Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, UNITED STATES, 2017

• Monovalent Hepatitis B vaccine should be administered within 24h of birth for medically stable infants weighing ≥2,000 grams born to hepatitis B surface antigen (HBsAg)-negative mothers. The recommendations for vaccination of infants <2,000 grams (as well as infants born to HBsAg-positive mothers or mothers whose hepatitis B status is unknown) remain unchanged.
• Preterm infants weighing <2,000 g born to HBsAg-negative mothers should receive the first dose of vaccine 1 month after birth or at hospital discharge.
• Additional detail regarding Hepatitis B vaccination of infants born to HBsAg-positive mothers or mothers whose hepatitis B status is unknown can be found in the ACIP Hepatitis B recommendations[39 pages].

The January 13 and February 17, 2017 MMWRs provide additional guidance regarding assessment of poliovirus vaccination status and vaccination of children who have received poliovirus vaccine outside the United States. View the complete guidance.

Specifically, the guidance provides information which offers additional clarification and changes impacting the IPV footnote in the 2017 catch-up schedule:

• If both OPV and IPV were administered as part of a series, the total number of doses needed to complete the series is the same as that recommended for the U.S. IPV schedule. A minimum interval of 4 weeks should separate doses in the series, with the final dose administered on or after the fourth birthday and at least 6 months after the previous dose.
• If only OPV was administered, and all doses were given before age 4 years, 1 dose of IPV should be given at 4 years or older and at least 6 months after the last OPV dose. This 6-month period is a change from the current footnote which indicates the period is 4 weeks after the last OPV dose.
• Only trivalent OPV (tOPV) counts toward the U.S. vaccination requirements (tOPV was used for routine poliovirus vaccination in all OPV-using countries until April 1, 2016). See Guidance to assess doses documented as “OPV”.

A new figure, Figure 3 “Vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications”, has been added. This figure:

• Demonstrates most children with medical conditions can (and should) be vaccinated according to the routine child/adolescent immunization schedule.
• Indicates when a medical condition is a precaution or contraindication to vaccination.
• Indicates when additional doses of vaccines may be necessary because of a child’s or adolescent’s medical condition. Providers should consult the relevant footnotes for additional information.

• The diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) footnote was revised to more clearly present recommendations following an inadvertently early administered fourth dose of DTaP.
• The tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) footnote for vaccination of pregnant adolescents between gestational weeks 27–36 has been updated to reflect a preference for vaccination earlier during this period. Currently available data suggest that vaccinating earlier in the 27 through 36 week time period will maximize passive antibody transfer to the infant.

• Within the Haemophilus influenzae type b vaccine (Hib) footnote, Comvax was removed from the routine vaccination portion of footnote. This vaccine has been removed from the market, and all available doses have expired. Additionally, Hiberix has been added to the list of vaccines that may be used for the primary vaccination series.

• A blue bar was added to the schedule for human papillomavirus vaccine (HPV) for children aged 9–10 years, indicating that persons in this age group may be vaccinated (even in the absence of a high-risk condition).
• The footnote for HPV vaccine has been updated to include the new 2-dose schedule for persons initiating the HPV vaccination series before age 15 years. Additionally, bivalent HPV vaccine has been removed from the schedule. This vaccine has been removed from the U.S. market, and all available vaccine doses have expired

• Live attenuated influenza vaccine (LAIV) has been removed from the influenza row of the schedule.
• The influenza vaccine footnote has been updated to indicate that LAIV should not be used during the 2016-2017 influenza season.

• The 16-year age column of the schedule has been separated from the 17–18-year age column to highlight the need for a meningococcal conjugate vaccine booster dose at age 16 years.
• The meningococcal vaccines footnote has been updated to include recommendations for meningococcal vaccination of children with human immunodeficiency virus (HIV) infection and to reflect recommendations for the use of a 2-dose Trumenba (meningococcal B vaccine) schedule.

• Within the pneumococcal vaccine footnote, references to 7-valent pneumococcal conjugate vaccine (PCV7) have been removed. All healthy children who may have received PCV7 as part of a primary series have now aged out of the recommendation for pneumococcal vaccine.