Immunization schedule

1^st dose; minimum age 6 weeks

Exception: DTaP-inactivated poliovirus 4 years

• Catch-up

• Catch-up

• 5^th dose

• Catch-up

• Single booster dose of Tdap is recommended
• If catch-up immunizations with Tdap already administered, the single booster dose is not necessary for adolescents

• Catch-up

• 4^th dose

• Catch-up

• Catch-up

• One dose recommended for high-risk groups

• Catch-up

• Recommended for high-risk groups

• High-risk groups, minimum age is 2 years

• Annual immunization: 1 or 2 doses

• Annual immunization: 1 dose (> 9 years)

• Annual immunization: 1 or 2 doses (2–9 years)

• Annual immunization: 1 dose (> 9 years)

• 2-dose series at 12–24 months (time between doses: 6–18 months)

• Catch-up

• High-risk groups

• 1^st dose

• Catch-up

• Booster dose at age 16 if first dose administered before 16th birthday
• Catch-up immunization recommended for persons aged 13–18 years

• High-risk groups: 2 or 3 doses depending on the brand (minimum age: 10 years)
• Based on clinical discretion: Adolescents and young adults aged 16–23 years to provide short-term protection against most strains of serogroup B meningococcal disease

• Catch-up

• 2^nd dose

• Catch-up

• Catch-up

• 2^nd dose

• Catch-up

• High-risk groups, minimum age 9 years

• 2-dose series (can be ages 9–14 years)

• 3-dose series for > 15 years

• Catch-up

• For all adults 19–59 years
• For all adults ≥ 60 years who are at risk of HBV infection (e.g., patients with HIV infection or chronic liver disease, prisoners)
• Individuals who do not respond to a primary 3-dose hep B vaccine series (i.e., anti-HBs < 10mIU/mL) should complete a 2^nd3-dose vaccine series
• Nonresponders: individuals who have an anti-HBs < 10mIU/mL after 6 doses of hep B vaccine, for whom an acute or chronic HBV infection has been ruled out.

• At least 20 years

• For all adults ≥ 19 years who have never received a Tdap vaccine, provide a dose of Tdap (regardless of the interval since the last tetanus and diphtheria vaccine)
• Booster doses of Td or Tdap every 10 years
• All pregnant women should receive a single dose of Tdap at 27–36 weeks of gestation regardless of the interval since the last Tdap or Td vaccination.

• Approx. 10 years

• Catch-up not routinely recommended for persons ≥ 18 years

• Up to 3 years after completion of series

• Catch-up immunization for high-risk groups (e.g., adults with asplenia, sick cell disease, or hematopoietic stem cell transplant)

• Unknown; requires further investigation

• For all adults age ≥ 19 with certain medical conditions (immunosuppression, CSF leaks, chronic renal failure, asplenia, cochlear implants), PCV13 vaccine followed by PPSV23 vaccine at least 8 weeks later is recommended.
• In immunocompetent adults ≥ 65 years, a shared decision between the physician and patient should be made. In a patient who wishes to receive both, administer PCV13 first and then PPSV23 at least 1 year later.

• Not lifelong

• Recommended for all adults ≥ 65 years
• Sequential PCV13 and PPSV23 are recommended for individuals age < 65 with certain high-risk conditions.
• For adults age < 65 who are current smokers or have a chronic medical condition (e.g., COPD), PPSV23 vaccine alone is recommended.

• Not lifelong

• Catch-up not routinely recommended for persons ≥ 18 years

• Probably lifelong after completion of series

• A yearly vaccine is recommended for all patients every flu season (Oct–April in northern hemisphere; May–Oct in southern hemisphere)

• 1 season

• 2 doses of HepA vaccine separated by 6–18 months for high risk groups (e.g., travelers to endemic countries, persons who use recreational drugs, men who have sex with men, patients with chronic liver disease)

• At least 25 years in adults and 14–20 years in children

• Repeat every 5 years in high-risk groups (e.g., patients with asplenia or complement component deficiency, complement inhibitor use, people traveling or residing in high-epidemic countries , microbiologists exposed to Neisseria meningitidis; first-year college students living in residence halls, military recruits)

• Up to 5 years

• Repeat every 2–3 years in high-risk groups

• 2–3 years

• Catch-up immunization is recommended in high-risk groups

• Probably lifelong

• For adults > 50 years
• For adults ≥ 19 years who will become immunodeficient due to a disease or treatment (e.g., patients undergoing immunosuppression)
• In case of pregnancy, vaccination can be delayed.

• At least 10–20 years after completion of series

• RZV: 2 doses in adults > 50 years (preferred over ZVL)

• -

• Catch-up immunization recommended for all adults < 26 years
  • 2 doses (0, 6–12 month schedule) in patients who began the immunization schedule at < 15 years
  • 3 doses (0, 1–2 month, 6 month schedule) in patients who began the immunization schedule ≥ 15 years or who are immunocompromised)

• No evidence of weakened protection over time after completion of series

• 2 doses, 28 days apart
• Should be completed at least one week before exposure
• Booster if last dose ≥ 1 year ago

• 2 months

• Southeast Asia

• Recommended for travelers or US citizens living in endemic areas during periods of JE transmission

• There is currently no efficacy data available for the vaccine.

• 1 dose; at least 10 days before departure

• 9 months

• Africa, Central and South America

• Recommended for all travelers or US citizens living in risk areas

• Many African and South American countries require proof of vaccination from incoming travelers.
• One dose provides lifelong protection.

• 3 doses: day 0, 7, and either 21 or 28 (depending on vaccine)
• Provides protection within ∼ 2 weeks

• none

• Rabies is endemic on all continents except Antarctica. However, several countries are considered rabies-free.

• May be recommended for travelers visiting countries with a high occurrence of animal rabies and low availability of antirabies biologics (e.g., countries in Africa, South America, and Southeast Asia)
• Depends also on planned activities (e.g., caving, wildlife work in rabies-epizootic areas)

• After being bitten by a mammal (e.g., dog, cat, monkey) persons who have been previously vaccinated should get 2 more doses of rabies vaccine (days 0 and 3). Rabies immune globulin is not required.

• Inactivated typhoid vaccine: 1 dose
  • At least 2 weeks before traveling
  • Booster dose every 2 years
• Live typhoid vaccine: 4 doses; day 0, 3, 5, 7);
  • At least 1 week before traveling
  • Booster dose every 5 years

• Inactivated typhoid vaccine: 2 years of age
• Live typhoid vaccine: 6 years of age

• Common in most developing countries, especially in Southern Asia

• Recommended for travelers with exposure to potentially contaminated foods and beverages
• Persons with intimate exposure to a chronic carrier of Salmonella typhi

• The vaccine can only prevent illness in about ¾ of cases.

• Children at 2 months of age: MenACWY-CRM as a 4-dose series at 2, 4, 6, and 12 months of age
• Children at 7–23 months of age: MenACWY-CRM or MenACWY-D as a 2-dose series
• Travelers 2–56 years: 1 dose MenACWY-CRM or MenACWY-D
• Travelers > 56 years: 1 dose of meningococcal polysaccharide vaccine (groups A, C, Y, W combined)

• 2 months

• Sub-Saharan Africa

• A quadrivalent meningococcal conjugate vaccination (e.g., MenACWY-CRM or MenACWY-D; protects against serogroups A, C, W, and Y) is recommended for persons traveling or residing in hyperendemic or epidemic countries who are in close contact with natives.

• Travelers aged ≥ 2 years going to Saudi Arabia on a pilgrimage to Mecca are required by the Saudi government to provide proof of vaccination with a quadrivalent meningococcal vaccine in the last 3 years. Documentation of 2 doses of a meningococcal vaccine against serogroup A is required for travelers aged 3 months to 2 years.