From the Guidelines
The recommended vaccines for each well-child visit follow a specific schedule established by immunization experts, with the most recent and highest quality study guiding the recommendation 1.
Recommended Vaccines by Age
At birth, infants typically receive the first dose of Hepatitis B vaccine.
- At the 2-month visit, babies receive DTaP (diphtheria, tetanus, pertussis), IPV (polio), Hib (Haemophilus influenzae type b), PCV13 (pneumococcal), RV (rotavirus), and the second Hepatitis B dose.
- The 4-month visit repeats DTaP, IPV, Hib, PCV13, and RV.
- At 6 months, babies receive DTaP, IPV, PCV13, RV (final dose), and potentially the third Hepatitis B dose and first influenza vaccine if during flu season.
- The 12-month visit includes MMR (measles, mumps, rubella), Varicella (chickenpox), Hepatitis A, and PCV13.
- At 15-18 months, children receive DTaP, Hib, and potentially Hepatitis A (second dose).
- The 4-6 year visit includes DTaP, IPV, MMR, and Varicella boosters.
- At 11-12 years, adolescents receive Tdap, HPV (human papillomavirus), and MenACWY (meningococcal). Annual influenza vaccines are recommended for everyone 6 months and older, as stated in the guidelines 1.
Key Considerations
- The inactivated poliovirus (IPV) vaccine is recommended for all children, with a schedule of 4 doses at age 2,4, and 6-18 months, and at age 4-6 years 1.
- The pneumococcal conjugate vaccine (PCV) is recommended for all children aged 2-23 months, and for certain children aged 24-59 months 1.
- The hepatitis A vaccine is recommended for children and adolescents in selected states and regions, and for certain high-risk groups, with a series of 2 doses administered at least 6 months apart 1.
From the Research
Recommended Vaccines at Each Well Child Visit
The following vaccines are recommended to be given at each well child visit:
- At 2 months:
- At 4 months:
- At 6 months:
- At 12-15 months:
- Measles, mumps, rubella, and varicella (MMRV) vaccine
- Hib conjugate
- DTaP 6
- At 11-12 months or 13.5 months:
- DTaP
- IPV
- Hib conjugate
- HepB vaccine (booster dose) 4
Vaccine Combinations and Safety
The combination vaccines, such as DTaP-HepB-IPV/Hib, have been shown to be safe and immunogenic when administered concomitantly with other vaccines 6, 2, 3, 4, 5. However, the safety profiles for each vaccination regimen were comparable, and the immunogenicity data support concomitant administration of MMRV with Hib/HepB 6.
Immunogenicity and Efficacy
The hexavalent vaccines, such as DTPa-HBV-IPV/Hib, have been shown to be highly immunogenic and provide a long-term immune response 3, 4, 5. The six clinical trials included in one review showed that infants who received the monovalent HBV vaccine at birth and three or four doses of DTPa-HBV-IPV/Hib vaccine achieved protective immunogenic titers with a clinically acceptable safety profile 3.