Version July 2025
| Vaccine | Recommended approach | Alternative approach* |
| MMR | Revaccination with MMR | Serologic testing for IgG antibodies to measles, mumps, and rubella |
| Hib | Age-appropriate revaccination | – |
| Hepatitis A | Age-appropriate revaccination | Serologic testing for IgG antibodies to hepatitis A |
| Hepatitis B | Age-appropriate revaccination and serologic testing for HBsAg¶ | – |
| Poliovirus | Revaccination with inactivated poliovirus vaccine | Serologic testing not recommended |
| DTaP | Revaccination with DTaP, with serologic testing for specific IgG antibody to tetanus and diphtheria toxins in the event of a severe local reaction | Persons whose records indicate receipt of ≥3 doses: Serologic testing for specific IgG antibody to diphtheria and tetanus toxins before administering additional doses, or administer a single booster dose of DTaP, followed by serological testing after one month for specific IgG antibody to diphtheria and tetanus toxins with revaccination as appropriateΔ |
| Tdap | Age-appropriate vaccination/revaccination of persons who are candidates for Tdap vaccine | – |
| Varicella | Age-appropriate vaccination/revaccination of persons who lack evidence of varicella immunity | – |
| Pneumococcal conjugate | Age-appropriate vaccination/revaccination | – |
| Rotavirus | Age-appropriate vaccination/revaccination | – |
| HPV | Age-appropriate vaccination | – |
| Meningococcal conjugate (MenACWY) | Age-appropriate vaccination/revaccination | – |
DTaP: diphtheria and tetanus toxoids and acellular pertussis; HBsAg: hepatitis B surface antigen; Hib: Haemophilus influenzae type b; HPV: human papillomavirus; IgG: immunoglobulin G; MenACWY: quadrivalent meningococcal conjugate vaccine; MMR: measles, mumps, and rubella; Tdap: tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis.
* There is a recommended approach for all vaccines and an alternative approach for some vaccines.
¶ In rare instances, hepatitis B vaccine can give a false-positive HBsAg result up to 18 days after vaccination; therefore, blood should be drawn to test for HBsAg before vaccinating (Source: Centers for Disease Control and Prevention. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices [ACIP]; Part I: Immunization in infants, children, and adolescents. MMWR 2005; 54[No. RR-16.]).
Δ If the child has a protective concentration, recorded doses are considered valid, and the vaccination series should be completed as age appropriate. Clinicians should contact the laboratory performing the test for interpretive standards and limitations. Protective concentrations for antibody to diphtheria and tetanus toxins are defined as >0.1 international unit/mL.
