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Summary of schedule, dose, route, and preferred site for routinely recommended immunizations for children <18 years of age in the United States

Summary of schedule, dose, route, and preferred site for routinely recommended immunizations for children <18 years of age in the United States
Vaccine Recommended ages for routine administration Dose Route Preferred site
Monoclonal antibody

RSV monoclonal antibody

(If birthing parent did not receive RSV vaccine during pregnancy*)
  • Infants <8 months of age:
    • Born October through March: Within 1 week of birth
    • Born April through September: Shortly before start of RSV season
  • Weight <5 kg: 50 mg
  • Weight ≥5 kg: 100 mg
 IM  
Inactivated vaccines and/or toxoids
Diphtheria, tetanus, acellular pertussis
  • 2 months
  • 4 months
  • 6 months
  • 15 through 18 months
  • 4 through 6 years
  • 0.5 mL
 IM
  • <3 years: Anterolateral thigh (vastus lateralis)
  • ≥3 years: Deltoid
Haemophilus influenzae type b
  • 2 months
  • 4 months
  • 6 months
  • 12 through 15 months
  • 0.5 mL
 IM
  • Anterolateral thigh
Hepatitis A
  • 2 doses, at least 6 months apart, between 12 and 24 months
  • 0.5 mL
 IM
  • Anterolateral thigh
Hepatitis BΔ
  • Within 24 hours of birth
  • 1 to 2 months
  • 6 to 12 months
  • 0.5 mL
 IM
  • Anterolateral thigh
Human papillomavirus◊
  • 11 through 12 years: 2 doses separated by at least 6 months
  • Series may begin as early as 9 years
  • 0.5 mL
 IM
  • Deltoid
Influenza, inactivated
  • 1 or 2 doses annually§ for children ≥6 months of age
  • Children 6 through 35 months: 0.25 (Afluria) or 0.5 mL (Fluarix, FluLaval, or Fluzone)
  • Children ≥36 months: 0.5 mL
 IM
  • <3 years: Anterolateral thigh
  • ≥3 years: Deltoid

Meningococcal conjugate vaccine, quadrivalent

(MenACWY-CRM [Menveo], MenACWY-TT [MenQuadfi])
  • 11 through 12 years
  • 16 years
  • 0.5 mL
 IM
  • Deltoid

Meningococcal serogroup B¥

(MenB-4C [Bexsero], MenB-FHbp [Trumenba])
  • 16 through 18 years
  • 0.5 mL
 IM
  • Deltoid
Pneumococcal conjugate vaccine
  • 2 months
  • 4 months
  • 6 months
  • 12 through 15 months
  • 0.5 mL
 IM
  • Anterolateral thigh
Poliovirus, inactivated
  • 2 months
  • 4 months
  • 6 through 18 months
  • 4 through 6 years
  • 0.5 mL
 IM or subcutaneous
  • IM:
    • <3 years: Anterolateral thigh (vastus lateralis)
    • ≥3 years: Deltoid
  • Subcutaneous:
    • <12 months: Fatty tissue over anterolateral thigh
    • ≥12 months: Fatty tissue over upper-outer triceps‡
Tetanus toxoid, reduced diphtheria toxoid, acellular pertussis
  • 11 through 12 years
  • 0.5 mL
 IM
  • Deltoid
Inactivated combination vaccines
DTaP-HepB-IPV vaccine (Pediarix)
  • 2 months
  • 4 months
  • 6 months
  • 0.5 mL
 IM
  • Anterolateral thigh
DTaP-IPV/Hib vaccine (Pentacel)
  • 2 months
  • 4 months
  • 6 months
  • 15 through 18 months
  • 0.5 mL
 IM
  • Anterolateral thigh
DTaP-IPV-Hib-HepB vaccine (Vaxelis)
  • 2 months
  • 4 months
  • 6 months
  • 0.5 mL
 IM
  • Anterolateral thigh
DTaP-IPV vaccine (Kinrix, Quadricel)
  • 4 through 6 years
  • 0.5 mL
 IM
  • Deltoid
MenACWY-TT/MenB-FHbp (Penbraya)
  • In place of MenACWY-TT and MenB-FHbp if both indicated at same visit and ≥10 years old
  • 0.5 mL
 IM
  • Deltoid
Live attenuated vaccines
Influenza
  • 1 or 2 doses annually§ for children ≥2 years of age
  • 0.2 mL (0.1 mL in each nostril)
 Intranasal  
Measles, mumps, and rubella (M-M-R II, Priorix)
  • 12 through 15 months
  • 4 through 6 years
  • 0.5 mL
 Subcutaneous or IM (M-M-R II vaccine only)
  • Subcutaneous: Fatty tissue over upper-outer triceps‡
  • IM:
    • <3 years: Anterolateral thigh (vastus lateralis)
    • ≥3 years: Deltoid
Rotavirus
  • RV1:
    • 2 months
    • 4 months
  • 1 mL
 Orally  
  • RV5:
    • 2 months
    • 4 months
    • 6 months
  • 2 mL
 Orally  
Varicella
  • 12 through 15 months
  • 4 through 6 years
  • 0.5 mL
 Subcutaneous or IM
  • Subcutaneous: Fatty tissue over upper-outer triceps‡
  • IM:
    • <3 years: Anterolateral thigh
    • ≥3 years: Deltoid
Dengue†
  • 9 through 16 years
  • 3 doses separated by 6 months
  • 0.5 mL
 Subcutaneous
  • Fatty tissue over upper-outer triceps‡
Live attenuated combination vaccines

MMRV vaccine (ProQuad)

Available only for children ≤12 years
  • 12 through 15 months**
  • 4 through 6 years
  • 0.5 mL
 Subcutaneous or IM
  • Subcutaneous: Fatty tissue over upper-outer triceps‡
  • IM:
    • <3 years: Anterolateral thigh
    • ≥3 years: Deltoid
Viral component vaccines
COVID-19 vaccines
  • Refer to UpToDate content on COVID-19 vaccines
This table summarizes recommendations for routine childhood immunizations in the United States.

COVID-19: coronavirus disease 2019; DTaP: diphtheria, tetanus, acellular pertussis; HepB: hepatitis B; Hib: Haemophilus influenzae type b; IM: intramuscular; IPV: inactivated poliovirus; MenACWY: meningococcal serogroup A, C, W, Y vaccine; MenB: meningococcal serogroup B vaccine; MMR: measles, mumps, and rubella; MMRV: measles, mumps, rubella, and varicella; RSV: respiratory syncytial virus; RV1: attenuated human rotavirus vaccine; RV5: pentavalent human-bovine rotavirus reassortant vaccine.

* Refer to separate UpToDate content for the criteria that constitute receipt of RSV vaccine during pregnancy.

¶ The 6-month dose may not be necessary, depending upon vaccine formulation.

Δ The recommended schedule varies with birth weight and HepB surface antigen status of the mother. Refer to UpToDate content on HepB vaccines for infants for details.

◊ If the human papillomavirus series is initiated at age ≥15 years, 3 doses should be administered: The 2nd dose is recommended 1 to 2 months after the 1st dose, and the 3rd dose is recommended 6 months after the 1st dose.

§ Refer to UpToDate content on seasonal influenza vaccines for children for additional information.

¥ MenB vaccines are not routinely recommended for adolescents who are not at increased risk for meningococcal disease. However, they may be given to adolescents and young adults age 16 through 23 years.

‡ The fatty tissue over the upper-outer triceps is the preferred site. The fatty tissue over the anterolateral thigh is an acceptable alternative.

† For children who live in dengue endemic United States territories and sovereign states in free association with the United States (American Samoa, Federated States of Micronesia, Republic of Marshall Islands, Republic of Palau, Puerto Rico, United States Virgin Islands) and have laboratory confirmation of previous Dengue infection. Refer to the ACIP recommendations and https://www.cdc.gov/dengue/hcp/vaccine/.

** Administration of MMRV as the first dose of measles-containing vaccine at age 12 through 15 months has been associated with an increased risk of febrile seizures. The Centers for Disease Control and Prevention and American Academy of Pediatrics suggest that MMR and varicella vaccines be administered as separate injections at age 12 through 15 months unless the parents/caregivers have a preference for MMRV. Refer to UpToDate content on MMR and varicella vaccination for children for additional details.

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