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Your Guide to Childhood Vaccinations

Measles, mumps and other preventable diseases are on the rise again. Here's how to keep your kids safe.

Medically reviewed in June 2022

Updated on June 6, 2022

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Whether you're dropping your little one at preschool or shuttling your high school graduate off to college, this school year, make sure immunizations top your list of September must-haves. 

Vaccines not only protect individuals from infectious diseases like measles and mumps, they help keep your school and community healthy. Children who are too young to be immunized, have medical conditions that make vaccinations unsafe, or don't respond well to certain vaccines are better protected if kids around them have immunity.

Though schools may have different immunization policies and requirements can vary by state, there are a number of must-get immunizations for most children. They are widely considered to be safe and effective. As with any vaccine, however, they may cause mild, temporary side effects, such as injection-site tenderness, headaches, tiredness, and low fever. 

Severe allergic reactions are rare, but possible. Any child who exhibits trouble breathing, dizziness, fainting, rapid heartbeat, or low blood pressure should be checked immediately by a health professional. Vaccines should not be given to kids with a known allergy to any ingredient, or to those who have had an allergic reaction to a previous dose.

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Diphtheria, tetanus and acellular pertussis (DTaP)

The DtaP vaccine protects against three serious bacterial diseases: diphtheria, tetanus, and pertussis. 

  • Diphtheria is characterized by a thick coating in the back of the throat and can cause breathing trouble, heart failure, and paralysis.
  • Tetanus causes muscles to tighten, which can lead to jaw cramping, spasms, seizures, headaches, and blood pressure and heart rate changes. Complications include trouble breathing, pneumonia, infections contracted during hospital visits, pulmonary embolisms, and even death if left untreated. 
  • Pertussis, or whooping cough, is a respiratory illness marked by coughing fits that can last for weeks and prevent infants from eating, drinking, and breathing. Pneumonia, seizures, and brain damage are all possible complications of the condition.

Children should receive five doses of the DTaP vaccine between 2 months and 6 years, plus a booster known as Tdap between ages 11 and 12. If your child misses a recommended shot, the immunization schedule will change, so it's important to consult a healthcare provider (HCP). Kids sick with a severe cold or flu should wait to be vaccinated.

DTaP has virtually eliminated childhood cases of tetanus and diphtheria and reduced instances of pertussis. 

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Inactivated poliovirus

Polio is caused by a virus spread through contact with an infected person or by consuming food contaminated with the stool of an infected person. Prior to the introduction of the polio vaccine in 1955, the disease killed thousands of Americans each year. While it’s been eliminated in the United States for more than four decades, polio still affects people in certain countries, making immunizations important for keeping the U.S. disease-free.

It’s recommended that children be vaccinated against polio with a four-dose series between 2 months and 6 years.

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Measles, mumps and rubella (MMR)

The MMR vaccine protects against measles, mumps, and rubella, diseases that are highly contagious and easily spread. 

  • Measles typically presents with fever, cough, runny nose, and a body-wide rash. The condition can lead to pneumonia, diarrhea, and in rare cases, brain damage. 
  • Mumps cause head and muscle aches, fatigue, and notably, inflammation of one or both salivary glands, which are located below the ears on both sides of the face. The virus can also cause brain and spinal cord swelling, deafness, testicular or ovarian swelling, and miscarriage. 
  • Rubella virus is characterized by a fever, sore throat, rash, and eye irritation. The condition can increase miscarriage risk in pregnant women and leads to arthritis in nearly half of teen girls and women who contract the disease.

Most children should receive two doses of the MMR vaccine—the first between 12 and 15 months and a second between 4 and 6 years. Those who miss the recommended age targets should be immunized with two doses at least 4 weeks apart. 

The vaccine isn’t suitable for those with a severely weakened immune system caused by HIV/AIDS, cancer, or other medical issues. Tell an HCP if there's a family history of immune disorders, or your child has a bleeding condition or bruises easily, has tuberculosis, or has received a blood transfusion within the last 90 days.

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Hepatitis B

Hepatitis B causes liver inflammation and symptoms like fever, chills, body aches, pale stool, dark urine, and jaundice. Long-term complications include liver failure, liver cancer, or cirrhosis, which leaves the liver permanently scarred. Immunization is especially important during childhood; adults typically recovery fully from exposure to the virus, but it's more likely children will develop a chronic infection. 

Between birth and 18 months, children should receive three doses of the hepatitis B vaccine. Certain circumstances can change when a child should be vaccinated:

  • Healthy infants born to mothers who test negative for the hepatitis B antigen should receive their first dose within 24 hours of birth. 
  • Newborns with a low birth weight—under 4.4 pounds—will receive their first shot at 1 month or upon being discharged from the hospital. 
  • The vaccine will be administered within 12 hours of birth to children born to mothers with hepatitis B, regardless of weight. 

A pregnant woman with hepatitis B can transmit the disease during birth, and one-fourth of infected newborns will eventually succumb to liver disease caused by the virus. Speedy vaccination can help prevent this.

If your newborn or child has a severe allergic reaction to the initial dose, speak with your HCP about whether they should continue with the immunization.

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Varicella (chickenpox)

Chickenpox is a highly contagious disease characterized by fever, fatigue, and itchy blisters covering part of or all of your body. Cases of chickenpox are common in the U.S. and usually require no treatment, but the condition can be uncomfortable. In rare cases, it can lead to infections, dehydration, pneumonia, or brain swelling. Infants whose mothers haven't had the disease or vaccine, children with a compromised immune system, and those taking steroid medications for conditions like asthma are at a higher risk for complications.

The surest prevention method is the varicella vaccine. Children should receive two doses, the first between 12 and 15 months and the second between 4 and 6 years, although the second dose can be given as early as 3 months after the first. While following this immunization schedule is recommended, children of all ages can receive the vaccine.

The varicella vaccine is widely regarded as safe and effective. Parents of children who have certain medical conditions or who take medications that compromise their immune systems should consult an HCP about potential risks.

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Haemophilus influenzae type b

The Haemophilus influenzae type b or Hib vaccine protects against a type of bacteria that can cause meningitis (brain and spinal cord swelling), pneumonia, severe throat swelling, and even death. 

The bacteria typically affects children under 5 years of age, so immunization is recommended beginning at 2 months. Depending on the specific brand of vaccine, some children may need up to four doses, while others will need three. Children on the three- and four-dose series should receive a shot at 2 months, 4 months, and between 12 and 15 months. Those receiving a fourth shot will also get a dose at 6 months.

There are a handful of special circumstances that could change vaccination recommendations. Speak with your child's HCP if your young one was born with HIV or is undergoing chemotherapy or radiation therapy.

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Pneumococcal conjugate

Pneumococcal disease commonly causes ear infections and can lead to more serious concerns like lung infections, blood infections, or meningitis. When children with pneumococcal disease develop meningitis, it can cause deafness and brain damage. In about 10 percent of cases, it leads to death. 

Before the pneumococcal conjugate vaccine’s existence, the U.S. recorded 700 related meningitis cases, 13,000 blood infections, and 200 deaths each year among children under 5 years of age. Vaccinations have eliminated about 9 in 10 of these cases.

Children under 2 years of age should receive four doses of the pneumococcal conjugate vaccine, one each at 2 months, 4 months, 6 months, and between 12 and 15 months. 

Children who miss recommended doses should still be vaccinated—it's never too late. Speak with an HCP for next steps if your child is behind schedule.

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Meningococcal

Meningococcal infections are caused by a bacteria called Neisseria meningitidis. Infected people often develop meningitis or a blood infection known as meningococcemia, both of which can become deadly very quickly. In young ones, symptoms include fever, irritability, lethargy, and poor eating. Even with treatment, 10 to 15 percent of infected people will die, and those who do survive often endure loss of limbs, deafness, or brain damage.

To safeguard your children from these diseases, they should be immunized between 11 and 12 years of age with a meningococcal conjugate vaccine and receive a booster shot at 16 years old. Teens between 16 and 18 may also receive a serogroup B meningococcal vaccine, which can be given at a younger age to those with certain disorders, a damaged or removed spleen, or who are taking a complement inhibitor (eculizumab, ravulizumab, etc.).

Nurse administering vaccine to a young boy
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Influenza

Anybody can get the seasonal flu, a viral respiratory infection that often causes high fever, muscle aches, nasal congestion, sore throat, and a dry cough. The flu spreads when an infected person coughs, talks, or sneezes.

Thousands of U.S. kids are hospitalized annually for complications related to the flu. Not everyone who catches it will have a severe case, but children under the age of 5—and especially those under 2 years old—are at a higher risk. Getting the vaccine can help lessen the likelihood of the sickness and ease your child’s symptoms if they do become ill.

A yearly flu vaccine is recommended for most people over 6 months of age. Kids between 6 months and 8 years of age who are receiving the flu vaccine for the first time should receive two doses separated by at least 28 days. A single dose is recommended every year thereafter.

The Centers for Disease Control and Prevention (CDC) recommends getting the flu vaccine before the end of October, although there is still benefit to being vaccinated any time during flu season.

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COVID-19

More than 1 million Americans have died of COVID-19. As the virus continues to evolve, vaccination remains critical to slowing infection and helping to prevent severe disease, hospitalization, and death. Having your child vaccinated doesn’t just help safeguard them from illness—it helps protect their family, school, and community.

The CDC recommends that kids ages 5 and older receive a two-dose vaccination series, plus a booster several months after the second shot. Children who have had COVID should still be vaccinated. Vaccination for children under age 5 is under review.

Tens of millions of children have received COVID-19 shots. They are widely regarded as safe and serious complications are rare. Side effects such as arm pain, fatigue, and headache may occur within two days of vaccination, but typically clear up quickly. If you have questions about the vaccine’s effectiveness, safety, or necessity, speak with your HCP for guidance.

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