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 - 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 • AAFP 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 • AAFP Adult Schedule

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 adults per AAFP recommendations

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 AAFP  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

AAFP

Immunization Schedules & Resources

Family physician - focused immunization guidance

View adult schedule here