The best way to protect your children from vaccine-preventable diseases is to vaccinate them. It sounds simple enough, but there are many questions that arise with vaccines, among them: Which vaccines does your child need? When does your child need to be vaccinated? Which diseases do vaccines protect against?
This vaccine checklist includes the latest immunization guidelines from birth and throughout the teenage years as recommended by the CDC.
When your child is due for a flu vaccine, keep in mind that the flu strain is different every season, and so is the flu vaccine. The vaccine can -- and should -- be given every year in the fall season, starting at 6 months of age.
All newborns should receive their first hepatitis B vaccine before leaving the hospital. Hepatitis B is a contagious liver disease caused by infection with hepatitis B virus.
One to Two Months
The second dose of the hepatitis B vaccine should be administered when your infant is one or two months old.
At two months, several other vaccines are also recommended.
- The first dose of the rotavirus vaccine. This is not a shot. It is an oral vaccine that is given to your infant as drops. Rotavirus infection is a common cause of diarrhea in children.
- The first dose of the diphtheria, tetanus, pertussis vaccine (DTaP). Diphtheria and pertussis (whooping cough) are spread via human contact; tetanus (lockjaw) enters the body through cuts or wounds. Children typically get five doses of this vaccine at the recommended ages of 2 months, 4 months, 6 months, 15 to 18 months, and a booster at 4 to 6 years of age. It is not licensed for use in children older than 7.
- The first dose of the Haemophilius influenzae type b conjugate vaccine (Hib). This is not a flu shot. It protects against Hib disease, which is a leading cause of bacterial meningitis.
- The first dose of the pneumococcal vaccine. The pneumococcal conjugate vaccine (PCV) protects against different types of pneumococcal disease, including pneumococcal pneumonia, bacteremia, meningitis, and otitis media (middle ear infection).
- The first dose of the inactivated poliovirus vaccine (IPV). This vaccine protects against polio.
This may seem like a lot of shots to get all at once, but “the reason that we recommend them when we recommend them is so your infant can get the protection as early as possible,” says Lance Rodewald, MD, pediatrician and director of the Immunization Services Division at the CDC. That said, combination vaccines are available that can reduce the number of shots your baby gets during one visit. Ask your pediatrician about combination vaccines.
At four months, your infant should receive the second dose of all the vaccines they received at two months. (This should include vaccines against rotavirus, diphtheria, tetanus and pertussis, Hib, pneumococcal disease, and polio.)
At the six-month well visit, your infant can receive a third hepatitis B shot. (This can actually be given anytime from six months to 18 months.)
If your child received the rotavirus vaccine at two and four months, they will probably not need one during this visit. The same is true for the Hib vaccine at six months. In both cases, this will depend on the types of vaccines they received at 2 and 4 months. Some rotavirus and Hib vaccines need 3 doses.
DTaP and pneumococcal vaccines are needed at the six-month well visit.
A third dose of the polio vaccine as well as Hib should be given.
Six months marks the minimum age for your infant's first flu shot. The flu shot can and should be given every year starting at six months, and because it is the first time they will receive a flu vaccine, your infant will need another flu shot 4 weeks after the initial vaccine is administered. This is required only during the first season your child receives the flu vaccine. After that, your child will need a single vaccine per year.
At one year, your child should receive the following vaccinations:
- DTaP. The fourth dose of this vaccine can be given at one year if, and only if, six months has passed since receiving the third dose.
- Hepatitis B. Your child can receive the third shot at this visit. (This can actually be given anytime from six months or 18 months of age.)
- Hib. A fourth dose of this vaccine can be given to children anytime from 12 and15 months of age.
- Pneumococcal vaccine. This can be given to children between 12 and 15 months of age.
- Polio vaccine. The third dose of the polio vaccine can be given to children between six and 18 months of age.
- Measles, mumps, and rubella vaccine (MMR). This vaccine is recommended for children between 12 and 15 months of age. There was some debate about the MMR vaccine because of a study that linked its use to increased autism spectrum disorder risk, but this study was later retracted by the journal that published it. “MMR is a critically important vaccine that protects against three diseases, and has a long track record of safety,” Rodewald says.
- Varicella vaccine. The minimum age for the varicella (chickenpox) vaccine is 12 months. It is typically given between 12 and 15 months of age.
- Hepatitis A. The first two doses of this vaccine should be given between 12 and 23 months of age (with at least six months in between the first and second dose.)
The vaccines that your child receives at 15 months depend on which ones they did -- or did not -- receive at the six-month and one-year visits. These may include:
- Hepatitis B
- PCV (pneumococcal)
- IPV (polio)
- Hepatitis A
The series of inoculations that your toddler needs at their 18-month well visit will vary based on your child's past history of vaccinations. They may need a dose of:
- Hepatitis B
- IPV (polio)
- Flu shot
- Hepatitis A
Vaccinations recommended when your child is between 19 and 23 months of age depends on which ones were -- or were not -- given during earlier visits. These may include:
- Flu shot
- Hepatitis A
Two to Three Years
From age two to three, your child may need a dose of the chickenpox vaccine, depending on when they received the last dose.
That's not all. Your child may also need the pneumococcal polysaccharide vaccine (PPSV) if they have certain underlying medical conditions. This is typically given two or more months after the last dose of the pneumococcal conjugate vaccine (PCV).
In addition, children who are not fully vaccinated against hepatitis A should receive the hepatitis A series between the ages of two and six. The meningococcal vaccine (MCV) is recommended for high risk children ages 2 months through 18 years. Meningococcal disease is the No. 1 cause of bacterial meningitis in the U.S. in children between ages 2 and 18 years. Meningitis is an infection of fluid surrounding the brain and the spinal cord. The meningococcal bacteria also can cause blood infections.
Four to Six Years
From the ages of four to six, your child may need a dose of the DTaP vaccine, the polio vaccine, MMR vaccine, and varicella vaccine. In addition, the pneumococcal polysaccharide vaccine (PPSV) may be needed if your child has certain underlying medical conditions (consult your doctor). It can be given between ages two and six. Children who are not fully vaccinated against hepatitis A should receive the hepatitis A series between ages two and six. The meningococcal vaccine (MCV) is recommended for high risk children ages 2 months through 18 years.
Eleven to 12 Years
The following vaccines are recommended for 11- and 12-year-olds:
- Tetanus-diphtheria-acellular pertussis vaccine (Tdap). Adolescents aged 11 to 18 should get one dose of this vaccine.
- Meningococcal vaccine (MCV4). The CDC recommends that adolescents receive this vaccine during their 11- to 12- year-old checkup or when they enter high school or college.
- Hepatitis B. This three-shot vaccine course is recommended for adolescents who did not receive it as part of their childhood vaccines.
- Human papillomavirus (HPV) or cervical cancer vaccine. One vaccine (Gardasil-9) is available to protect against the types of HPV that cause most cervical cancers. It’s given in three shots over a 6-month period and is recommended for both boys and girls.
Gardasil-9 also protects against most genital warts in males and females. It’s recommended for 11- and 12-year-olds but can be given as early as age 9 and up to 26 years old.
Starting at age 12, children should be vaccinated for COVID-19. You can get this vaccine at the same time as other vaccines you may be getting as part of a routine checkup with your pediatrician.
Older children should receive hepatitis B, polio, MMR, and varicella vaccines if they did not receive the recommended doses when they were younger. The CDC also recommends a second “catch-up” varicella shot for children, adolescents, and adults who have previously received one dose. Some children may need additional vaccines either based on their personal risk profile such as pneumococcal polysaccharide (PPV), hepatitis A, and influenza.
“The schedule is very complicated compared to 15 years ago,” Rodewald says. “There are twice as many diseases that can be prevented through vaccines and the schedule changes every year."
The best way to ensure your child has received all the necessary vaccinations is to consult with your pediatrician or nurse and review your child's file. “Vaccination is the safest way to protect children from vaccine-preventable diseases,” Rodewald says. “Get them in as timely a manner as possible and adhere to school immunization laws.”