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DTaP and DTaP-combination vaccines: Infanrix, Daptacel, Pediarix, Kinrix, Quadracel, Vaxelis and Pentacel

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Vaccine School · Childhood and adolescent

A pharmacist-focused lesson on diphtheria, tetanus and acellular pertussis vaccination of children younger than 7 years and the combination products that add hepatitis B, poliovirus and Hib: the 5-dose schedule, which products are used for which doses, administration, storage, contraindications and precautions, safety, and the shift from DT to Td for children who cannot receive pertussis vaccine. Unreviewed draft.

Content current as of October 11, 2026. AI-assisted draft; not yet reviewed by a licensed pharmacist. Current CDC schedules: immunization schedules.

The disease and why it matters

Diphtheria is an acute disease caused by toxin-producing strains of Corynebacterium diphtheriae; it is very rare in the United States and usually associated with international travel to an endemic area. [1]

Pertussis (whooping cough) is an acute infectious disease caused by Bordetella pertussis; it is a human disease, spread person to person through respiratory droplets, with symptoms usually developing 5 to 10 days after exposure (sometimes up to 21 days). Anyone, but especially infants and young children, may experience serious and potentially life-threatening complications. [2]

Immunity after pertussis infection may last 4 to 20 years but is not lifelong, according to some observational studies; pertussis is common and reportable in the United States. [2]

CDC's VIS says diphtheria can lead to difficulty breathing, heart failure, paralysis or death; tetanus causes painful stiffening of the muscles and can lead to being unable to open the mouth, trouble swallowing and breathing, or death; pertussis can be extremely serious in babies and young children, causing pneumonia, convulsions, brain damage or death. [3]

Video and figures

Video

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What is Pertussis and whooping cough? - Bordetella pertussis symptoms, pathophysiology and treatment
Channel: Armando Hasudungan · Uploaded January 2, 2024 · Confirmed available October 12, 2026 · Open on YouTubeRxEvidence has not checked every statement in this video.

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Products available

DTaP vaccine is for children younger than 7 years; Tdap and Td are used for older children, adolescents and adults. CDC says DT vaccine is no longer available in the United States, and lists DTaP, Tdap and Td as the three types of combination vaccines that include tetanus protection. [4] [5] [6]

DTaP-containing vaccines on FDA's licensed-vaccine list, from FDA product pages and prescribing information
VaccineComponentsManufacturer (FDA page)FDA-approved useInitial U.S. approval
InfanrixDTaPGlaxoSmithKline Biologicals [7]5-dose series in infants and children aged 6 weeks through 6 years (prior to the seventh birthday) [8]1997 [8]
DaptacelDTaPSanofi Vaccines Canada Ltd [9]Five-dose series in infants and children 6 weeks through 6 years of age (prior to 7th birthday) [10]2002 [10]
PediarixDTaP-HepB-IPVGlaxoSmithKline Biologicals [11]3-dose series in infants born of HBsAg-negative mothers; may be given from 6 weeks through 6 years of age (prior to the seventh birthday) [12]2002 [12]
KinrixDTaP-IPVGlaxoSmithKline Biologicals [13]Single dose as the fifth DTaP dose and the fourth IPV dose in children 4 through 6 years whose previous DTaP doses were with Infanrix and/or Pediarix for the first 3 doses and Infanrix for the fourth dose [14]2008 [14]
QuadracelDTaP-IPVSanofi Pasteur Limited [15]Single dose as the fifth DTaP dose and the fourth or fifth IPV dose in children 4 through 6 years whose previous DTaP doses were with Pentacel, Daptacel and/or Vaxelis [16]2015 [16]
VaxelisDTaP-IPV-Hib-HepBMSP Vaccine Company [17]3-dose series in children from 6 weeks through 4 years of age (prior to the 5th birthday) [18]2018 [18]
PentacelDTaP-IPV/HibSanofi Pasteur Limited [19]Four-dose series in children 6 weeks through 4 years of age (prior to 5th birthday) [20]2008 [20]

Every pertussis-containing vaccine dose is given intramuscularly and contains aluminum as an adjuvant but no preservative; Pediarix, Pentacel, Vaxelis, Kinrix and Quadracel contain neomycin and polymyxin B as antibiotics, Vaxelis also contains streptomycin, Pediarix and Vaxelis contain yeast protein, and presentations of some pertussis-containing vaccines contain latex rubber. [21]

Label currency as posted by FDA: Infanrix, Pediarix and Kinrix pages content current as of 05/15/2026 (labels 5/2026); Daptacel page 08/27/2026 with a placeholder label revision date ("X/2026"); Quadracel page 03/18/2026 (label 1/2026); Vaxelis page 03/16/2026 with a placeholder revision date ("x/2026"); Pentacel page 03/13/2026 (label 1/2025). [7] [8] [11] [12] [13] [14] [9] [10] [15] [16] [17] [18] [19] [20]

Who should get it

CDC / ACIP (pertussis vaccine recommendations page, December 2, 2025)

As of December 2, 2025

CDC recommends routine DTaP vaccination for all infants and children younger than 7 years old, as a 5-dose series at 2 months, 4 months, 6 months, 15 through 18 months and 4 through 6 years; adolescents receive a single dose of Tdap at 11 to 12 years, and a single dose of Tdap is recommended during every pregnancy. [4]

FDA labels (DTaP: Infanrix 5/2026, Daptacel)

As of May 15, 2026

The Infanrix label gives the 5-dose series as one dose each at 2, 4 and 6 months, one booster at 15 to 20 months and another at 4 to 6 years; the Daptacel label gives doses at 2, 4, 6 and 15 to 20 months and at 4 to 6 years. CDC gives the fourth dose at 15 through 18 months. [8] [10] [4]

CDC's VIS says DTaP is only for children younger than 7 years, that different vaccines (Tdap and Td) are available for older children, adolescents and adults, and that DTaP may be given as a stand-alone vaccine or as part of a combination vaccine and may be given at the same time as other vaccines. [3]

The Pink Book chapter says Pediarix is licensed for the first 3 doses of the DTaP series in children 6 weeks through 6 years; Pentacel for the first 4 doses in children 6 weeks through 4 years; Kinrix only for the fifth DTaP dose and fourth IPV dose in children 4 through 6 years; Quadracel only for the fifth DTaP dose and fourth or fifth IPV dose in children 4 through 6 years; and Vaxelis for children 6 weeks through 4 years. [21]

Vaxelis cannot serve as the Hib booster: CDC's schedule notes say Vaxelis is not recommended for use as a booster dose and a different Hib-containing vaccine should be used for the booster dose at 12 to 15 months. [22]

CDC: January 2026 schedule revision and its legal status (DTaP)

As of June 11, 2026

On January 5, 2026 the CDC Acting Director approved a revised childhood and adolescent schedule whose first category (recommended for all children) lists measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Hib, pneumococcal disease, HPV and varicella, so DTaP stayed in the all-children category. A federal district court stayed that schedule on March 16, 2026 and reverted it to the version as of May 2025, and CDC's schedule page continues to show the July 2, 2025 addendum edition. [23] [24] [25]

American Academy of Pediatrics 2026 schedule (endorsed by AAFP, ACOG, AMA, IDSA, APhA and others)

As of January 26, 2026

The AAP published its own 2026 schedule on January 26, 2026, which continues to recommend routine immunization for protection against 18 diseases, including RSV, hepatitis A, hepatitis B, rotavirus, influenza and meningococcal disease, and differs from the schedule recently issued by CDC; the AAP schedule is formally endorsed by 12 organizations, including AAFP, ACOG, AMA, IDSA and the American Pharmacists Association. [26]

Dosing and schedule, including catch-up

CDC schedule notes (July 2, 2025): minimum age 6 weeks (4 years for Kinrix or Quadracel); 5-dose series (3-dose primary series at 2, 4 and 6 months, then boosters at 15 to 18 months and 4 to 6 years). Dose 4 may be given as early as age 12 months if at least 6 months have elapsed since dose 3 (a dose 4 inadvertently given as early as 12 months may be counted if at least 4 months elapsed since dose 3). [22]

Dose 5 is not necessary if dose 4 was given at age 4 years or older and at least 6 months after dose 3 (the Pink Book says the fifth dose is optional if dose 4 is given on or after the 4th birthday; its primary-series interval is 4 to 8 weeks with a minimum of 4 weeks). [22] [21]

FDA label dosing for the combination products
VaccineDosing in the label
Infanrix5 doses of 0.5 mL: 2, 4 and 6 months, one booster at 15 to 20 months and another at 4 to 6 years. [8]
PediarixThree doses (0.5 mL each) at 2, 4 and 6 months of age. [12]
KinrixA single 0.5 mL dose. [14]
QuadracelA single intramuscular injection of 0.5 mL. [16]
Vaxelis3-dose series of 0.5 mL intramuscular injections at 2, 4 and 6 months of age. [18]
PentacelFour-dose series of 0.5 mL intramuscular injections after reconstitution at 2, 4, 6 and 15 to 18 months of age; reconstitute the lyophilized ActHIB component with the DTaP-IPV component immediately before administration. [20]

Wound management in children younger than 7 years with a history of 3 or more doses of tetanus-toxoid-containing vaccine: for all wounds except clean and minor wounds, give DTaP if more than 5 years have passed since the last tetanus-toxoid-containing dose. [22]

Children with a contraindication to the pertussis component: DT versus Td

As of December 1, 2025

CDC says it previously recommended DT instead of DTaP for children younger than 7 years who develop a contraindication to pertussis-containing vaccine, that production of DT was discontinued in late 2022, and that Td should now be used off-label with the same schedule as DTaP; children who receive Td in place of DTaP may have sub-optimal protection against diphtheria because Td contains approximately 1/12th the diphtheria toxoid of DT. [27]

CDC Pink Book chapter 16 (page dated April 12, 2024)

As of April 12, 2024

The Pink Book chapter still says children younger than age 7 years should receive DTaP or DT (where the pertussis component is contraindicated), which pre-dates CDC's December 2025 statement that DT is no longer available. [21] [27]

Administration

  • All pertussis-containing vaccines are given by intramuscular injection; each dose of Infanrix, Daptacel, Pediarix, Kinrix, Quadracel, Vaxelis and Pentacel is 0.5 mL. [21] [8] [10] [12] [14] [16] [18] [20]
  • Pentacel is supplied as a liquid DTaP-IPV component and a lyophilized ActHIB component that are combined by reconstitution immediately before administration. [20]
  • DTaP may be given at the same time as other vaccines. [3]

Storage and handling

  • CDC says DTaP, Td and Tdap vaccines should be maintained at refrigerator temperature between 2 °C and 8 °C (36 °F and 46 °F); manufacturer package inserts contain additional information. [28]
  • Infanrix, Pediarix and Kinrix: store refrigerated at 2 to 8 °C (36 to 46 °F); do not freeze; discard if the vaccine has been frozen; protect prefilled syringes from light. [8] [12] [14]
  • Daptacel, Quadracel and Pentacel: store at 2 to 8 °C (35 to 46 °F); do not freeze; product that has been exposed to freezing should not be used; do not use after the expiration date. [10] [16] [20]
  • Vaxelis: store at 2 to 8 °C (36 to 46 °F); do not freeze; product that has been exposed to freezing should not be used; protect from light; discard unused portion. [18]

Contraindications and precautions

Contraindications and precautions (CDC appendix, July 2, 2025 edition)
CategoryDTaP
ContraindicationsSevere allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component; encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of a previous dose of DTP or DTaP. [29]
PrecautionsGuillain-Barré syndrome within 6 weeks after a previous dose of tetanus-toxoid-containing vaccine; history of Arthus-type hypersensitivity after a previous dose of diphtheria- or tetanus-toxoid-containing vaccine (defer until at least 10 years since the last tetanus-toxoid-containing vaccine); for DTaP only, progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy or progressive encephalopathy (defer DTaP until neurologic status clarified and stabilized); moderate or severe acute illness with or without fever. [29]

CDC says encephalopathy within 7 days of vaccination, when not attributable to another identifiable cause, is the only contraindication specific to the pertussis component of DTaP, that it is extremely rare, and that a family history of a contraindication or reaction to pertussis-containing vaccines is not a contraindication for young children to receive DTaP. [27]

Labels: Infanrix, Pediarix and Kinrix list as contraindications severe allergic reaction after a previous dose of a related toxoid-, pertussis- (Pediarix also hepatitis B- and poliovirus-; Kinrix also poliovirus-) containing vaccine or any component (Kinrix including neomycin and polymyxin B), encephalopathy within 7 days of a previous pertussis-containing vaccine, and progressive neurologic disorders; Daptacel, Quadracel, Vaxelis and Pentacel list the same, with progressive neurologic disorder stated as "until a treatment regimen has been established and the condition has stabilized". [8] [12] [14] [10] [20]

Safety and adverse events

Infanrix: injection-site reactions (pain, redness, swelling) ranged from 10% to 53% depending on reaction and dose number and were highest after doses 4 and 5; fever was common (20% to 30%) after doses 1 to 3; drowsiness, irritability/fussiness and loss of appetite were reported in approximately 15% to 60% of participants. [8]

Daptacel and Pentacel: systemic reactions in more than 50% of subjects after any dose included fussiness/irritability, inconsolable crying and (Daptacel) decreased activity/lethargy; fever of 38.0 °C or higher occurred in 6% to 16% of subjects depending on dose number; injection-site reactions in more than 30% included tenderness, redness (Daptacel) and increase in arm circumference. [10] [20]

Pediarix: common solicited adverse reactions after any dose (25% or more) were local injection-site reactions, fever (100.4 °F or higher), drowsiness, irritability/fussiness and loss of appetite, and in clinical trials Pediarix was associated with higher rates of fever relative to separately administered vaccines. [12]

Kinrix and Quadracel at 4 to 6 years: the most frequently reported solicited local reaction with Kinrix (more than 50%) was injection-site pain; Quadracel solicited injection-site reactions were pain (more than 75%), increase in arm circumference (more than 65%), erythema (more than 55%) and swelling (more than 40%), with myalgia (more than 50%), malaise (more than 35%) and headache (more than 15%). [14] [16]

Vaxelis: solicited adverse reactions following any dose were irritability (55% or more), crying (45% or more), injection-site pain (44% or more), somnolence (40% or more), injection-site erythema (25% or more), decreased appetite (23% or more), fever of 38.0 °C or higher (19% or more), injection-site swelling (18% or more) and vomiting (9% or more). [18]

Pertussis-related precautions: if temperature of 105 °F or higher, collapse or shock-like state, or persistent inconsolable crying lasting 3 hours or more occurred within 48 hours, or seizures within 3 days, after a pertussis-containing vaccine, the decision to give the next dose should be based on potential benefits and risks; antipyretics may be given at the time of vaccination for children at higher risk for seizures. [8] [20]

Guillain-Barré syndrome and apnea: if GBS occurred within 6 weeks of receipt of a prior vaccine containing tetanus toxoid, the decision to give the vaccine should be based on potential benefits and risks (for Daptacel, Pentacel and Vaxelis the risk for GBS may be increased); apnea following intramuscular vaccination has been observed in some infants born prematurely. [8] [20] [18]

Vaxelis: urine antigen detection may not have definitive diagnostic value in suspected H. influenzae type b disease following vaccination with Vaxelis. [18]

CDC's VIS says soreness or swelling where the shot was given, fever, fussiness, feeling tired, loss of appetite and vomiting sometimes happen after DTaP; seizures, non-stop crying for 3 hours or more, or high fever (over 105 °F) happen much less often; rarely vaccination is followed by swelling of the entire arm or leg, especially in older children after their fourth or fifth dose. [3]

Special populations

Premature infants: apnea following intramuscular vaccination has been observed in some infants born prematurely, and decisions about when to give an intramuscular vaccine to a premature infant should be based on the infant's medical status and the potential benefits and risks. [8]

Immunosuppressed children: immunosuppressive therapies (irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids at greater than physiologic doses) may reduce the immune response to Daptacel. [10]

Infants of HBsAg-positive or unknown-status mothers: Pediarix is approved as a 3-dose series only in infants born of hepatitis B surface antigen (HBsAg)-negative mothers. [12]

Children older than the labeled age: Td is the vaccine to use off-label (same schedule as DTaP) for children younger than 7 years with a contraindication to the pertussis component, and Tdap is used for ages 7 years or older even without a completed DTaP series. [27] [21]

Counseling pearls for the pharmacy counter

  • Children need 5 doses of DTaP, usually at 2 months, 4 months, 6 months, 15 to 18 months and 4 to 6 years. [3]
  • Tell the vaccination provider about a previous severe allergic reaction to a tetanus-, diphtheria- or pertussis-containing vaccine, coma or prolonged seizures within 7 days of a previous pertussis dose, seizures or another nervous system problem, a history of Guillain-Barré syndrome, or severe pain or swelling after a previous tetanus- or diphtheria-containing dose. [3]
  • Children with minor illnesses such as a cold may be vaccinated; moderately or severely ill children should usually wait until they recover. [3]
  • Signs of a severe allergic reaction (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness or weakness) warrant calling 9-1-1. [3]
  • Pertussis can be extremely serious in babies and young children; vaccination protects them, and CDC recommends Tdap in every pregnancy to protect newborns. [3] [4]

Common patient questions

Can Kinrix or Quadracel be used for the fourth dose?

No. Both are labeled only for the fifth dose of the DTaP series (Kinrix when prior doses were with Infanrix and/or Pediarix for the first 3 and Infanrix for the fourth; Quadracel when prior doses were with Pentacel, Daptacel and/or Vaxelis) in children 4 through 6 years of age. [14] [16]

A child received dose 4 at 4 years and 2 months, 8 months after dose 3. Is dose 5 needed?

No. CDC says dose 5 is not necessary if dose 4 was given at age 4 years or older and at least 6 months after dose 3. [22]

A 3-year-old had encephalopathy after DTaP. What is used for the remaining doses?

CDC says to use Td off-label with the same schedule that would be used for DTaP, because DT is no longer available; protection against diphtheria may be sub-optimal. [27]

Can Vaxelis be used for the Hib booster?

No. CDC's notes say Vaxelis is not recommended for use as a booster dose and a different Hib-containing vaccine should be used for the booster dose. [22]

Is a family history of seizures after DTaP a reason to withhold it?

No. CDC says a family history of a contraindication or reaction to pertussis-containing vaccines is not a contraindication for young children to receive DTaP. [27]

References

  1. Centers for Disease Control and Prevention. Clinical overview of diphtheria. Page dated July 31, 2026. Accessed October 11, 2026. https://www.cdc.gov/diphtheria/hcp/clinical-overview/index.html. Accessed October 11, 2026.
  2. Centers for Disease Control and Prevention. Clinical overview of pertussis. Page dated December 1, 2025. Accessed October 11, 2026. https://www.cdc.gov/pertussis/hcp/clinical-overview/index.html. Accessed October 11, 2026.
  3. Centers for Disease Control and Prevention. DTaP (diphtheria, tetanus, pertussis) vaccine: what you need to know. Vaccine Information Statement, August 6, 2021. Accessed October 11, 2026. https://www.cdc.gov/vaccines/hcp/current-vis/dtap.html. Accessed October 11, 2026.
  4. Centers for Disease Control and Prevention. Pertussis vaccine recommendations (for health care providers). Page dated December 2, 2025. Accessed October 11, 2026. https://www.cdc.gov/pertussis/hcp/vaccine-recommendations/index.html. Accessed October 11, 2026.
  5. Centers for Disease Control and Prevention. Diphtheria vaccine recommendations (for health care providers). Page dated July 31, 2026. Accessed October 11, 2026. https://www.cdc.gov/diphtheria/hcp/vaccine-recommendations/index.html. Accessed October 11, 2026.
  6. Centers for Disease Control and Prevention. Tetanus vaccine recommendations (for health care providers). Page dated September 10, 2026. Accessed October 11, 2026. https://www.cdc.gov/tetanus/hcp/vaccine-recommendations/index.html. Accessed October 11, 2026.
  7. U.S. Food and Drug Administration. INFANRIX product page (content current as of 05/15/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/infanrix. Accessed October 11, 2026.
  8. INFANRIX (diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed): prescribing information, revised 5/2026. GlaxoSmithKline Biologicals. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/75157/download?attachment. Accessed October 11, 2026.
  9. U.S. Food and Drug Administration. DAPTACEL product page (content current as of 08/27/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/daptacel. Accessed October 11, 2026.
  10. DAPTACEL (diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed): prescribing information as posted on FDA's product page (revision date shown as a placeholder, "X/2026"). Sanofi Pasteur Limited. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/74035/download?attachment. Accessed October 11, 2026.
  11. U.S. Food and Drug Administration. PEDIARIX product page (content current as of 05/15/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix. Accessed October 11, 2026.
  12. PEDIARIX (diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B [recombinant] and inactivated poliovirus vaccine combined): prescribing information, revised 5/2026. GlaxoSmithKline Biologicals. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/79830/download?attachment. Accessed October 11, 2026.
  13. U.S. Food and Drug Administration. KINRIX product page (content current as of 05/15/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/kinrix. Accessed October 11, 2026.
  14. KINRIX (diphtheria and tetanus toxoids, acellular pertussis adsorbed and inactivated poliovirus vaccine): prescribing information, revised 5/2026. GlaxoSmithKline Biologicals. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/80128/download?attachment. Accessed October 11, 2026.
  15. U.S. Food and Drug Administration. Quadracel product page (content current as of 03/18/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/quadracel. Accessed October 11, 2026.
  16. Quadracel (diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine): prescribing information, revised 1/2026. Sanofi Pasteur Limited. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/146047/download?attachment. Accessed October 11, 2026.
  17. U.S. Food and Drug Administration. VAXELIS product page (content current as of 03/16/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaxelis. Accessed October 11, 2026.
  18. VAXELIS (diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus, Haemophilus b conjugate and hepatitis B vaccine) injectable suspension: prescribing information as posted on FDA's product page (revision date shown as a placeholder, "x/2026"). MSP Vaccine Company. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/119465/download?attachment. Accessed October 11, 2026.
  19. U.S. Food and Drug Administration. Pentacel product page (content current as of 03/13/2026). Accessed October 11, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/pentacel. Accessed October 11, 2026.
  20. Pentacel (diphtheria and tetanus toxoids and acellular pertussis adsorbed, inactivated poliovirus and Haemophilus b conjugate [tetanus toxoid conjugate] vaccine): prescribing information, revised 1/2025. Sanofi Pasteur Limited. U.S. Food and Drug Administration. Accessed October 11, 2026. https://www.fda.gov/media/146048/download?attachment. Accessed October 11, 2026.
  21. Centers for Disease Control and Prevention. Pertussis. In: Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book), chapter 16. Page dated April 12, 2024. Accessed October 11, 2026. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-16-pertussis.html. Accessed October 11, 2026.
  22. Centers for Disease Control and Prevention. Child and adolescent immunization schedule notes: recommendations for ages 18 years or younger, United States, 2025. July 2, 2025. Accessed October 11, 2026. https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-notes.html. Accessed October 11, 2026.
  23. Centers for Disease Control and Prevention. CDC acts on Presidential Memorandum to update childhood immunization schedule. News release, January 5, 2026. Accessed October 11, 2026. https://www.cdc.gov/media/releases/2026/2026-cdc-acts-on-presidential-memorandum-to-update-childhood-immunization-schedule.html. Accessed October 11, 2026.
  24. Congressional Research Service. The 2026 Childhood Immunization Schedule (R48982). June 11, 2026. Accessed October 11, 2026. https://www.congress.gov/crs_external_products/R/PDF/R48982/R48982.1.pdf. Accessed October 11, 2026.
  25. Centers for Disease Control and Prevention. Healthcare professionals: immunization schedules. Accessed October 11, 2026. https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html. Accessed October 11, 2026.
  26. American Academy of Pediatrics. AAP releases recommended childhood and adolescent immunization schedule for 2026. HealthyChildren.org news. Accessed October 11, 2026. https://healthychildren.org/English/news/Pages/AAPs-recommended-childhood-and-adolescent-immunization-schedule-for-2026.aspx. Accessed October 11, 2026.
  27. Centers for Disease Control and Prevention. About young children with a contraindication to pertussis-containing vaccines. Page dated December 1, 2025. Accessed October 11, 2026. https://www.cdc.gov/pertussis/hcp/vaccine-recommendations/td-offlabel.html. Accessed October 11, 2026.
  28. Centers for Disease Control and Prevention. Diphtheria. In: Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book), chapter 7. Page dated April 23, 2024. Accessed October 11, 2026. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html. Accessed October 11, 2026.
  29. Centers for Disease Control and Prevention. Child and adolescent immunization schedule appendix: guide to contraindications and precautions (July 2, 2025 edition). Accessed October 11, 2026. https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-appendix.html. Accessed October 11, 2026.

For professional education. Check current labeling and guidance before acting. Not medical advice.

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