HealthDay News — The updated 2013 childhood and adolescent immunization schedules have been merged into a single schedule covering people ages 0 to 18 years, according to the American Academy of Pediatrics.

The new five-page 2013 format replaces the previous two separate schedules for children aged 0 to 6 years and those aged 7 to 18 years.

The AAP cited the increasing complexity of the childhood and adolescent immunization schedules and a lack of space for new information in the footnotes as factors responsible for the redesign.

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The schedule, published online in Pediatrics, also reflects new recommendations adopted by the Advisory Committee on Immunization Practices (ACIP), and is approved by the AAP, the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG).

Specific changes to the pediatric immunization schedule from the 2012 recommendations include:

  • A clarification of the number of doses for rotavirus-1 (RV-1, Rotarix) and rotavirus-5 (RV-5, Rotateq) in the rotavirus footnotes
  • A new recommendation that tetanus-diphtheria-acellular pertussis be administered to pregnant adolescents and adults during the second half of each pregnancy to protect both the mother and the newborn before it can begin receiving the childhood DTaP series
  • A footnote clarifying that only one dose of Haemophilus influenzae type b should be administered to unvaccinated children aged 15 months of age or older. 

To highlight school entry and adolescent vaccine age group recommendations, new columns have been added at age 4 to 6 years and 11 to 12 years. Expanded footnotes now contain the recommendations for routine vaccination, for catch-up vaccination and for vaccination of youth with high-risk conditions or in special circumstances.

The ACIP also released the updated 2013 adult immunization schedule, which were published online in Annals of Internal Medicine. The adult schedule is approved by the AAFP, ACOG, American College of Physicians and American College of Nurse Midwives.

For the first time, information on the timing of the 13-valent pneumococcal conjugate vaccine (PCV13) relative to the 23-valent pneumococcal

polysaccharide vaccine (PPSV23) will be included in the adult schedule. Neither vaccine should be used in adults who have immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leaks or cochlear implants.

The recommendations for the tetanus-diphtheria-acellular pertussis vaccine were expanded to include all adults 65 years and older as well as pregnant women with each pregnancy.

In addition, the FDA has approved a quadrivalent influenza vaccine containing two influenza A (H3N2) virus strains — H3N2 and H1N1 — and two influenza B virus strains, which is expected to be available in the 2013-2014 influenza season.

Because there likely will be both trivalent and quadrivalent influenza vaccines available in the upcoming season, the new schedule changes the acronym for inactivated influenza vaccine, which had been TIV (trivalent inactivated influenza vaccine), to IIV (inactivated influenza vaccine). The acronym for the live-attenuated influenza vaccine (LAIV) will remain the same.

Additional minor changes were made to footnotes, figures, and the contraindications and precautions table.


  1. Committee on Infectious Diseases “Recommended childhood and adolescent immunization schedule — United States, 2013” Pediatrics. 2013; doi: 10.1542/peds.2012-3706.
  2. Advisory Committee on Immunization Practices “Recommended adult immunization schedule: United States, 2013” Ann Intern Med. 2013; 158.