Vaccinations at 18 Months
At the 18-month visit, babies typically receive no routine vaccinations according to the standard U.S. immunization schedule, though catch-up doses may be administered if the child is behind schedule. 1
Standard Schedule at 18 Months
The 18-month age point falls within a window period between major vaccination milestones:
The 15-18 month window is designated for the fourth dose of DTaP and the fourth dose of Hib (Haemophilus influenzae type b), which are typically given at 15 months rather than waiting until 18 months 1
No vaccines are specifically scheduled at exactly 18 months in the standard ACIP/AAP immunization schedule 1
Vaccines That May Be Given at 18 Months
Catch-Up Vaccinations
If a child is behind schedule, the following may be administered at 18 months:
Hepatitis B (HepB): The final dose can be given anytime between 6-18 months if not yet completed 1
Hepatitis A (HepA): The first dose is recommended for all children at 12-23 months of age, with the second dose given at least 6 months after the first 1
Any missed doses from the primary series (DTaP, IPV, Hib, PCV, MMR, Varicella) can be administered as catch-up 1
Annual Influenza Vaccine
- Influenza vaccine is recommended annually for all children aged 6 months and older, so this could be given at the 18-month visit if it coincides with flu season 1
Important Clinical Context
The key vaccination visits occur at 12-15 months and then not again until 4-6 years for routine immunizations 1. The 18-month visit is primarily for well-child care and developmental assessment rather than routine vaccinations, unless the child needs catch-up immunizations 1.
Common Pitfall to Avoid
Do not assume every well-child visit requires vaccinations—review the child's immunization record to determine if they are up-to-date or need catch-up doses 1. Approximately 37% of U.S. children do not follow the recommended ACIP schedule precisely, making individualized record review essential 2.