Children and Teens

It's recommended that children visit their doctor for a physical exam at least once a year between the ages of 3 and 5 and every two years between the ages of 6 and 18, or as recommended by their doctor. The Hawaii Department of Health also recommends exams for children in grades 1, 4, 7, and 10.

HMSA offers a Child Immunization Program to make it easier to stay on top of your keiki's vaccine schedule.

Screenings & Immunizations

This chart offers guidelines only. Your doctor or nurse will personalize the timing of each test and immunization to meet your health care needs.

Ages: 0-6

Immunizations	Recommendations
Hepatitis B	Administer monovalent HepB to all newborns before hospital discharge. The second dose should be administered at age 1 or 2 months. Monovalent HepB vaccine should be used for doses administered before age 6 weeks. The final dose should be administered no earlier than age 24 weeks.
Rotavirus	Minimum age: 6 weeks Administer the first dose at age 6 through 14 weeks (maximum age: 14 weeks, 6 days). Vaccination should not be initiated for infants age 15 weeks or older. The maximum age for the final dose in the series is 8 months, 0 days.
Diphtheria, Tetanus, Pertussis	Minimum age: 6 weeks The fourth dose may be administered as early as age 12 months, provided at least 6 months have elapsed since the third dose. Administer the final dose in the series at ages 4 through 6 years.
Haemophilus influenzae type b	Minimum age: 6 weeks If PRP-OMP (PedvaxHIB or Comvax [HepB-Hib]) is administered at ages 2 and 4 months, a dose at age 6 months is not indicated. TriHiBit (DTaP/Hib) and Hiberix (PRP-T) should not be used for doses at ages 2, 4, or 6 months for the primary series, but can be used as the final dose in children ages 12 months through 4 years.
Pneumococcal	Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPSV] PCV is recommended for all children ages younger than 5 years. Administer 1 dose of PCV to all healthy children ages 24 through 59 months who are not completely vaccinated for their age. Administer PPSV 2 or more months after last dose of PCV to children ages 2 years or older with certain underlying medical conditions, including a cochlear implant.
Inactivated poliovirus	Minimum age: 6 weeks The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose. If 4 doses are administered prior to age 4 years, a fifth dose should be administered at ages 4 through 6 years.
Influenza	Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV] Administer annually to children ages 6 months through 18 years. For healthy children ages 2 through 6 years (i.e., those who do not have underlying medical conditions that predispose them to influenza complications), either LAIV or TIV may be used, except LAIV should not be given to children ages 2 through 4 years who have had wheezing in the past 12 months. Children receiving TIV should receive 0.25 mL if ages 6 through 35 months or 0.5 mL if ages 3 years or older. Administer 2 doses (separated by at least 4 weeks) to children ages younger than 9 years who are receiving an influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose.
Measles, mumps, and rubella	Minimum age: 12 months Administer the second dose routinely at ages 4 through 6 years. However, the second dose may be administered before age 4, provided at least 28 days have elapsed since the first dose.
Varicella	Minimum age: 12 months Administer the second dose routinely at ages 4 through 6 years. However, the second dose may be administered before age 4, provided at least 3 months have elapsed since the first dose. For children ages 12 months through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.
Hepatitis A	Minimum age: 12 months Administer to all children ages 1 year (i.e., ages 12 through 23 months). Administer 2 doses at least 6 months apart. Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits. HepA also is recommended for older children who live in areas where vaccination programs target older children, who are at increased risk for infection, or for whom immunity against hepatitis A is desired.
Meningococcal	Minimum age: 2 years for meningococcal conjugate vaccine [MCV4] and for meningococcal polysaccharide vaccine [MPSV4] Administer MCV4 to children ages 2 through 10 years with persistent complement component deficiency, anatomic or functional asplenia, and certain other conditions placing them at high risk. Administer MCV4 to children previously vaccinated with MCV4 or MPSV4 after 3 years if first dose was administered at ages 2 through 6 years.

Ages: 7-10

Immunizations	Recommendations
Meningococcal conjugate (MCV4)	Administer MCV4 to children ages 2 through 10 years with persistent complement component deficiency, anatomic or functional asplenia, or certain other conditions placing them at high risk. Administer to children previously vaccinated with MCV4 or MPSV4 who remain at increased risk after 3 years (if first dose was administered at ages 2 through 6 years) or after 5 years (if first dose was administered at age 7 years or older). Persons whose only risk factor is living in on-campus housing are not recommended to receive an additional dose.
Influenza	Administer annually to children ages 6 months through 18 years For healthy nonpregnant persons ages 7 through 18 years (i.e., those who do not have underlying medical conditions that predispose them to influenza complications), either LAIV or TIV may be used. Administer 2 doses (separated by at least 4 weeks) to children ages younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose.
Pneumococcal polysaccharide	Administer to children with certain underlying medical conditions, including a cochlear implant. A single revaccination should be administered after 5 years to children with functional or anatomic asplenia or an immunocompromising condition.
Hepatitis A	Administer 2 doses at least 6 months apart. HepA is recommended for children ages older than 23 months who live in areas where vaccination programs target older children, who are at increased risk for infection, or for whom immunity against hepatitis A is desired.
Hepatitis B	Administer the 3-dose series to those not previously vaccinated. A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB is licensed for children ages 11 through 15 years.
Inactivated poliovirus	The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose. If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child's current age.
Measles, mumps, and rubella	If not previously vaccinated, administer 2 doses or the second dose for those who have received only 1 dose, with at least 28 days between doses.
Varicella	For children ages 7 through 18 years without evidence of immunity, administer 2 doses if not previously vaccinated, or the second dose if only 1 dose has been administered. For children ages 7 through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.

Ages: 11-12

Immunizations	Recommendations
Tetanus, Diphtheria, Pertussia (Tdap)	Minimum age: 10 years for Boostrix and 11 years for Adacel Administer at age 11 or 12 years for those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a tetanus and diphtheria toxoid (Td) booster dose. A 5-year interval from the last Td dose is encouraged when Tdap is used as a booster dose; however, a shorter interval may be used if pertussis immunity is needed.
Human papillomavirus (HPV)	Minimum age: 9 years Two HPV vaccines are licensed: a quadrivalent vaccine (HPV4) for the prevention of cervical, vaginal, and vulvar cancers (in females) and genital warts (in females and males), and a bivalent vaccine (HPV2) for the prevention of cervical cancers in females. HPV vaccines are most effective for both males and females when given before exposure to HPV through sexual contact. HPV4 or HPV2 is recommended for the prevention of cervical precancers and cancers in females. HPV4 is recommended for the prevention of cervical, vaginal, and vulvar precancers and cancers and genital warts in females. Administer the first dose to females at age 11 or 12 years. Administer the second dose 1 to 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose). HPV4 may be administered in a 3-dose series to males ages 9 through 18 years to reduce their likelihood of acquiring genital warts.
Meningococcal conjugate (MCV4)	Administer at age 11 or 12 years, or at ages 13 through 18 years if not previously vaccinated. Administer to children previously vaccinated with MCV4 or MPSV4 who remain at increased risk after 3 years (if first dose was administered at ages 2 through 6 years) or after 5 years (if first dose was administered at age 7 years or older). Persons whose only risk factor is living in on-campus housing are not recommended to receive an additional dose.
Influenza	Administer annually to children ages 6 months through 18 years For healthy, non-pregnant children ages 7 through 18 years (i.e., those who do not have underlying medical conditions that predispose them to influenza complications), either LAIV or TIV may be used.
Pneumococcal polysaccharide	Administer to children with certain underlying medical conditions, including a cochlear implant. A single revaccination should be administered after 5 years to children with functional or anatomic asplenia or an immunocompromising condition.
Hepatitis A	Administer 2 doses at least 6 months apart. HepA is recommended for children ages older than 23 months who live in areas where vaccination programs target older children, who are at increased risk for infection, or for whom immunity against hepatitis A is desired.
Hepatitis B	Administer the 3-dose series to those not previously vaccinated. A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB is licensed for children ages 11 through 15 years.
Inactivated poliovirus	The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose. If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child's current age.
Measles, mumps, and rubella	If not previously vaccinated, administer 2 doses or the second dose for those who have received only 1 dose, with at least 28 days between doses.
Varicella	For children ages 7 through 18 years without evidence of immunity, administer 2 doses if not previously vaccinated, or the second dose if only 1 dose has been administered. For children ages 7 through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.

Ages: 13-18

Immunizations	Recommendations
Tetanus, Diphtheria, Pertussia (Tdap)	Persons ages 13 through 18 years who have not received Tdap should receive a dose. A 5-year interval from the last Td dose is encouraged when Tdap is used as a booster dose; however, a shorter interval may be used if pertussis immunity is needed.
Human papillomavirus (HPV)	Two HPV vaccines are licensed: a quadrivalent vaccine (HPV4) for the prevention of cervical, vaginal, and vulvar cancers (in females) and genital warts (in females and males), and a bivalent vaccine (HPV2) for the prevention of cervical cancers in females. HPV vaccines are most effective for both males and females when given before exposure to HPV through sexual contact. HPV4 or HPV2 is recommended for the prevention of cervical precancers and cancers in females. HPV4 is recommended for the prevention of cervical, vaginal, and vulvar precancers and cancers and genital warts in females. Administer the series to females at age 13 through 18 years if not previously vaccinated. Administer the second dose 1 to 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose). HPV4 may be administered in a 3-dose series to males ages 9 through 18 years to reduce their likelihood of acquiring genital warts.
Meningococcal conjugate (MCV4)	Administer at ages 13 through 18 years if not previously vaccinated. Administer to children previously vaccinated with MCV4 or MPSV4 who remain at increased risk after 3 years (if first dose was administered at ages 2 through 6 years) or after 5 years (if first dose was administered at age 7 years or older). Persons whose only risk factor is living in on-campus housing are not recommended to receive an additional dose.
Influenza	Administer annually to children ages 6 months through 18 years For healthy, non-pregnant children ages 7 through 18 years (i.e., those who do not have underlying medical conditions that predispose them to influenza complications), either LAIV or TIV may be used.
Pneumococcal polysaccharide	Administer to children with certain underlying medical conditions, including a cochlear implant. A single revaccination should be administered after 5 years to children with functional or anatomic asplenia or an immunocompromising condition.
Hepatitis A	Administer 2 doses at least 6 months apart. HepA is recommended for children ages older than 23 months who live in areas where vaccination programs target older children, who are at increased risk for infection, or for whom immunity against hepatitis A is desired.
Hepatitis B	Administer the 3-dose series to those not previously vaccinated. A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB is licensed for children ages 11 through 15 years.
Inactivated poliovirus	The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose. If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child's current age.
Measles, mumps, and rubella	If not previously vaccinated, administer 2 doses or the second dose for those who have received only 1 dose, with at least 28 days between doses.
Varicella	For children ages 7 through 18 years without evidence of immunity, administer 2 doses if not previously vaccinated or the second dose if only 1 dose has been administered. For children ages 7 through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.

Children and Teens

Screenings & Immunizations

Ages: 0-6

Ages: 7-10

Ages: 11-12

Ages: 13-18

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