What vaccines does my child need at the 11-12 year old checkup?

At the 11-12 year visit, ACIP recommends three vaccines: Tdap (one dose, replacing the childhood DTaP booster), the HPV series (2 doses if started at age 9-14, with dose 2 given 6-12 months after dose 1), and the first MenACWY meningococcal dose. Starting HPV before age 15 means only 2 doses are needed instead of 3. A MenACWY booster follows later at age 16.

How many doses of HPV vaccine does my child need?

It depends on the age at the first dose. Starting at age 9-14 requires only 2 doses, given at month 0 and 6-12 months later (minimum interval 5 months). Starting at age 15 or later requires 3 doses, at month 0, 1-2 months, and month 6. Immunocompromised children always need the 3-dose schedule regardless of starting age. Catch-up is recommended through age 26.

My child's vaccine records are missing — can a blood test prove they're already immune?

Yes, for four vaccines. A quantitative blood titer can document existing immunity from prior vaccination or natural infection for MMR, varicella, hepatitis A, and hepatitis B. If the titer shows immunity, most schools accept it instead of repeating the vaccine series. Titers do not substitute for vaccines the child hasn't received yet, such as Tdap, HPV, or meningococcal.

What's the minimum time between MMR and varicella catch-up doses for a teen?

For MMR, the two catch-up doses must be at least 28 days apart, with the first dose on or after the child's first birthday. For varicella, the interval depends on age: children under 13 need at least 3 months between doses, while those 13 or older need at least 4 weeks. Doses given sooner than these intervals generally have to be repeated.

Does my child still need the chickenpox vaccine if they already had chickenpox?

Not medically, since documented chickenpox history confers immunity, but most schools still want proof beyond a parent's memory. Acceptable documentation is either a physician-verified diagnosis or a varicella IgG titer showing detectable antibodies. Parent recollection alone rarely satisfies school enrollment requirements.

Where can teens get vaccinated if we don't have insurance?

Most routine adolescent vaccines are free through ACA-compliant insurance and the federal Vaccines for Children (VFC) program for uninsured, underinsured, Medicaid-eligible, or American Indian/Alaska Native children. County and city health departments run low- or no-cost immunization clinics for minors, and federally-qualified community health centers serve everyone regardless of ability to pay. Many chain pharmacies also vaccinate teens 12 and older.

Guide · Ages 7–18

The child and adolescent vaccine schedule.

Reviewed August 2026 · Based on the CDC/ACIP Child and Adolescent Immunization Schedule¹, the ACIP Catch-Up Schedule (Table 2), the parent-facing CDC Adolescent Easy-Read schedule², and Immunize.org's state-by-state requirement tables³. Educational reference, not medical advice.

The pediatric schedule is dose- and interval-sensitive in a way the adult schedule isn't. Most of what happens between ages 7 and 18 is a small set of well-defined moments: a Tdap booster and an HPV series at 11–12, a meningitis booster at 16, and — if a child has fallen behind — catch-up doses at specific intervals. This guide walks parents through exactly what's due when, what to do if records are missing, and where state and school rules diverge from the CDC recommendation.

The three routine adolescent visits

Under the ACIP schedule¹, most children only need three well-child visits to complete adolescent vaccination: the 11–12 visit, the 16-year-old visit, and annual flu.

Age 11–12: Tdap, HPV, and the first meningitis dose

Three routine adolescent vaccines are scheduled at the 11–12 visit — the same appointment where most pediatricians do a school sports physical and check growth. Per the ACIP notes⁴:

Tdap — 1 dose replaces the childhood DTaP booster. Minimum age is 11 years. This is the only tetanus dose adolescents typically get; the next Td or Tdap booster isn't due for 10 years.
HPV — 2-dose series if started at age 9–14. Dose 1 at month 0, dose 2 at 6–12 months (minimum interval 5 months). Starting before age 15 saves a dose. If the series is started at 15 or later, it becomes a 3-dose series.
MenACWY (Meningococcal ACWY) — 1 dose at age 11–12. A booster follows at age 16. Minimum age for the routine dose is 11 years⁴.

Age 16: MenACWY booster, and MenB conversation

Age 16 is the second adolescent vaccine visit. The MenACWY booster is scheduled here — the two-dose adolescent schedule is "dose 1 at age 11–12 years and dose 2 at 16 years"⁴. A dose given on or after age 16 typically satisfies most college dorm requirements.

Meningococcal B (MenB) is a separate vaccine from MenACWY. It's recommended for teens age 16–23 based on shared clinical decision-making⁴ — meaning the pediatrician discusses it with the family, and the decision is individualized rather than universal. Bexsero and Trumenba are the two brand options; use the same brand for all doses. The 2-dose series is given at least 6 months apart.

Every year: flu vaccine

Annual seasonal flu vaccination is recommended for everyone 6 months and older who doesn't have a contraindication. Children age 6 months through 8 years may need 2 doses in a single season if they haven't previously received a flu vaccine; ages 9 and up get 1 dose per season².

What about COVID-19?

ImmunityCheck defers COVID-19 vaccination decisions to your pediatrician. Recommendations depend on individual health status, prior vaccination history, prior COVID-19 infection, and family preference. This is a conversation to have with your child's doctor rather than a checklist item to satisfy. The CDC's current adolescent guidance is available here if you want to review it directly.

School requirements vary — check your state, district, and school

The ACIP recommendation is the medical baseline. What your child's school actually requires for enrollment can differ. States decide their own K–12 immunization laws — number of doses, grade-level triggers, catch-up rules, accepted forms of proof (paper records, portal records, or titers), religious and medical exemption rules — and individual districts and private schools can layer additional requirements on top.

Two authoritative cross-references maintained by Immunize.org³: state-by-state vaccine requirement tables for K–12 and childcare, and links to every state's immunization program website. When in doubt, the school nurse or district registrar's office is the final word on what your specific school requires.

Catch-up: what to do if a child is behind

If a child hasn't received the routine doses on schedule — because they were born abroad, foster-adopted, moved between providers, or simply missed a well-child visit — the ACIP catch-up schedule (Table 2 of the immunization schedule¹) specifies minimum intervals between doses. Doses given too close together generally have to be repeated, so the intervals matter.

MMR — 2 doses, at least 28 days apart

Two doses of MMR are recommended in childhood, typically at 12–15 months and 4–6 years. A child or adolescent catching up needs 2 doses at least 28 days apart, with the first dose given on or after the first birthday. If records are missing, a quantitative MMR titer can document existing immunity from prior vaccination or natural infection.

Varicella — 2 doses, interval depends on age

Two doses of varicella (chickenpox) vaccine are recommended, typically at 12–15 months and 4–6 years. In catch-up:

Under age 13: 2 doses at least 3 months apart.
Age 13 or older: 2 doses at least 4 weeks apart.

If your teen "had chickenpox" without a documented pediatrician visit, most schools want either a physician-verified diagnosis or a varicella titer to prove immunity. Anecdotal parent recollection alone rarely satisfies enrollment requirements.

Hepatitis B — 3-dose series with graduated intervals

Hep B is a routine 3-dose childhood series (birth, 1–2 months, 6–18 months). A child or adolescent without a documented complete series should catch up. Minimum intervals:

At least 4 weeks between doses 1 and 2.
At least 8 weeks between doses 2 and 3.
At least 16 weeks between doses 1 and 3.
Final dose no earlier than 24 weeks of age.

If prior doses are undocumented but you're fairly certain the child received them, a Hepatitis B surface antibody (anti-HBs) titer can document existing protection without repeating the series.

Hepatitis A — 2 doses, 6 months apart

Two-dose series (dose 1 at 12–23 months, dose 2 at least 6 months later). Any child or adolescent without a documented 2-dose series should catch up. A Hepatitis A IgG titer can document existing immunity if records are missing.

Tdap — 1 adolescent dose at any point 11–18

Every adolescent gets 1 dose of Tdap. If it wasn't given at the routine 11–12 visit, catch up at any subsequent well-child visit through age 18. If the child was under-vaccinated as a young child (missed multiple DTaP doses), 1 dose is Tdap and any additional catch-up doses are Td or Tdap, per the ACIP catch-up notes⁴.

HPV — 2 doses if started 9–14, 3 doses if started at 15+

The two-dose vs. three-dose rule is the single most consequential thing to know about adolescent HPV vaccination:

Started at age 9–14: 2 doses. Dose 1 at month 0, dose 2 at 6–12 months. Minimum interval is 5 months — a dose given sooner has to be repeated.
Started at age 15 or later: 3 doses. Dose 1 at month 0, dose 2 at 1–2 months, dose 3 at month 6.

Immunocompromised children need the 3-dose schedule regardless of starting age. Catch-up is recommended through age 26.

MenACWY — first dose plus a 16+ booster

Catch-up rules from the ACIP notes⁴:

Ages 13–15 with no prior dose: 1 dose now, then a booster at age 16–18 (at least 8 weeks after the first).
Ages 16–18 with no prior dose: 1 dose. The dose on or after age 16 typically satisfies college requirements without a booster.

Polio (IPV) — 4-dose series with graduated intervals

Adolescents without a documented 4-dose IPV series should complete the catch-up schedule. Minimum intervals: 4 weeks between doses 1–2 and 2–3, and at least 6 months between doses 3 and 4. The final dose is given at age 4 or older.

Missing records? Titers may satisfy the school

Missing childhood vaccination records is a common situation — families move, pediatricians close their practices, adopted and fostered children arrive without complete histories, and paper records get lost. Before scheduling the full catch-up series, check whether the school will accept proof of immunity rather than proof of vaccination.

A quantitative blood titer documents existing immunity from either prior vaccination or natural infection. For MMR, varicella, hepatitis A, and hepatitis B, titers are widely accepted. If the titer shows immunity, most schools accept it in lieu of repeating the vaccine series — saving your child multiple shots and saving your family the expense of doses that are medically unnecessary.

Also check the state's Immunization Information System (IIS) directly — many pediatric doses are recorded there even when paper records have been lost. See the state records directory.

Where child guidance differs materially from adult guidance

A few adolescent-specific rules parents should know that differ from the adult schedule:

HPV dose count depends on age at first dose. Adults 15 and older always get 3 doses; the 2-dose option only exists for children starting before age 15.
MenACWY has a routine 2-dose adolescent schedule. Adults typically get 1 dose only in specific circumstances (asplenia, HIV, complement inhibitors, first-year college students in dorms, military recruits, travel to hyperendemic areas).
Varicella catch-up interval is age-dependent. Under 13, 3 months; 13+, 4 weeks. Adult catch-up uses the 4-week interval.
Shingles vaccine is not adolescent. Recombinant Zoster Vaccine starts at age 50 in the general population (age 19 in immunocompromised adults).
Pneumococcal, RSV, Hepatitis A for chronic conditions. The adolescent schedule adds pneumococcal doses only for children with specific chronic conditions (asplenia, sickle cell, HIV, cochlear implant, CSF leak, chronic heart or lung disease). Routine adult pneumococcal starts at age 50.

Where to get vaccinated

Most routine adolescent vaccines are covered at 100% (no copay) by ACA-compliant health insurance plans and by the federal Vaccines for Children (VFC) program for eligible children — uninsured, underinsured, Medicaid-eligible, or American Indian / Alaska Native. The 11–12 and 16-year-old well-child visits are the natural slots for adolescent doses; most pediatric offices flag them as "vaccine visits" on the appointment reminder.

For families without a regular pediatrician, county and city health departments run adult and adolescent immunization clinics that see minors at low or no cost, and federally-qualified community health centers (find via HRSA's Find a Health Center tool) serve everyone regardless of ability to pay. Many chain pharmacies now administer adolescent vaccines to teens 12 and older — check your state's specific rules and whether your pharmacy takes minors.

Trustworthy resources for parents

Beyond the CDC schedule itself, three organizations produce parent-facing material that pediatricians consider authoritative:

American Academy of Pediatrics (AAP) — the professional body that endorses the ACIP schedule for children. Their parenting site HealthyChildren.org has plain-language explainers.
Immunize.org — Parent Handouts — vetted one-page handouts for each vaccine and each age group. They also maintain the state-by-state requirement tables cited above.
Children's Hospital of Philadelphia — Vaccine Education Center — one of the most respected patient-education resources on vaccines, with content specifically for hesitant parents.

Sources

CDC — Child and Adolescent Immunization Schedule by Age. The full ACIP recommended schedule, ages birth through 18, including catch-up (Table 2) and medical-indication (Table 3) tables.
CDC — Recommended Immunizations for Children 7–18 Years Old, United States (Adolescent Easy-Read). The parent-facing summary of the adolescent schedule, including dose counts and vaccine descriptions.
Immunize.org — State Vaccine-Specific Requirements. State-by-state tables of school and childcare vaccine requirements, compiled from state health-department sources.
CDC — Child and Adolescent Notes. The detailed vaccine-by-vaccine notes accompanying the ACIP schedule, including minimum ages, dosing intervals, catch-up rules, and special-situation guidance.

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