Vaccine Education Center

Vaccine Timetable

The following list provides a suggested timetable. Although vaccine schedules can differ slightly, you can generally expect the following vaccines at the ages indicated:

Print a downloadable version of the vaccine timetable:

  Birth 1 mo. 2 mos. 4 mos. 6 mos. 12 mos. 15 mos. 18 mos. 19-23 mos.
Hepatitis B #1 #2   #3  
Rotavirus     #1 #2 #3**        
Diphtheria/
Tetanus/
Pertussis (DTaP)
    #1 #2 #3   #4  
Haemophilus influenzae
type b (Hib)
    #1 #2 #3 #4    
Pneumococcal     #1 #2 #3 #4    
Polio     #1 #2 #3  
Influenza         2 doses 1 month apart, then 1 dose every year
Measles/Mumps/
Rubella (MMR)
          #1    
Varicella
(Chickenpox)
          #1    
Hepatitis A           2 doses 6 month apart

** Depending on the type of rotavirus vaccine used, the third dose may be omitted.

Vaccines questions and answers

I can’t find my vaccine record. Can I look at the history and determine which vaccines I had as a child?

No. The history is a good way to see which vaccines existed when you were a child, but that does not mean you had them. There are several reasons for this:

Why is hepatitis B vaccine given to newborns?

Hepatitis B is primarily a sexually-transmitted disease, so many parents question why their newborn infants need to get this vaccine at birth. Indeed when the vaccine first became available in 1982, only those at high risk of becoming infected were recommended to get the vaccine. Despite these efforts, about 1 of every 3 patients with acute disease was not in these high-risk categories. These efforts were not controlling disease because:

Infants exposed at birth are particularly susceptible to chronic infection and death from liver disease as adults. However, testing women prior to giving birth would not prevent all cases of transmission to infants nor would it decrease exposure from other family members who may be infected. This was the case in some immigrant populations from countries in which hepatitis B was endemic. By beginning the immunization series with newborns, the risks to the child could be minimized and the number of chronic carriers in the community could be decreased as these children reached adulthood. Since the universal infant recommendation was made in 1991, public health officials have witnessed a virtual elimination of hepatitis B virus infections in those less than 21 years old, and will likely see a decrease in liver cancer as this group gets older.

Why was the rotavirus vaccine removed from the schedule in 1999 and then put back in 2006?

The first rotavirus vaccine, known as RotaShield®, was approved for use in 1998; however, less than one year later it was removed from the market because of an increased risk of a condition known as intussusception. Intussusception is an uncommon, yet painful intestinal blockage that occurs when the intestine folds into itself. This side effect of the vaccine was found to occur in about 1 recipient for every 10,000 doses administered. Because RotaShield caused this side effect, it was removed from the recommended vaccine schedule.

In 2006 and 2008, two new rotavirus vaccines were licensed. Both vaccines were made of different versions of the virus as compared to RotaShield, which contained monkey strains of rotavirus. In 2006, RotaTeq® was licensed containing cow strains of rotavirus. The latter vaccine to be licensed was Rotarix®, which contains a weakened human strain of rotavirus. Both vaccines were tested extensively before licensure to determine if they too caused intussusception. The rate of intussusception in those who received the rotavirus vaccine was found to be similar to that which occurred naturally — about 1 of every 100,000 infants. Because virtually every young child gets rotavirus, and about 1 of every 65 are hospitalized as a result, the benefit of getting the rotavirus vaccine clearly outweighs the risk. Therefore, rotavirus has been added back to the infant immunization schedule and is recommended for all infants.

What are the differences between the DTP, DTaP, and Tdap vaccines?

All three of these are vaccines that protect against diphtheria, tetanus and pertussis. They differ in the quantities and purity of the components, for whom they are recommended, and how many doses are given:

Why do we use the polio shot and not the oral polio vaccine?

In about 1 of every 2.4 million recipients, the live, weakened virus contained in the oral polio vaccine causes paralysis. The shot does not have this same side effect because, unlike the oral version, the shot contains killed virus which cannot replicate and, therefore, cannot cause paralysis.

Between 1961 and 1996, children in the U.S. received four doses of the oral vaccine. This changed beginning in 1997 and continued throughout 1999 when children typically received two doses of the shot followed by two doses of the oral version. Since that time, infants have received four doses of the shot.

Many other countries continue to use the oral polio vaccine because it is more economical, easier to administer, and provides better herd immunity; therefore, allowing more people to get the vaccine.

Why has the age of the children who are supposed to get influenza vaccine changed?

Indeed the ages of children recommended to get influenza vaccine have been variable in the past:

These changes were coupled with increasing recommendations for adults, ultimately leading to the recommendation in 2010 for everyone older than 6 months of age to receive an annual influenza vaccine. Because there was not a supply of influenza vaccine to recommend it for the entire population, the recommendations had to gradually increase the number of people that should get the vaccine beginning with the most susceptible populations. As demand for the vaccine grew, so too did the quantity produced. Because the vaccine is made in eggs, this increase had to take into account the availability of eggs - and the chickens that produce them of course!

Why was the hepatitis A vaccine recommended for all infants after it was given to only certain groups at first?

When the hepatitis A vaccine first became available, it was only recommended for sub-groups of the population that were at increased risk of getting hepatitis A. However, in 2006 the recommendation was extended to include all infants between 12 months and 23 months of age:

Reviewed by: Paul A. Offit, MD
Date: April 2013

Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.

 

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