What is the recommended vaccination schedule for a child from birth through adolescence?

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Last updated: September 29, 2026 • View editorial policy

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Childhood Vaccination Schedule

Follow the CDC/ACIP recommended immunization schedule which provides specific timing for all childhood vaccines from birth through 18 years, with vaccines administered at birth, 2,4,6,12-15 months, 4-6 years, and 11-12 years to prevent serious morbidity and mortality from vaccine-preventable diseases 1.

Birth to 6 Months

At birth:

  • Hepatitis B vaccine (first dose) - administer within 24 hours of birth to all newborns 2
  • If mother is HBsAg-positive: give HepB vaccine plus 0.5 mL hepatitis B immune globulin (HBIG) within 12 hours 3

At 2 months:

  • Hepatitis B (second dose)
  • Rotavirus (first dose - must start between 6-12 weeks of age)
  • DTaP (diphtheria, tetanus, pertussis - first dose)
  • Haemophilus influenzae type b/Hib (first dose)
  • Pneumococcal conjugate/PCV (first dose)
  • Inactivated poliovirus/IPV (first dose) 3

At 4 months:

  • Rotavirus (second dose)
  • DTaP (second dose)
  • Hib (second dose)
  • PCV (second dose)
  • IPV (second dose) 3

At 6 months:

  • Hepatitis B (third dose - complete by 18 months)
  • Rotavirus (third dose if using certain brands - must complete by 32 weeks of age)
  • DTaP (third dose)
  • Hib (third dose if needed - depends on vaccine brand)
  • PCV (third dose)
  • IPV (third dose)
  • Influenza vaccine (start annual vaccination, two doses 4 weeks apart for first-time recipients under 9 years) 3, 1

12-18 Months

At 12-15 months:

  • Hib (final dose)
  • PCV (final dose)
  • MMR (measles, mumps, rubella - first dose, minimum age 12 months)
  • Varicella (chickenpox - first dose, minimum age 12 months)
  • Hepatitis A (first dose at 12-23 months, second dose 6 months later) 3, 4

At 15-18 months:

  • DTaP (fourth dose - can give as early as 12 months if 6 months elapsed since third dose) 3

4-6 Years (School Entry)

  • DTaP (fifth and final dose)
  • IPV (fourth and final dose)
  • MMR (second dose)
  • Varicella (second dose) 3, 4

11-12 Years (Adolescent Visit)

  • Tdap (tetanus, diphtheria, acellular pertussis - one-time adolescent booster)
  • HPV (human papillomavirus - two-dose series, second dose 6 months after first)
  • Meningococcal ACWY/MenACWY (first dose, booster at age 16)
  • Meningococcal B/MenB (may be given based on shared clinical decision-making at 16-23 years) 3, 1, 4

Annual Vaccines

  • Influenza vaccine: Give annually starting at 6 months of age through 18 years 1
  • Children under 9 years receiving influenza vaccine for the first time need two doses separated by 4 weeks 5

Critical Timing Considerations

Rotavirus has strict age limits: First dose must be given between 6-12 weeks of age; do not start after 12 weeks. Final dose must be completed by 32 weeks of age - insufficient safety data beyond this 3.

Minimum intervals matter: If a child falls behind schedule, use catch-up schedules with minimum intervals between doses. Never restart a vaccine series regardless of time elapsed 3.

Hepatitis B for infants of HBsAg-positive mothers: Test infant for HBsAg and antibody at 9-12 months after completing the series 2.

Common Pitfalls to Avoid

  • Do not delay the birth dose of hepatitis B - it must be given within 24 hours to prevent maternal-infant transmission 2
  • Do not give rotavirus after 32 weeks of age - this is a hard stop due to safety concerns 3
  • Do not skip the adolescent visit at 11-12 years - this is when Tdap, HPV, and meningococcal vaccines are due, preventing serious adolescent and young adult diseases 3, 4
  • Do not use DTaP in children 7 years or older - use Tdap instead 3

The schedule prioritizes protection during periods of highest vulnerability: hepatitis B at birth prevents vertical transmission, the 2-4-6 month series protects during peak infant susceptibility to invasive bacterial disease and pertussis, the 12-15 month vaccines protect as maternal antibodies wane, and adolescent vaccines protect before high-risk exposures 4, 6.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.