AAP & AAFP • 2026 Reference

Childhood through Adulthood

Vaccine Schedule



Quick reference guide for physicians, parents & care teams. 

Evidence-based immunization schedules protecting children and adults.

Infants & Toddlers

Birth through 18 months  • AAP/AAFP Schedule

Birth

  • Hepatitis B (HepB) #1

Within 24 hours of birth

2 Months

  • HepB #2
  • DTaP #1
  • IPV #1
  • Hib #1
  • PCV #1
  • Rotavirus #1

4 Months

  • DTaP #2
  • IPV #2
  • Hib #2
  • PCV #2
  • Rotavirus #2

Second doses of the series

6 Months

  • HepB #3
  • DTaP #3
  • IPV #3
  • PCV #3
  • Rotavirus #3
  • Influenza (annual)

12 - 15 Months

  • MMR #1
  • Varicella #1
  • Hepatits A #1
  • Hib booster
  • PCV booster

15 - 18 Months

  • DTaP #4 (booster)
  • Hepatitis A #2

HepA series completes 6 - 18 months after first dose

Children

2 through 10 years - Pre-K boosters & ongoing protection

4 - 6 Years

  • DTaP #5
  • IPV #4
  • MMR #2
  • Varicella #2
  • Influenza (annual)

Pre-kindergarten milestone boosters

7 - 10 Years

  • Influenza (annual)
  • Catch-up vaccines as needed

No new routine vaccines.

ensure series completion & annual flu

Adolescents

11 through 18 years - ACIP/AAP Recommendations

11 - 12 Years

  • Tdap
  • HPV #1 & 2
  • MenACWY #1
  • Influenza (annual)

HPV series: 2 doses if started before age 15

13 - 15  Years

  • HPV #3 (if started at or before 15)
  • Catch-up vaccines
  • Influenza (annual)

3-dose series if the first does given at age 15 or older

16 Years

  • MenACWY booster
  • MenB (SCDM)
  • Influenza (annual)

MenB via shared clinical decision making

17 - 18 Years

  • HPV series completion
  • Catch-up immunizations
  • Influenza (annual)

Ensure all series complete before adulthood

Adults 19 - 49

Young & middle adulthood • ACIP 2025 Adult Schedule

19 - 26 Years

  • HPV (catch-up, if not prior)
  • Tdap (if not given as a teen)
  • MenACWY (if at-risk)
  • HepA (if no prior series)
  • HepB (if no prior series)
  • Influenza (annual)

HPV recommended through age 26 for all adults

27 - 45  Years

  • HPV (SCDM, if not prior)
  • Tdap every 10 yrs (or Td)
  • HepA (if indicated)
  • HepB (if no prior series)
  • Pneumococcal (if at-risk)
  • Influenza (annual)

HPV ages 27 - 45 based on shared clinical decision-making

All Adults 19 - 49

  • MMR (if no evidence of immunity)
  • Varicella (2 doses, if susceptible)
  • Meningococcal (if at-risk)
  • COVID - 19 (SCDM)
  • Influenza (annual)

Pregnancy: Tdap each pregnancy; RSV vaccine in weeks 32 - 26

Adults 50 & Older

Older adulthood • ACIP 2025 Adult Schedule (updated July 2025)

50 - 59 Years

  • Shingrix (RZV) 2-doses series
  • Tdap / Td booster (every 10 years)
  • Pneumococcal (PCV21 or PCV20)
  • HepB (if no prior series)
  • HepA (if indicated)
  • Review all catch-up vaccines
  • Covid-19 (SCDM)
  • Influenza (annual)

Shingrix: 2 doses 2-6 months apart; RSV for high-risk per ACIP 2025

Assess travel, occupational & medical condition-based needs annually.

60 - 64  Years

  • Shingrix (if not yet given)
  • RSV vaccine (1 dose, SCDM)
  • Pneumoccal vaccine
  • Tdap / Td booster
  • HepB (if no prior series)
  • HepA (if indicated)
  • Review all catch-up vaccines
  • Covid-19 (SCDM)
  • Influenza (annual)

RSV via shared clinical decision making with the provider.

Assess travel, occupational & medical condition-based needs annually.

65+ Years

  • Shingrix (if not yet given)
  • RSV vaccine (1 dose, routine)
  • Pneumococcal (PCV21 + PPSV23)
  • Tdap / Td booster
  • High-dose or adjuvanted flu
  • Influenza (annual - preferred formulations)

Preferred: Fluzone HD, Fublok, or FLUAD for adults 65 years or older.

Assess travel, occupational & medical condition-based needs annually.

Influenza

Recommended annually for everyone 6 months and older.  Adults 65+ should receive high-dose (Fluzone HD), adjuvanted (FLUAD), or recombinant (Flublok) formulations for stronger protection

COVID-19

Current ACIP guidance recommends updated COVID-19 vaccines based on shared clinical decision-making.  Clinicians should review CDC / ACIP recommendations each season, as guidance continues to evolve.

RSV

Routine RSV vaccine is recommended for adults 60+ (single dose, one).  Adults 50 - 59 at high risk may also receive RSV vaccine per ACIP 2025 guidance.  Pregnant individuals: RSVpreF in weeks 32 - 36 of gestation.

Catch-Up & Incomplete Series


  • Do not restart a vaccine series regardless of the time elapsed between doses.
  • Self-reported prior vaccine history is acceptable for most vaccines.
  • Adults with no documented immunization history should be assessed and vaccinated.


Special Populations

Enhanced or additional recommendations apply for:

  • Immunocompromised patients (cancer, HIV, transplant)
  • Pregnant individuals (Tdap, RSV, influenza)
  • Chronic conditions (diabetes, heart/lung/kidney disease)
  • International travelers (chikungunya, typhoid, yellow fever)
  • Healthcare workers (hepatitis B, annual influenza, MMR)
  • Asplenia or complement deficiencies (meningococcal)

Authoratative Sources

AAP

Childhood & Adolescent Immunization Schedule 2026

Official AAP schedule for birth through 18 years

View adult schedule here

ACIP

Adult Immunization Schedule by age

ACIP recommendations for adults 19 years and older, July 2025

View adult schedule here

AAFP

Immunization Schedules & Resources

Family physician - focused immunization guidance

View adult schedule here