Vaccine Schedule

The Centers for Disease Control and Prevention (CDC) releases a recommended vaccine schedule each year. Studies have shown vaccines save lives by helping to eradicate vaccine-preventable diseases that can cause permanent disability and death.

The bulk of vaccine recommendations are for infants and school-aged children. In fact, by around age 1, most babies have gotten 24 shots. But the CDC also recommends certain vaccines, such as the flu shot and shingles vaccine, for adults.

Generally, health officials consider vaccines to be safe and effective, but they are not without risks. Vaccines, just like all medicines and biologics, can cause side effects. Some of these side effects may be severe and/or permanent.

The CDC maintains that serious side effects are rare, and it says the benefits of vaccination outweigh the risks.

Because infants and young children are especially vulnerable to diseases, it is important to make sure they receive all recommended vaccine doses. The CDC recommends infants and children up to six years old receive vaccines to protect against 14 diseases.

The first vaccine a baby receives is Hepatitis B. They receive the first dose at birth, their second shot between one and two months and their third at 6–18 months. Many of the vaccines babies receive include multiple doses spaced out over a few months.

Children start their two-dose series of MMR vaccine at 12–15 months. They should receive their second dose at 4–6 years.

Children between 6 and 18 months old should receive two doses of Hepatitis A vaccine. If a child 2 years of age or older misses this deadline, he or she can still receive a HepA vaccine as long as the doses are six months apart.

*Flu vaccine — One or two doses can be given annually to children 6 months or older.

**HepA Vaccine — Children should receive a 2-dose series, shots separated by six to 18 months, between 1st and 2nd birthdays (series begun before the 2nd birthday should be completed even if the child turns 2 before the 2nd dose is given).

Some parents may ask for an alternative vaccine schedule that allows children to skip doses because the number of shots a child receives can be overwhelming. They may be concerned that the number of vaccines may harm their child.

However, alternative vaccine schedules that skip doses can do more harm than good.

The CDC designed the immunization schedule in accordance with recommendations from public health experts and the Advisory Committee on Immunization Practices (ACIP) to protect children from serious illnesses. Pediatricians and family physicians have also approved the schedule.

Some doctors or parents have developed alternative vaccine schedules, but the American Academy of Pediatrics and the CDC do not support them.

A child receives the majority of their vaccines prior to age seven. But the CDC still recommends four vaccines for children aged 7 to 18. One of them is the HPV vaccine, a vaccine that protects children against several types of cancer caused by the HPV virus.

One of the key vaccines recommended by the CDC for older children is the HPV vaccine. It protects children against the human papillomavirus, a virus that can cause cervical, anal and throat cancers, among others.

Children aged 9–14 receive two doses. They should receive their second dose at least 5 months after their first.

Children aged 15 or older receive three doses. They must wait at least four weeks in between dose one and two and 12 weeks in between dose two and three.

Children younger than six years old receive DTaP vaccines, but children aged seven or older receive a variation called Tdap. It protects against tetanus, diphtheria and acellular pertussis.

If a child older than six misses a DTaP vaccine, he or she can catch up with Tdap. Otherwise, the CDC recommends one dose of Tdap at age 11.

The CDC does not mandate vaccines. Instead, states have established their own vaccination laws for school-age children. Children may be unable to enroll in school prior to receiving certain vaccines.

For more information on required vaccinations by state, please visit the Immunization Action Coalition website.

If a child misses any regular doses of vaccines, the CDC recommends a catch-up immunization schedule. The catch-up vaccine schedule is also useful for children who start vaccination late.

For more detailed catch-up schedules for children younger than seven, please see the CDC’s catch-up vaccine schedule.

While people receive most of their vaccines as a child, the CDC still recommends a vaccine schedule for adults.

The CDC notes contraindications — conditions that increase the risk of adverse reactions — and precautions that should be considered before vaccinations are administered to adults. Additionally, the CDC identifies special populations, groups at a higher risk for vaccine-preventable diseases, in its adult immunization schedule. Special populations include, for example, pregnant women, people with allergies or chronic diseases, and people whose lifestyles put them at risk for disease.

For updated information on vaccine schedules for specific age groups, reference the CDC’s list of resources for parents and adults and its resource library.