Immunization Schedule: When Kids Get Their Shots

You would probably do anything to protect your kids, but is following a children’s immunization schedule near the top of the list? Our bodies are wonderfully made, and so are our immune systems. Over the centuries, we have battled numerous diseases that have killed people of all ages. But immunizations are responsible for helping to eradicate some diseases that are now only found in a few countries. And once the science of immunizations, and a vaccine schedule, was available, people realized that we do not need to fear certain diseases, and we’ve extended people’s lifespans.

Extending people’s lives begins in childhood. The Centers for Disease Control (CDC) annually recommends the children’s immunization schedule. They also list diseases these vaccines prevent and why we should prevent them.

What Are Vaccines and How Do They Work?

Vaccines contain a dead or weakened form of a disease. Once put into the body, they teach it to recognize certain germs or foreign invaders. If you are ever exposed, your body’s immune system will kick into high gear to attack and destroy the invader and protect you from the disease. Vaccines on the childhood immunization schedule are safe because they are tested for up to 15 years before the Food and Drug Administration (FDA) approval.

Some childhood vaccinations used for decades have completely erased diseases like smallpox and almost eradicated polio. The polio virus has three strains; strain two was eliminated in 1999, and strain three in 2000. According to the World Health Organization (WHO), in 2022, the polio virus strain one was only found in two countries: Pakistan and Afghanistan. To date, we have 20 vaccines that can prevent 20 life-threatening illnesses.^1,2,3

Vaccine Effectiveness Differs

The WHO says our current children’s immunizations have an 85% to 95% effectiveness in preventing disease if the immunizations are administered correctly according to the CDC children’s immunization schedule. But the annual vaccines, such as influenza (flu), have a different effectiveness rate, between an average of 40% to 60%. The influenza virus has countless, ever-changing strains, so the vaccine effectiveness changes yearly.³

General Vaccine Side Effects

Any vaccine can have basic side effects such as redness, soreness, slight swelling at the injection site, tiredness that day or for the next few days, fussiness in children, a slightly elevated temperature, and loss of appetite. Many other side effects can be possible with vaccines, and each vaccine has its specific, more severe side effects listed on the Vaccination Information Statements (VIS), which are produced by the CDC and required by federal law to be given to parents with each vaccine administered.⁵

Vaccine Information Statements

Every time your child receives a vaccine, federal law dictates that the provider must give the parents a Vaccine Information Statement (VIS) for each vaccine. These handouts contain important information such as:

• the name of the vaccine
• what disease it prevents
• why it is good to prevent that disease
• how the disease is spread
• information you should give to your provider to make sure it is safe to receive the vaccine
• possible side effects and what to do if you see them

There is also a section titled “The National Vaccine Injury Compensation Program.” This program allows you to receive compensation if certain vaccines injure your child. You must report the information to the Vaccine Adverse Event Reporting System (VAERS) website (here).

The CDC updates the VIS handouts when new information about a vaccine becomes available. These VIS handouts can be found on the CDC website (here). I highly recommend you review these and have the doctor answer all your questions about each vaccine because most vaccines are given more than once to your child. So, you will see the same vaccines repeatedly, along with the same VIS information.

Diseases and Their Vaccines

Here is a short description of each vaccine and what disease it prevents:^1,2

• Hepatitis B: a liver disease
• Rotavirus: a gastrointestinal virus with severe diarrhea
• Diphtheria: a heart muscle disease that can lead to heart failure
• Pertussis (whooping cough): a lung infection with severe coughing
• Tetanus: primarily affects muscles with spasms
• Haemophilus influenzae type b: affects the lungs with pneumonia and can cause meningitis
• Pneumococcal: lung disease that can lead to blood infection and meningitis
• Polio: affects the nervous system and causes paralysis
• Influenza (flu): a lung virus that can lead to pneumonia
• Measles: a virus with fever, rash, and cough that can lead to pneumonia and encephalitis (brain infection)
• Mumps: a virus with swollen salivary glands under the jaw that can lead to meningitis and encephalitis (brain infection)
• Rubella (German measles): a virus with a fever, rash, and swollen lymph nodes that can cause fetal issues in pregnant women
• Chickenpox: a virus with a rash, fever, and infected blisters that can lead to pneumonia and encephalitis (brain infection)
• Hepatitis A: a liver disease with fever, vomiting, and stomach pain that can lead to liver failure
• Human papillomavirus: a virus that can lead to genital warts and genital cancers
• Meningococcal: fever, headache, stiff neck, rash, can lead to seizures, stroke, nervous system issues

Immunization Schedule

The child and adolescent immunization schedules are broken down by age group. The first group is for birth through age 6. It is the busiest of the two groups because young children receive the most vaccines to provide the most protection at their most vulnerable age. But remember that many of these vaccines are given as combinations, with two to three vaccines in the same dose. These combination vaccines not only help to limit the number of injections given at one time to your child, but they also help determine the vaccine schedule itself. Additionally, a little wiggle room is built into the vaccine schedules to make up for missed vaccines. The second age group is from age 7 to age 18.^1,2

Commonly Used Children’s Immunization Schedule

Many pediatricians follow this common vaccine schedule. This list shows the number of actual shots your child will receive by age and how many shots are needed to complete each series:

Birth

• Hepatitis B #1 (Hepatitis B vaccine is a three-shot series)

1 month

• Hepatitis B #2

2 months

There are only two shots.

• Rotavirus #1 (Rotavirus is a two or three-dose oral vaccine series)
• DTaP #1 (Diphtheria, tetanus, and acellular pertussis is a five-dose series)
• Hib #1 (Haemophilus influenzae type b is a three or four-dose series)
• IPV #1 (Inactivated polio virus is a four-dose series)
• PCV #1 (Pneumococcal conjugate is a four-dose series)

4 months

There are only two shots.

• Rotavirus #2
• DTaP #2
• Hib #2
• IPV #2
• PCV #2

6 months

Two shots, three if they need the influenza shot.

• Rotavirus #3
• DTaP #3
• Hib #3
• IPV #3
• PCV #3
• Influenza #1 (This is an annual vaccine, with the first-time annual dose for children six months to 8 years as a two-dose series given at least four weeks apart.)

9 months

There are two shots.

• Hepatitis B #3
• Influenza #2

12 months

There are three shots, four if they need the influenza shot.

• Hep A #1 (Hepatitis A is a two-dose series)
• PCV #4
• MMR #1 (measles, mumps, rubella is a two-dose series)
• Influenza if needed

15 months

• DTaP #4
• Hib #4
• Varicella #1 (chickenpox vaccine is a two-dose series)
• Influenza

18 months

Only one shot, two if they need the influenza shot.

• Hep A #2
• Influenza

19-23 months

Make up for missed doses and if they need the influenza shot.

2- 3 years

Make up for missed doses and if they need the influenza shot.

4-6 years

Two shots, three if they need the influenza shot.

• DTaP #5
• IPV #4
• Varicella #2
• MMR #2

7-10 years

Make up for missed doses and influenza as needed.

11-12 years

Three shots, four if they need the influenza shot.

• Tdap booster. This is given every 10 years for life unless there’s a recent injury.
• MenACWY #1 (meningococcal meningitis, covers virus groups A, C, Y, and W)
• HPV #1 (Human papillomavirus is a two-dose series)

13-15 years

One shot, two if they need the influenza shot.

• HPV #2

16-21 years

• MenACWY #2 (Meningococcal Meningitis)
• Men B (Meningococcal Meningitis, covers virus group B)
• HPV #2

Children’s Immunization Schedule Updates Yearly

Generally, the Advisory Committee on Immunization Practices (ACIP) gives annual recommendations to update the childhood immunization schedule once a year. The ACIP comprises 15 experts who meet three times a year to review research, scientific data, statistics on safety and effectiveness, and clinical trial information to determine immunization recommendations. These meetings are available to the public online via webcast. The ACIP also participates in ongoing work groups related to vaccines and immunization schedules throughout the year.⁴

Wouldn’t you do anything to protect your children? Even when pregnant, you did everything you could to protect your unborn child. You completed every test, measurement, doctor’s visit, ultrasound, and blood draw. You learned how to feed and bathe a new baby and other incredibly helpful information. But your children’s immunization schedule is likely not near the top of the list, but it should be!