The 2023 recommended childhood and adolescent immunization schedules have been approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Physician Associates, and National Association of Pediatric Nurse Practitioners. The schedules are revised annually to reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration.
The 2023 childhood and adolescent immunization schedule has been updated to ensure consistency between the format of the childhood and adolescent and adult immunization schedules. Similar to last year, the cover page includes a table with an alphabetical listing of vaccines, approved abbreviations for each vaccine, and vaccine trade names.
Table 1 contains the recommended immunization schedule from birth to 18 years of age.
Table 2 is the catch-up immunization schedule for persons 4 months to 18 years of age who start late or who are more than 1 month behind the recommended age for vaccine administration.
Table 3 lists the vaccines that may be indicated for children and adolescents 18 years of age or younger on the basis of medical conditions.
Similar to the 2022 schedule, the notes are presented in vaccine alphabetical order.
The Appendix provides conditions when vaccines are contraindicated or not recommended or when precautions should be considered.
The following changes have been made to the 2023 schedule:
Coronavirus disease 2019 (COVID-19) vaccine: A new row for COVID-19 vaccines has been added.
Measles, mumps, and rubella: MMR (Priorix, GlaxoSmithKline Biologicals SA) has been added.
Pneumococcal conjugate vaccine: PCV15 (Vaxneuvance, Merck Sharp & Dohme) has been added.
Table 1 (Recommended Child and Adolescent Immunization Schedule by Age)
Pneumococcal conjugate vaccine row: PCV15 has been added.
COVID-19: A new row for COVID-19 vaccines has been added.
Dengue row: Overlying text has been changed from “Seropositive in endemic areas only” to “Seropositive in endemic dengue areas.”
Inactivated polio vaccine (IPV) row: “See Notes” has been added to the column for age 18 years.
Table 2 (Recommended Catch-up Immunization Schedule for Persons 4 Months to 18 Years of Age)
Pneumococcal conjugate, dose 3 to dose 4 interval: The text has been revised to be consistent with ACIP’s recommendation for dose 4. “This dose is only necessary for children aged 12 through 59 months regardless of risk, or age 60 through 71 months with any risk, who received 3 doses before age 12 months.”
Table 3 (Recommended Schedule by Medical Indication)
COVID-19 vaccine: A new row for COVID-19 vaccines has been added.
Additional information: The COVID-19 vaccination box has been deleted.
COVID-19: A new section has been added that contains information regarding the use of COVID-19 vaccines for routine vaccination and special situations.
Dengue: The text has been updated to clarify that dengue vaccine should not be administered to children traveling to or visiting endemic dengue areas.
Hepatitis B: This section has been rearranged to clarify recommendations for infants born to mothers with HBsAg-positive and unknown status.
^ Recommendations for 2022–23 influenza vaccination have been added.1
^ The text has been updated to clarify that LAIV4 should not be administered to close contacts of immunocompromised persons who require a protected environment. “Close contacts (eg, caregivers, healthcare personnel) of severely immunosuppressed persons who require a protected environment: these persons should not receive LAIV4. If LAIV4 is given, they should avoid contact with or caring for such immunosuppressed persons for 7 days after vaccination.”
Measles, mumps, and rubella (MMR): Language for additional MMR doses in mumps outbreak setting has been added. “In mumps outbreak settings, for information about additional doses of MMR (including 3rd dose of MMR), seewww.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm.”
Meningococcal serogroup A, C, W, and Y (MenACWY): Language for use of the new Meneveo liquid formulation has been added. “Menveo has 2 formulations: lyophilized and liquid. The liquid formulation shouldnotbe used before age 10 years.”
Meningococcal serogroup B (MenB): In special situations for Trumenba, recommendations have been added for when dose 2 or dose 3 of Trumenba is administered earlier or later than the recommended intervals. “If dose 2 was administered at least 6 months after dose 1, dose 3 not needed; if dose 3 is administered earlier than 4 months after dose 2, a fourth dose should be administered at least 4 months after dose 3.”
^ PCV15 has been added.2
^ For general discussions of pneumococcal conjugate vaccines, PCV13 has been changed to PCV.
^ A note has been added, “PCV13 and PCV15 can be used interchangeably for children who are healthy or have underlying conditions. PCV15 is not indicated for children who have received 4 doses of PCV13 or another age appropriate complete PCV13 series.”
^ “Chronic liver disease, alcoholism” has been deleted from special situations.
^ A new special situations section for persons aged 18 years at increased risk of exposure to polioviruses has been created.
Committee on Infectious Diseases, 2022–2023
Sean T. O’Leary, MD, MPH, FAAP, ChairpersonJames D. Campbell, MD, MS, FAAPMonica I. Ardura, DO, MSCS, FAAPRitu Banerjee, MD, PhD, FAAPKristina A Bryant, MD, FAAPMary T. Caserta, MD, FAAPRobert W. Frenck, Jr. MD, FAAPJeffrey S. Gerber, MD, PhD, FAAPChandy C. John, MD, MS, FAAPAthena P. Kourtis, MD, PhD, MPH, FAAPAngela Myers, MD, MPH, FAAPPia S. Pannaraj, MD, MPH, FAAPAdam J. Ratner, MD, MPH, FAAPSamir S. Shah, MD, MSCE, FAAP
David W. Kimberlin, MD, FAAP – Red Book EditorElizabeth D. Barnett MD, FAAP – Red Book Associate EditorRuth Lynfield, MD, FAAP – Red Book Associate EditorMark H. Sawyer, MD, FAAP – Red Book Associate EditorHenry H. Bernstein, DO, MHCM, FAAP – Red Book Online Associate Editor
Cristina Cardemil, MD MPH – National Institutes of HealthKaren M. Farizo, MD – US Food and Drug AdministrationLisa M. Kafer, MD, FAAP – Committee on Practice Ambulatory MedicineDavid Kim, MD – HHS Office of Infectious Disease and HIV/AIDS PolicyEduardo López Medina, MD, MSc – Sociedad Latinoamericana de Infectologia PediatricaDenee Moore, MD, FAAFP – American Academy of Family PhysiciansLakshmi Panagiotakopoulos, MD, MPH – Centers for Disease Control and PreventionLaura Sauvé, MD, MPH, FAAP, FRCPS – Canadian Pediatric SocietyJeffrey R. Starke, MD, FAAP – American Thoracic SocietyJennifer Thompson, MD – American College of Obstetricians and GynecologistsMelinda Wharton, MD, MPH – Centers for Disease Control and PreventionCharles R. Woods, Jr., MD, MS, FAAP – Pediatric Infectious Diseases Society
Jennifer M. Frantz, MPH
This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.
Advisory Committee on Immunization Practices
Centers for Disease Control and Prevention
quadrivalent inactivated influenza vaccine
inactivated poliovirus vaccine
live attenuated influenza vaccine
quadrivalent live attenuated influenza vaccine
meningococcal serogroup A, C, W, and Y
meningococcal serogroup B
measles, mumps, and rubella vaccine
measles, mumps, rubella, and varicella vaccine
pneumococcal conjugate vaccine
tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine