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TABLE 1. Recommended and minimum ages and intervals between vaccine doses*†
Vaccine and dose number	Recommended age for this dose	Minimum age for this dose	Recommended interval to next dose	Minimum interval to next dose
HepB-1§	Birth	Birth	1--4 months	4 weeks
HepB-2	1--2 months	4 weeks	2--17 months	8 weeks
HepB-3¶	6--18 months	24 weeks	---	---
DTaP-1§	2 months	6 weeks	2 months	4 weeks
DTaP-2	4 months	10 weeks	2 months	4 weeks
DTaP-3	6 months	14 weeks	6--12 months	6 months**,††
DTaP-4	15--18 months	12 months	3 years	6 months**
DTaP-5	4--6 years	4 years	---	---
Hib-1§,§§	2 months	6 weeks	2 months	4 weeks
Hib-2	4 months	10 weeks	2 months	4 weeks
Hib-3¶¶	6 months	14 weeks	6--9 months	8 weeks
Hib-4	12--15 months	12 months	---	---
IPV-1§	2 months	6 weeks	2 months	4 weeks
IPV-2	4 months	10 weeks	2--14 months	4 weeks
IPV-3	6--18 months	14 weeks	3--5 years	6 months
IPV-4***	4--6 years	4 years	---	---
PCV-1§§	2 months	6 weeks	8 weeks	4 weeks
PCV-2	4 months	10 weeks	8 weeks	4 weeks
PCV-3	6 months	14 weeks	6 months	8 weeks
PCV-4	12--15 months	12 months	---	---
MMR-1†††	12--15 months	12 months	3--5 years	4 weeks
MMR-2†††	4--6 years	13 months	---	---
Varicella-1†††	12--15 months	12 months	3--5 years	12 weeks§§§
Varicella-2†††	4--6 years	15 months	---	---
HepA-1	12--23 months	12 months	6--18 months**	6 months**
HepA-2	≥18 months	18 months	---	---
Influenza, inactivated¶¶¶	≥6 months	6 months****	1 month	4 weeks
LAIV (intranasal)¶¶¶	2--49 years	2 years	1 month	4 weeks
MCV4-1††††	11--12 years	2 years	5 years	8 weeks
MCV4-2	16 years	11 years (+8 weeks)	---	---
MPSV4-1††††	---	2 years	5 years	5 years
MPSV4-2	---	7 years	---	---
Td	11--12 years	7 years	10 years	5 years
Tdap§§§§	≥11 years	7 years	---	---
PPSV-1	---	2 years	5 years	5 years
PPSV-2¶¶¶¶	---	7 years	---	---
HPV-1*****	11--12 years	9 years	2 months	4 weeks
HPV-2	11--12 years (+2 months)	9 years (+4 weeks)	4 months	12 weeks†††††
HPV-3†††††	11--12 years (+6 months)	9 years (+24 weeks)	---	---
Rotavirus-1§§§§§	2 months	6 weeks	2 months	4 weeks
Rotavirus-2	4 months	10 weeks	2 months	4 weeks
Rotavirus-3¶¶¶¶¶	6 months	14 weeks	---	---
Herpes zoster******	≥60 years	60 years	---	---
See table footnotes on page 37

TABLE 1. (Continued) Recommended and minimum ages and intervals between vaccine doses*,†

Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis; HepA = hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; HPV = human papillomavirus; IPV = inactivated poliovirus; LAIV = live, attenuated influenza vaccine; MCV4 = quadrivalent meningococcal conjugate vaccine; MMR = measles, mumps, and rubella; MMRV = measles, mumps, rubella, and varicella; MPSV4 = quadrivalent meningococcal polysaccharide vaccine; PCV = pneumococcal conjugate vaccine; PPSV = pneumococcal polysaccharide vaccine; PRP-OMB = polyribosylribitol phosphate-meningococcal outer membrane protein conjugate; Td = tetanus and diphtheria toxoids; TIV = trivalent inactiated influenza vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis; Var = varicella vaccine. * Combination vaccines are available. Use of licensed combination vaccines is generally preferred to separate injections of their equivalent component vaccines. When administering combination vaccines, the minimum age for administration is the oldest age for any of the individual components; the minimum interval between doses is equal to the greatest interval of any of the individual components. † Information on travel vaccines, including typhoid, Japanese encephalitis, and yellow fever, is available at http://www.cdc.gov/travel. Information on other vaccines that are licensed in the United States but not distributed, including anthrax and smallpox, is available at http://www.bt.cdc.gov. § Combination vaccines containing the hepatitis B component are available (see Table 2). These vaccines should not be administered to infants aged <6 weeks because of the other components (i.e., Hib, DTaP, HepA, and IPV). ¶ HepB-3 should be administered at least 8 weeks after HepB-2 and at least 16 weeks after HepB-1 and should not be administered before age 24 weeks. ** Calendar months. †† The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3. §§ For Hib and PCV, children receiving the first dose of vaccine at age ≥7 months require fewer doses to complete the series. ¶¶ If PRP-OMP (Pedvax-Hib, Merck Vaccine Division) was administered at ages 2 and 4 months, a dose at age 6 months is not necessary. *** A fourth dose is not needed if the third dose was administered at ≥4 years and at least 6 months after the previous dose. ††† Combination MMRV vaccine can be used for children aged 12 months--12 years. See text for details. §§§ The minimum interval from Varicella-1 to Varicella-2 for persons beginning the series at age ≥13 years is 4 weeks. ¶¶¶ One dose of influenza vaccine per season is recommended for most persons. Children aged <9 years who are receiving influenza vaccine for the first time or who received only 1 dose the previous season (if it was their first vaccination season) should receive 2 doses this season. **** The minimum age for inactivated influenza vaccine varies by vaccine manufacturer. See package insert for vaccine-specific minimum ages. †††† Revaccination with meningococcal vaccine is recommended for previously vaccinated persons who remain at high risk for meningococcal disease. (Source: CDC. Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR 2009;58:[1042--3]). §§§§ Only 1 dose of Tdap is recommended. Subsequent doses should be given as Td. For one brand of Tdap, the minimum age is 11 years. For management of a tetanus-prone wound in persons who have received a primary series of tetanus-toxoid--containing vaccine, the minimum interval after a previous dose of any tetanus-containing vaccine is 5 years. ¶¶¶¶ A second dose of PPSV 5 years after the first dose is is recommended for persons aged ≤65 years at highest risk for serious pneumococcal infection and those who are likely to have a rapid decline in pneumococcal antibody concentration. (Source: CDC. Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1997;46[No. RR-8]). ***** Bivalent HPV vaccine is approved for females aged 10--25 years. Quadrivalent HPV vaccine is approved for males and females aged 9--26 years. ††††† The minimum age for HPV-3 is based on the baseline minimum age for the first dose (i.e., 108 months) and the minimum interval of 24 weeks between the first and third dose. Dose 3 need not be repeated if it is administered at least 16 weeks after the first dose. §§§§§ The first dose of rotavirus must be administered at age 6 weeks through 14 weeks and 6 days. The vaccine series should not be started for infants aged ≥15 weeks, 0 days. Rotavirus should not be administered to children older than 8 months, 0 days of age regardless of the number of doses received between 6 weeks and 8 months, 0 days of age. ¶¶¶¶¶ If 2 doses of Rotarix (GlaxoSmithKline) are administered as age appropriate, a third dose is not necessary. ****** Herpes zoster vaccine is recommended as a single dose for persons aged ≥60 years.

TABLE 2. FDA-licensed combination vaccines*
Vaccine†	Trade name (year licensed)	Age range	Routinely recommended ages
Hib-HepB	Comvax (1996)	6 weeks--71 months	Three-dose schedule at 2, 4, and 12--15 months of age
DTaP/Hib	TriHIBit (1996)	15--18 months	Fourth dose of Hib and DTaP series
HepA-HepB	Twinrix (2001)	≥18 years	Three doses on a schedule of 0, 1, and 6 months
DTaP-HepB-IPV	Pediarix (2002)	6 weeks--6 years	Three-dose series at 2, 4 and 6 months of age
MMRV	ProQuad (2005)	12 months--12 years	Two doses, the first at 12--15 months, the second at 4--6 years
DTaP-IPV	Kinrix (2008)	4--6 years	Fifth dose of DTaP and fourth dose of IPV
DTaP-IPV/Hib	Pentacel (2008)	6 weeks--4 years	Four-dose schedule at 2, 4, 6, and 15--18 months of age
Abbreviations: DT = diphtheria and tetanus toxoids; DTaP = diphtheria and tetanus toxoids and acellular pertussis; FDA = Food and Drug Administration; HepA = hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; IPV = inactivated poliovirus; MMR = measles, mumps, and rubella; MMRV = measles, mumps, rubella, and varicella; Td = tetanus and diphtheria toxoids; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis. Source: American Academy of Pediatrics. Passive immunization. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red book: 2009 report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009. * Although MMR, DTaP, DT, Td, and Tdap are combination vaccines, they are not included on this list because they are not available in the United States as single-antigen products. † A dash ( - ) between vaccine products indicates that products are supplied in their final form by the manufacturer and do not require mixing or reconstitution by the user. A slash ( / ) indicates that the products must be mixed or reconstituted by the user.

TABLE 3. Guidelines for spacing of live and inactivated antigens
Antigen combination	Recommended minimum interval between doses
Two or more inactivated*	May be administered simultaneously or at any interval between doses
Inactivated and live	May be administered simultaneously or at any interval between doses
Two or more live injectable†	28 days minimum interval, if not administered simultaneously
Source: American Academy of Pediatrics. Pertussis. In: Pickering LK, Baker, CJ, Kimberlin DW, Long SS, eds. Red book: 2009 report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009:22. * Certain experts suggest a 28-day interval between tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and tetravalent meningococcal conjugate vaccine if they are not administered simultaneously. † Live oral vaccines (e.g., Ty21a typhoid vaccine and rotavirus vaccine) may be administered simultaneously or at any interval before or after inactivated or live injectable vaccines.

TABLE 4. Guidelines for administering antibody-containing products* and vaccines
Type of administration	Products administered		Recommended minimum interval between doses
Simultaneous (during the same office visit)	Antibody-containing products and inactivated antigen		Can be administered simultaneously at different anatomic sites or at any time interval between doses
	Antibody-containing products and live antigen		Should not be administered simultaneously.† If simultaneous administration of measles-containing vaccine or varicella vaccine is unavoidable, administer at different sites and revaccinate or test for seroconversion after the recommended interval (see Table 5)
Nonsimultaneous	Administered first	Administered second
	Antibody-containing products	Inactivated antigen	No interval necessary
	Inactivated antigen	Antibody-containing products	No interval necessary
	Antibody-containing products	Live antigen	Dose related†,§
	Live antigen	Antibody-containing products	2 weeks†
* Blood products containing substantial amounts of immune globulin include intramuscular and intravenous immune globulin, specific hyperimmune