Summary
Vaccinations are among the most effective measures of preventive medicine. Especially in infants and young children, they can prevent potentially harmful diseases and hospitalization. Almost no one currently living in the US has seen vaccine-preventable diseases first-hand because their frequency has been dramatically decreased by vaccination. However, they persist worldwide and vaccination programs are essential to prevent future outbreaks of diseases like pertussis, mumps, and measles. In the US, immunization guidelines are published and updated every year by the Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP). The schedule is designed to protect children when they are most vulnerable and individuals at high-risk before they are exposed to possibly life-threatening diseases.
Furthermore, international travelers are at risk of exposure to vaccine-preventable diseases depending on the region visited and the activities planned. Travelers should therefore seek advice about potential immunizations before departure. At a pretravel consultation, the traveler's prior immunizations, health conditions, and likely exposure to diseases while traveling should be taken into account. Information on travel vaccinations may be found on the CDC and the WHO websites.
ACIP immunization schedule
Immunization schedule for birth to 18 months
Birth | 1 mo | 2 mo | 4 mo | 6 mo | 9 mo | 12 mo | 15 mo | 18 mo | |
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Hepatitis B vaccine (HepB) | 1st dose (if infant > 2 kg) | 2nd dose | Catch-up | 3rd dose | |||||
Diphtheria and tetanus toxoids, acellular pertussis DTaP < 7 yrs | 1st dose; minimum age 6 weeks Exception: DTaP-inactivated poliovirus 4 years | 2nd dose | 3rd dose | Catch-up | 4th dose | ||||
Inactivated poliovirus vaccine (IPV) | 1st dose, minimum age 6 weeks | 2nd dose | 3rd dose | ||||||
Rotavirus vaccine (RV) | 1st dose orally, minimum age 6 weeks | 2nd dose | 3rd dose | ||||||
Hemophilus influenza type b vaccine (Hib) | 1st dose, minimum age 6 weeks | 2nd dose | (3rd dose) | Catch-up | 3rd / 4th dose (booster dose) | Catch-up | |||
Pneumococcal conjugate (PCV13) | 1st dose; minimum age 6 weeks | 2nd dose | 3rd dose | Catch-up | 4th dose | Catch-up | |||
Meningococcal conjugate | High-risk groups, minimum age of 6 weeks for Hib-MenCY, 2 months for MenACWY-CRM ,and 9 months for MenACWY-D | ||||||||
Hepatitis A vaccine (HepA) | 2-dose series at 12–24 months (time between doses: 6–18 months) | ||||||||
Influenza vaccine (IIV) | Annual immunization: 1 or 2 doses | ||||||||
Measles, mumps, rubella vaccine (MMR) | High risk groups prior to international travel: 1st dose at age 6–11 months | 1st dose (minimum age is 12 months) | Catch-up | ||||||
Varicella vaccine (VAR) | 1st dose | Catch-up |
Immunization schedule for 19 months to 18 years
19-23 mos | 2–3 years | 4–6 years | 7–10 years | 11–12 years | 13–15 years | 16–18 years | ||
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Hepatitis B vaccine (HepB) | Catch-up | |||||||
Diphtheria and tetanus toxoids, acellular pertussis | DTaP < 7 yrs | Catch-up | 5th dose | |||||
Tdap ≥ 7 yrs | Catch-up |
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Inactivated poliovirus vaccine (IPV) | Catch-up | 4th dose | Catch-up | |||||
Hemophilus influenza type b vaccine (Hib) | Catch-up | One dose recommended for high-risk groups | ||||||
Pneumococcal vaccines | Pneumococcal conjugate (PCV13) | Catch-up | Recommended for high-risk groups | |||||
Pneumococcal polysaccharide (PPSV23) | High-risk groups, minimum age is 2 years | |||||||
Influenza vaccine | IIV | Annual immunization: 1 or 2 doses | Annual immunization: 1 dose (> 9 years) | |||||
LAIV | Annual immunization: 1 or 2 doses (2–9 years) | Annual immunization: 1 dose (> 9 years) | ||||||
Hepatitis A vaccine (HepA) | 2-dose series at 12–24 months (time between doses: 6–18 months) | Catch-up | ||||||
Meningococcal conjugate | High-risk groups | 1st dose | Catch-up |
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Meningococcal B vaccine (MenB) |
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Measles, mumps, rubella vaccine (MMR) | Catch-up | 2nd dose | Catch-up | |||||
Varicella vaccine (VAR) | Catch-up | 2nd dose | Catch-up | |||||
Human papillomavirus vaccine (HPV) | High-risk groups, minimum age 9 years | 2-dose series | 3-dose series for > 15 years | Catch-up |
Adult recommendations and duration of protection
Adult recommendations | Duration of protection | ||
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Hepatitis B vaccine (HepB) |
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Rotavirus vaccine (RV) |
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Hemophilus influenza type b vaccine (Hib) |
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Pneumococcal vaccines | Pneumococcal conjugate (PCV13) |
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Pneumococcal polysaccharide (PPSV23) |
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Inactivated poliovirus vaccine (IPV) |
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Influenza vaccine (IIV, LAIV) |
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Hepatitis A vaccine (HepA) |
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Meningococcal conjugate |
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Meningococcal B vaccine |
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Measles, mumps, rubella vaccine (MMR) |
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Varicella vaccine (VAR) |
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Zoster recombinant vaccine (RZV) or zoster live vaccine (ZVL) |
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Human papillomavirus vaccine (HPV) |
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To remember the childhood immunization schedule think: HHating PeDs Immunization/Vaccination MmeHMorizing: HepB 0, 2, 6; Hib 2, 4, 6, 12–15; Pneumo: 2, 4, 6, 12–15; DTaP: 2, 4, 6, 15–18, 4–6 years; Td 10 years; IPV: 2, 4, 6, 4–6 years; Varicella 12–15, 4–6 years; MMR: 12–15, 4–6 years; HepA 2 years, Meningococcus 11–12 years
References:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]
Immunizations for travel
Below is only a selection of recommendations. Not included are immunizations recommended for the US. For details on recommendations regarding specific countries, further diseases, vaccinations or drugs, see the CDC Yellow Book.
Immunization | Schedule | Minimum age | Risk areas | Recommendation | Other |
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Japanese encephalitis vaccine (JE) |
| 2 months | Southeast Asia |
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Yellow fever vaccine |
| 9 months | Africa, Central and South America |
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Rabies vaccine |
| none | Rabies is endemic on all continents except Antarctica. However, several countries are considered rabies-free. |
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Typhoid and paratyphoid fever vaccine | Common in most developing countries, especially in Southern Asia |
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Meningococcal conjugate |
| 2 months | Sub-Saharan Africa |
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References:[20][21][22][23][24][25][26][27][28][29]