Catch-up schedule for measles, mumps, and rubella immunization for children in the United States*

Current age	Number of previous doses	Number and timing of doses for catch-up if using
≥12 months to 4 years	0 doses of MMR 0 doses of varicella	First dose of MMR and first dose of varicella now^¶ Second dose of MMR and second dose of varicella^¶ at 4 to 6 years of age^Δ
≥12 months to 4 years	0 doses of MMR 1 dose of varicella	First dose of MMR now or as soon as possible at least 28 days after first dose of varicella vaccine Second dose of MMR and second dose of varicella vaccine^¶ at 4 to 6 years^Δ
≥4 years and <13 years	0 doses of MMR 0 doses of varicella	First dose of MMR and first dose of varicella now^¶ Second dose of MMR in ≥28 days and second dose of varicella in ≥3 months, or MMRV in ≥3 months
	0 doses of MMR 1 dose of varicella	First MMR now (if ≥28 days after first dose of varicella vaccine) and MMRV in ≥28 days (if ≥3 months after first varicella), or MMRV now (if ≥3 months after first varicella) and MMR ≥28 days later, or First MMR now (if ≥28 days after first dose of varicella vaccine); second MMR in ≥28 days, and varicella ≥3 months after first varicella
	1 dose of MMR 0 doses of varicella	MMRV now (if ≥28 days after first MMR) and varicella vaccine ≥3 months later, or MMR and varicella now (if ≥28 days after first MMR) and varicella in ≥3 months, or Varicella now (if ≥28 days after first MMR) and MMRV in ≥3 months
>13 years	0 doses of MMR 0 doses of varicella	MMR and varicella now and MMR and varicella in ≥28 days
	0 doses of MMR 1 dose of varicella	MMR and varicella now (if ≥28 days after first dose of varicella) and MMR in ≥28 days
	1 dose of MMR 0 doses of varicella	MMR and varicella now (if ≥28 days after first MMR) and varicella in ≥28 days

MMR: measles, mumps, rubella combination vaccine; MMRV: measles, mumps, rubella, varicella combination vaccine; ACIP: Advisory Committee on Immunization Practices.
* This catch-up schedule is for children who have no plans for upcoming international travel. For children who are planning to travel internationally, refer to UpToDate topic on immunizations for travel.
¶ Either separate injections of MMR and varicella or MMRV may be used depending upon caregiver preference; for the first dose of MMR and varicella in children 12 through 47 months of age whose caregivers do not have a preference, the ACIP prefers separate injections of MMR and varicella vaccine. For the second dose at any age (15 months through 12 years), the ACIP prefers MMRV.
Δ The ACIP recommends that the second doses of MMR and varicella be administered at 4 to 6 years of age. However, the second dose of MMR may be administered as early as 28 days after the first dose; doses of varicella-containing vaccines should be separated by ≥3 months for children <13 years and ≥28 days for children ≥13 years. However, for children 12 months through 12 years, if the second dose is administered at least 28 days after the first dose, the second dose does not need to be repeated.

Graphic 101591 Version 3.0

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Catch-up schedule for measles, mumps, and rubella immunization for children in the United States*