Catchup Vaccination in Unvaccinated Child

Core Principles Of Catch-Up Immunization

Missed immunization requires no restarting of entire vaccine series due to robust immune memory.
Resume interrupted schedule exactly from point of interruption.
Multiple vaccines remain permissible on same day via separate injection sites spaced 2.5 centimeters apart.
Maintain minimum 4-week interval between live injectable vaccines if not administered simultaneously.
Inactivated vaccines remain permissible at any interval with live or other inactivated formulations.

Treat child possessing unknown immunization status as completely unimmunized.
Initiate age-appropriate catch-up vaccination schedule immediately.
Reject self-reported undocumented vaccine doses, excluding influenza and pneumococcal polysaccharide vaccines.
Serologic testing remains not cost-effective, reduces compliance, and causes missed vaccination opportunities.

Count doses administered up to 4 days prior to minimum interval as valid.
Reject doses administered 5 or more days before minimum recommended interval.
Repeat invalid live virus vaccine doses at least 4 weeks following expired or invalid dose.
Repeat invalid inactivated vaccine doses as soon as possible.

Vaccine	Maximum Age And Catch-Up Guideline
Bacillus Calmette-Guerin	Administer up to 5 years; pre-vaccination Mantoux test remains not recommended.
Oral poliovirus vaccine	Administer up to 5 years; provide three doses 4 weeks apart.
Diphtheria-tetanus-pertussis	Administer up to 7 years; provide three doses at 0, 1, and 6 months.
Hemophilus influenzae type b	Administer up to 5 years in healthy children; recommended beyond 5 years exclusively for high-risk groups.
Pneumococcal conjugate vaccine	Administer up to 5 years in healthy children; recommended beyond 5 years exclusively for high-risk groups.
Rotavirus vaccine	Maximum age for first dose comprises 14 weeks 6 days; maximum age for final dose comprises 8 months.
Typhoid conjugate vaccine	Administer up to 18 years; provide single intramuscular dose.
Measles-mumps-rubella	Administer up to 5 years routinely; previously unimmunized older children require two doses 4 weeks apart.
Hepatitis B vaccine	Administer at any age; provide three doses at 0, 1, and 6 months.

Diphtheria-tetanus-pertussis vaccines remain strictly contraindicated beyond 7 years due to increased reactogenicity.
Substitute whole-cell vaccines with tetanus-diphtheria-acellular pertussis vaccine or tetanus-diphtheria vaccine.
Unimmunized children above 7 years require three doses of tetanus-containing vaccines administered at 0, 1, and 6 months.
Administer tetanus-diphtheria-acellular pertussis for initial catch-up dose.
Administer tetanus-diphtheria formulation for second and third catch-up doses.
Administer Varicella vaccine in two doses spaced 3 months apart for children under 13 years, or 4 weeks apart for older adolescents.