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Vaccines: Keep your child's shots on track

By Mayo Clinic staff
Original Article:  http://www.mayoclinic.com/health/vaccines/MY01013
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Vaccines: Keep your child's shots on track

Childhood vaccines offer protection from serious or potentially fatal diseases. Know which vaccines your child needs now and which vaccines are coming up.

By Mayo Clinic staff

The vaccine schedule is designed to ensure that children receive vaccines at the optimal time to protect them from infectious diseases. The schedule is updated every year, and changes range from the addition of a new vaccine to tweaks of current recommendations.

Given the schedule's complexity and frequent updates, it can be challenging for parents to stay on top of which vaccines their children need and when. Use this guide to find out which vaccines your child needs now and which vaccines are coming up based on recommendations from the Centers for Disease Control and Prevention.

If your child has health issues, such as HIV or diabetes, or if you're planning to travel outside the U.S., talk to your doctor about whether your child needs to follow a different vaccine schedule.

If your child misses a dose of a vaccine, ask your child's doctor about scheduling a catch-up vaccination. If you're ever unsure about which vaccines your child needs, don't hesitate to ask the doctor. You might also ask about combination vaccines to reduce the number of shots in a single visit.

Birth

The first dose of the hepatitis B vaccine is usually given at birth. A second dose may be given at age 1 month or at 2 months when other vaccinations are typically given.

  • Hepatitis B vaccine, first dose

Age 2 months

At age 2 months, a series of several vaccinations usually begins. Combination vaccines are generally used to reduce the number of shots.

  • Hepatitis B vaccine, second dose if not given at 1 month
  • Rotavirus (RV) vaccine, first dose
  • Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, first dose
  • Haemophilus influenzae type b (Hib) conjugate vaccine, first dose
  • Pneumococcal conjugate vaccine (PCV13), first dose
  • Inactivated poliovirus vaccine (IPV), first dose

Age 4 months

At age 4 months, follow-up doses of the vaccines administered at 2 months are usually given. Check with your child's doctor about catch-up vaccinations if your child is behind schedule or has missed any doses of vaccines.

  • Rotavirus (RV) vaccine, second dose
  • Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, second dose
  • Haemophilus influenzae type b (Hib) conjugate vaccine, second dose
  • Pneumococcal conjugate vaccine (PCV13), second dose
  • Inactivated poliovirus vaccine (IPV), second dose

Age 6 months

At age 6 months, a third round of vaccinations is given. A yearly seasonal influenza (flu) vaccine also is recommended beginning at age 6 months and continuing through age 18 years. For children younger than age 2 years, the influenza vaccine is given as a shot. The first time a child receives the vaccine, it's usually divided into two doses. Ask your child's doctor for details.

  • Hepatitis B vaccine, third dose
  • Rotavirus (RV) vaccine, third dose if needed
  • Diphtheria toxoid, tetanus toxoid and acellular pertussis (DTaP) vaccine, third dose
  • Haemophilus influenzae type b (Hib) conjugate vaccine, third dose
  • Pneumococcal conjugate vaccine (PCV13), third dose
  • Inactivated poliovirus vaccine (IPV), third dose
  • Influenza vaccine, once a year

Ages 12 to 18 months

The final doses of both Hib vaccine and PCV13 are usually given between ages 12 and 15 months. The fourth dose of DTaP is usually given between ages 15 and 18 months. However, in some cases, the fourth dose can be given as early as age 12 months — as long as it's been six months since the previous dose.

In addition, the first doses of MMR, varicella and hepatitis A vaccines are usually given at this time. The second dose of the hepatitis A vaccine can be given between ages 12 months and 23 months — as long as it's been six months since the previous dose.

  • Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, fourth dose
  • Haemophilus influenzae type b (Hib) conjugate vaccine, fourth dose
  • Pneumococcal conjugate vaccine (PCV13), fourth dose
  • Measles-mumps-rubella (MMR) vaccine, first dose
  • Varicella vaccine, first dose
  • Hepatitis A vaccine, two doses given at least six months apart
  • Influenza vaccine, once a year

Ages 2 to 3 years

For healthy children ages 2 years and older, the yearly influenza vaccine can be given as a shot or a nasal spray.

Children between ages 14 months and 59 months (4 years, 11 months) who completed the PCV series with a previous version of the vaccine may need a single additional dose of the new version (PCV13) — as long as it's been eight weeks since the most recent dose of PCV.

  • Hepatitis A vaccine, if needed
  • Pneumococcal conjugate vaccine (PCV13), if needed
  • Influenza vaccine, once a year

Ages 4 to 6 years

The final doses of DTaP, IPV, MMR and varicella vaccines are usually given before a child begins kindergarten.

  • Diphtheria toxoid, tetanus toxoid and acellular pertussis (DTaP) vaccine, fifth dose
  • Inactivated poliovirus vaccine (IPV), fourth dose
  • Measles-mumps-rubella (MMR) vaccine, second dose
  • Varicella vaccine, second dose
  • Influenza vaccine, once a year

Ages 7 to 10 years

Children who are behind schedule or have missed one or more doses of vaccines may need catch-up vaccinations. For example, children who haven't been fully vaccinated against pertussis need a dose of Tdap. Ask your child's doctor if your child needs any catch-up vaccinations.

  • Influenza vaccine, once a year

Ages 11 to 12 years

Single doses of Tdap and MCV4 are recommended for adolescents at age 11 or 12 years. In addition, HPV vaccination is recommended for both boys and girls at age 11 or 12 — although it can be given as early as age 9. It's given as a series of three injections over a six-month period.

  • Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine, one dose
  • Meningococcal conjugate vaccine (MCV4), one dose
  • Human papillomavirus (HPV) vaccine, three doses over six months
  • Influenza vaccine, once a year

Ages 16 to 18 years

A booster dose of MCV4 is recommended for adolescents at age 16 years. An additional dose of Tdap is recommended for adolescents who are pregnant, regardless of the number of years since prior Tdap or tetanus and diphtheria toxoids (Td) vaccination.

  • Meningococcal conjugate vaccine (MCV4), booster
  • Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine, during pregnancy
  • Influenza vaccine, once a year
References
  1. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedules for Persons Aged 0 Through 18 years and Adults Aged 19 Years and Older — United States, 2013. MMWR. 2013;62:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0128a1.htm.  Accessed Jan. 29, 2013.
  2. The childhood immunization schedule and safety: Stakeholder concerns, scientific evidence, and future studies. Institute of Medicine. http://www.iom.edu/Reports/2013/The-Childhood-Immunization-Schedule-and-Safety.aspx. Accessed Jan. 29, 2013.
MY01013 March 21, 2013

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