Recommended Childhood and Adolescent Immunization Schedule, United States, 2005
This schedule indicates the recommended ages for routine administration of currently licensed childhood vaccines, as of April 1, 2004, for children through age 18 years. Any dose not given at the recommended age should be given at any subsequent visit when indicated and feasible.
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Hepatitis B (Hep B) vaccine
All infants should receive the first dose of hepatitis B vaccine soon after birth and before hospital discharge; the first dose may also be administered by age 2 months if the mother is hepatitis B surface antigen (HBsAg) negative. Only monovalent Hep B may be used for the birth dose. Monovalent or combination vaccine containing Hep B may be used to complete the series. Four doses of vaccine may be administered when a birth dose is given. The second dose should be administered at least 4 weeks after the first dose, except for combination vaccines which cannot be administered before age 6 weeks. The third dose should be given at least 16 weeks after the first dose and at least 8 weeks after the second dose. The last dose in the vaccination series (third or fourth dose) should not be administered before age 24 weeks.
Infants born to HBsAg-positive mothers should receive Hep B and 0.5 mL of Hepatitis B Immune Globulin (HBIG) at separate sites within 12 hours of birth. The second dose is recommended at age 1 to 2 months. The final dose in the immunization series should not be administered before age 24 weeks. These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9 to 15 months.
Infants born to mothers whose HBsAg status is unknown should receive the first dose of the Hep B series within 12 hours of birth. Maternal blood should be drawn as soon as possible to determine the mother's HBsAg status; if the HBsAg test is positive, the infant should receive HBIG as soon as possible (no later than age 1 week). The second dose is recommended at age 1 to 2 months. The last dose in the immunization series should not be administered before age 24 weeks.
Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine
The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at age 15 to 18 months. The final dose in the series should be given at age greater than or equal to 4 years. Tetanus and diphtheria toxoids (Td) is recommended at age 11 to 12 years if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine. Subsequent routine Td boosters are recommended every 10 years.
