The Centers for Disease Control and Prevention (CDC) published the 2024 immunization schedules online today, several months ahead of the usual timeline. The schedules have been approved by the AAP, which has published a policy statement. The schedules incorporate policies approved over the past year and tweaks to improve clarity and readability.
The following key changes have been made in the 2024 immunization schedule:
- Headers were changed from “Vaccine” to “Vaccines and Other Immunizing Agents” to include monoclonal antibodies.
- New entries, indications, notes, and contraindications and precautions were added for:
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- RSV-mAb (nirsevimab) for children from birth through <8 months and for certain high-risk groups from 8 to 19 months, including information describing timing of immunization and guidance for jurisdictions with respiratory syncytial virus (RSV) seasonality that differs from most of the continental United States;
- RSVPreF vaccine (Abrysvo) for pregnant persons, including information describing timing of immunization and guidance for jurisdictions with RSV seasonality that differs from most of the continental United States; and
- mpox vaccine (Jynneos) for those who are age 18 years and at risk.
- The following vaccines were deleted from the schedule because they no longer are distributed or recommended for use in the U.S.:
- bivalent mRNA COVID-19 vaccines,
- 13-valent pneumococcal conjugate vaccine (PCV13),
- diphtheria and tetanus toxoid vaccine (DT), and
- Menactra
- COVID-19: The routine vaccination and “Special situations” sections were revised to reflect the current COVID-19 (2023-’24 formula) vaccination recommendations for children and adolescents.
- Influenza: A note was added to state that people with a history of egg allergy of any severity can be vaccinated with any influenza vaccine indicated for the recipient’s age and health status with no additional safety considerations.
- Meningococcal (Men): Information was added about use of the newly licensed MenACWY-TT/MenB-FHbp (Penbraya) vaccine. A resource to assist health care providers with shared clinical decision-making recommendations for MenB vaccination was added.
- Pneumococcal: Recommendations were added for use of the 15-valent pneumococcal conjugate vaccine (PCV15), PCV20 and 23-valent pneumococcal polysaccharide vaccine (PPSV23) for routine vaccination, catch-up vaccination and “special situations.”
- Poliovirus: “Catch-up” vaccination was revised to include updated recommendations for adolescents age 18 years, and the “Special situations” section was revised to describe administering one lifetime inactivated polio vaccine (IPV) booster to adolescents age 18 years who have completed the primary series and are at increased risk for exposure to poliovirus.
Comprehensive details about changes to tables and footnotes in the updated schedules will be published in an upcoming issue of Pediatrics and the CDC’s Morbidity and Mortality Report (MMWR) in early 2024.
Traditionally, the online and MMWR publication takes place in February. The CDC decided to publish the schedules earlier and to provide an addenda with regular updates, as the timing impacts insurance payment and the ability of certain health care providers to administer immunizations in some states. The AAP and numerous other medical organizations have expressed support for updating the schedules more frequently.
Health care providers can refer to the Addenda on the last page of the immunization schedules for new and updated Advisory Committee on Immunization Practices recommendations made after publication.
A recent CDC report showed kindergarten vaccination rates have not rebounded from the COVID-19 pandemic, and exemptions from school requirements reached an all-time high during the 2022-'23 school year. Another report found vaccine coverage for children by 2 years of age has been relatively stable but disparities continue.
Resources
- Immunization schedule for children and adolescents
- AAP policy Recommended Childhood and Adolescent Immunization Schedule: United States, 2024
- AAP immunization resources
- CDC’s Let’s RISE vaccine initiative
- Information for parents from HealthyChildren.org on recommended childhood immunizations
