Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

2018 ACIP Immunization Schedule for Children

MMWR; ePub 2018 Feb 6; Robinson, et al

The Advisory Committee on Immunization Practices (ACIP) from the Centers of Disease Control and Prevention (CDC) has issued its recommended immunization schedule for children and adolescents aged ≤18 years in the US. Changes include new or revised recommendations for poliovirus, influenza, and measles, mumps, and rubella vaccines, and clarification of the recommendation for rotavirus and pneumococcal vaccines. Simplified figures and footnotes are also part of the new immunization schedule. Some of the key figure changes include:

  • The maximum ages for the first and last doses in the rotavirus vaccination series were added to the rotavirus vaccine row.
  • The inactivated poliovirus vaccine rows were edited to clarify the catch-up recommendations for children aged ≥4 years.
  • A reference for use of live vaccines in patients with HIV was added.

The full updated 2018 ACIP immunization schedule can be found at


Robinson CL, Romero JR, Kempe A, Pellegrini C, Szilagyi P. Advisory Committee on Immunization Practices Recommended Immunization schedule for children and adolescents aged 18 years or younger—United States, 2018. MMWR Morb Mortal Wkly Rep 2018;67:156–157. doi:10.15585/mmwr.mm6705e.


The updated ACIP immunization schedule is always worth looking at. Judging from questions we receive in the office, there are areas of confusion based on changes over the last few years with the HPV and the meningitis vaccines. To clarify those areas:

  • ACIP recommends routine HPV vaccination at age 11 or 12 years. For persons initiating vaccination before their 15th birthday, the recommended immunization schedule is 2 doses of HPV vaccine. The second dose should be administered 6–12 months after the first dose. For persons initiating vaccination on or after their 15th birthday, the recommended immunization schedule is 3 doses of HPV vaccine. The second dose should be administered 1–2 months after the first dose, and the third dose should be administered 6 months after the first dose.
  • ACIP recommends routine administration of a MenACWY vaccine for all persons aged 11 through 18 years. A single dose of vaccine should be administered at age 11 or 12 years, and a booster dose should be administered at age 16 years. Adolescents who receive their first dose at age 13 through 15 years should receive a booster dose at age 16 through 18 years.
  • The ACIP currently recommends routine use of MenB vaccines [Bexsero, Trumenba] among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease. Men B may be given at clinical discretion to adolescents 16–23 years (preferred age 16–18 years) who are not at increased risk according to the following schedule: Bexsero: 2 doses at least 1 month apart; Trumenba: 2 doses at least 6 months apart. —Neil Skolnik, MD

This Week's Must Reads

Screening for Syphilis Infection in Pregnant Women, JAMA; 2018 Sep 4; US Preventive Services Task Force

Treatment Intensification Guidelines for T2D , Ann Intern Med; ePub 2018 Sep 4; Roglic, et al

Immediate vs Gradual Nicotine Reduction in Cigarettes, JAMA; ePub 2018 Sep 4; Hatsukami, et al

Prevalence of Diabetes Among US Adults, BMJ; ePub 2018 Aug 27; Xu, Liu, et al

Effect of Fish Oil Supplementation in Pregnancy, BMJ; ePub 2018 Sep 4; Vinding, Stokholm, et al

Must Reads in Pediatrics

Prescription Medication Use Among US Children, Pediatrics; ePub 2018 Aug 27; Qato, et al

AHA Statement on Sedentary Behaviors in Youth, Circulation; ePub 2018 Aug 6; Barnett, et al

Interrupting Sedentary Behavior in Children, Diabetes Care; ePub 2018 Aug 6; Broadney, et al

Healthy Behaviors & Reduced Risk of Obesity , Mayo Clin Proc; ePub 2018 Jul 27; Shook, et al

Psychological Screening for Youth with Abdominal Pain, Pediatrics; ePub 2018 Jul 25; Cunningham, et al