Page 2

Agency Name Family Support Chapter No./Name 4 – Economic Stability (ES) Part No./Name B – Eligibility Factors Section No./Name B-700 Immunization Document No./Name B-710-FITAP Immunization Effective Date May 1, 2023

2 of 8 Examples:

If a 6-month old child’s birthday is July 2nd, the child will be noncompliant on August 2nd if the recommended immunizations for a 6-month old are not administered.

If a 12-year old child’s birthday is June 10th, the child will be noncompliant on July 11th if the recommended immunizations for an 11 – 12 year old are not administered.

Child’s Age Total Recommended Immunizations Birth 1 HepB 2 Months 1 DTaP, 1 Hib, 1 IPV, 2 HepB, 1 PCV, 1 RV 4 Months 2 DTaP, 2 Hib, 2 IPV, 2 HepB, 2 PCV, 2 RV 6 Months 3 DTaP, 3 Hib, 3 IPV, 3 HepB, 3 PCV, 3 RV 12-15 Months 4 DTaP, 4 Hib, 3 IPV, 3 HepB, 4 PCV, 3 RV, 1 MMR, 1 VAR, 1 HepA 18-23 Months 4 DTaP, 4 Hib, 3 IPV, 3 HepB, 4 PCV, 3 RV, 1 MMR, 1 VAR, 2 HepA 4 Years or Prior to School Entry 5 DTaP, 4 Hib, 4 IPV, 3 HepB, 4 PCV, 3 RV, 2 MMR, 2 VAR, 2 HepA (If DTaP #4 and IPV #3 are given after fourth birthday, only need 4 DTaP and 3 IPV) 11 – 12 Years 5 DTaP, 4 Hib, 4 IPV, 3 HepB, 4 PCV, 3 RV, 2 MMR, 2 VAR, 2 HepA, 1 Tdap, 1 MCV, 1 HPV (VAR, MMR, HepA, HepB if needed) 16 year and above 5 DTaP, 4 Hib, 4 IPV, 3 HepB, 4 PCV, 3 RV, 2 MMR, 2 VAR, 2 HepA, 1 Tdap, 2 MCV, 1 HPV (HPV, VAR, MMR, HepA, HepB if needed)

Subsequent routine Td boosters are recommended every 10 years.

Time sensitive vaccines:

Hib is an abbreviation for Haemophilus Influenza Type B and may be written as Hib Titer, Act Hib, PedVax Hib, or given as combination with HepB (Comvax). No Hib is given after 60 months of age. If Hib vaccines were manufactured by Merck and administered at 2 and 4 months of age, a dose at 6 months is not required.

RV is an abbreviation for Rotavirus Vaccine. The first dose of the RV Vaccine can be administered between 8 weeks of age and 15 weeks of age. The RV cannot be administered later than 8 months (32 weeks) of age. If Monavalent RV1 is administered at 2 months and 4 months of age, a dose at 6 months is not required. Pentavalent RV5 is administered at 2 months, 4 months and 6 – 8 months.

Remaining vaccines recommended:

HepA is an abbreviation for Hepatitis A Vaccine. HepA is recommended for all children 12 months through 18 years of age.

HepB is an abbreviation for Hepatitis B Vaccine. HepB is routinely recommended for all children up to 19 years of age.

DTaP is an abbreviation for Diphtheria, Tetanus and acellular Pertussis. The following vaccines are acceptable as DTaP equivalents: DTP, DTaP, DT, Td, or any combination including these, such as DTP-Hib, DTP-HBV, DTaP-Hib, etc.