Table 1.
Specifications for calculating days undervaccinated for vaccine doses in the combined 7-vaccine seriesa
| Vaccine dose | Recommended age per ACIP | Minimum acceptable age in days, allowing for 4 day grace period | Minimum acceptable number of days between doses, allowing for 4 day grace period | Age in days when child is considered late |
|---|---|---|---|---|
| Diphtheria, tetanus, acellular pertussis (DTaP) | ||||
| Dose 1 | 2 months | 38 | -- | 93 |
| Dose 2 | 4 months | 66 | 24 | 154 |
| Dose 3 | 6 months | 94 | 24 | 215 |
| Dose 4 | 15–18 months | 361 | 179 | 580 |
| Inactivated poliovirus (IPV) | ||||
| Dose 1 | 2 months | 38 | -- | 93 |
| Dose 2 | 4 months | 66 | 24 | 154 |
| Dose 3 | 6–18 months | 94 | 24 | 580 |
| Measles, mumps, rubella (MMR) | ||||
| 1 dose | 12–15 months | 361 | -- | 489 |
| Hepatitis B | ||||
| Dose 1 | 0–2 months | 0 | -- | 93 |
| Dose 2 | 1–4 months | 24 | 24 | 154 |
| Dose 3 | 6–18 months | 164 | 38 | 580 |
| Haemophilus infleunzae type b (Hib) b,c | ||||
| Dose 1 | 2 months | 38 | -- | 93 |
| Dose 2 | 4 months | 66 | 24 | 154 |
| Dose 3 | 6 months | 94 | 24 | 215 |
| Dose 4 | 12–15 months | 361 | 52 | 580 |
| Varicella | ||||
| 1 dose | 12–15 months | 361 | -- | 489 |
| Pneumoccocal conjugate c | ||||
| Dose 1 | 2 months | 38 | -- | 93 |
| Dose 2 | 4 months | 66 | 24 | 154 |
| Dose 3 | 6 months | 94 | 24 | 215 |
| Dose 4 | 12–15 months | 361 | 52 | 580 |
Abbreviations: ACIP, Advisory Committee on Immunization Practices
These specifications were adapted from Glanz et al. (reference 9), which were adapted from Luman et al. (reference 8). For our calculations, we changed the minimum age of the 3rd dose of the Hepatitis B birth dose to 164 days from 176 days to account for ACIP guidelines that the final dose of this series be administered at age 24 weeks or later (24 × 7 days = 168 – 4 day grace period = 164 days) (Newcomer et al., reference 19; Robinson et al., reference 5).
If the first two Hib doses are PRP-OMP [PedvaxHib® or Comvax® brands], then a 6-month dose of the vaccine is not required.
Even though ACIP recommends the 4th dose of Hib and pneumococcal vaccines at age 12–15 months, we did not consider the 4th doses of Hib or pneumococcal conjugate vaccines late until age 580 days, which is approximately age 19 months. The combined DTaP-IPV-Hib vaccine (Pentacel® brand) is recommended to be given at ages 2,4,6 and 15–18 months, and pneumococcal, DTaP-containing, and Hib-containing vaccines are often concomitantly administered (Glanz et al., reference 9; Newcomer et al., reference 19; Sanofi Pentacel, reference 49).