Measure description
Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday
Rationale
Infants and toddlers are particularly vulnerable to infectious diseases because their immune systems have not built up the necessary defenses to fight infection (Centers for Disease Control and Prevention (CDC, 2019). Most childhood vaccines are between 90 and 99 percent effective in preventing diseases (American Academy of Pediatrics, 2013). Vaccination of each U.S. birth cohort with the current childhood immunization schedule prevents approximately 42,000 deaths and 20 million cases of disease and saves nearly $14 billion in direct costs and $69 billion in societal costs each year (Zhou et al., 2014).
Immunizing a child not only protects that child's health but also the health of the community, especially for those who are not immunized or are unable to be immunized due to other health complications (Centers for Disease Control and Prevention, 2018).
Clinical Recommendation Statements
Recommended Child and Adolescent Immunization Schedule
for ages 18 years or younger, United States 2020 (Centers for Disease Control and Prevention, 2020)
Hepatitis B vaccination
(minimum age: birth)
"Routine series
-- 3-dose series at 0, 1–2, 6–18 months (use monovalent HepB vaccine for doses administered before age 6 weeks)
-- Infants who did not receive a birth dose should begin the series as soon as feasible (see Table 2).
-- Administration of 4 doses is permitted when a combination vaccine containing HepB is used after the birth dose.
-- Minimum age for the final (3rd or 4th ) dose: 24 weeks
-- Minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to
dose 3: 8 weeks / dose 1 to dose 3: 16 weeks (when 4 doses are administered, substitute "dose 4" for "dose 3" in these calculations) "
Diphtheria, tetanus, and pertussis (DTaP) vaccination (minimum age: 6 weeks [4 years for Kinrix or Quadracel])
"Routine vaccination
-- 5-dose series at 2, 4, 6, 15–18 months, 4–6 years
- Prospectively: Dose 4 may be administered as early as age 12 months if at least 6 months have elapsed since dose 3.
- Retrospectively: A 4th dose that was inadvertently administered as early as 12 months may be counted if at least 4 months have elapsed since dose 3. "
Haemophilus influenzae type b vaccination
(minimum age: 6 weeks)
"Routine vaccination
-- ActHIB, Hiberix, or Pentacel: 4-dose series at 2, 4, 6, 12–
15 months
-- PedvaxHIB: 3-dose series at 2, 4, 12–15 months"
Pneumococcal vaccination
(minimum age: 6 weeks [PCV13], 2 years [PPSV23])
"Routine vaccination with PCV13
-- 4-dose series at 2, 4, 6, 12–15 months"
Poliovirus vaccination
(minimum age: 6 weeks)
"Routine vaccination
-- 4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer the final dose at or after age 4 years and at least 6 months after the previous dose.
-- 4 or more doses of IPV can be administered before age 4 years when a combination vaccine containing IPV is used. However, a dose is still recommended at or after age 4 years and at least 6 months after the previous dose"
Measles, mumps, and rubella vaccination
(minimum age: 12 months for routine vaccination)
"Routine vaccination
-- 2-dose series at 12–15 months, 4–6 years
-- Dose 2 may be administered as early as 4 weeks after dose 1."
Varicella vaccination
(minimum age: 12 months)
"Routine vaccination
-- 2-dose series at 12–15 months, 4–6 years
-- Dose 2 may be administered as early as 3 months after dose 1 (a dose administered after a 4-week interval may be counted)."
Hepatitis A vaccination
(minimum age: 12 months for routine vaccination)
"Routine vaccination
-- 2-dose series (minimum interval: 6 months) beginning at age 12 months"
Rotavirus vaccination
(minimum age: 6 weeks)
"Routine vaccination
-- Rotarix: 2-dose series at 2 and 4 months
-- RotaTeq: 3-dose series at 2, 4, and 6 months
-- If any dose in the series is either RotaTeq or unknown, default to 3-dose series"
Influenza vaccination
(minimum age: 6 months [IIV], 2 years [LAIV],
18 years [recombinant influenza vaccine, RIV])
"Routine vaccination
-- Use any influenza vaccine appropriate for age and health status annually:
- 2 doses, separated by at least 4 weeks, for children age 6
months–8 years who have received fewer than 2 influenza
vaccine doses before July 1, 2019, or whose influenza vaccination history is unknown (administer dose 2 even if the child turns 9 between receipt of dose 1 and dose 2)
- 1 dose for children age 6 months–8 years who have received at least 2 influenza vaccine doses before July 1, 2019
- 1 dose for all persons age 9 years and older
-- For the 2020–21 season, see the 2020–21 ACIP influenza vaccine recommendations."