Is it acceptable for 12-month-old infants to receive five vaccinations (intramuscular injections) simultaneously?

From the Guidelines

It is generally safe and recommended for 12-month-old babies to receive multiple vaccines in one visit, even if it involves 5 separate injections. At the 12-month visit, babies typically receive vaccines for measles, mumps, and rubella (MMR), varicella (chickenpox), hepatitis A, pneumococcal disease (PCV13), and sometimes influenza (seasonally) 1. These vaccines protect against serious diseases that can cause severe complications in young children. The immune system of a 12-month-old is capable of responding effectively to multiple vaccines simultaneously without being overwhelmed, as supported by the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) 1. In fact, babies encounter thousands of immune challenges in their environment every day. While receiving multiple shots may cause temporary discomfort for your baby, the protection provided against potentially life-threatening diseases outweighs this brief distress.

Some key points to consider:

• The simultaneous administration of routine childhood vaccines does not interfere with the immune response to these vaccines 1.
• The fourth dose of DTaP is recommended to be administered at ages 15--18 months, but can be administered as early as age 12 months under certain circumstances 1.
• The booster dose of the Hib or pneumococcal conjugate series can be deferred until ages 15--18 months for children who are likely to return for future visits 1.
• To help your baby through the experience, you can hold them during the shots, breastfeed or offer a pacifier, and comfort them immediately afterward.
• Some mild side effects like low-grade fever, fussiness, or soreness at the injection sites may occur but typically resolve within a day or two.

It's essential to follow the recommended vaccination schedule to ensure your baby receives the necessary protection against serious diseases. If you have concerns about your baby's vaccination schedule, it's best to consult with your healthcare provider.

From the Research

Vaccine Administration for 12-Month-Old Babies

• The US Advisory Committee on Immunization Practices recommends a series of vaccines for infants, including those against hepatitis B, diphtheria, tetanus, pertussis, pneumococcus, rotavirus, poliovirus, and Haemophilus influenzae type b 2.
• Studies have shown that administering multiple vaccines concurrently, such as MMRV (measles, mumps, rubella, and varicella) and PCV-7 (pneumococcal 7-valent conjugate vaccine), is safe and effective in healthy children aged 12-15 months 3, 4.
• The immune responses to all antigens present in MMRV and PCV-7 were similar whether administered concomitantly or sequentially 4.
• Concomitant administration of MMRV with other childhood vaccines, such as Hib/HepB (Haemophilus influenzae type b conjugate-hepatitis B vaccines) and DTaP (diphtheria-tetanus-acellular pertussis vaccines), is also well-tolerated and effective 5.

Safety and Immunogenicity

• The safety profiles for concomitant administration of MMRV with other vaccines were comparable to sequential administration 3, 4, 5.
• The antibody response rates were high for all vaccine components, with ≥96.8% for measles, mumps, and rubella, ≥88.0% for varicella-zoster virus, and ≥98.3% for all 7 Streptococcus pneumoniae serotypes 4.
• The incidence of local and systemic adverse experiences was comparable between concomitant and sequential administration groups 4.

Recommendations

• The evidence supports concomitant administration of multiple vaccines, including MMRV, PCV-7, Hib/HepB, and DTaP, in healthy children aged 12-15 months 3, 4, 5.
• The American Academy of Pediatrics and other health organizations recommend following the recommended immunization schedule, which includes administering multiple vaccines concurrently at 12-15 months of age 2, 6.