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
General principles
- Different vaccination types can be administered simultaneously (including live attenuated and inactivated vaccines) as specified in the ACIP immunization schedule.
- Vaccines are given without dose adjustment for weight.
- Missed doses should be caught up by simply continuing with the next doses required in the vaccine series.
- Restarting the immunization series (i.e., from the first dose) if one or more doses are missed is never necessary, regardless of how much time has elapsed since the last dose.
- The catch-up vaccinations are continued as per the minimum recommended interval between doses
Immunization schedule for birth to 18 months
Overview of immunization schedule for birth to 18 months | |||||||||
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Birth | 1 mo | 2 mo | 4 mo | 6 mo | 9 mo | 12 mo | 15 mo | 18 mo | |
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
Overview of immunization schedule for 19 months to 18 years | ||||||||
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19-23 mos | 2–3 years | 4–6 years | 7–10 years | 11–12 years | 13–15 years | 16–18 years | ||
Hepatitis B vaccine (HepB) |
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Diphtheria and tetanus toxoids, acellular pertussis | DTaP < 7 yrs |
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Tdap ≥ 7 yrs |
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Inactivated poliovirus vaccine (IPV) |
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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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Influenza vaccine | IIV |
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LAIV |
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Hepatitis A vaccine (HepA) |
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Meningococcal conjugate |
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Meningococcal B vaccine (MenB) |
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Measles, mumps, rubella vaccine (MMR) |
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Varicella vaccine (VAR) |
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Human papillomavirus vaccine (HPV) |
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Adult recommendations and duration of protection
Overview immunization schedule for adults | |||
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Adult recommendations | Duration of protection | ||
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) |
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Human papillomavirus vaccine (HPV) |
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“HHating PeDs Immunization/Vaccination MmeHMorizing:” the childhood immunization schedule includes: 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]
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.
Overview of travel immunizations | |||||
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Immunization | Schedule | Minimum age | Risk areas | Recommendation | Other |
Japanese encephalitis vaccine (JE) |
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Yellow fever vaccine |
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Rabies vaccine |
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Typhoid and paratyphoid fever vaccine |
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References:[17][18][19][20][21][22][23][24][25]
Pathogens affecting unvaccinated children
Overview of pathogens affecting unvaccinated children | |||||
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Pathogen | Disease | Clinical features | Treatment | ||
Measles virus |
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Rubella virus |
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Varicella zoster virus |
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Mumps virus |
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Corynebacterium diphtheriae |
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Haemophilus influenzae type b |
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Streptococcus pneumoniae | |||||
Neisseria meningitidis |
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Poliovirus |
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Clostridium tetani |
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Bordetella pertussis |
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Hepatitis A virus |
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Hepatitis B virus |