2019 Vaccine Guide & Insert - VG14

Routine vaccination with PCV13

02/22/19

Sickle cell disease and other hemoglobinopathies;
anatomic or functional asplenia; congenital or acquired
immunodeficiency; HIV infection; chronic renal failure;
nephrotic syndrome; malignant neoplasms, leukemias,
lymphomas, Hodgkin disease, and other diseases

Chronic heart disease (particularly cyanotic congenital
heart disease and cardiac failure); chronic lung
disease (including asthma treated with high-dose, oral
corticosteroids); diabetes mellitus:
Age 2-5 years
y Any incomplete* series with:
- 3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior
PCV13 dose)
- Less than 3 PCV13 doses: 2 doses PCV13 (8 weeks after the
most recent dose and administered 8 weeks apart)
y No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after
any prior PCV13 dose)
Age 6-18 years
y No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after
any prior PCV13 dose)
Cerebrospinal fluid leak, cochlear implant:
Age 2-5 years
y Any incomplete* series with:
- 3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior
PCV13 dose)
- Less than 3 PCV13 doses: 2 doses PCV13, 8 weeks after the
most recent dose and administered 8 weeks apart
y No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after
any prior PCV13 dose)
Age 6-18 years
y No history of either PCV13 or PPSV23: 1 dose PCV13, 1 dose
PPSV23 at least 8 weeks later
y Any PCV13 but no PPSV23: 1 dose PPSV23 at least 8 weeks
after the most recent dose of PCV13
y PPSV23 but no PCV13: 1 dose PCV13 at least 8 weeks after the
most recent dose of PPSV23

High-risk conditions below: When both PCV13 and PPSV23
are indicated, administer PCV13 first. PCV13 and PPSV23
should not be administered during same visit.

Special situations

y 1 dose for healthy children age 24-59 months with any
incomplete* PCV13 series
y For other catch-up guidance, see Table 2.

Catch-up vaccination with PCV13

y 4-dose series at 2, 4, 6, 12-15 months

y Ensure persons age 7-18 years without evidence of immunity
(see MMWR at www.cdc.gov/mmwr/pdf/rr/rr5604.pdf ) have
2-dose series:
- Ages 7-12 years: routine interval: 3 months (minimum
interval: 4 weeks)
- Ages 13 years and older: routine interval: 4-8 weeks
(minimum interval: 4 weeks).
- The maximum age for use of MMRV is 12 years.

Catch-up vaccination

y 2-dose series: 12-15 months, 4-6 years
y Dose 2 may be administered as early as 3 months after dose 1
(a dose administered after a 4-week interval may be counted).

Routine vaccination

Varicella vaccination
(minimum age: 12 months)

y Adolescents age 13-18 years who have not received Tdap:
1 dose Tdap, then Td booster every 10 years
y Persons age 7-18 years not fully immunized with DTaP:
1 dose Tdap as part of the catch-up series (preferably the first
dose); if additional doses are needed, use Td.
y Children age 7-10 years who receive Tdap inadvertently or
as part of the catch-up series should receive the routine Tdap
dose at 11-12 years.
y DTaP inadvertently given after the 7th birthday:
- Child age 7-10 years: DTaP may count as part of catch-up
series. Routine Tdap dose at 11-12 should be administered.
- Adolescent age 11-18 years: Count dose of DTaP as the
adolescent Tdap booster.
y For other catch-up guidance, see Table 2.
y For information on use of Tdap or Td as tetanus prophylaxis in
wound management, see www.cdc.gov/mmwr/volumes/67/
rr/rr6702a1.htm.

Catch-up vaccination

Routine vaccination

y Adolescents age 11-12 years: 1 dose Tdap
y Pregnancy: 1 dose Tdap during each pregnancy, preferably in
early part of gestational weeks 27-36
y Tdap may be administered regardless of the interval since the
last tetanus- and diphtheria-toxoid-containing vaccine.

Tetanus, diphtheria, and pertussis (Tdap)
vaccination
(minimum age: 11 years for routine vaccination,
7 years for catch-up vaccination)

Centers for Disease Control and Prevention | Recommended Child and Adolescent Immunization Schedule, United States, 2019 | Page 8

y Do not start the series on or after age 15 weeks, 0 days.
y The maximum age for the final dose is 8 months, 0 days.
y For other catch-up guidance, see Figure 2.

Catch-up vaccination

y Rotarix: 2-dose series at 2 and 4 months.
y RotaTeq: 3-dose series at 2, 4, and 6 months.
If any dose in the series is either RotaTeq or unknown, default
to 3-dose series.

Routine vaccination

Rotavirus vaccination
(minimum age: 6 weeks)

associated with treatment with immunosuppressive drugs
or radiation therapy; solid organ transplantation; multiple
myeloma:
Age 2-5 years
y Any incomplete* series with:
- 3 PCV13 doses: 1 dose PCV13 (at least 8 weeks after any prior
PCV13 dose)
- Less than 3 PCV13 doses: 2 doses PCV13 (8 weeks after the
most recent dose and administered 8 weeks apart)
y No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after
any prior PCV13 dose) and a 2nd dose of PPSV23 5 years later
Age 6-18 years
y No history of either PCV13 or PPSV23: 1 dose PCV13, 2 doses
PPSV23 (dose 1 of PPSV23 administered 8 weeks after PCV13
and dose 2 of PPSV23 administered at least 5 years after dose
1 of PPSV23)
y Any PCV13 but no PPSV23: 2 doses PPSV23 (dose 1 of PPSV23
administered 8 weeks after the most recent dose of PCV13
and dose 2 of PPSV23 administered at least 5 years after dose
1 of PPSV23)
y PPSV23 but no PCV13: 1 dose PCV13 at least 8 weeks after
the most recent PPSV23 dose and a 2nd dose of PPSV23
administered 5 years after dose 1 of PPSV23 and at least
8 weeks after a dose of PCV13
Chronic liver disease, alcoholism:
Age 6-18 years
y No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after
any prior PCV13 dose)
*An incomplete series is defined as not having received
all doses in either the recommended series or an ageappropriate catch-up series. See Tables 8, 9, and 11 in the ACIP
pneumococcal vaccine recommendations (www.cdc.gov/
mmwr/pdf/rr/rr5911.pdf ) for complete schedule details.

Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019

Pneumococcal vaccination
(minimum age: 6 weeks [PCV13], 2 years [PPSV23])

Notes
http://www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.html http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf http://www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.html http://www.cdc.gov/mmwr/pdf/rr/rr5911.pdf http://www.cdc.gov/mmwr/pdf/rr/rr5911.pdf
2019 Vaccine Guide & Insert

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