What vaccines are recommended for a 6-month-old infant?

Recommended Vaccines for a 6-Month-Old Infant

At 6 months of age, infants should receive the third doses of DTaP, IPV, PCV, and Hepatitis B vaccines, as well as begin the annual influenza vaccination if during flu season. 1

Core Vaccines Due at 6 Months

The following vaccines are specifically recommended for 6-month-old infants:

1. DTaP (Diphtheria, Tetanus, and acellular Pertussis) - Third dose

   • Protects against three serious bacterial diseases 2, 3
   • The third dose is critical in boosting antibody titers and ensuring continued protection 2
   • May be given as part of a combination vaccine

2. Hepatitis B (HepB) - Third dose

   • Completes the HepB series that began at birth 2, 4
   • The third dose should be given at least 16 weeks after the first dose and at least 8 weeks after the second dose 2
   • The last dose should not be administered before 24 weeks (6 months) of age 2

3. Inactivated Poliovirus Vaccine (IPV) - Third dose

   • Part of the all-IPV schedule recommended for routine childhood vaccination 2
   • Protects against poliomyelitis 4

4. Pneumococcal Conjugate Vaccine (PCV) - Third dose

   • Protects against invasive pneumococcal disease 2
   • The third dose is important for continued protection 2

5. Influenza Vaccine - First dose (seasonal)

   • Should be initiated at 6 months of age if during flu season 2, 5
   • Children receiving influenza vaccine for the first time require two doses separated by at least 4 weeks 2
   • Only the inactivated influenza vaccine (not live attenuated) should be used in this age group 2

Vaccines That May Not Be Due at 6 Months

1. Haemophilus influenzae type b (Hib)

   • If PRP-OMP (PedvaxHIB or ComVax) was administered at 2 and 4 months, a dose at 6 months is not required 2
   • If other Hib vaccines (HbOC or PRP-T) were used, a third dose at 6 months is needed 2

2. Rotavirus

   • Depending on the brand used, a third dose may or may not be needed at 6 months 2, 1
   • If Rotarix® was administered at 2 and 4 months, a dose at 6 months is not indicated 2
   • The final dose must be administered by 8 months of age 2

Combination Vaccines

Combination vaccines can reduce the number of injections required at this visit 2, 6:

• DTaP-IPV-Hib-HepB (Hexavalent) can be used for the 6-month doses 1, 6
• Only FDA-approved combinations should be used; individual vaccines must never be mixed in the same syringe unless specifically approved 2

Important Considerations

• Timing: The third dose of Hepatitis B vaccine should not be given before 24 weeks (6 months) of age 2

• Catch-up scheduling: If the infant has missed previous doses, follow minimum intervals between doses for catch-up scheduling 1

• Multiple injections: Administer multiple injections at separate sites, at least 1 inch apart 1

• Observation: Monitor the infant for at least 15 minutes after vaccination for immediate adverse reactions 1

• Documentation: Record vaccine name, date of administration, manufacturer, lot number, site, and route of administration 1

Special Circumstances

• Preterm infants should receive vaccines according to the same schedule as full-term infants, based on chronological age 1

• Immunocompromised infants may have special considerations, particularly for live vaccines like rotavirus 2

• Travel: Additional vaccines may be recommended if international travel is planned

By following this vaccination schedule at 6 months of age, parents can help ensure their infant receives optimal protection against vaccine-preventable diseases that pose significant risks of morbidity and mortality.