Recommended Childhood and Adolescent Immunization Schedule—United States, 2014

COMMITTEE ON INFECTIOUS DISEASES

doi:10.1542/peds.2013-3965

The 2014 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. The 2014 format is similar to last year and includes a single schedule for persons 0 through 18 years of age (Fig 1). The yellow bars indicate the recommended age range for all children and contain a notation indicating the recommended dose number by age. The green bars indicate the recommended catch-up age. The purple bars designate the range for immunization for certain groups at high risk. The combined green and purple bar indicates the recommended age when hepatitis A vaccine catch-up is recommended. The white boxes show the ages when a vaccine is not recommended routinely. The catch-up schedule offers recommendations for children and adolescents who start late or are >1 month behind (Fig 2).

FIGURE 1

Recommended immunization schedule for persons aged 0 through 18 years—2014. (For those who fall behind or start late, see the catch-up schedule [Fig 2].)

FIGURE 2

Catch-up immunization schedule for persons aged 4 months through 18 years who start late or who are >1 month behind—United States, 2014.

Footnotes contain recommendations for routine vaccination, for catch-up vaccination, and for vaccination of children and adolescents with high-risk conditions or in special circumstances. Numerous changes have been made to improve the clarity and readability of the footnotes. A parent-friendly vaccine schedule for children and adolescents is available at http://www.cdc.gov/vaccines/schedules/index.html. An adult immunization schedule also is published in February of each year and is available at www.cdc.gov/vaccines. These schedules are revised annually to reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration and include the following specific changes from last year:

Both generic names and trade names are referenced in the title of each vaccine footnote; thereafter, only the trade name is used, as in the rotavirus footnote.
The Tdap footnote includes information on vaccination of persons 7 years and older with a single lifetime dose of Tdap, except for pregnant adolescents, who should be vaccinated with each pregnancy. For pregnant adolescents, administration is preferred during week 27 through week 36 of gestation, regardless of time since previous Td or Tdap.
The Haemophilus influenzae type b footnote clarifies vaccination of children 12 through 59 months of age who are at increased risk because of incomplete vaccination, asplenia, HIV infection, receipt of hematopoietic stem cell transplant, or receipt of chemotherapy or radiation treatment.
The pneumococcal vaccine footnote itemizes recommendations for PCV13 and PPSV23 use in children and adolescents at increased risk on the basis of age and degree of risk.
The influenza vaccine footnote describes vaccine dosing for children 6 months through 8 years of age and for those 9 years of age and older for the 2013–2014 season.
The hepatitis A vaccine footnote includes the list of persons at increased risk of hepatitis A disease.
The HPV footnote clarifies the intervals between vaccine doses.
The meningococcal footnote includes guidance for use of Menveo (Novartis, Cambridge, MA) starting at 2 months of age for certain persons at increased risk. Clarification is added regarding immunization of children with sickle cell disease or persistent complement component deficiency, travelers to areas where meningococcal disease is hyperendemic/epidemic, and children at risk during a community outbreak. Catch-up recommendations for persons at high risk are addressed.

Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form can be obtained at www.vaers.hhs.gov or by calling 800-822-7967. Additional information can be found in the Red Book and at Red Book Online (http://aapredbook.aappublications.org/). Statements from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that contain details of recommendations for individual vaccines, including recommendations for children with high-risk conditions, are available at www.cdc.gov/vaccines/pubs/ACIP-list.htm. Information on new vaccine releases, vaccine supplies, and interim recommendations resulting from vaccine shortages and statements on specific vaccines can be found at www.aapredbook.org/news/vaccstatus.shtml and www.cdc.gov/vaccines/pubs/ACIP-list.htm.

Committee on Infectious Diseases, 2013–2014

Michael T. Brady, MD, Chairperson, Red Book Associate Editor

Carrie L. Byington, MD

H. Dele Davies, MD

Kathryn M. Edwards, MD

Mary Anne Jackson, MD, Red Book Associate Editor

Yvonne A. Maldonado, MD

Dennis L. Murray, MD

Walter A. Orenstein, MD

Mobeen Rathore, MD

Mark Sawyer, MD

Gordon E. Schutze, MD

Rodney E. Willoughby, MD

Theoklis E. Zaoutis, MD

Liaisons

Marc A. Fischer, MD – Centers for Disease Control and Prevention

Bruce Gellin, MD – National Vaccine Program Office

Richard L. Gorman, MD – National Institutes of Health

Lucia Lee, MD – Food and Drug Administration

R. Douglas Pratt, MD – Food and Drug Administration

Jennifer S. Read, MD – National Vaccine Program Office

Joan Robinson, MD – Canadian Pediatric Society

Marco Aurelio Palazzi Safadi, MD – Sociedad Latinoamericana de Infectologia Pediatrica (SLIPE)

Jane Seward, MBBS, MPH – Centers for Disease Control and Prevention

Jeffrey R. Starke, MD – American Thoracic Society

Geoffrey Simon, MD – Committee on Practice Ambulatory Medicine

Tina Q. Tan, MD – Pediatric Infectious Diseases Society

Ex Officio

Henry H. Bernstein, DO, Red Book Online Associate Editor

David W. Kimberlin, MD, Red Book Editor

Sarah S. Long, MD, Red Book Associate Editor

H. Cody Meissner, MD, Visual Red Book Associate Editor

Staff

Jennifer Frantz, MPH

Footnotes

Accepted December 4, 2013.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.