Version July 2025
| Vaccine | <2 years old | 2 to 10 years old | >10 years old | Revaccination (booster doses) |
| Pneumococcus¶ | Refer to UpToDate content for details | Refer to UpToDate content for details | Refer to UpToDate content for details | |
Haemophilus influenzae type b
| ActHIB, Hiberix, Pentacel: 4-dose series at 2, 4, 6, and 12 to 15 months of age or PedvaxHIB: 3-dose series at 2, 4, and 12 to 15 months of age | Recommended only if not previously vaccinated, vaccination status is unknown, or primary series is incompleteפ | Not required | |
Meningococcus serotype ACWY
| 4-dose series of Menveo at 2, 4, 6, and 12 months of age‡† | Menveo or MenQuadfi: 2 doses ≥8 weeks apart** | Revaccinate at intervals based on age:
| |
Meningococcus serotype B
| Not recommended until age 10 | 3 doses at 0, 1 to 2, and 6 months MenB formulations are not interchangeable. The same MenB formulation must be used for each dose of the primary series and all booster doses. | 1 year after completing the primary series and every 2 to 3 years thereafter | |
| Seasonal influenza¶¶ | 1 dose annually for children >6 monthsΔΔ | Annually at start of influenza season | ||
| COVID-19 | Refer to UpToDate content for details | Refer to UpToDate content for details | ||
COVID-19: coronavirus disease 2019.
* Available vaccine formulations and recommendations may differ outside of the United States.
¶ Pneumococcal vaccine regimens have become more complex as more formulations have become available. Refer to UpToDate topics and tables on pneumococcal vaccination.
Δ Pentacel is a combination vaccine that targets diphtheria, pertussis, polio, and tetanus in addition to H. influenzae type B.
◊ For children <5 years old with anatomic or functional asplenia who are unvaccinated or who received only one dose before 12 months of age, give two doses eight weeks apart; if two or more doses were given before 12 months of age, then give one dose at least eight weeks after the last dose. For unvaccinated patients ≥5 years old, give one dose.
§ For unvaccinated children ≥15 months undergoing an elective splenectomy, give one dose at least 14 days prior to the procedure.
¥ Another MenACWY-TT vaccine (Nimenrix) is licensed in some countries outside the United States.
‡ Only Menveo can be given before age 2.
† If the first dose is given at ≥7 months of age, give two doses. The second dose should be given ≥12 weeks after the first and when the child is >1 year old.
** Menveo or MenQuadfi can be given at age 2 or greater. Each should be given as a two-dose series spaced at least 8 weeks apart.
¶¶ Although live attenuated vaccines can be safely given to patients with impaired splenic function who lack other immunosuppressive conditions, the inactivated influenza vaccine is preferred over the live formulation because it is equally effective.
ΔΔ Children <9 years old who did not receive a total of two doses of influenza vaccine previously should receive two doses given ≥4 weeks apart followed by annual revaccination with a single dose thereafter.
