Childhood Immunization Schedule

Overview

What is the childhood immunization schedule?

The childhood immunization schedule, or childhood vaccine schedule, is the list of common vaccines the Centers for Disease Control and Prevention (CDC) recommends most children should receive. Immunization is a way to protect your child from getting many different infections and diseases. Many of these illnesses spread easily from child to child and can cause serious health problems. They can even cause death.

When should my child get immunized?

Your child should receive their first doses of most vaccines during their first two years of life. They may need several doses of the vaccines to reach full protection. For example, the CDC recommends children receive their first dose of the measles, mumps and rubella (MMR) vaccine at 12 months of age or older. They should then receive a second dose before entering elementary school (about 4 to 6 years of age). Your baby can get their childhood vaccines at their regularly scheduled well-baby checkups.

How many vaccines do children get?

By the age of 15 months, your baby may receive up to 10 different types of vaccines. The American Academy of Pediatrics recommends all healthy babies receive these initial vaccines. Your child may receive additional doses and other vaccines between the ages of 15 months and 16 years old. If your child has a chronic condition or a weakened immune system, their pediatrician may recommend a different schedule.

What are the different types of vaccines?

The following vaccines can help protect your child from serious infection or disease.

Hepatitis B (HepB)

The hepatitis B vaccine can help protect your child against hepatitis B. The newborn vaccine schedule includes three doses of the HepB vaccine. Your newborn will generally receive their first dose within 12 hours of birth. They’ll receive their second dose at 1 to 2 months of age and their third dose between 6 and 18 months of age. Slight variations in this schedule are possible based on the birthing parent’s hepatitis B surface antigen status and the potential use of combination vaccines.

Rotavirus (RV)

The rotavirus vaccine can help protect your child against rotavirus. Rotavirus is a viral infection that can cause fever, vomiting and diarrhea. Your child will receive the rotavirus vaccine in two (Rotarix®) or three (RotaTeq®) doses, starting at age 2 months.

Diphtheria, tetanus and acellular pertussis (DTaP)

The DTaP vaccine can help protect your child against diphtheria, tetanus and pertussis. Baby vaccines include five doses of the DTaP combination vaccine. Your baby will receive their first dose at 2 months of age and their second at 4 months of age. They’ll receive their third dose at 6 months, their fourth dose between 15 and 18 months of age and their fifth dose between 4 and 6 years of age.

Haemophilus influenzae type b (Hib)

The Hib vaccine can help protect your child against the most common type of Haemophilus influenzae bacteria. Your child will receive three to four doses of the Hib vaccine, depending on the brand. They’ll receive their first dose at 2 months of age and their second dose at 4 months of age. They’ll possibly receive a third dose at 6 months of age. They’ll then receive their final dose between 12 and 15 months of age. Slight variations in this schedule are possible.

Pneumococcal conjugate (PCV13)

The PCV13 vaccine can help protect your child against pneumococcus bacterial infections. These infections include pneumonia and meningitis. Your child will receive four doses of the PCV13 vaccine. They’ll receive their first dose at 2 months of age and their second dose at 4 months of age. They’ll receive their third dose at 6 months of age and their fourth dose between 12 and 15 months of age.

Inactivated poliovirus (IPV)

The inactivated poliovirus (IPV) vaccine can help protect your child against infections of polio. Your child will receive four doses of the IPV vaccine. They’ll receive their first dose at 2 months of age and their second dose at 4 months of age. They’ll receive their third dose between 6 and 18 months of age and their fourth dose between 4 and 6 years of age.

Influenza

The influenza virus vaccine can help protect your child against the flu (influenza). Your child may get the influenza vaccine each year. They may receive one or two doses. They may receive their first dose at 6 months old and their second dose at least 1 month later.

Measles, mumps and rubella (MMR)

The measles, mumps and rubella (MMR) vaccine can help protect your child against measles, mumps and rubella. Your child will receive two doses of the MMR combination vaccine. They’ll receive their first dose between 12 and 15 months of age and their second dose between 4 and 6 years of age. The MMR vaccine may be combined with the VAR vaccine (MMRV).

Varicella (VAR)

The chickenpox (varicella) vaccine can help protect your child against chickenpox. Your child will receive two doses of the varicella vaccine. They’ll receive their first dose between 12 and 15 months of age and their second dose between 4 and 6 years of age. The varicella vaccine may be combined with the MMR vaccine (MMRV).

Hepatitis A (HepA)

The hepatitis A vaccine can help protect your child against hepatitis A. Hepatitis A is a type of liver disease. Your child will receive the HepA vaccine as a two-dose series. Your child will receive their first dose between 12 and 23 months and their second dose at least six months later.

Human papillomavirus (HPV)

The HPV vaccine can help protect your child against diseases caused by certain types of human papillomavirus (HPV). These diseases include:

If your child is aged 15 or over, they’ll receive the HPV vaccine in three doses. They’ll receive their second dose two months after their first dose. They’ll receive their final dose six months after their first dose.

Children who start the HPV vaccine before they turn 15 years old only need two doses, given six to 12 months apart. This is because younger immune systems generate more immunity.

Meningococcal

The meningococcal vaccine can help protect your child against meningococcal disease. Meningococcal disease is a serious bacterial infection that can cause meningitis. Meningitis is severe swelling of your brain and spinal cord. It can also lead to sepsis, a dangerous and potentially life-threatening blood infection.

Other vaccines

Your child’s pediatrician may recommend additional vaccines if your child is at a high risk of certain infections or diseases. They’ll also provide a revised vaccination schedule if your child has missed any vaccine doses during their recommended time frames.

What ages do kids get shots?

The infant vaccine schedule starts at birth. Your newborn will receive their first shots within their first months of life. Your child may receive certain vaccines within a range of ages. The following represents one recommended child vaccine schedule. Your child’s pediatrician may follow different guidelines. You should speak with your child’s pediatrician about which vaccines your child should receive and when. The recommended vaccines by age include:

Birth vaccine

Vaccines for babies include their first doses of Hepatitis B (HepB).

  • Hepatitis B (HepB).

1- to 2-month vaccine

  • Hepatitis B (HepB).

2-month vaccines

Babies get several shots at 2 months of age. The DTaP vaccine schedule starts at 2 months. Your baby will get their first dose of:

  • Rotavirus (RV).
  • Diphtheria, tetanus and acellular pertussis (DTaP).
  • Haemophilus influenzae type B (Hib).
  • Pneumococcal conjugate (PCV13).
  • Inactivated poliovirus (IPV).

4-month vaccines

For their 4-month shots, babies get a second dose of the vaccines they received at their 2-month appointment. These include:

  • Rotavirus (RV).
  • Diphtheria, tetanus and acellular pertussis (DTaP).
  • Haemophilus influenzae type B (Hib).
  • Pneumococcal conjugate (PCV13).
  • Inactivated poliovirus (IPV).

6-month vaccines

At 6 months of age, your child may start to receive the influenza vaccine annually. In addition, your child may or may not need a third dose of the RV and Hib vaccines, depending on the brand your child’s healthcare provider used for their previous doses.

  • Influenza.
  • Rotavirus (RV).
  • Haemophilus influenzae type B (Hib).
  • Diphtheria, tetanus and acellular pertussis (DTaP).
  • Pneumococcal conjugate (PCV13).

6- to 18-month vaccines

The timing of your baby’s third dose of these vaccines will depend on their healthcare provider’s recommendation. Six- to 18-month shots may include:

  • Hepatitis B (HepB).
  • Inactivated poliovirus (IPV).

12- to 15-month vaccines

Your child will receive their first dose of MMR and varicella after they’ve hit their first birthday. Twelve- to 15-month shots include:

  • Measles, mumps and rubella (MMR).
  • Varicella (VAR).
  • Haemophilus influenzae type B (Hib).
  • Pneumococcal conjugate (PCV13).

12- to 23-month vaccine

Your baby’s 12-month vaccines may include the first in a two-dose series of hepatitis A. They may receive the second vaccine at 2 years old.

  • Hepatitis A (HepA).

15- to 18-month vaccine

Your baby will receive one shot during this time frame, their fourth dose of DTaP.

  • Diphtheria, tetanus and acellular pertussis (DTaP).

4- to 6-year vaccines

Between 4 and 6 years old, your child may receive the following shots:

  • Diphtheria, tetanus and acellular pertussis (DTaP).
  • Inactivated poliovirus (IPV).
  • Measles, mumps and rubella (MMR).
  • Varicella (VAR).

11- to 12-year vaccines

Your child gets to wait a bit before their next round of vaccines.

  • Tetanus, diphtheria and acellular pertussis (Tdap) booster.
  • Human papillomavirus (HPV).
  • Meningococcal.

16-year vaccine

Your 16-year-old should receive their second dose of meningococcal.

  • Meningococcal.

Are the vaccines safe?

Yes. Vaccines for childhood diseases are very safe. Sometimes, a vaccine will cause mild side effects such as a sore arm or leg or a low fever. A bad side effect isn’t likely to happen. Childhood diseases are a greater health risk to children than vaccines are. Ask your child’s healthcare provider to tell you about the risks and side effects.

When shouldn’t my child be vaccinated?

In a few cases, it's better to wait to get a vaccine. Some children who are very sick shouldn’t get a vaccine at all. Reasons your child should wait or not get a vaccine may include:

  • Being sick with something more serious than a cold.
  • Having a bad reaction after the first dose of a vaccine.
  • Having sudden jerky body movements (convulsions), possibly caused by a vaccine.

Frequently Asked Questions

What’s the difference between immunization and vaccination?

The words “immunization” and “vaccination” are often used interchangeably, but they have slightly different meanings. One term describes the specific action, and the other describes the process. According to the CDC, vaccination is the act of introducing a vaccine to give you immunity to a specific disease. The definition of immunization is the process by which vaccination protects you from a disease.

A note from Cleveland Clinic

The sight of your baby getting a shot may make you cry along with them. But getting your child vaccinated according to the childhood immunization schedule is the best way to protect them against many different infections and diseases. The Centers for Disease Control and Protection and the American Academy of Pediatrics both recommend following a specific immunization schedule. However, talk to your child’s pediatrician to find out what works best for your child.

Last reviewed by a Cleveland Clinic medical professional on 06/14/2022.

References

  • American Academy of Pediatrics. All About the Recommended Immunization Schedules. (https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Recommended-Immunization-Schedules.aspx) Accessed 6/14/2022.
  • Centers for Disease Control and Prevention. Child and Adolescent Immunization Schedule. (https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html) Accessed 6/14/2022.
  • March of Dimes. Your Baby’s Vaccinations. (https://www.marchofdimes.org/baby/your-babys-vaccinations.aspx) Accessed 6/14/2022.
  • Merck Manual. Childhood Vaccination Schedule. (https://www.merckmanuals.com/home/children-s-health-issues/vaccination-of-children/childhood-vaccination-schedule) Accessed 6/14/2022.

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