(Updated November 2021)

Table 3: Recommendations* for Interrupted or Delayed Routine Immunization - Summary of WHO Position Papers

Doses in Primary Interrupted Doses for those who start vaccination late
Antigen Age of 1st Dose Series (min interval primary Booster
If ≤ 12 months of
between doses)** series*** If > 12 months of age
age
Recommendations for all immunization programmes

BCG 1 As soon as possible after birth 1 dose NA 1 dose 1 dose Not recommended

Resume without
Birth dose <24 hrs plus 2-3
Hepatitis B 2 As soon as possible after birth (<24h) repeating previous 3 doses 3 doses Not recommended
doses with DTPCV (4 weeks)
dose

bOPV 6 weeks Resume 5 doses (if >3 months old

5 5 doses (IPV to be given with 1st
bOPV + IPV without repeating IPV to be given with 1st & Not recommended
(3 bOPV and 2 IPV) dose & 3rd dose of bOPV)
IPV 14 weeks previous dose 3rd dose of bOPV)

Resume without
1-2 doses IPV and 1-2 doses IPV and 2 doses
Polio 3 IPV / bOPV Sequential 8 weeks (IPV 1st) repeating previous 1-2 doses IPV and 2 doses bOPV Not recommended
2 doses bOPV (4 weeks) bOPV
dose

Resume without If the primary series begins < 2 months

IPV 8 weeks 3 doses (4 weeks) repeating previous 3 doses 3 doses of age, booster to be given at least 6
dose months after the last dose

3 doses with interval of at least 4 3 boosters: 12-23 months (DTP-

weeks between 1st & 2nd dose, containing vaccine); 4-7 years (Td/DT
and at least 6 mos between 2nd containing vaccine), see footnotes; and
Resume without & 3rd dose 9-15 yrs (Td containing) (if > 7 yrs use
DTP-containing vaccine (DTPCV) 4 6 weeks (min) 3 doses (4 weeks) repeating previous 3 doses only aP containing vaccine)
dose (if > 7 yrs use only aP containing
vaccine; if > 4 yrs Td containing If tetanus vaccination started during
vaccine is preferred and should adolescence or adulthood only 5 doses
only be used for >7 yrs) required for lifelong protection

Option 1 3 doses (4 weeks) Resume without 3 doses 1 dose None

Haemophilus
6 weeks (min) repeating previous >5 yrs not recommended if
influenzae type b 5 2-3 doses (8 weeks if 2
Option 2 dose 2-3 doses healthy At least 6 months (min) after last dose
doses; 4 weeks if 3 doses)

Booster at 9-18 months if

3 doses (3p+0) with DTPCV
Resume without following 2 dose schedule
(4
Pneumococcal (Conjugate) 6 6 weeks (min) repeating previous 2-3 doses 1-5 yrs at high-risk: 2 doses Another booster if HIV+
weeks)
dose or preterm neonate
or 2 doses (2p+1) (8 weeks)
Vaccination in older adults

Resume without
2 or 3 depending on product
Rotavirus 7 6 weeks (min) repeating previous 2 or 3 depending on product >24 months limited benefit Not recommended if > 24 months old
given with DTPCV
dose

Resume without
9 or 12 months
Measles 8 2 doses (4 weeks) repeating previous 2 doses 2 doses Not recommended
(6 months min, see footnote)
dose

1 dose with measles

Rubella 9 9 or 12 months NA 1 dose 1 dose Not recommended
containing vaccine

If 1st dose given

before 15 years of
As soon as possible from 9 years of Girls: 9-14 years 2 doses
HPV 10 2 doses (5 months) age resume without NA Not recommended
age (females) (see footnote)
repeating previous
dose

* For some antigens the WHO position paper does not provide a recommendation on interrupted or delayed schedules at this present time. When the position paper is next revised this will be included. In the meantime, some of the recommendations are based on
expert opinion.
** See Table 2: Summary of WHO Position Papers - Recommended Routine Immunizations for Children for full details ([Link]/immunization/documents/positionpapers/).
*** Same interval as primary series unless otherwise specified.

P.1 /10
 (Updated
Table 3: Recommendations* for Interrupted or Delayed Routine Immunization Summary of WHO Position Papers November 2021)

Doses in Primary Doses for those who start vaccination late

Interrupted primary
Antigen Age of 1st Dose Series (min interval Booster Dose
series***
between doses)** If ≤ 12 months of age If > 12 months of age
Recommendations for certain regions
Inactivated Vero cell- Resume without repeating
6 months 2 (4 weeks) generally 2 doses (generally) 2 doses (generally)
derived vaccine previous dose
Japanese
Not recommended
Encephalitis 11 Live attentuated 8 months 1 NA 1 dose 1 dose

Live recombinant vaccine 9 months 1 NA 1 dose 1 dose

1 dose with measles

Yellow Fever 12 9-12 months NA 1 dose 1 dose Not recommended
containing vaccine

3 doses (1st to 2nd 1-3 Resume without repeating

FSME-Immun & Encepur ≥ 1 yr 3 doses 3 doses At least 1 booster
Tick-Borne mos; 2nd to 3rd 12 mos) previous dose
Encephalitis 13
3 doses (1st to 2nd 1-7 Resume without repeating
TBE_Moscow & EnceVir ≥ 3 yr 3 doses 3 doses Every 3 years
mos; 2nd to 3rd 12 mos) previous dose

Recommendations for some high-risk populations

TCV-Typbar >6 months 1 dose NA 1 dose 1 dose

Vi PS 2 years (min) 1 dose NA Not recommended 1 dose Every 3 years

Typhoid 14 If interruption between

doses is < 21 days resume
3-4 doses (1 day)
Ty21a Capsules 5 years (min) (see footnote) without repeating previous Not recommended > 5 yrs: 3-4 doses Every 3-7 years
(see footnote)
dose; If > 21 days restart
primary series

2-5 yrs: 3 doses 2-5 yrs: every 6 months. If booster is

2-5 yrs: 3 doses
delayed > 6 months the primary series
must be repeated.
If interval since last dose ≥ 6
Dukoral (WC-rBS) 2 years (min) Not recommended
weeks restart primary series
Cholera 15 >6 yrs: every 2 years. If booster is
≥ 6 yrs: 2 doses delayed > 2 yrs the primary series
> 6 yrs: 2 doses
(≥ 7 days) must be repeated.

Shanchol, Euvchol and Resume without repeating

1 year (min) 2 doses (2 weeks) Not recommended 2 doses After 2 years
mORCVAX previous dose

2 doses if < 9 months with 8

MenA conjugate (5µg) 9-18 months 1 NA 1 dose of 5µg up to 24 months Not recommended
week interval

Resume without repeating

2-11 months 2 (8 weeks min)
MenC conjugate previous dose 2 doses 1 dose 2-11 months of age after 1 year
Meningococcal 16
>12 months 1 NA

Resume without repeating

9-23 months 2 (12 weeks min)
Quadrivalent conjugate previous dose 2 doses 1 dose

≥ 2 years 1 NA

Hepatitis A 17 1 year (min) At least 1 dose Not recommended At least 1 dose Not recommended

Only if occupation puts a frequent or

Resume without repeating
Rabies 18 As required 2 (1st to 2nd 7 days) 2 doses 2 doses continual risk of exposure, titres
previous dose;
should be tested if possible

Resume without repeating

Dengue ( CYD-TDV) 19 9 years (min) 3 doses (6 months) Not recommended 3 doses ≥ 9 years Not recommended
dose

Recommendations for immunization programmes with certain characteristics

2 doses with measles Resume without repeating
Mumps 20 12-18 months Not recommended 2 doses Not recommended
containing vaccine (4 weeks) previous dose

Seasonal influenza (inactivated tri- and qudri- < 9 yrs: 2 doses (4 weeks) Resume without repeating < 9 yrs: 2 doses
6 months (min) 2 doses Revaccinate annually 1 dose only
valent) 21 ≥ 9 yrs: 1 dose previous dose ≥ 9 yrs: 1 dose

1-2 (4 weeks – 3 months, Resume without repeating

Varicella 22 12-18 months Not recommended 1-2 doses
depending on manufacturer) previous dose

P.2 /10
Summary Table 3 - Notes • The preferred schedule is to administer the first IPV dose at 14 weeks of age (with DTPCV3/
Penta3), and to administer the second IPV dose at least 4 months later (possibly coinciding
• The attached table summarizes the WHO recommendations for interrupted or delayed routine with other vaccines administered at 9 months of age). This schedule provides the highest
vaccination. Its purpose is to assist national decision-makers and programme managers to immunogenicity and may be carried out using full dose IPV or fractional intradermal IPV (fIPV)
develop appropriate policy guidance in relation to their national immunization schedule. without loss of immunogenicity. (Oct SAGE 2020 Meeting Report). Sabin-IPV (sIPV) may be
used interchangeably with wIPV, but sIPV is not recommended to be used as a fractional dose
• This table is designed to be used together with two other summary tables - Table 1: Summary
due to current lack of evidence. (March 2021 SAGE Meeting Report)
of WHO Position Papers - Recommendations for Routine Immunization; and Table 2: Summary
of WHO Position Papers - Recommended Routine Immunization for Children. • Based on local epidemiology, programmatic implications and feasibility of delivery, countries
may choose an alternative early IPV schedule starting with the first dose at 6 weeks of age
• Vaccines can generally be co-administered (i.e. more than one vaccine given at different
(with DTP1/Penta1) and the second dose at 14 weeks (with DTPCV3/Penta3). This alternative
sites during the same visit). Recommendations that explicitly endorse co-administration are
schedule offers the advantage of providing early-in-life protection; however, there is a lower
indicated in the footnotes. Lack of an explicit co-administration recommendation is often due to
total immunogenicity achieved. If this schedule is chosen, full dose IPV (for both wIPV and sIPV)
a lack of evidence and does not necessarily imply that the vaccine cannot be co-administered.
should be used rather than fIPV due to lower immunogenicity of fIPV at early ages. (Oct 2020
Exceptions to co-administration are stated.
SAGE Meeting Report)
• Refer to [Link] for the most recent version of this
• In polio-endemic countries and in countries at high risk for importation and subsequent spread
table (and Tables 1 and 2) and position papers.
of poliovirus, WHO recommends a bOPV birth dose (zero dose) followed by a primary series of
3 bOPV doses and at least 2 IPV doses. (2016 PP; adjusted for 2 IPV doses)
• The zero dose of bOPV should be administered at birth, or as soon as possible after birth, to
1
BCG maximize seroconversion rates following subsequent doses and to induce mucosal protection.
• Position paper reference: Weekly Epid. Record (2017, 92:369-392) [pdf 660KB] (2016 PP)

• BCG vaccination is recommended for unvaccinated TST- or IGRA-negative older children, • Both OPV and IPV may be co-administered concurrently and both may be given with other
adolescents and adults from settings with high incidence of TB and/or high leprosy burden and infant vaccines. (2016 PP)
those moving from low to high TB incidence/ leprosy burden settings. • For infants starting the routine immunization schedule late (age >3 months) the IPV dose should
be administered at the first immunization contact along with bOPV and the other routinely
recommended vaccines. (2016 PP)
2
Hepatitis B • The implementation of 3 bOPV doses + 2 IPV doses does not replace the need for supplementary
immunization activities (SIAs). (2016 PP)
• Position paper reference: Weekly Epid. Record (2017, 92:369-392) [pdf 2.4MB]
• Countries that delayed the introduction of IPV or experience stock-outs should provide catch-up
• In general, the dose for infants and children (aged < 15 years) is half the recommended adult vaccination to all children who were missed as soon as the vaccine becomes available. (2016
dose. PP)

• Co-administration of HepB vaccine does not interfere with the immune response to any other Sequential IPV–OPV schedule
vaccine and vice versa.
• In countries with high vaccination coverage (e.g. 90%–95%) and low importation risk
• If delayed or interrupted scheduling of vaccination for children, adolescents and adults, 3 doses (neighbouring countries and major population movement all having similarly high coverage)
are recommended, with the second dose administered at least 1 month after the first, and the an IPV–bOPV sequential schedule can be used when VAPP is a significant concern. (2016 PP)
third dose 6 months after the first dose. If the vaccination schedule is interrupted it is not
• The initial administration of 1 or 2 doses of IPV should be followed by ≥2 doses of bOPV to
necessary to restart the vaccine series.
ensure both sufficient levels of protection in the intestinal mucosa and a decrease in the burden
of VAPP. (2016 PP)
• For sequential IPV–bOPV schedules, WHO recommends that IPV be given at 2 months of age
3
Polio (e.g. a 3-dose IPV–bOPV–bOPV schedule), or at 2 months and 3–4 months of age (e.g. a
4-dose IPV–IPV–bOPV–bOPV schedule) followed by at least 2 doses of bOPV. Each of the doses
• A revised Polio Vaccine Position Paper is forthcoming in 2022. Position paper reference: Weekly in the primary series should be separated by 4–8 weeks depending on the risk of exposure to
Epid. Record (2016, 9:145-68)[pdf 611KB] and Meetings of the Strategic Advisory Group of poliovirus in early childhood. (2016 PP)
Experts on immunization: Conclusions and Recommendations. Weekly Epid. Record (2021,
96:133-144) [pdf 448KB], Weekly Epid. Record (2020, 95: 585 - 607) [pdf 468.8Kb], Weekly IPV-only schedule
Epid. Record (2020, 95: 241-256) [pdf 480.8Kb]
• In the current epidemiological context and as a general principle, SAGE expressed the need for
OPV plus IPV regions or countries to be cautious about moving from a bOPV + IPV schedule to an IPV- only
schedule in their routine immunization programmes and recommended that instead they take
• All countries that currently administer three bOPV and one IPV dose should add a 2nd IPV dose a gradual approach, by first introducing a second dose of IPV into their routine immunization
in their routine immunization schedule. (Oct 2020 SAGE Meeting Report) schedules. (March 2020 SAGE Meeting Report)
• Regardless of the 2 dose IPV schedule used, introduction of the second IPV dose does not • An IPV-only schedule may be considered in countries with sustained high vaccination coverage
reduce the number of bOPV doses (three) used in the routine immunization schedule. (Oct 2020 and very low risk of both WPV importation and transmission. (2016 PP)
SAGE Meeting Report)

Table 3: Recommendations for Interrupted or Delayed Routine Immunization (Updated November 2021) P.3 /10
4
DTP-containing vaccines (Diphtheria, Tetanus and Pertussis) 5
Haemophilus influenzae type b (Hib)
• Position paper reference: Diphtheria - Weekly Epid. Record (2017, 92:417-436) [pdf 526KB]; • Position paper reference: Weekly Epid. Record (2013, 88: 413-428) [pdf 209KB]

• Tetanus - Weekly Epid. Record (2017, 92: 53-76) [pdf 636KB]; Pertussis - Weekly Epid. Record • The number of primary doses should be set after consideration of the local epidemiology, vaccine
(2015, 90: 433-460) [pdf 667KB] presentation (Hib conjugate monovalent vaccine versus Hib conjugate vaccine in combination
with other antigens) and how this fits into the overall routine immunization schedule.
• If either the start or the completion of the primary series has been delayed, the missing doses
should be given at the earliest opportunity with an interval of at least 4 weeks between doses. • If the vaccination course has been interrupted, the schedule should be resumed without
repeating the previous dose. Children who start vaccination late, but are aged under 12 months,
• 3 booster doses of diphtheria toxoid-containing vaccine should be provided during childhood should complete the vaccination schedule (e.g. have 3 primary doses or 2 primary doses plus
and adolescence. The diphtheria booster doses should be given in combination with tetanus a booster).
toxoid using the same schedule, i.e at 12–23 months of age, 4–7 years of age, and 9–15 years
of age, using age-appropriate vaccine formulations. Ideally, there should be at least 4 years • When a first dose is given to a child older than 12 months of age, only one dose is recommended.
between booster doses.
• Hib vaccine is not required for healthy children after 5 years of age.
• Tetanus - To ensure lifelong protection against tetanus all people should receive 6 doses (3
primary plus 3 booster doses) of tetanus toxoid-containing vaccine (TTCV) through routine
childhood immunization schedules. 6
Pneumococcal (Conjugate)
• If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately
spaced doses are required to obtain lifelong protection. • Position Paper Reference: Weekly Epid. Record (2019, 94: 85-104) [pdf 444KB]

• To provide and sustain both tetanus and diphtheria immunity throughout the life course and for • For administration of PCV to infants, WHO recommends a 3-dose schedule administered either
both sexes, age-appropriate combinations of tetanus and diphtheria toxoids should be used. For as 2p+1 or as 3p+0, starting as early as 6 weeks of age.
children <7 years of age DTwP or DTaP combinations may be used. For children aged 4 years
• If the 2p+1 schedule is selected, an interval of ≥8 weeks is recommended between the 2 primary
and older Td containing vaccine may be used and is preferred.
doses the booster dose should be given at 9–18 months of age, according to programmatic
• From 7 years of age only Td combinations should be used. Age-appropriate combinations considerations; there is no defined minimum or maximum interval between the primary series
containing pertussis vaccine with low-dose diphtheria antigen are also available. and the booster dose.

• Pregnant women and their newborn infants are protected from birth-associated tetanus if the • If the 3p+0 schedule is used, a minimum interval of 4 weeks should be maintained between
mother received either 6 TTCV doses during childhood or 5 doses if first vaccinated during doses.
adolescence/adulthood (documented by card, immunization registry and/or history) before the
• Interrupted schedules should be resumed without repeating the previous dose.
time of reproductive age. Vaccination history should be verified in order to determine whether
a dose of TTCV is needed in the current pregnancy. • If a series cannot be completed with the same type of vaccine, the available PCV product should
be used. Restarting a series is not recommended, even for the primary series.
• Pertussis vaccine: Only aP-containing vaccines should be used for vaccination of persons aged
≥7 years. • Wherever possible, catch-up vaccination at the time of introduction of PCV should be used to
accelerate its impact on disease in children aged 1–5 years, particularly in settings with a high
• Pertussis containing booster: A booster dose is recommended for children aged 1–6 years,
disease burden and mortality. If there is limited availability of vaccine or of financial resources
preferably during the second year of life (≥6 months after last primary dose), unless otherwise
for catch-up vaccination, the youngest children (e.g. < 2 years of age) should be prioritized to
indicated by local epidemiology; the contact could also be used to catch up on any missed doses
receive catch-up doses of PCV because of their higher risk for pneumococcal disease.
of other vaccines. This schedule should provide protection for at least 6 years for countries
using wP vaccine. For countries using aP vaccine, protection may decline appreciably before 6 • Catch-up vaccination can be done with a single dose of vaccine for children ≥24 months
years of age.
• Unvaccinated children aged 1–5 years who are at high risk for pneumococcal infection because
• Delayed or interrupted DTP-containing series: For children whose vaccination series has been of underlying medical conditions, such as HIV infection or sickle-cell disease, should receive at
interrupted, the series should be resumed without repeating previous doses. Children aged 1 to least 2 doses separated by at least 8 weeks.
< 7 years who have not previously been vaccinated should receive 3 doses of vaccine following
a 0, 1, 6 month schedule. Two subsequent booster doses using Td or Tdap combination vaccines • WHO does not currently have recommendations on the use of PCV in individuals over 5 years
are needed with an interval of at least 1 year between doses. of age.

Table 3: Recommendations for Interrupted or Delayed Routine Immunization (Updated November 2021) P.4 /10
7
Rotavirus at least 3 months before vaccination and, if possible, blood products should be avoided for up
to 2 weeks post-vaccination. Vaccinated persons are not eligible to donate blood for 1 month
• Position paper reference: Weekly Epid. Record (2013, 88: 49-64) [pdf 950KB] after vaccination.
• Early immunization is favoured with the first dose of rotavirus vaccine to be administered from
6 weeks of age, however, in order to benefit those who may come late infants can receive
doses without age restriction. Because of the typical age distribution of rotavirus gastroenteritis
(RVGE), rotavirus vaccination of children >24 months of age is not recommended.
10
Human Papillomavirus (HPV)
• Position paper reference: Weekly Epid. Record (2017, 92:241-268) [pdf 2.9MB].
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
possible without repeating previous doses. • Recommended target population for the prevention of cervical cancer: females aged 9–14
• Rotavirus vaccinations can be administered simultaneously with other vaccines in the infant years, prior to becoming sexually active.
immunization programme. • A 2-dose schedule with a 6-month interval between doses is recommended for individuals
receiving the first dose before 15 years of age. Those aged ≥15 years at the time of the second
dose are also adequately covered by 2 doses.
8
Measles • If the interval between doses is shorter than 5 months, then a third dose should be given at
least 6 months after the first dose.
• Position paper reference: Weekly Epid. Record (2017, 92:205-228) [pdf 600KB].
• A 3-dose schedule (0, 1-2, 6 months) should be used for all vaccinations initiated ≥15 years
• Reaching all children with 2 doses of measles vaccine should be the standard for all national
of age, including in those younger than 15 years know to be immunocompromised and/or HIV
immunization programmes. In addition to the first routine dose of MCV1, all countries should
infected (regardless of whether they are receiving antiretroviral therapy). It is not necessary to
add a second routine dose of MCV2 to their national immunization schedules regardless of the
screen for HPV infection or HIV infection prior to HPV vaccination.
level of MCV1 coverage.
• All three HPV vaccines can be co-administered with other live and non-live vaccines using
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
separate syringes and different injection sites.
possible without repeating previous doses.
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
• Because many cases of measles occur in children aged >12 months who have not been
possible without repeating previous doses.
vaccinated, routine delivery of MCV1 should not be limited to infants aged 9–12 months
and routine delivery of MCV2 should not be limited to infants 15 to 18 months of age. Every
opportunity (e.g. when children come into contact with health services) should be taken to
vaccinate all children that missed one or both MCV routine doses, particularly those under 15 11
Japanese Encephalitis (JE)
years of age. Policies which prohibit use of vaccine in children >1 year of age, older children and
teenagers should be changed to allow these individuals to be vaccinated. • Position paper reference: Weekly Epid. Record (2015, 90: 69-88) [pdf 950 KB].

• The minimum interval between MCV1 and MCV2 is 4 weeks. • The following vaccine dosing schedules and age of administration are recommended. The need
for a booster dose in endemic settings has not been clearly established for any of the vaccines
listed below:
• Inactivated Vero cell-derived vaccine: Primary series according to manufacturer’s
9
Rubella recommendations (these vary by product), generally 2 doses at 4-week intervals starting
• Position paper reference: Weekly Epid. Record (2020, 86: 301-316) [pdf 413KB] the primary series at ≥6 months of age in endemic setting

• Because rubella is not as highly infectious as measles and because the effectiveness of 1 dose • Live attenuated vaccine: Single dose administered at ≥8 months of age
of an RCV is > 95% even at 9 months of age, only 1 dose of rubella vaccine is required to • Live recombinant vaccine: Single dose administered at ≥9 months of age
achieve rubella elimination if high coverage is achieved. However, when combined with measles
vaccination, it may be easier to implement a second dose of RCV’s using the same combined • Despite a lack of comprehensive immunogenicity/effectiveness and safety data for all possible
MR vaccine or MMR vaccine for both doses. combinations of JE and other routine vaccines, co-administration for programmatic reasons
seems acceptable, even in the context of mass campaigns.
• RCV’s can be administered concurrently with inactivated vaccines. As a general rule, live vaccines
should be given either simultaneously with RCV’s, or at least 4 weeks apart. An exception to this • Regardless of the duration of delay, interrupted schedules should be resumed as soon as
is oral polio vaccine, which can be given at any time before or after RCV’s without interfering in possible without repeating previous doses.
the response to either vaccine.
• Interference may occur between MMR and yellow fever vaccines if they are simultaneously
administered to children < 2 years of age.
• Because of a theoretical, but never demonstrated, teratogenic risk rubella vaccination in
pregnant women should be avoided in principle, and those planning a pregnancy are advised to
avoid pregnancy for 1 month following vaccination.
• Administration of blood or blood products before or shortly after vaccination may interfere with
vaccine efficacy. If using only rubella vaccines persons who received blood products should wait

Table 3: Recommendations for Interrupted or Delayed Routine Immunization (Updated November 2021) P.5 /10
12
Yellow Fever 16
Meningococcal
• Position paper reference: Weekly Epid. Record (2013, 88: 269-284) [pdf 1.24MB] • Position paper reference: Weekly Epid. Record (2011, 86: 521-540) [pdf 1.1MB] and Update for
MenA conjugate Weekly Epid Record (2015, 90: 57-68) [pdf 852KB]
• A single dose of YF vaccine is sufficient to confer sustained life-long protective immunity against
YF disease; a booster dose is not necessary. • MenA conjugate vaccine (5µg) a 1-dose schedule is recommended at 9-18 months of age based
on local programmatic and epidemiologic considerations.
• The vaccine is contraindicated in children aged < 6 months and is not recommended for those
aged 6-8 months, except during epidemics when the risk of infection with the YF virus is very • There is no reason to expect interference when co-administered with other vaccines. The need
high. Other contraindications for YF vaccination are severe hyper-sensitivity to egg antigens and for a booster dose has not been established.
severe immunodeficiency.
• If in a specific context there is a compelling reason to vaccinate infants younger than 9 months,
• YF vaccine may be administered simultaneously with other vaccines a 2-dose schedule should be used starting at 3 months of age, with an interval of at least 8
weeks between doses.
• For monovalent MenC conjugate vaccine one single intramuscular dose is recommended for
13
Tick-Borne Encephalitis (TBE) children aged ≥12 months, teenagers and adults. Children 2-11 months require 2 doses
administered at an interval of a least 2 months and a booster about 1 year after.
• Position paper reference: Weekly Epid. Record (2011, 86: 241-256) [pdf 318KB]
• If the primary series is interrupted, vaccination should be resumed without repeating the
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as previous dose.
possible without repeating previous doses.

14
Typhoid
• Position paper reference: Weekly Epid. Record (2018, 93: 153-172) [pdf 297KB].
17
Hepatitis A
• Position paper reference: Weekly Epid. Record (2012, 87: 261-276) [pdf 1.24 MB]
• TCV is recommended for infants and children from 6 months of age and in adults up to 45 years.
Administration of TCV at the same time as other vaccine visits at 9 month of age or in the second • Inactivated HAV vaccine is licensed for intramuscular administration in a 2-dose schedule
year of life is encouraged. ViPS – single dose from 2 years of age. Ty21a is recommended as with the first dose given at the age of 1 year or older. The interval between the first and
3-doses to be administered orally every second day from 6 years of age. second dose is flexible (from 6 months up to 4-5 years) but is usually 6-18 months. Countries
may consider a 1-dose schedule as this option seems comparable in terms of effectiveness,
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
and is less expensive and easier to implement. However, in individuals at substantial risk of
possible without repeating previous doses.
contracting hepatitis A and in immunocompromised individuals, a 2-dose schedule is preferred.
• Typhoid vaccination is recommended in response to confirmed outbreaks of typhoid fever and Inactivated HAV vaccines produced by different manufacturers, including combined hepatitis A
may be considered in humanitarian emergency settings depending on the risk assessment in vaccines, are interchangeable. Apart from severe allergic reaction to the previous dose, there
the local setting. is no contraindication to their use. These vaccines can be co-administered simultaneously with
other routine childhood vaccines, and should be considered for use in pregnant women at
• The potential need for revaccination with TCV is currently unclear. Revaccination is recommended definite risk of HAV infection.
every 3 years for ViPS, and every 3-7 years for Ty21a.
• Live attenuated HAV vaccine is administered as a single subcutaneous dose to those ≥ 1 year
of age. Severe allergy to components included in the live attenuated hepatitis A vaccine is a
contraindication to their use. As a rule, live vaccines should not be used in pregnancy or in
15
Cholera severely immunocompromised patients. There is no information available on co-administration
• Position paper reference: Weekly Epid. Record (2017, 92:477-500) [pdf 676KB] of live attenuated hepatitis A vaccines with other routinely used vaccines.

• Regardless of the duration of delay, interrupted schedules should be resumed as soon as

possible without repeating previous doses. 18
Rabies
• Revaccination is recommended where there is continued risk of V. cholerae infection. For WC
vaccines revaccination is recommended after 3 years. For WC-rBS vaccine: children age 2-5 • Position paper reference: Weekly Epid. Record (2018, 93: 201-220) [pdf 370 KB].
years revaccination is recommended within 6 months. If less than 6 months have passed, 1
• If any doses are delayed, vaccination should be resumed, not restarted. A change in the route of
dose for revaccination. If more than 6 months have passed, the primary series of 3 doses
administration or in vaccine product during a PEP or PrEP course is acceptable if such a change
should be repeated. For those aged ≥6 years of age, if less than 2 years have passed, 1 dose
is unavoidable.
for revaccination. If more than 2 years have passed, the primary series of 2 doses should be
repeated.
• For control of cholera outbreaks vaccination should be considered to help prevent the spread
to new areas. For vaccination campaigns, a single-dose strategy using WC vaccines (Shanchol,
Euvchol or mORCVAX) could be considered in areas experiencing cholera outbreaks.

Table 3: Recommendations for Interrupted or Delayed Routine Immunization (Updated November 2021) P.6 /10
19
Dengue (CYD-TDV)
• Position paper reference: Weekly Epid. Record (2108, 93, 457-76) [pdf 513KB].
• CYD-TDV is recommended as a 3-dose series given 6 months apart. Should a vaccine dose be
delayed for any reason, it is not necessary to restart the course and the next dose in the series
should be administered as soon as possible.

20
Mumps
• Position paper reference: Weekly Epid. Record (2007, 82: 49-60) [pdf 311KB]
• In countries that decide to use mumps vaccine, the combination of mumps vaccine with measles
and rubella vaccines is recommended.
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
possible without repeating previous doses.

21
Seasonal Influenza (Inactivated Vaccine)
• Position paper reference: Weekly Epid. Record (2012, 87: 461-476) [pdf 1.9 MB]
• Previously unvaccinated children aged <9 years should receive 2 doses administered at least 4
weeks apart. Children aged 6–35 months should receive a paediatric dose.
• If previously vaccinated, children require only one-dose.
• A single dose of the vaccine is appropriate for children aged ≥9 years and healthy adults.
• Annual vaccination (or re-vaccination, if the vaccine strains are identical) is recommended,
particularly for high-risk groups.

22
Varicella
• Position paper reference: Weekly Epid. Record (2014, 89: 265-288) [pdf 889KB]
• Varicella vaccine can be administered concomitantly with other vaccines. Unless given together
with other live viral vaccines (measles, MR, MMR), it should be administered at a minimum
interval of 28 days.
• Regardless of the duration of delay, interrupted schedules should be resumed as soon as
possible without repeating previous doses.

Table 3: Recommendations for Interrupted or Delayed Routine Immunization (Updated November 2021) P.7 /10