What vaccines are typically administered to a 2-year-old child?

Vaccines Administered at Two Years of Age

At exactly two years old, healthy children should receive the annual influenza vaccine, and may receive catch-up doses of any previously missed vaccines from their routine schedule, but no new vaccine series are routinely initiated at this specific age. 1

Routine Vaccines Due at Two Years

Annual Influenza Vaccine

• All children aged 2 years should receive the annual influenza vaccine during flu season, which is the primary vaccine routinely administered at this age. 1
• Children under 9 years of age who have previously received fewer than two doses of influenza vaccine require two doses separated by at least 4 weeks. 2
• The dose for children aged 3 years and older is 0.5 mL. 2

Completion of Earlier Vaccine Series

By age 2, children should have already completed the following vaccine series (though catch-up doses may be given if missed):

• DTaP series: The fourth dose should have been administered between 15-18 months, with the fifth dose due at 4-6 years. 1, 2
• Hib vaccine series: Should be completed by 15-18 months of age. 1, 2
• Pneumococcal conjugate vaccine (PCV): The series should be completed by 24 months for routine vaccination. 1
• MMR vaccine: First dose given at 12-15 months, with second dose typically at 4-6 years (though can be given earlier if at least 4 weeks have elapsed). 1, 2
• Varicella vaccine: First dose at 12-15 months, with second dose typically at 4-6 years. 1, 2
• Hepatitis A vaccine: Two-dose series initiated at 12-23 months, with doses at least 6 months apart. 1

High-Risk Children at Two Years

Pneumococcal Polysaccharide Vaccine (PPV)

• Children aged 2 years and older in certain high-risk groups should receive PPV in addition to the completed PCV series. 1
• High-risk conditions include functional or anatomic asplenia, immunocompromising conditions, and other specified medical conditions. 1

Meningococcal Vaccine

• Children aged 2 years and older with terminal complement deficiencies or anatomic/functional asplenia should receive meningococcal vaccine. 1
• For high-risk children aged 2-10 years, a 2-dose primary series of MenACWY vaccine should be administered 8-12 weeks apart. 1
• The minimum age for meningococcal polysaccharide vaccine (MPSV4) is 2 years, though conjugate vaccines (MenACWY) are preferred. 1

Important Clinical Considerations

Catch-Up Vaccination

• Any missed vaccines from the routine schedule should be administered immediately using catch-up schedules with minimum intervals between doses. 2
• Multiple vaccines can and should be administered simultaneously at separate anatomic sites when indicated. 2

Common Pitfalls

• Do not confuse the age when vaccine series are completed with when new vaccines are initiated at age 2—most vaccines at this age are either catch-up doses or the annual influenza vaccine. 1, 2
• The second year of life (12-23 months) is when many vaccine series are completed, not the exact age of 2 years (24 months). 1
• Hepatitis A vaccination is recommended for all children starting at 1 year of age (12-23 months), so by age 2, children should have already initiated or completed this series. 1