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Age-by-age guide to kids' immunizations
Babies start getting shots the day they’re born, and for good reason. Here are all the immunizations that protect your child’s health, from day 1 through year 18.
Bringing your baby, toddler or middle schooler to the doctor for their shots (immunizations) can be tough. They may not be thrilled to get them. And you’re not thrilled to see them cry.
But in the end, the prick — and tears — may help prevent kids from getting sick with dangerous diseases.
“We’re so fortunate to be able to fight deadly illnesses,” says Michael W. Karp, MD. “And it’s thanks to vaccines and antibiotics.” He’s an Optum pediatrician in Vista, California.
It may seem like a lot of shots, especially for babies and toddlers. But it’s important not to miss any. Each one is timed for optimal protection and given early enough so that your child is protected when they’re at the greatest risk of getting sick, according to the American Academy of Pediatrics (AAP).1
Following the immunization schedule helps keep your child safe from illness, says Dr. Karp. What’s more, vaccinating your child can help protect other members of your family. This includes older relatives whose bodies may be less able to fight illness.
But if your child misses a shot, they don’t need to start over. You can call your child’s doctor’s office and discuss the best way to catch up.
Here’s a look at all the shots for children, according to the Centers for Disease Control and Prevention (CDC):2,3
Shots (vaccines) schedule, birth to 18 years
1. Hepatitis B (HepB) vaccine
Protects against a liver infection caused by the hepatitis B virus
Total doses: 3
Age needed: Birth, 1 to 2 months, 6 to 18 months
2. Rotavirus (RV) vaccine
Protects against an infection that causes severe diarrhea and vomiting in infants and young children
Total doses: 2 (possibly 3, depending on vaccine brand)
Age needed: 2 months, 4 months (possibly 6 months)
3. Diphtheria, tetanus and pertussis (DTaP) vaccine
- Diphtheria, a potentially fatal infection that can cause difficulty breathing and heart failure. Symptoms may also include sore throat, mild fever, weakness and swollen glands in the neck.
- Tetanus, a bacterial infection that can cause symptoms like stiffness in the neck and stomach muscles, trouble swallowing and fever.
- Pertussis, also known as whooping cough. (This is a highly contagious respiratory illness that can affect the lungs and airways. through the air.)
Total doses: 5
Age needed: 2 months, 4 months, 6 months, 15 to 18 months, 4 to 6 years; a DTaP booster should be given at 11 to 12 years
4. Haemophilus influenzae type b (Hib) vaccine
Protects against a bacterial infection that can cause meningitis (a potentially deadly infection of the brain, spinal cord, and bloodstream)
Total doses: 3 (possibly 4, depending on vaccine brand)
Age needed: 2 months, 4 months, (possibly 6 months), 12 to 15 months
5. Pneumococcal (PCV13, PCV15) vaccine
Protects against bacteria that can cause pneumonia (a lung infection) and meningitis
Total doses: 4
Age needed: 2 months, 4 months, 6 months, 12 to 15 months
6. Polio vaccine (IPV)
Protects against polio, a potentially fatal disease that may cause paralysis (where you can’t move your legs or other parts of your body)
Total doses: 4
Age needed: 2 months, 4 months, 6 to 18 months, 4 to 6 years
7. Coronavirus disease 2019 (COVID-19) vaccine
Protects against the virus that causes COVID-19
Total doses: 2; boosters are age-dependent
Age needed: 6 months and up; timing differs by type of vaccine manufacturer
8. Influenza (flu) vaccine
Protects against viruses that cause the flu
Total doses: 1 every year, in the fall
Age needed: Starting at 6 months; some kids 6 months to 8 years may need 2 doses
9. Measles, mumps and rubella (MMR) vaccine
- Measles, which causes a rash and fever
- Mumps, which causes swelling of the glands in your head or neck that release fluids and saliva into your mouth
- Rubella, which causes a fever, sore throat, and face and body rash
Total doses: 2
Age needed: 12 to 15 months, 4 to 6 years
10. Chickenpox (Varicella) vaccine
Protects against the virus that causes chickenpox (itchy skin rash with small red blisters)
Total doses: 2
Age needed: 12 to 15 months, 4 to 6 years
11. Hepatitis A (HepA) vaccine
Protects against hepatitis A, a liver disease
Total doses: 2
Age needed: 12 to 23 months, with 2 total doses spaced 6 months apart
12. Human papillomavirus (HPV) vaccine
Protects against cancers of the cervix, vagina, vulva, penis, anus and back of the throat
Total doses: 2 (if started at age 9 to 14) or 3 (if started at age 15 or older or those with a weakened immune system)
Age needed: Recommended at ages 11 to 12, can start as early as age 9
13. Meningococcal (MenACWY) vaccine
Protects against a potentially deadly bacterial illness that can affect the lining of the brain, spinal cord and bloodstream
Total doses: 2
Age needed: First dose at age 11 to 12, second dose at age 16
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Your questions about immunizations, answered
It can be hard to keep track of all the shots your child needs, and why each is important. Here are some common questions parents have:
Do the shots hurt my baby?
Yes, but only for a few seconds.
What can help: Keep up with your child’s doctor visits so that your child can get multiple vaccinations in a single visit. “It’s likely more uncomfortable for a child to have three painful visits compared to one,” Dr. Karp says. “When children get their shots all together, it’s just as safe and effective as if you were to spread them out.”
Some shots can be combined into a single dose. So, that may change your child’s schedule slightly. The timing of when they’ll need certain shots will be based on when they’re recommended to be given. If you’re not sure, you can call their doctor to figure out the best timing.
Why does my kid need so many shots?
You’re right that the vaccination schedule includes a lot of shots, but it’s for good reason.
A vaccine contains either a dead or reduced “live” particle that can stimulate your immune system, notes Dr. Karp. “That way if you get exposed to the real disease, your immune system recognizes it and can kill it without it leading to illness.” (In some instances, such as the flu, your child may still get sick. But the illness will be less severe.4)
A different number of vaccine doses and boosters are needed to create a robust immune system response.
I’ve heard vaccines cause autism. Is that true?
No. There are no studies that show higher rates of autism in people who are vaccinated compared with those who are not, Dr. Karp says.
Many children with autism begin to show signs of the condition during their infant and toddler years, according to the AAP.5 That’s the same time when kids are also getting many vaccinations. But the two things are not related.
What side effects can I expect?
Soreness where they got the shot (usually in the arm) is the most common side effect of vaccinations, Dr. Karp says. (Infants usually get shots in the upper leg.) Other side effects may include a low-grade fever or general fussiness in younger children.
Experiencing side effects does not mean your child is allergic to the immunization. All medications may cause side effects. But only about 5% to 10% of those side effects are allergic, according to the American Academy of Allergy Asthma & Immunology.6 If your child is having an allergic reaction, they could need emergency care.
Dr. Karp recommends treating discomfort, fever and fussiness with children’s acetaminophen (Tylenol). If you have any concerns, talk with your provider and read the vaccine information sheet you received at the appointment.
Does my child really need the HPV vaccine?
HPV is a virus that can cause cancer. It is most commonly spread during sex.7 Some parents are reluctant to start HPV vaccination at the recommended age of 11 or 12. They feel it is too early because they know their child is not yet sexually active, Dr. Karp says.
But there’s a reason the vaccination schedule works that way. Your child’s immune system responds better to certain vaccinations when they’re younger. The protection will be in place for when they get older and may need it. That’s why children who start HPV vaccinations between ages 9 and 14 only need two doses, while those who start at age 15 and older need three doses.1,3
- American Academy of Pediatrics. All about the recommended immunization schedules. Last updated February 9, 2023. Accessed March 1, 2023.
- Centers for Disease Control and Prevention. 2023 recommended immunizations for children from birth through 6 years old. Last reviewed February 10, 2023. Accessed March 1, 2023.
- Centers for Disease Control and Prevention. 2023 recommended immunizations for children 7–18 years old. Last reviewed February 10, 2023. Accessed March 1, 2023.
- Centers for Disease Control and Prevention. Vaccine effectiveness: How well do flu vaccines work? Last reviewed February 8, 2023.
- American Academy of Pediatrics. 3 Early Signs of Autism Spectrum Disorder (ASD). Last updated March 21, 2023. Accessed March 31, 2023.
- American Academy of Allergy Asthma & Immunology. Medications and Drug Allergic Reactions. Last reviewed September 28, 2020. Accessed March 29, 2023.
- Centers for Disease Control and Prevention. Genital HPV infection – basic fact sheet. Last reviewed April 12, 2022. Accessed March 1, 2023.
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