What is the recommended vaccination schedule for babies?

Recommended Vaccination Schedule for Babies

The recommended childhood vaccination schedule includes hepatitis B vaccine at birth, followed by multiple vaccines at 2,4,6,12-15, and 18 months of age to protect against serious infectious diseases, with additional vaccines and boosters at 4-6 years and 11-12 years of age. 1

Birth to 6 Months

• Hepatitis B (HepB): First dose should be administered at birth before hospital discharge, with the second dose at 1-2 months of age, and the third dose at 6-18 months 1
• Rotavirus (Rota): First dose at 2 months, second dose at 4 months, and third dose at 6 months (depending on vaccine brand); should not be started after 14 weeks 6 days of age and final dose should be administered by 8 months of age 1
• Diphtheria, Tetanus, and acellular Pertussis (DTaP): First dose at 2 months, second dose at 4 months, third dose at 6 months 1, 2
• Haemophilus influenzae type b (Hib): First dose at 2 months, second dose at 4 months, third dose at 6 months (note: if PRP-OMP [PedvaxHIB] is used, the dose at 6 months is not required) 1
• Pneumococcal conjugate vaccine (PCV): First dose at 2 months, second dose at 4 months, third dose at 6 months 1, 2
• Inactivated Poliovirus (IPV): First dose at 2 months, second dose at 4 months 1
• Influenza: Annual vaccination beginning at 6 months of age; children under 9 years receiving influenza vaccine for the first time need two doses separated by at least 4 weeks 1, 3

12-18 Months

• Measles, Mumps, Rubella (MMR): First dose at 12-15 months 1, 3
• Varicella: First dose at 12-15 months 1
• Hepatitis A (HepA): First dose at 12-23 months with second dose 6 months later 1
• DTaP: Fourth dose at 15-18 months (can be given as early as 12 months if 6 months have elapsed since the third dose) 1
• Hib: Final dose at 12-15 months 1, 3
• PCV: Final dose at 12-15 months 1, 3
• IPV: Third dose at 6-18 months 1, 3

4-6 Years

• DTaP: Fifth dose at 4-6 years 1, 3
• IPV: Fourth dose at 4-6 years 1, 3
• MMR: Second dose at 4-6 years 1
• Varicella: Second dose at 4-6 years 1, 3

Special Considerations

Preterm Infants

• Preterm and low birth weight infants should be vaccinated at the same chronological age using the same schedule as full-term infants, with the exception of hepatitis B vaccine 4, 5
• For preterm infants weighing less than 2000g born to HBsAg-negative mothers, the first dose of hepatitis B vaccine should be delayed until 1 month of age or hospital discharge 5
• Preterm infants born to HBsAg-positive mothers should receive hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth regardless of birth weight 1

Catch-Up Vaccination

• Children who start late or fall behind on vaccinations should follow catch-up schedules to ensure they receive all recommended vaccines 1
• Minimum intervals between doses must be maintained to ensure adequate immune response 1

Common Pitfalls and Caveats

• Delaying vaccinations increases the period of vulnerability to vaccine-preventable diseases, which can have serious consequences for infant health 6
• Only monovalent hepatitis B vaccine should be used for the birth dose; combination vaccines containing hepatitis B can be used for subsequent doses 1
• Rotavirus vaccination should not be initiated for infants older than 14 weeks 6 days and should be completed by 8 months of age 1
• Children with certain medical conditions may require additional vaccines or modified schedules; consult with a healthcare provider for individualized recommendations 1
• Vaccine adverse events should be reported to the Vaccine Adverse Event Reporting System (VAERS) 1

The vaccination schedule is updated annually by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) to reflect current recommendations based on the latest evidence 1.