Recommended Childhood and Adolescent Immunization Schedule: United States, 2025

Publication Date: November 21, 2024
Last Updated: November 22, 2024

Key Updates for 2025

  • COVID-19:
    • The vaccine formula has been updated for 2024-’25. All individuals ages 6 month and older should receive at least one dose of the 2024-’25 vaccine and additional COVID vaccine doses are recommended for children and adolescents who are immunocompromised. Updated notes state all doses should be from the same manufacturer for healthy children ages 6 months through 4 years and immunocompromised children and adolescents receiving their initial vaccine series.
  • Dengue:
    • The schedule clarifies the vaccine is recommended only for certain populations in the age group.
  • Diphtheria, tetanus and acellular pertussis (DTaP):
    • A note addresses the use of Td vaccine in children under 7 years with a contraindication to the pertussis component of DTaP.
  • Haemophilus influenzae type b (Hib):
    • Vaxelis is one of two preferred vaccines to protect American Indian/Alaska Native infants from Hib. The other preferred vaccine is PedvaxHIB.
  • Inactivated poliovirus:
    • Clarifies an earlier recommendation that catch-up vaccination is recommended for 18-year-olds who are known or suspected to be unvaccinated or incompletely unvaccinated.
  • Influenza:
    • Vaccines for 2024-’25 are trivalent. High-dose inactivated and adjuvanted inactivated influenza vaccines are acceptable options for 18-year-old solid organ transplant recipients who are receiving immunosuppressive medications with no preference over other age-appropriate inactivated or recombinant influenza vaccines.
  • Measles, mumps, rubella:
    • A new note indicates children 12 months and older vaccinated with one dose should get a second dose at least four weeks after the first if they are going to travel internationally.
  • Measles, mumps, rubella, varicella:
    • The vaccine is contraindicated in HIV-infected people.
  • Meningococcal B:
    • Bexsero dosing has been changed to a two-dose series for healthy adolescents and a three-dose series for those at increased risk of disease. Patients who need rapid protection (such as during an outbreak) can choose a three-dose series.
  • Respiratory syncytial virus (RSV):
    • Updated notes clarify that for infants born in October through March, the ideal timing of nirsevimab administration is during the birth hospitalization. In addition, infants born to people who received an RSV vaccine during a previous pregnancy should receive nirsevimab.

Summary Of Recommendations

COVID-19 vaccination

Routine vaccination

Age 6 months–4 years

All vaccine doses should be from the same manufacturer.

  • Unvaccinated:
    • 2 doses 2024–25 Moderna at 0, 4–8 weeks
    • 3 doses 2024–25 Pfizer-BioNTech at 0, 3–8, and at least 8 weeks after dose 2
  • Incomplete initial vaccination series before 2024–25 vaccine with:
    • 1 dose Moderna: complete initial series with 1 dose 2024–25 Moderna 4–8 weeks after most recent dose
    • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 2024–25 Pfizer-BioNTech 8 weeks apart (administer dose 1 3–8 weeks after most recent dose).
    • 2 doses Pfizer-BioNTech: complete initial series with 1 dose 2024–25 Pfizer-BioNTech at least 8 weeks after the most recent dose.
  • Completed initial vaccination series before 2024–25 vaccine with:
    • 2 or more doses Moderna: 1 dose 2024–25 Moderna at least 8 weeks after the most recent dose.
    • 3 or more doses Pfizer-BioNTech: 1 dose 2024–25 Pfizer-BioNTech at least 8 weeks after the most recent dose.

Age 5–11 years

  • Unvaccinated: 1 dose 2024–25 Moderna or Pfizer-BioNTech
  • Previously vaccinated before 2024–25 vaccine with 1 or more doses Moderna or Pfizer-BioNTech: 1 dose 2024–25 Moderna or Pfizer-BioNTech at least 8 weeks after the most recent dose.

Age 12–18 years

  • Unvaccinated:
    • 1 dose 2024–25 Moderna or Pfizer-BioNTech
    • 2 doses 2024–25 Novavax at 0, 3–8 weeks
  • Previously vaccinated before 2024–25 vaccine with:
    • 1 or more doses Moderna or Pfizer-BioNTech: 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose.
    • 1 dose Novavax: 1 dose 2024–25 Novavax 3–8 weeks after most recent dose. If more than 8 weeks after most recent dose, administer 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech.
    • 2 or more doses Novavax: 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose.
Unvaccinated persons have never received any COVID-19 vaccine doses. There is no preferential recommendation for the use of one COVID-19 vaccine over another when more than one recommended age-appropriate vaccine is available. Administer an age-appropriate COVID-19 vaccine product for each dose.
For information about transition from age 4 years to age 5 years or age 11 years to age 12 years during COVID-19 vaccination series, see Tables 1 and 2 at www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.
For information about interchangeability of COVID-19 vaccines, see www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#Interchangeability.
Current COVID-19 schedule and dosage formulation available at www.cdc.gov/covidschedule. For more information on Emergency Use Authorization (EUA) indications for COVID-19 vaccines, see www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.

Special situations

Persons who are moderately or severely immunocompromised

Age 6 months–4 years

Use vaccine from the same manufacturer for all doses (initial vaccination series and additional doses*).

  • Unvaccinated:
    • 4 doses (3-dose initial series 2024–25 Moderna at 0, 4 weeks, and at least 4 weeks after dose 2, followed by 1 dose 2024–25 Moderna 6 months later [minimum interval 2 months]). May administer additional doses.*
    • 4 doses (3-dose initial series 2024–25 Pfizer-BioNTech at 0, 3 weeks, and at least 8 weeks after dose 2, followed by 1 dose 2024–25 Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses.*
  • Incomplete initial 3-dose vaccination series before 2024–25 vaccine:
    • Previous vaccination with Moderna
      • 1 dose Moderna: complete initial series with 2 doses 2024–25 Moderna at least 4 weeks apart (administer dose 1 4 weeks after most recent dose), followed by 1 dose 2024–25 Moderna 6 months later (minimum interval 2 months). May administer additional doses of Moderna.*
      • 2 doses Moderna: complete initial series with 1 dose 2024–25 Moderna at least 4 weeks after most recent dose, followed by 1 dose 2024–25 Moderna 6 months later (minimum interval 2 months). May administer additional doses of Moderna.*
    • Previous vaccination with Pfizer-BioNTech
      • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 2024–25 Pfizer-BioNTech at least 8 weeks apart (administer dose 1 3 weeks after most recent dose), followed by 1 dose 2024–25 Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Pfizer-BioNTech.*
      • 2 doses Pfizer-BioNTech: complete initial series with 1 dose 2024–25 Pfizer-BioNTech at least 8 weeks after most recent dose, followed by 1 dose 2024–25 Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Pfizer-BioNTech.*
  • Completed initial 3-dose vaccination series before 2024–25 vaccine with:
    • 3 or more doses Moderna: 2 doses 2024–25 Moderna 6 months apart (minimum interval 2 months). Administer dose 1 at least 8 weeks after the most recent dose. May administer additional doses of Moderna.*
    • 3 or more doses Pfizer-BioNTech: 2 doses 2024–25 Pfizer-BioNTech 6 months apart (minimum interval 2 months). Administer dose 1 at least 8 weeks after the most recent dose. May administer additional doses of Pfizer-BioNTech.*

Age 5–11 years

Use vaccine from the same manufacturer for all doses in the initial vaccination series.

  • Unvaccinated:
    • 4 doses (3-dose initial series 2024–25 Moderna at 0, 4 weeks, and at least 4 weeks after dose 2, followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses.*
    • 4 doses (3-dose initial series 2024–25 Pfizer-BioNTech at 0, 3 weeks, and at least 4 weeks after dose 2, followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses.*
  • Incomplete initial 3-dose vaccination series before 2024–25 vaccine:
    • Previous vaccination with Moderna
      • 1 dose Moderna: complete initial series with 2 doses 2024–25 Moderna at least 4 weeks apart (administer dose 1 4 weeks after most recent dose), followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Pfizer-BioNTech.*
      • 2 doses Moderna: complete initial series with 1 dose 2024–25 Moderna at least 4 weeks after most recent dose, followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Pfizer-BioNTech.*
    • Previous vaccination with Pfizer-BioNTech
      • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 2024–25 Pfizer-BioNTech at least 4 weeks apart (administer dose 1 3 weeks after most recent dose), followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Pfizer-BioNTech.*
      • 2 doses Pfizer-BioNTech: complete initial series with 1 dose 2024–25 Pfizer-BioNTech at least 4 weeks after most recent dose, followed by 1 dose 2024–25 Moderna or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Pfizer-BioNTech.*
  • Completed initial 3-dose vaccination series before 2024–25 vaccine with:
    • 3 or more doses Moderna or 3 or more doses Pfizer-BioNTech: 2 doses 2024–25 Moderna or Pfizer-BioNTech 6 months apart (minimum interval 2 months). Administer dose 1 at least 8 weeks after the most recent dose. May administer additional doses of Moderna or Pfizer-BioNTech.*

Age 12–18 years

Use vaccine from the same manufacturer for all doses in the initial vaccination series.

  • Unvaccinated:
    • 4 doses (3-dose initial series Moderna at 0, 4 weeks, and at least 4 weeks after dose 2, followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
    • 4 doses (3-dose initial series Pfizer-BioNTech at 0, 3 weeks, and at least 4 weeks after dose 2, followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech *
    • 3 doses (2-dose initial series Novavax at 0, 3 weeks, followed by 1 dose Moderna or Novavax or Pfizer-BioNTech 6 months later [minimum interval 2 months]). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
  • Incomplete initial vaccination series before 2024–25 vaccine:
    • Previous vaccination with Moderna
      • 1 dose Moderna: complete initial series with 2 doses 2024–25 Moderna at least 4 weeks apart (administer dose 1 4 weeks after most recent dose), followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
      • 2 doses Moderna: complete initial series with 1 dose 2024–25 Moderna at least 4 weeks after most recent dose, followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
    • Previous vaccination with Pfizer-BioNTech
      • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 2024–25 Pfizer-BioNTech at least 4 weeks apart (administer dose 1 3 weeks after most recent dose), followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
      • 2 doses Pfizer-BioNTech: complete initial series with 1 dose 2024–25 Pfizer-BioNTech at least 4 weeks after most recent dose, followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
    • Previous vaccination with Novavax 1 dose Novavax: complete initial series with 1 dose 2024–25 Novavax at least 3 weeks after most recent dose, followed by 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months later (minimum interval 2 months). May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
  • Completed initial 3-dose vaccination series before 2024–25 vaccine with:
    • 3 or more doses Moderna or 3 or more doses Pfizer-BioNTech: 2 doses 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months apart (minimum interval 2 months). Administer dose 1 at least 8 weeks after the most recent dose. May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*
    • 2 or more doses Novavax: 2 doses 2024–25 Moderna or Novavax or Pfizer-BioNTech 6 months apart (minimum interval 2 months). Administer dose 1 at least 8 weeks after the most recent dose. May administer additional doses of Moderna or Novavax or Pfizer-BioNTech.*

*Additional doses of 2024–25 COVID-19 vaccine for moderately or severely immunocompromised: based on shared clinical decision-making and administered at least 2 months after the most recent dose (see Table 2 at www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#table-02). For description of moderate and severe immunocompromising conditions and treatment, see https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#immunocompromising-conditions-treatment.

Unvaccinated persons have never received any COVID-19 vaccine doses. There is no preferential recommendation for the use of one COVID-19 vaccine over another when more than one recommended age-appropriate vaccine is available. Administer an age-appropriate COVID-19 vaccine product for each dose.

For information about transition from age 4 years to age 5 years or age 11 years to age 12 years during COVID-19 vaccination series, see Tables 1 and 2 at www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html.

For information about interchangeability of COVID-19 vaccines, see www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#Interchangeability.

Current COVID-19 schedule and dosage formulation available at www.cdc.gov/covidschedule. For more information on Emergency Use Authorization (EUA) indications for COVID-19 vaccines, see www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.

Overview

Title

Recommended Childhood and Adolescent Immunization Schedule: United States, 2025

Authoring Organization

Centers for Disease Control and Prevention