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Vaccine Schedule

The Centers for Disease Control and Prevention (CDC) recommend a vaccination schedule for infants, children, adolescents and adults. The CDC updates its recommendations each year, though not all recommendations change every year. Keep in mind that some vaccines require more than one dose to be effective.

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.

Immunization Schedule for Infants and Children Up to Six Years of Age

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.

“Immunization gives you the power to protect your baby from 14 serious childhood diseases.”

CDC recommends children zero to six years of age receive the following vaccines:
  • Hepatitis B
  • Rotavirus (stomach flu)
  • Hib
  • Pneumococcal (PCV13)
  • Pneumococcal (PPSV23)
  • Polio
  • MMR (measles, mumps, rubella)
  • Varicella (chickenpox)
  • Hepatitis A
  • Meningococcal
  • Influenza (Flu)
  • DTaP (diphtheria, tetanus, whopping cough)

Baby’s First Vaccine: Hepatitis B Vaccine Schedule

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.

Other shots babies receive at two months include:
  • Polio
  • Pneumococcal (PCV13)
  • DTaP (Diphtheria, Tetanus, Pertussis)
  • Hib (Haemophilus influenzae type b)
Vaccine Safety Fact
Some babies may be allergic to DTaP or PCV13 vaccines. Talk to your doctor before getting another dose of these vaccines if your baby develops a nervous systems disease, doesn’t stop crying for three hours or more, has a high fever or suffers a seizure.

Measles, Mumps, Rubella (MMR) Vaccine Schedule for Children

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

Hepatitis A Vaccine Schedule

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.

Birth-6 Years Immunization Schedule
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Source: CDC

*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).

Alternative Vaccine Schedule

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.

“To be fully immunized, children need all doses of all vaccines in the recommended schedule. If your child does not receive the full number of doses, they are vulnerable to serious diseases.”

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

Vaccine Schedule for Children and Adolescents Aged 7 to 18

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.

HPV Vaccine Schedule

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.

Tdap Vaccine Schedule

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.

Shots for School

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.

Immunization schedule for children 7 to 18 years
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Source: CDC

Catch-Up Vaccine Schedule for Children Aged 7 to 18 Years

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.

Catch-Up Immunization Schedule: 7 to 18 Years
Vaccine Minimum Age to be Given Dose 1 Minimum Interval Between Dose 1 and Dose 2 Minimum Interval Between Dose 2 and Dose 3 Minimum Interval Between Dose 3 and Dose 4
Meningococcal Not applicable 8 weeks
Tetanus, diphtheria; tetanus, diphtheria and acellular pertussis (Tdap) 7 years 4 weeks If first dose of DTaP/DT given before 1st birthday: 4 weeks

If first dose of DTaP/DT given at or after 1st birthday: 6 months (as final dose)
If first dose of DTaP/DT given before 1st birthday: 6 months
Human papillomavirus (HPV) 9 years Number of doses and minimum intervals between each dose dependent on age at initial vaccination

If first dose was given at age 9-14 years: 2-dose series/minimum interval of 5 months

If first dose was given at age 15 or older: 3-dose series/minimum interval of 4 weeks between 1st and 2nd doses
If first dose was given at age 15 or older: 3-dose series/minimum interval of 12 weeks between 2nd and 3rd doses or 5 months between 1st and 3rd doses
Hepatitis A Not applicable 6 months
Hepatitis B Not applicable 4 weeks
Polio Not applicable 4 weeks 6 months If third dose was given at age 4 or older and at least 6 months after second dose, then fourth dose is not necessary.
Measles, mumps, rubella (MMR) Not applicable 4 weeks
Varicella (Chickenpox) Not applicable If younger than age 13: 3 months
If age 13 or older: 4 weeks

Vaccination Schedule for Adults 19 or Older

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

Adult Immunization Schedule by Age Group

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.

Influenza
One dose annually for all ages
Tdap or Td
One dose Tdap and then Td booster every 10 years
MMR
One or two doses depending on indication (people born 1957 or later)
Varicella (Chickenpox)
Two doses for all ages
Zoster (Shingles)
CDC prefers the Shingrix (RZV) vaccine at two doses for adults 50 or older or one dose Zostavax (ZVL) for adults 60 or older.
HPV
Two or three doses for people aged 19 to 26
Pneumococcal (PCV13 and PPSV23)
CDC recommends one dose for adults 65 or older, or one or two doses in younger adults with other indications.
HepA, HepB, Meningococcal, Hib
DC recommends one to three doses depending on vaccine and indication for all adults.

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.

Please seek the advice of a medical professional before making health care decisions.

Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for seven years. She specializes in fluoroquinolone antibiotics, vaccines and products that affect women’s health such as Essure birth control, transvaginal mesh and talcum powder. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • American Medical Writers Association (AMWA) Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Edited By

6 Cited Research Articles

  1. CDC. (2018). Catch-Up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html
  2. CDC. (2018, August 30). What are the Reasons to Vaccinate My Baby? Retrieved from https://www.cdc.gov/features/reasonstovaccinate/index.html
  3. CDC. (2018, February 6). Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States 2018. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/adult.html
  4. Immunization Action Coalition. (n.d.). State Information. Retrieved from http://www.immunize.org/laws/
  5. CDC. (2018, July 11). Your Child’s First Vaccines. Retrieved from https://www.cdc.gov/vaccines/hcp/vis/vis-statements/multi.html
  6. CDC. (2018, February 6). Catch-Up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html
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