Childhood Immunization Schedule: What Parents Need to Know

Becoming a new parent brings plenty of challenges, and getting your young children all the vaccines they need, when they need them, can be daunting.

“Immunizations are a way for us to help people develop immunity so they can prevent infections,” explained Dr. Jonathan Miller, chief of primary care and pediatrics at Nemours Children’s Health in Wilmington, Del.

Yet, parents can sometimes feel overwhelmed trying to get all their children’s vaccines scheduled at the right time. To help, here's a timeline and dosing schedule for each vaccine from the U.S. Centers for Disease Control and Prevention, including the recommended ages for each dose.

Childhood immunization schedule

Hepatitis B

The Hepatitis B vaccine helps protect against the hepatitis B virus. It’s given in three doses:

• First dose: birth
• Second dose: 1-2 months
• Third dose: 6-18 months

DTaP

This five-dose vaccine protects against three different bacterial infections: diphtheria, tetanus and pertussis (whooping cough):

• First dose: 2 months
• Second dose: 4 months
• Third dose: 6 months
• Fourth dose: 15-18 months
• Fifth dose: 4-6 years

Pneumococcal

Pneumococcal (PCV) vaccine helps keep your child safe from a bacterial infection called pneumococcal disease:

• First dose: 2 months
• Second dose: 4 months
• Third dose: 6 months
• Fourth dose: 12-15 months

Tdap

The Tdap vaccine is administered for the same diseases as the DTaP vaccine but is recommended for older children aged 11-12 years, in one dose.

Rotavirus

This vaccine is given to protect against the rotavirus:

• Rotarix: first dose at 2 months and second dose at 4 months

OR

• RotaTeq: first dose at 2 months, second dose at 3 months and third dose at 6 months

Hib

Haemophilus influenzae type b (Hib) vaccinations guard against a type of bacteria that can cause a number of debilitating health conditions:

• PedvaxHIB: first dose at 2 months, second dose at 4 months and a booster at 12-15 months

OR

• ActHIB, Hiberix, Pentacel, or Vaxelis: first dose at 2 months, second dose at 4 months, third dose at 6 months and a booster at 12-15 months

IPV

Inactivated polio vaccine (IPV) vaccines protect against the life-threatening, paralyzing poliovirus:

• First dose: 2 months
• Second dose: 4 months
• Third dose: 6-18 months
• Fourth dose: 4-6 years

Influenza

Starting at age 6 months, the influenza vaccine, which protects against different strains of the flu virus, is recommended annually:

• One dose for children aged 6 months to 8 years who’ve had at least 2 influenza vaccine doses before July 1, 2022 (or 2 doses for children who have not)
• One dose for children aged 9 or older

In July 2023, the U.S. Food and Drug Administration approved an antibody shot known as nirsevimab (Beyfortus) to guard against severe respiratory syncytial virus (RSV) in children. The next month, the CDC's Advisory Committee on Immunization Practices recommended the shot for the following age groups:

• Babies aged 8 months or younger who were born during or are entering their first RSV season
• Infants and children aged 8 to 19 months who are at increased risk of severe RSV disease entering their second RSV season.

MMR

Measles, mumps and rubella are all caused by three different viruses, and the MMR vaccine protects against all of them:

• First dose: 12-15 months
• Second dose: 4-6 years

Varicella

Also known as the chickenpox vaccine, this protects against the varicella-zoster virus:

• First dose: 12-15 months
• Second dose: 4-6 years

Hepatitis A

The Hepatitis A vaccine protects against the hepatitis A virus. It’s given in two doses between the ages of 12-23 months, with a minimum of six months between doses.

Meningococcal

Meningococcal disease is caused by bacteria, and the vaccine helps prevent the most common form of the disease found in the United States:

• First dose: 11-12 years
• Second dose: 16 years

COVID-19

COVID-19 vaccines guard against severe disease.

For children aged 6 months to age 4:

• Two doses of Moderna, 4-8 weeks apart

OR

• Three doses of Pfizer, with 3-8 weeks between the initial two doses and 11-16 weeks between the final two doses

For children aged 5 to 11:

• Two doses of Moderna 4-8 weeks apart

OR

• Two doses of Pfizer, 3-8 weeks apart

For children aged 12 to 18:

• Two doses of Moderna 4-8 weeks apart

OR

• Two doses of Pfizer or Novavax, 3-8 weeks apart

Miller explained how COVID mRNA vaccines are a little different from many other childhood shots.

“The mRNA teaches the cells in our body to create a protein that looks like the spike protein on [the] COVID [virus], and that allows us to then make antibodies against that spike protein,” he said.

HPV

The CDC says that the human papillomavirus (HPV) is the most common sexually transmitted disease. Its namesake vaccine can defend against the diseases it causes, such as cervical cancer:

• For children 9 to 14, two doses six to 12 months apart
• For children ages 15 and older, three doses, with 1-2 months between the initial two doses and 6 months between the final two doses

Dengue

Dengue is caused by a virus that's spread by mosquitoes. Children ages 9-16 who have had dengue infection in the past and live in places where dengue is common need to be vaccinated. The vaccine is given in three doses, six months apart.

“Many of the…immunizations we give require more doses over time in order to make sure the immune system creates a lasting response to those infections,” Miller noted.

If you miss certain childhood vaccine doses, the CDC has a convenient catch-up immunization schedule you can follow.

Resources

Jonathan Miller, MD, chief, primary care and pediatrics, Nemours Children’s Health, Wilmington, Del.

U.S. Centers for Disease Control and Prevention: Child and Adolescent Immunization Schedule by Age

U.S. Centers for Disease Control and Prevention: Recommended Vaccinations for Infants and Children, Parent-Friendly Version

U.S. Centers for Disease Control and Prevention: Recommended Vaccinations for Children 7 to 18 Years Old, Parent-Friendly Version

U.S. Centers for Disease Control and Prevention: Meningococcal Vaccination

U.S. Centers for Disease Control and Prevention: Genital HPV Infection — Basic Fact Sheet

U.S. Centers for Disease Control and Prevention: Who Can Get a Dengue Vaccine & When

U.S. Centers for Disease Control and Prevention: Catch-Up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More Than 1 Month Behind

Morbidity and Mortality Weekly Report: Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023