The Basics: Your Child’s Vaccination Schedule

The Childhood Vaccine Schedule Starts at Birth

Parents will often come into well-child visits with their little ones and are shocked to learn that their child is due for shots, or they're pleasantly surprised to find out their child doesn't need any shots. So here are the basics on when kids are due for childhood immunizations.

This is the schedule from the Centers for Disease Control in conjunction with the Advisory Committee on Immunization Practices, which helps set out the schedule based on a ton of research.

First, it's the hepatitis B vaccine, and that's normally given with the vitamin K shot at birth.

Vaccines at 2, 4, and 6 Months

The next set of vaccines is given at 2, 4, and 6 months old. Now, this will seem like a lot of shots, but it's designed to give babies the maximum protection against bacterial and viral illnesses that hit infants and toddlers most and provide protection after they lose the natural immunity they got from their mothers through the placenta before birth.

At the 2-, 4-, and 6-month well-visits, they get three shots, and they get one oral vaccine.

1. The shots are Pediarix, which is a combination vaccine containing DTaP for diphtheria, tetanus, and whooping cough. It also contains hepatitis B and polio.
2. The second is Hib, for Haemophilus influenzae type B, which can cause ear infections and meningitis, a bacterial infection of the lining of the brain and spinal cord, which can be fatal.
3. The third is Prevnar, and that protects against streptococcal pneumonia bacteria that cause ear infections, meningitis, pneumonia, and infections of the bloodstream.
4. The oral vaccine is called RotaTeq and protects against rotavirus, which is a nasty viral infection that causes vomiting and diarrhea severe enough to hospitalize babies due to dehydration. This is a virus that I saw a lot when I was in residency. The vaccine didn't come out until just after my oldest son was 4 months old. The first dose has to be given before 3 months old, so he didn't get it. I was pregnant with him when I caught rotavirus after being on the inpatient service, and he got it at 5 months old. It was definitely not fun.

At 9 months, unless it's influenza season, babies get a break from shots, but they are still due for a well-visit.

Vaccines at 12 Months

The next well-visit is at 12 months. At that age, they get their fourth Prevnar, and then they have completed that series. They also get their first hepatitis A vaccine. And they get vaccines to protect them from measles, mumps, rubella, and varicella, also known as chickenpox.

Vaccines at 15 and 18 Months

Then at 15 months, they get the DTaP and the Hib again, which completes the Hib series.

And at 18 months, they get the second hepatitis vaccine and complete that series.

Then we give kids a break again.

The “Kindergarten Shots” Come Around Age 4

The next vaccines are what most parents call the "kindergarten shots". We give them at age 4, but they can be given any time after age 4 and before the child starts kindergarten. The schools will need documentation that your child has had these when you register them.

The kindergarten shots are combination vaccines also, which is good because, again, it means fewer pokes for more protection.

1. The first is Kinrix, which is DTaP and polio.
2. The second is called ProQuad, which is measles, mumps, rubella, and varicella. This finishes the polio, measles, mumps, rubella, and varicella series.

Preteens Get Their Next Set of Routine Vaccines

The next vaccines are given at 11, and many parents call these the junior high vaccines.

Now, let me clarify. There are current recommendations to start the HPV, human papillomavirus vaccine, at age 9. That is a new recommendation that is just now being put out. The HPV vaccine protects them from a virus that causes warts and cancer in the mouth, throat, and genitals. It's the one that causes cervical cancer in women, and one of the biggest causes of oral cancer in men.

The other junior high vaccines include the first dose of Tdap, which is the adult dose of tetanus, diphtheria, and whooping cough. The P stands for pertussis, which is whooping cough. And people still need them every 10 years pretty much for the rest of their lives. This is the one that everyone asks about if they have a puncture wound. The whole "if you step on a rusty nail, you have to have this vaccine." Yeah, it's that one.

Additional Meningococcal Vaccines

They also get one for meningitis groups A, C, W, and Y. There are several brand names for this vaccine. Menveo is the one we give at our clinic. This vaccine protects against the Neisseria meningitidis bacteria that causes meningitis. They get the second dose at 16.

There is an additional vaccine for meningitis group B that some teens need for college. It can be given from ages 16 to 23.

Flu, COVID, and Travel Vaccines

So those are the basic vaccines, the ones that are needed for school specifically. Of course, there are always other vaccines, like for influenza and COVID.

Also, if you are traveling outside of the United States, there may be other vaccines you need to visit other parts of the world. For those, you would be best to check with the health department or a travel clinic of your local hospital, as your pediatrician would not have those vaccines at their office.

If you have any questions about any of these vaccines, please talk to your child's pediatrician.