What are the recommended immunizations and doses for a 2-year-old child?

From the Guidelines

At two years old, children should receive several important immunizations to protect against various diseases, including the fourth dose of DTaP, the fourth dose of Hib, the fourth dose of pneumococcal conjugate vaccine (PCV), the third dose of inactivated poliovirus vaccine (IPV), and the annual influenza vaccine, as recommended by the Advisory Committee on Immunization Practices 1. The recommended immunizations and doses for a 2-year-old child are crucial for developing immunity against serious childhood diseases before children enter preschool environments where disease transmission is more likely.

• The fourth dose of DTaP (diphtheria, tetanus, and acellular pertussis) vaccine is recommended to provide protection against these diseases.
• The fourth dose of Hib (Haemophilus influenzae type b) vaccine is also recommended to protect against Haemophilus influenzae type b infection.
• The fourth dose of pneumococcal conjugate vaccine (PCV) is recommended to protect against pneumococcal disease.
• The third dose of inactivated poliovirus vaccine (IPV) is recommended to provide protection against poliovirus.
• The annual influenza vaccine is recommended to protect against influenza. If not already given, the hepatitis A vaccine series should also begin at this age, with two doses separated by at least 6 months, as recommended by the Centers for Disease Control and Prevention 1. The timing of these vaccines is carefully determined to provide protection when children are most vulnerable while ensuring optimal immune response.
• The recommended schedule for these vaccines is based on the child's age and medical history.
• Parents should bring their child's immunization record to appointments and discuss any concerns about vaccines with their healthcare provider. Side effects are generally mild and may include low-grade fever, fussiness, or soreness at the injection site, as reported in the Morbidity and Mortality Weekly Report 1. It is essential to follow the recommended immunization schedule to ensure that children receive the necessary protection against serious childhood diseases.
• The Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention provide guidance on the recommended immunization schedule 1.
• Healthcare providers should record patients for whom vaccination has been deferred and should contact them once the supply has been restored, as recommended by the Centers for Disease Control and Prevention 1.

From the FDA Drug Label

Infants 2 to 14 months of age should receive a 0.5 mL dose of vaccine ideally beginning at 2 months of age followed by a 0.5 mL dose 2 months later (or as soon as possible thereafter). When the primary two-dose regimen is completed before 12 months of age, a booster dose is required. Children 15 months of age and older previously unvaccinated against Hib disease should receive a single 0.5 mL dose of vaccine. Booster Dose In infants completing the primary two-dose regimen before 12 months of age, a booster dose (0.5 mL) should be administered at 12 to 15 months of age, but not earlier than 2 months after the second dose.

The recommended immunization and dose for a 2-year-old child is a single 0.5 mL dose of vaccine if they have not been previously vaccinated against Hib disease 2.

• Key Points:
  • Age: 2 years
  • Dose: 0.5 mL
  • Number of doses: 1 (if not previously vaccinated)
  • Vaccine type: Hib (IM)
• Important Considerations:
  • The child's vaccination history should be checked to determine if they have already received the Hib vaccine.
  • If the child has already received the primary series and booster dose, no additional doses are needed.

From the Research

Recommended Immunizations for a 2-Year-Old Child

The US Advisory Committee on Immunization Practices recommends the following vaccines for children in their second year of life:

• Measles-mumps-rubella vaccine series: a two-dose series, with the first dose given at 12 to 15 months of life 3
• Varicella vaccine series: a two-dose series, with the first dose given at 12 to 15 months of life 3
• Hepatitis A vaccine series: a two-dose series, with the first dose given in the second year of life 3
• Haemophilus influenzae type B vaccine series: completion of the series in the second year of life 3, 4, 5
• Pneumococcal conjugate vaccine series: completion of the series in the second year of life 3
• Poliovirus vaccine: a third dose given before 19 months of life 3
• Diphtheria-tetanus-acellular pertussis (DTaP) vaccine: a fourth dose given before 19 months of life 3

Vaccine Administration and Safety

The vaccines can be administered separately or in combination, such as the DTaP-IPV-Hib combination vaccine 4 or the DTaP-IPV-Hib-HepB combination vaccine 5

• The safety and immunogenicity of these combination vaccines have been evaluated in clinical studies, showing similar or superior immune responses compared to separate vaccine administration 4, 5
• The vaccines have been shown to be well-tolerated, with similar reactogenicity profiles to separate vaccine administration 4, 6

Additional Recommendations

• Influenza vaccine: given annually, starting at 6 months of age, with two doses given at least one month apart for children under 9 years of age who have not previously received two doses 3