Vaccines for Babies: How Long Can They Be Delayed? All Organized for You!

Author of this article:

Vaccine Science Wang Teacher, Master of Public Health from Fudan University, former Deputy Chief Physician of the Disease Control Center

When a baby comes into the world, it is equivalent to entering a “battlefield”.

Regardless of the external environment or relatives and friends, for their immature immune systems, they can be a huge “virus/bacteria bank”.

Wearing a helmet and armor can reduce the risk of babies getting hurt (getting sick) on the “battlefield”.

(illness)
. And this helmet and armor are vaccines!

Warm reminder⚠️: There are benefits at the end of the article.

Is it urgent to delay vaccination?

Many parents may feel wronged – it’s not that I want to delay, but really “have no choice”.

Baby’s illness, going to other places for holidays, vaccine shortage… All these may cause a dose of vaccine to be delayed.

Some parents are always worried:

Some vaccines require several injections, if one is missed and delayed for several months, is the previous one invalid?

In fact, the human immune system has a certain “memory”, and the vaccines that have been given will not “expire”.

And
delaying vaccination delays the time when “vaccines start to provide protection”, without affecting the final protective effect of the vaccine.

How to make up for delayed vaccinations?

If it’s not delayed for too long, it’s okay, just make up the incomplete doses, there’s no need to start over.

One thing to note:

As children grow older, their immune function also develops more maturely, their immune response to vaccines is stronger, and the risk of infection and disease burden from some pathogens is also lower.

For some vaccines, the number of doses that need to be made up may be less than the number of doses in the original vaccination program. However, if the delay is too long, it may also lead to some doses being “overdue” and unable to be made up, increasing the risk of disease.

So,
unless there are special circumstances, it is not recommended to delay vaccination, early vaccination, early protection.

When should free vaccines be made up?

The “National Immunization Program for Children’s Immunization Schedule and Instructions (2021 Edition)” points out:

When children reach the vaccination age for the corresponding dose, they should be vaccinated as soon as possible
^[2].

At the same time, it also provides the recommended maximum age for supplementary vaccination for some vaccines:

Note that the above recommendations are mainly to urge children who are late for vaccination to make up in time, and not “you can’t make up if you are over this age”.

So, what is the maximum age for supplementary vaccination for various vaccines?

In conjunction with relevant regulations and vaccine instructions, the maximum age for vaccination for various vaccines is as follows
(if marked “no strict limit”, the maximum age for supplementary vaccination is <18 years old)
^[2-3]:

1. Hepatitis B Vaccine

Age Limit:

All 3 doses should be completed <12 months of age.
No strict limit.

Supplementary Vaccination Plan:

When making up, the interval between Dose 1 and Dose 2 should be ≥28 days, and the interval between Dose 2 and Dose 3 should be ≥60 days.

2. BCG Vaccine

Age Limit:

Must be completed <4 years old (47 months old).

Supplementary Vaccination Plan:

Directly make up if <3 months old;
If between 3 months and 3 years old, a PPD test is required first, and only those who test negative should make up;

No make-up if ≥4 years old.

3. Polio Vaccine

Age Limit:

The first 3 doses should be completed <12 months of age;
Dose 4 should be completed <5 years of age.
No strict limit.

Supplementary Vaccination Plan:

Children <4 years old who have not received 3 doses should make up 3 doses;
Children ≥4 years old who have not received 4 doses should make up 4 doses.

The interval between doses should be ≥28 days when making up.

4. DTP/DT Vaccine

Age Limit:

The first 3 doses of DTP vaccine should be completed <12 months of age;
Dose 4 of DTP vaccine should be completed <6 years old (71 months old);

DT vaccine should be completed <12 years old.

Supplementary Vaccination Plan:

The interval between the first 3 doses of DTP vaccine should be ≥28 days, and the interval between Dose 4 and Dose 3 should be ≥6 months.

If children ≥6 years old have a total of <3 doses of “DTP + DT vaccine”, make up 3 doses with DT vaccine:
The interval between the second and first doses of DT vaccine when making up should be ≥28 days, and the interval between the third and second doses should be ≥6 months.

5. Group A/Group A and C Polysaccharide Meningococcal Vaccine

Age Limit:

Group A polysaccharide meningococcal vaccine should be completed <24 months of age;
There is no strict limit for Group A and C polysaccharide meningococcal vaccine.

Supplementary Vaccination Plan:

Children <24 months old should make up the doses of Group A polysaccharide meningococcal vaccine.
Children ≥24 months old should only make up Group A and C polysaccharide meningococcal vaccine, and should not use or make up doses of Group A.

6. MMR Vaccine

Age Limit:

Dose 1 should be completed <12 months of age;
Dose 2 should be completed <24 months of age.
No strict limit.
There is no strict limit.

Supplementary Vaccination Plan:

Make up 2 doses
(some areas need to make up 3 doses);

The interval between two doses of MMR vaccine should be ≥28 days when making up.

7. JE Live Vaccine

Age Limit:

Dose 1 should be completed <12 months of age;
Dose 2 should be completed <3 years of age.
No strict limit.

Supplementary Vaccination Plan:

Make up 2 doses, interval ≥12 months.

8. JE Inactivated Vaccine

Age Limit:

Dose 2 should be completed <12 months of age;
Dose 3 should be completed <3 years of age;
Dose 4 should be completed <7 years of age.
No strict limit.
There is no strict limit.

Supplementary Vaccination Plan:

Make up 4 doses.

The interval between Dose 1 and Dose 2 is 7-10 days, the interval between Dose 2 and Dose 3 is 1-12 months, and the interval between Dose 3 and Dose 4 is ≥3 years.

9. Hepatitis A Vaccine

Age Limit:

Dose 1 of Hepatitis A
(Live/Inactivated) vaccine should be completed <24 months of age;
Dose 2 of Hepatitis A inactivated vaccine should be completed <3 years of age.
No strict limit.
There is no strict limit.

Supplementary Vaccination Plan:

①If you have never been vaccinated with Hepatitis A vaccine, you need to make up 1 dose of Hepatitis A live vaccine or 2 doses of Hepatitis A inactivated vaccine
(interval ≥6 months);

②If you have been vaccinated with 1 dose of Hepatitis A inactivated vaccine, you should make up 1 dose of Hepatitis A inactivated vaccine;

If it is not possible, you can also make up 1 dose of Hepatitis A live vaccine
(both need an interval ≥6 months).

10. Varicella Vaccine

Age Limit:

Dose 1 should be completed ≥12 months of age;

Dose 2 should be completed ≥4 years of age
(some provinces and cities are 3 years old).

No strict limit.
There is no strict limit.

Supplementary Vaccination Plan:

Make up 2 doses.

For those aged 1-12, the interval between the two doses should be ≥3 months;

For those aged ≥13, the interval between the two doses should be ≥1 month.

11. Pentavalent/Quadrivalent Vaccine

Age Limit:

The first 3 doses should be completed <12 months of age;
Dose 4 should be completed <24 months of age (some areas are <6 years old).

Supplementary Vaccination Plan:

Directly make up if <12 months old, with an interval of ≥28 days between each dose;
Only 1 dose of pentavalent/quadrivalent vaccine is given if >12 months old.

If the corresponding component doses are insufficient, make up with separate components
(such as DTP, polio, Hib) vaccines.

12. Rotavirus Vaccine (Trivalent/Pentavalent)

Age Limit:

Dose 1 should be completed between 6 weeks and 12 weeks of age
(trivalent is 13 weeks old), Dose 2 should be completed between 10 and 22 weeks of age, and Dose 3 should be completed between 14 and 32 weeks of age.

The interval between each two doses should be 4-10 weeks.

Supplementary Vaccination Plan:

If a dose is overdue, this dose and the remaining doses cannot be made up (the strictest!⚠️).

13. EV71 (Hand, Foot, and Mouth Disease) Vaccine

Age Limit:

Dose 2 should be completed <6 years old (71 months old);

Supplementary Vaccination Plan:

Make up 2 doses, interval ≥28 days, no make-up if overdue.

14. Group A and C Conjugate Meningococcal Vaccine

Age Limit:

No strict limit.

Supplementary Vaccination Plan:

Make up 2 or 3 doses according to the instructions, with an interval of ≥28 days.

15. ACYW135 Group Polysaccharide Meningococcal Vaccine

Age Limit:

No strict limit.

Supplementary Vaccination Plan:

Make up 2 doses, with an interval of ≥3 years.

16. ACYW135 Group Conjugate Meningococcal Vaccine

Age Limit:

Should be completed <4 years old (47 months old).

Supplementary Vaccination Plan:

Can use this vaccine as an alternative to free meningococcal vaccines:

Complete 2 or 3 doses before the age of 2, with an interval of ≥1 month;

Administer 1 dose at the age of 3.

(Routine vaccination schedule for ACYW135 group conjugate meningococcal vaccine)

17. Haemophilus influenzae type b (Hib) Vaccine

Age Limit:

The first 3 doses should be completed <12 months of age;
The booster shot should be completed between 12 and 71 months of age.

Supplementary Vaccination Plan:

The first dose should be administered <6 months old, and 3 doses should be made up <12 months old, with an interval of ≥28 days;
If the first dose is administered between 6 and 11 months old, 2 doses should be made up <12 months old;
A booster shot should be administered between 12 and 71 months old.

No vaccination after 72 months old.

18. 13-Valent Pneumococcal Conjugate Vaccine

Age Limit:

The first 3 doses should be completed <12 months of age;
The final dose should be completed between 12 and 71 months of age.

Supplementary Vaccination Plan:

If ≤1 dose is administered within 1 year of age, 2 doses can be made up between 1 and 2 years of age, with an interval of ≥2 months;

If ≤1 dose is administered within 2 years of age, 1 dose can be made up after 2 years of age.

(Routine vaccination schedule for 13-valent pneumococcal conjugate vaccine)

19. HPV (Human Papillomavirus) Vaccine

Age Limit:

All doses should be completed <46 years old.

Supplementary Vaccination Plan:

Depending on age, 2 or 3 doses should be administered;

Just make up the incomplete doses according to the schedule.

In addition, an image of “The maximum age for the last dose of various vaccines” is attached for everyone. If there are still doubts, you can consult online with doctors in the vaccine department.

(Photo source:
Self-made)

Finally, to help everyone comprehensively understand all aspects of vaccines, the [Zhuozheng Vaccine Manual] has been specially updated. You can:

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Disclaimer:
The purpose of the article is to provide general health information, please consult a doctor for personal medical issues.
For article reprinting, please contact:
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