Vaccinations Given at the 2-Month Visit
At the 2-month visit, infants should receive DTaP, Hib, IPV, PCV, HepB, and Rotavirus vaccines, which can be administered together safely and effectively to provide early protection against multiple serious infectious diseases. 1
Recommended Vaccines for the 2-Month Visit
The standard vaccines administered at the 2-month visit include:
- DTaP (Diphtheria, Tetanus, and acellular Pertussis) - First dose in the series
- Hib (Haemophilus influenzae type b) - First dose in the series
- IPV (Inactivated Poliovirus) - First dose in the series
- PCV (Pneumococcal Conjugate Vaccine) - First dose in the series
- HepB (Hepatitis B) - Second dose in the series (first dose typically given at birth)
- Rotavirus - First dose in the series (oral administration)
Combination Vaccines
To reduce the number of injections, combination vaccines are often used:
- DTaP-IPV-Hib-HepB (Hexavalent vaccine) - This single injection combines six vaccines, significantly reducing the number of shots needed 1, 2
- When using the hexavalent vaccine, only two injections (hexavalent + PCV) and one oral administration (rotavirus) are needed at the 2-month visit
Studies show that the hexavalent DTaP-IPV-Hib-HepB vaccine is safe and immunogenic when given to infants at 2,4, and 6 months of age 2, 3. The vaccine produces robust immune responses to all antigens and has a safety profile similar to separately administered vaccines 4, 5.
Specific Vaccine Information
DTaP-IPV-Hib-HepB
- Can be used for the first 3 doses of the recommended DTaP series (at 2,4, and 6 months)
- Not indicated for the fourth dose (15-18 months) or fifth dose (4-6 years) 1
- Minimum age for first dose is 6 weeks
- Minimum interval between doses is 4 weeks 1
Hib Vaccine
- When using PRP-OMP formulation (PedvaxHIB), only 2 primary doses are needed at 2 and 4 months 1, 6
- Other Hib formulations require 3 primary doses at 2,4, and 6 months 6
PCV (Pneumococcal Conjugate Vaccine)
- Administered as an intramuscular injection
- Studies show it can be safely co-administered with other vaccines at the 2-month visit 7
- Shake the vaccine vial thoroughly before administration 1
Rotavirus Vaccine
- Administered orally
- First dose must be given before 14 weeks and 6 days of age 1
- Series must be completed by 8 months of age
Administration Technique
- Injection sites: Use the anterolateral thigh muscle for injectable vaccines in infants 1
- Multiple injections: Administer at separate sites, at least 1 inch apart 1
- Technique: Insert needle at a 90-degree angle, inject using steady pressure 1
- Documentation: Record vaccine name, date, manufacturer, lot number, site, and route of administration 1
Special Considerations
- Combination preference: Use of licensed combination vaccines is preferred over separate injections of equivalent component vaccines 8
- Monitoring: Observe the infant for at least 15 minutes after vaccination for immediate adverse reactions 1
- Fever rates: Higher rates of fever may occur with combination vaccines (47.1%-47.4% with DTaP-IPV-Hib-HepB vs. 33.2%-34.4% with pentavalent vaccine) 1
Clinical Pitfalls to Avoid
- Spacing errors: Ensure minimum intervals between doses are maintained for catch-up scheduling
- Mixing vaccines: Individual vaccines must never be mixed in the same syringe unless specifically approved for mixing by FDA 8
- Manufacturer consistency: Whenever feasible, use the same manufacturer's product to complete the primary series, though vaccination should not be deferred if the specific product previously administered is unavailable or unknown 1
- Age limitations: Be aware of minimum and maximum ages for each vaccine; the first dose of rotavirus vaccine must be given before 14 weeks and 6 days 1
By administering all recommended vaccines at the 2-month visit, healthcare providers can ensure timely protection against multiple serious infectious diseases while minimizing the number of office visits required for vaccination.