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Table 1. Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2021
Always make recommendations by determining needed vaccines based on age (Table 1), determining appropriate intervals for catch-up, if needed (Table 2), assessing for medical indications (Table 3), and reviewing special situations (Notes).
ACIP recommends use of COVID-19 vaccines for everyone ages 12 and older within the scope of the Emergency Use Authorization for the particular vaccine. COVID-19 vaccine and other vaccines may be administered on the same day. See the COVID-19 Vaccine Product Information page for additional information about COVID-19 vaccines authorized for use in the United States.
Resources for health care providers
Range of recommended ages for all children
Range of recommended ages for catch-up immunization
Range of recommended ages for certain high-risk groups
Recommended based on shared clinical decision-making or
*can be used in this age group
Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to vaccine series for extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.
For vaccination recommendations for persons ages 19 years or older, see the Recommended Adult Immunization Schedule, 2021.
ACIP recommends use of COVID-19 vaccines for everyone ages 12 and older within the scope of the Emergency Use Authorization for the particular vaccine. COVID-19 vaccine and other vaccines may be administered on the same day. See the COVID-19 Vaccine Product Information page for additional information about COVID-19 vaccines authorized for use in the United States.
Doses administered within 14 days of starting therapy or during therapy should be repeated at least 3 months after therapy completion.
Unvaccinated* persons age 5 years or older
Unvaccinated* persons age 15 months or older
Unvaccinated* persons age 5–18 years
*Unvaccinated = Less than routine series (through age 14 months) OR no doses (age 15 months or older)
Anatomic or functional asplenia (including sickle cell disease), HIV infection, persistent complement component deficiency, complement inhibitor (e.g., eculizumab, ravulizumab) use:

Travel in countries with hyperendemic or epidemic meningococcal disease, including countries in the African meningitis belt or during the Hajj
(http://www.cdc.gov/travel/):
First-year college students who live in residential housing (if not previously vaccinated at age 16 years or older) or military recruits:
Adolescent vaccination of children who received MenACWY prior to age 10 years:
Note: Menactra should be administered either before or at the same time as DTaP. For MenACWY booster dose recommendations for groups listed under “Special situations” and in an outbreak setting and additional meningococcal vaccination information, see https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm.
Anatomic or functional asplenia (including sickle cell disease), persistent complement component deficiency, complement inhibitor (e.g., eculizumab, ravulizumab) use:
Bexsero and Trumenba are not interchangeable; the same product should be used for all doses in a series. For MenB booster dose recommendations for groups listed under “Special situations” and in an outbreak setting and additional meningococcal vaccination information, see https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm.
Underlying conditions below: When both PCV13 and PPSV23 are indicated, administer PCV13 first. PCV13 and PPSV23 should not be administered during same visit. Chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma treated with high-dose, oral corticosteroids); diabetes mellitus:
Cerebrospinal fluid leak, cochlear implant:
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 associated with treatment with immunosuppressive drugs or radiation therapy; solid organ transplantation; multiple myeloma:
*Incomplete series = Not having received all doses in either the recommended series or an age-appropriate catch-up series. See Tables 8, 9, and 11 in the in the ACIP pneumococcal vaccine recommendations (https://www.cdc.gov/mmwr/pdf/rr/rr5911.pdfpdf icon) for complete schedule details.
Series containing oral polio vaccine (OPV), either mixed OPV-IPV or OPV-only series:
*Fully vaccinated = 5 valid doses of DTaP OR 4 valid doses of DTaP if dose 4 was administered at age 4 years or older.
(Use combination vaccines instead of separate injections when appropriate)
The comprehensive summary of the ACIP recommended changes made to the child and adolescent immunization schedule can be found in the February 12, 2021 MMWR.
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