Birth-18 Years Immunization Schedule – Healthcare Providers - CDC

Dengue (DEN4CYD)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)
• Lack of laboratory confirmation of a previous Dengue infection

• Pregnancy
• HIV infection without evidence of severe immunosuppression
• Moderate or severe acute illness with or without fever

Diphtheria, tetanus, pertussis (DTaP)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• For DTaP only: Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of previous dose of DTP or DTaP

• Guillain-Barré syndrome (GBS) within 6 weeks after previous dose of tetanus-toxoid–containing vaccine
• History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria-toxoid–containing or tetanus-toxoid–containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus-toxoid-containing vaccine
• For DTaP only: Progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, progressive encephalopathy; defer DTaP until neurologic status clarified and stabilized
• Moderate or severe acute illness with or without fever

Haemophilus influenzae type b (Hib)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Less than age 6 weeks

• Moderate or severe acute illness with or without fever

Hepatitis A (HepA)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³ including neomycin

• Moderate or severe acute illness with or without fever

Hepatitis B (HepB)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component3 including yeast
• Pregnancy: Heplisav-B and PreHevbrio are not recommended due to lack of safety data in pregnant persons. Use other hepatitis B vaccines if HepB is indicated⁴.

• Moderate or severe acute illness with or without fever

Hepatitis A-Hepatitis B vaccine (HepA-HepB)
[Twinrix]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³ including neomycin and yeast

• Moderate or severe acute illness with or without fever

Human papillomavirus (HPV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Pregnancy: HPV vaccination not recommended

• Moderate or severe acute illness with or without fever

Measles, mumps, rubella (MMR)
Measles, mumps, rubella, and varicella (MMRV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)
• Pregnancy
• Family history of altered immunocompetence, unless verified clinically or by laboratory testing as immunocompetent

• Recent (≤11 months) receipt of antibody-containing blood product (specific interval depends on product)
• History of thrombocytopenia or thrombocytopenic purpura
• Need for tuberculin skin testing or interferon-gamma release assay (IGRA) testing
• Moderate or severe acute illness with or without fever
• For MMRV only: Personal or family (i.e., sibling or parent) history of seizures of any etiology

Meningococcal ACWY (MenACWY)
(MenACWY-CRM) [Menveo]
(MenACWY-TT) [MenQuadfi]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• For MenACWY-CRM only: severe allergic reaction to any diphtheria toxoid–or CRM197–containing vaccine
• For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine

• For MenACWY-CRM only: Preterm birth if less than age 9 months
• Moderate or severe acute illness with or without fever

Meningococcal B (MenB)
MenB-4C [Bexsero]
MenB-FHbp [Trumenba]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

• Pregnancy
• For MenB-4C only: Latex sensitivity
• Moderate or severe acute illness with or without fever

Meningococcal ABCWY
(MenACWY-TT/MenB-FHbp) [Penbraya]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe allergic reaction to a tetanus toxoid-containing vaccine

• Moderate or severe acute illness, with or without fever

Mpox [Jynneos]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

• Moderate or severe acute illness, with or without fever

Pneumococcal conjugate (PCV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe allergic reaction (e.g., anaphylaxis) to any diphtheria-toxoid– containing vaccine or its component³

• Moderate or severe acute illness with or without fever

Pneumococcal polysaccharide (PPSV23)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

• Moderate or severe acute illness with or without fever

Poliovirus vaccine, inactivated (IPV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

• Pregnancy
• Moderate or severe acute illness with or without fever

RSV monoclonal antibody (RSV-mAb)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component⁵

• Moderate or severe acute illness with or without fever

Respiratory syncytial virus vaccine (RSV)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

• Moderate or severe acute illness with or without fever

Rotavirus (RV)
RV1 [Rotarix], RV5 [RotaTeq]

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe combined immunodeficiency (SCID)
• History of intussusception

• Altered immunocompetence other than SCID
• Chronic gastrointestinal disease
• RV1 only: Spina bifida or bladder exstrophy
• Moderate or severe acute illness with or without fever

Tetanus, diphtheria, and acellular pertussis (Tdap)
Tetanus, diphtheria (Td)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• For Tdap only: Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of previous dose of DTP, DTaP, or Tdap

• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus-toxoid–containing vaccine
• History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria-toxoid–containing or tetanus-toxoid–containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus-toxoid–containing vaccine
• For Tdap only: Progressive or unstable neurological disorder, uncontrolled seizures, or progressive encephalopathy until a treatment regimen has been established and the condition has stabilized
• Moderate or severe acute illness with or without fever

Varicella (VAR)

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³
• Severe immunodeficiency (e.g., hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)
• Pregnancy
• Family history of altered immunocompetence, unless verified clinically or by laboratory testing as immunocompetent

• Recent (≤11 months) receipt of antibody-containing blood product (specific interval depends on product)
• Receipt of specific antiviral drugs (acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination (avoid use of these antiviral drugs for 14 days after vaccination)
• Use of aspirin or aspirin-containing products
• Moderate or severe acute illness with or without fever
• If using MMRV, see MMR/MMRV for additional precautions