From the Guidelines
The recommended vaccination schedule for children in the United States begins at birth and continues through adolescence, with a series of vaccines administered at specific ages to provide optimal protection against serious diseases. According to the most recent guidelines 1, children should receive the hepatitis B vaccine at birth, followed by multiple vaccines at 2,4,6,12-15, and 15-18 months of age, including DTaP (diphtheria, tetanus, pertussis), IPV (polio), Hib (Haemophilus influenzae type b), PCV13 (pneumococcal), rotavirus, and MMR (measles, mumps, rubella). Some key points to note include:
- The hepatitis B vaccine series should not be completed before 24 weeks of age 1
- Healthy children aged 6--23 months are encouraged to receive influenza vaccine when feasible during the influenza season 1
- Boosters for DTaP, IPV, MMR, and varicella are given at 4-6 years
- In adolescence, children should receive Tdap (tetanus, diphtheria, pertussis), meningococcal vaccines, and HPV vaccine starting at 11-12 years The timing of the vaccination schedule is carefully designed to provide protection when needed while ensuring vaccines work effectively with a child's developing immune system. Parents should maintain regular well-child visits to stay on schedule, as delays can leave children vulnerable to serious preventable diseases. It's also important to note that a catch-up immunization schedule is available for children and adolescents who start late or who are >1 month behind 1.
From the FDA Drug Label
The usual immunization regimen (see Table 1) consists of 3 doses of vaccine given according to the following schedule: first dose: at elected date; second dose: 1 month later; third dose: 6 months after first dose. Table 1. Recommended Dosage and Administration Schedules Group Dose Schedules Infants born of: HBsAg-negative mothers 10 mcg/0. 5 mL 0,1,6 months HBsAg-positive mothers 10 mcg/0.5 mL 0,1,6 months Children: Birth through 10 years of age 10 mcg/0.5 mL 0,1,6 months Adolescents: 11 through 19 years of age 10 mcg/0.5 mL 0,1,6 months
The recommended vaccination schedule for children is as follows:
- Infants born of HBsAg-negative mothers: 3 doses at 0,1, and 6 months
- Infants born of HBsAg-positive mothers: 3 doses at 0,1, and 6 months
- Children (birth through 10 years of age): 3 doses at 0,1, and 6 months
- Adolescents (11 through 19 years of age): 3 doses at 0,1, and 6 months 2
From the Research
Vaccination Schedule for Children
The recommended vaccination schedule for children varies depending on the country and region. However, according to the US Advisory Committee on Immunization Practices 3, infants should receive several vaccines directed against various infectious diseases, including:
- Hepatitis B (HepB) series, with the first dose due at birth
- Diphtheria, tetanus, pertussis, pneumococcus, rotavirus, poliovirus, and Haemophilus influenzae type b vaccines at 2 months
- Repeat of the above vaccines (except HepB) at 4 months
- Completion of the HepB series and third doses of the other vaccines at 6 months
- Influenza vaccine starting at 6 months, depending on the time of year
Special Considerations for Preterm Infants
For preterm infants, the timing of the first dose of the hepatitis B vaccine may vary depending on the country and region 4. Some guidelines recommend a nationwide birth dose of the hepatitis B vaccine to all preterm infants, while others recommend it only for infants with a birth weight of more than 2000-2200 g.
Immunogenicity and Safety of Vaccines
Studies have shown that combination vaccines, such as DTaP5-IPV-HB-Hib 5 and DTaP-HepB-IPV 6, are immunogenic and safe when administered to infants. These vaccines induce antibody responses similar to the respective component vaccines and appear to be well tolerated, with some mild side effects such as fever and irritability.
Benefits of Combination Vaccines
Combination vaccines, such as DTaP5-IPV-Hib-HepB 7, can simplify the childhood immunization schedule and reduce the "shot burden" for infants and toddlers. These vaccines can protect against multiple diseases, including diphtheria, tetanus, pertussis, hepatitis B, H influenzae type b, and polio.