ACIP statements for detailed
recommendations at www.cdc.gov/vaccines/hcp/acip-recs/
index.html.
y For calculating intervals between doses, 4 weeks = 28 days.
Intervals of ≥4 months are determined by calendar months.
y Within a number range (e.g., 12–18), a dash (–) should
be read as “through.”
y Vaccine doses administered ≤4 days before the minimum
age or interval are considered valid. Doses of any vaccine
administered ≥5 days earlier than the minimum age or
minimum interval should not be counted as valid and
should be repeated as age appropriate. The repeat
dose should be spaced after the invalid dose by the
recommended minimum interval. For further details,
see Table 3-2, Recommended and minimum ages and
intervals between vaccine doses, in General Best Practice
Guidelines for Immunization at www.cdc.gov/vaccines/hcp/
acip-recs/general-recs/timing.html.
y Information on travel vaccination requirements and
recommendations is available at www.cdc.gov/travel/.
y For vaccination of persons with immunodeciencies, see
Table 8-1, Vaccination of persons with primary and secondary
immunodeciencies, in General Best Practice Guidelines for
Immunization at www.cdc.gov/vaccines/hcp/acip-recs/
general-recs/immunocompetence.html, and Immunization in
Special Clinical Circumstances (In: Kimberlin DW, Barnett ED,
Lyneld Ruth, Sawyer MH, eds. Red Book: 2021–2024 Report
of the Committee on Infectious Diseases. 32
nd
ed. Itasca, IL:
American Academy of Pediatrics; 2021:72–86).
y For information about vaccination in the setting of a
vaccine-preventable disease outbreak, contact your
state or local health department.
y The National Vaccine Injury Compensation Program (VICP)
is a no-fault alternative to the traditional legal system for
resolving vaccine injury claims. All vaccines included in the
child and adolescent vaccine schedule are covered by VICP
except dengue, PPSV23, and COVID-19 vaccines. COVID-19
vaccines that are authorized or approved by the FDA are
covered by the Countermeasures Injury Compensation
Program (CICP). For more information, see www.hrsa.gov/
vaccinecompensation or www.hrsa.gov/cicp.
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2023
Notes
Dengue vaccination
(minimum age: 9 years)
Routine vaccination
y Age 9–16 years living in areas with endemic dengue AND
have laboratory conrmation of previous dengue infection
- 3-dose series administered at 0, 6, and 12 months
y Endemic areas include Puerto Rico, American Samoa, US
Virgin Islands, Federated States of Micronesia, Republic of
Marshall Islands, and the Republic of Palau. For updated
guidance on dengue endemic areas and pre-vaccination
laboratory testing see www.cdc.gov/mmwr/volumes/70/rr/
rr7006a1.htm?s_cid=rr7006a1_w and www.cdc.gov/dengue/
vaccine/hcp/index.html
y Dengue vaccine should not be administered to children
traveling to or visiting endemic dengue areas.
Diphtheria, tetanus, and pertussis (DTaP)
vaccination (minimum age: 6 weeks [4 years
for Kinrix® or Quadracel®])
Routine vaccination
y 5-dose series at age 2, 4, 6, 15–18 months, 4–6 years
- Prospectively: Dose 4 may be administered as early as age
12months if at least 6 months have elapsed since dose 3.
- Retrospectively: A 4
th
dose that was inadvertently
administered as early as age 12 months may be counted if at
least 4 months have elapsed since dose 3.
Catch-up vaccination
y Dose 5 is not necessary if dose 4 was administered at age
4years or older and at least 6 months after dose 3.
y For other catch-up guidance, see Table 2.
Special situations
y Wound management in children less than age 7 years with
history of 3 or more doses of tetanus-toxoid-containing
vaccine: For all wounds except clean and minor wounds,
administer DTaP if more than 5 years since last dose of
tetanus-toxoid-containing vaccine. For detailed information,
see www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.htm.
COVID-19 vaccination
(minimum age: 6 months [Moderna and Pzer-
BioNTech COVID-19 vaccines], 12 years [Novavax
COVID-19 Vaccine])
Routine vaccination
y Primary series:
- Age 6 months–4 years: 2-dose series at 0, 4-8 weeks
(Moderna) or 3-dose series at 0, 3-8, 11-16 weeks
(Pzer-BioNTech)
- Age 5–11 years: 2-dose series at 0, 4-8 weeks (Moderna)
or 2-dose series at 0, 3-8 weeks (Pzer-BioNTech)
- Age 12–18 years: 2-dose series at 0, 4-8 weeks (Moderna)
or 2-dose series at 0, 3-8 weeks (Novavax, Pzer-BioNTech)
y For booster dose recommendations see www.cdc.
gov/vaccines/covid-19/clinical-considerations/interim-
considerations-us.html
Special situations
Persons who are moderately or severely
immunocompromised
y Primary series
- Age 6 months–4 years: 3-dose series at 0, 4, 8 weeks
(Moderna) or 3-dose series at 0, 3, 11 weeks
(Pzer-BioNTech)
- Age 5–11 years: 3-dose series at 0, 4, 8 weeks (Moderna) or
3-dose series at 0, 3, 7 weeks (Pzer-BioNTech)
- Age 12–18 years: 3-dose series at 0, 4, 8 weeks (Moderna)
or 2-dose series at 0, 3 weeks (Novavax) or 3-dose series at
0, 3, 7 weeks (Pzer-BioNTech)
y Booster dose: see www.cdc.gov/vaccines/covid-19/clinical-
considerations/interim-considerations-us.html
y Pre-exposure prophylaxis (monoclonal antibodies) may be
considered to complement COVID-19 vaccination. See
www.cdc.gov/vaccines/covid-19/clinical-considerations/
interim-considerations-us.html#immunocompromised
For Janssen COVID-19 Vaccine recipients see COVID-19
schedule at www.cdc.gov/vaccines/covid-19/clinical-
considerations/interim-considerations-us.html
Note: Administer an age-appropriate vaccine product for each
dose. Current COVID-19 schedule and dosage formulation
available at www.cdc.gov/vaccines/covid-19/downloads/
COVID-19-immunization-schedule-ages-6months-older.
pdf. For more information on Emergency Use Authorization
(EUA) indications for COVID-19 vaccines, see www.fda.gov/
emergency-preparedness-and-response/coronavirus-disease-
2019-covid-19/covid-19-vaccines.