Childhood Immunization Schedule

What is the childhood vaccine schedule?

The childhood vaccine schedule (also called an immunization schedule) is a list of vaccines your child should have at specific ages. Infectious disease experts recommend your child gets these vaccines to protect them from serious — potentially life-threatening — diseases and their complications.

You might be wondering how important it is for your child to follow the schedule of immunizations. It’s very important because the timing of each vaccine affects how well it can protect your child. Experts develop and update this schedule based on the latest science. They choose vaccination ages according to:

• When your child’s immune system will best respond to a specific vaccine (by making antibodies to develop enough protection).
• When your child faces the greatest risk of catching the disease in question.

Your child will get their vaccines at routine well-check visits. Following the well-check schedule means your child will stay on track with vaccines. But it’s still helpful to know which vaccines your child needs and at what ages. So, let’s dive a little deeper.

At what ages do kids get vaccines?

Your child will get most of their immunizations by their second birthday — and a good chunk of these occur during their first year of life. Infants are vulnerable to many different diseases that could cause serious illness or even death. So, following the infant vaccine schedule (birth through 12 months) is crucial for protecting your baby.

Most childhood vaccines happen at a certain age or series of ages and then they’re done. But there are a couple of exceptions. Experts recommend an influenza (flu) vaccine and a COVID-19 vaccine at regular intervals starting at 6 months of age — and continuing throughout childhood and adolescence.

The flu vaccine is yearly. Your pediatrician will tell you how often your child needs the COVID-19 vaccine based on their age and the latest science.

Below is a list of childhood vaccines by age. Experts recommend most children follow this schedule. Your pediatrician will tell you if your child needs any additional vaccines or doses based on their health status or other risk factors.

Newborn vaccines

• Hepatitis B (HepB) within 24 hours of birth. This is the first dose in a three-dose series.
• RSV (respiratory syncytial virus) antibody within one week of birth. This only happens if your baby is born during RSV season (typically October to March) AND you didn’t receive the RSV vaccine while pregnant. If it’s not yet RSV season, your baby can wait until just before the season starts for this immunization.

RSV antibody technically isn’t a vaccine, as it provides ready-made protection. This makes it different from a vaccine, which trains your baby’s immune system to create antibodies. So, providers call it an immunization. But most people use the words interchangeably.

2-month vaccines

• HepB, dose two.
• Rotavirus, dose one.
• Diphtheria, tetanus and acellular pertussis (DTaP), dose one.
• Haemophilus influenza type B (Hib), dose one.
• Pneumococcal conjugate (PCV), dose one.
• Inactivated poliovirus (IPV), dose one.

4-month vaccines

• Rotavirus, dose two.
• DTaP, dose two.
• Hib, dose two.
• PCV, dose two.
• IPV, dose two.

6-month vaccines

• HepB, dose three.
• Rotavirus, dose three — only if doing the three-dose series.
• DTaP, dose three.
• Hib, dose three — only if doing the four-dose series.
• PCV, dose three.
• IPV, dose three.
• Flu vaccine.
• COVID-19 vaccine.

12-month vaccines

• Measles, mumps and rubella (MMR), dose one.
• Hepatitis A (HepA), dose one.
• PCV, dose four.

15-month vaccines

• Varicella (VAR), dose one.
• DTaP, dose four.
• Hib, final dose — this will be dose three or four depending on the series.

18-month vaccines

• HepA, dose two.

Vaccines for 4-year-olds

• DTaP, dose five.
• IPV, dose four.
• MMR, dose two.
• VAR, dose two.

Your child can have these vaccines starting at age 4 but a little later is OK, too — up until their 6th birthday. Your pediatrician can advise you on appropriate timing and help make sure your child gets all the vaccines they need before turning 6.

Vaccines for 11- to 12-year-olds

• Tetanus, diphtheria and acellular pertussis (Tdap), dose one (one dose in childhood, but every 10 years for life).
• Human papillomavirus (HPV), dose one and dose two, separated by at least five months. Your child can begin this series prior to their 11th birthday — starting at age 9.
• Meningococcal (MenACWY), dose one.

Vaccines for 16-year-olds

• MenACWY, dose two.

How many vaccines do children get?

The childhood vaccine schedule includes 15 different immunizations (shots or drops). Some vaccines protect against more than one disease. Some require more than one dose.

It may help to know that pediatricians can use combination vaccines to decrease the number of shots your child gets at a single appointment. For example, your pediatrician can give your child Vaxelis® at the two-, four- and six-month visits. Vaxelis combines DTaP, HepB, Hib and IPV into one injection.

This might feel like a lot to you, especially during your baby’s first year when they’re getting multiple vaccines at a single appointment. But most vaccines happen early in life so kids can get the protection when they’re most vulnerable.

Thanks to advances in medical science, your child can avoid disease complications that caused serious illness or death for many people in the past. Each time your child receives a vaccine, it’s like giving them another layer of armor that’ll protect them as they grow up. 

Vaccination chart with age

The chart below lists childhood immunizations, the disease complications they protect against and typical dosing and ages.

To learn more about the diseases that childhood vaccination protects against, visit the links below (listed in alphabetical order):

• COVID-19.
• Diphtheria.
• Haemophilus influenzae type B.
• Hepatitis A.
• Hepatitis B.
• Human papillomavirus (HPV).
• Influenza (flu).
• Measles.
• Meningococcal disease.
• Mumps.
• Pertussis.
• Pneumococcal disease.
• Polio.
• Respiratory syncytial virus (RSV).
• Rotavirus.
• Rubella.
• Tetanus.
• Varicella (chickenpox).

Is it OK if vaccination is delayed?

It’s not safe to delay vaccines or to follow another schedule you might find online or through friends. The vaccine schedule that pediatricians across the U.S. use (which we describe here) has the backing of careful medical science. And it’s kept millions of kids safe. Scientists develop vaccines through a long process of research and approval.

But life has many moving parts, and you might miss an appointment for any number of reasons. If this happens, it’s OK. Simply talk to your pediatrician about the best way to catch up on any vaccines. They’ll make sure your child still gets the vaccines they need within the recommended age ranges or as close as possible.