What is the recommended vaccine schedule for a typical newborn baby with no underlying medical conditions?

Recommended Childhood Vaccination Schedule for Newborns

All medically stable newborns weighing ≥2,000 grams born to HBsAg-negative mothers should receive their first dose of hepatitis B vaccine within 24 hours of birth, followed by a comprehensive vaccination series beginning at 2 months of age that includes DTaP, IPV, Hib, PCV, and rotavirus vaccines. 1, 2

Birth (Day 0-1)

• Hepatitis B (HepB) - First Dose: Administer monovalent hepatitis B vaccine within 24 hours of birth to all medically stable infants ≥2,000 grams born to HBsAg-negative mothers 1, 2
• Special consideration for low birth weight infants: Infants weighing <2,000 grams born to HBsAg-negative mothers should defer the birth dose until 1 month of age or hospital discharge, and will require 4 total doses to complete the series 1, 2
• Infants of HBsAg-positive mothers: Administer both HepB vaccine AND 0.5 mL hepatitis B immune globulin (HBIG) within 12 hours of birth, regardless of birth weight 1

2 Months of Age

• Hepatitis B (HepB) - Second Dose: Minimum age 4 weeks after first dose 1, 2
• DTaP (Diphtheria, Tetanus, Pertussis) - First Dose: Minimum age 6 weeks 1, 2
• IPV (Inactivated Poliovirus) - First Dose: Minimum age 6 weeks 1, 2
• Hib (Haemophilus influenzae type b) - First Dose: Minimum age 6 weeks 1, 2
• PCV (Pneumococcal Conjugate) - First Dose: Minimum age 6 weeks 1, 2
• Rotavirus - First Dose: Must be administered between 6-14 weeks 6 days of age; do not start after this window 1, 2

4 Months of Age

• DTaP - Second Dose: Minimum 4 weeks after first dose 1, 2
• IPV - Second Dose: Minimum 4 weeks after first dose 1, 2
• Hib - Second Dose: Minimum 4 weeks after first dose (note: if PRP-OMP brand is used, the 6-month dose is not required) 1, 2
• PCV - Second Dose: Minimum 4 weeks after first dose 1, 2
• Rotavirus - Second Dose: Minimum 4 weeks after first dose 1, 2

6 Months of Age

• Hepatitis B (HepB) - Third Dose: Must be administered at ≥24 weeks of age (6 months), with minimum 8 weeks after second dose and minimum 16 weeks after first dose 1, 3
• DTaP - Third Dose: Minimum 4 weeks after second dose 1, 2
• IPV - Third Dose: Minimum 4 weeks after second dose 1, 2
• Hib - Third Dose: Minimum 4 weeks after second dose (if applicable based on vaccine brand) 1, 2
• PCV - Third Dose: Minimum 4 weeks after second dose 1, 2
• Rotavirus - Third Dose: Final dose must be completed by 8 months of age; do not administer after 32 weeks of age 1, 2
• Influenza - First Dose: Begin annual influenza vaccination starting at 6 months; children <9 years receiving for first time need two doses separated by at least 4 weeks 1, 2

12-15 Months of Age

• Hib - Fourth Dose (Booster): Final dose must be given after 12 months of age 1, 2
• PCV - Fourth Dose (Booster): Administered at 12-15 months 1, 2
• MMR (Measles, Mumps, Rubella) - First Dose: Minimum age 12 months 1, 2
• Varicella - First Dose: Minimum age 12 months 1, 2
• Hepatitis A (HepA) - First Dose: Administer at 12-23 months 1, 2

15-18 Months of Age

• DTaP - Fourth Dose: Can be given as early as 12 months if 6 months have elapsed since third dose 1, 2

18 Months of Age

• Hepatitis A (HepA) - Second Dose: Administer 6 months after first dose 1, 2

4-6 Years of Age

• DTaP - Fifth Dose: Final dose in series 1, 2
• IPV - Fourth Dose: Final dose in series 1, 2
• MMR - Second Dose: Can be given earlier if at least 4 weeks have elapsed since first dose 1, 2
• Varicella - Second Dose: Can be given earlier if at least 3 months have elapsed since first dose 1, 2

Critical Timing Constraints and Common Pitfalls

• Never restart a vaccine series: If the schedule is interrupted, simply continue where you left off rather than restarting 2, 3
• Rotavirus strict age limits: The first dose must be initiated between 6-14 weeks 6 days of age due to theoretical increased risk of intussusception if started later, and the final dose must be completed by 8 months of age 1, 2
• Hepatitis B third dose timing: The final HepB dose must not be administered before 24 weeks of age to ensure adequate long-term immunity, regardless of when earlier doses were given 1, 3
• Preterm infant vaccination: Vaccinate at chronological age, not corrected gestational age, with the exception of the HepB birth dose in infants <2,000 grams born to HBsAg-negative mothers 2
• Birth dose is monovalent only: Only single-antigen hepatitis B vaccine should be used for the birth dose; combination vaccines containing HepB can be used for subsequent doses 2

Post-Vaccination Testing Requirements

• Infants born to HBsAg-positive mothers: Test for HBsAg and anti-HBs at 9-15 months of age (after completion of the vaccine series) to identify chronic infection or need for revaccination 1, 3
• Healthy infants born to HBsAg-negative mothers: Routine post-vaccination serologic testing is NOT recommended 4