Table 3. Recommended Child and Adolescent Immunization Schedule by Medical Indication, United States, 2021
¶ = Vaccination according to the routine schedule recommended
§ = Recommended for persons with an additional risk factor for which the vaccine would be indicated
» = Vaccination is recommended, and additional doses may be necessary based on medical condition. See Notes.
± = Not recommended/Contraindicated—vaccine should not be administered
| = Precaution—vaccine might be indicated if benefit of protection outweighs risk of adverse reaction
^ = Delay vaccination until after pregnancy if vaccine indicated
• = No recommendation/Not applicable
| Vaccine | Indication | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Pregnancy | Immunocompromised status (excluding HIV infection) | HIV infection CD4+ count1 | Kidney failure, end-stage renal disease, on hemodialysis | Heart disease, chronic lung disease | CSF leaks/cochlear implants | Asplenia and persistent complement component deficiencies | Chronic liver disease | Diabetes | ||
| <15% and total CD4 cell count of <200/mm3 | ≥15% and total CD4 cell count of ≥200/mm3 | |||||||||
Hepatitis B  |
¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Rotavirus |
• | | | | | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| SCID2± | ||||||||||
| Diphtheria, tetanus, & acellular pertussis (DTaP) |
• | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Haemophilus influenzae type b |
• | » | » | ¶ | ¶ | ¶ | » | ¶ | ¶ | |
| Pneumococcal conjugate |
• | » | » | » | » | » | » | » | » | |
| Inactivated poliovirus |
| | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Influenza (IIV) |
¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
 Influenza (LAIV4) |
± | ± | ± | | | | | ± | ± | | | | | |
| Asthma, wheezing: 2-4yrs3± | ||||||||||
| Measles, mumps, rubella |
± * | ± | ± | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ |
| Varicella |
± * | ± | ± | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ |
| Hepatitis A |
¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Tetanus, diphtheria, & acellular pertussis (Tdap) |
» | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Human papillomavirus |
± * | » | » | ¶ | ¶ | ¶ | ¶ | ¶ | ¶ | |
| Meningococcal ACWY |
¶ | ¶ | » | ¶ | ¶ | ¶ | » | ¶ | ¶ | |
| Meningococcal B |
| | § | § | § | § | § | » | § | § | |
| Pneumococcal polysaccharide |
§ | » | » | » | » | » | » | » | » | |
- For additional information regarding HIV laboratory parameters and use of live vaccines, see the General Best Practice Guidelines for Immunization “Altered Immunocompetence” and Table 4-1 (footnote D).
- Severe Combined Immunodeficiency
- LAIV contraindicated for children 2–4 years of age with asthma or wheezing during the preceding 12 months.