When Does My Kid Need That? A Guide to Childhood Immunizations

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In September the back-to-school rush begins. Before life gets too hectic, it is good idea to check your child's immunization record to be sure that everything is up-to-date.

The Centers for Disease Control and Prevention (CDC) has issued the following recommendations to ensure that your child receives all the necessary immunizations to prevent serious disease.

The first 2 Months
Hepatitis B—Usually a few hours after being born, all babies receive the first dose of hepatitis B vaccine. If the mother does not have hepatitis B, the first shot could wait until up to 2 months of age. However, if the mother does have hepatitis B, the baby should receive the first shot within 12 hours of birth and the second dose by 2 months. By 18 months of age, all children should have received three doses of the vaccine. Together, these three shots provide long-lasting immunity against hepatitis B. If your child is older than 2 months and has not yet received this vaccination, they can safely receive three injections over a period of six months.

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Two to 6 Months
Diphtheria, Tetanus and Pertussis (DTaP)—This immunization consists of a series of five injections. The first three are usually given at 2, 4 and 6 months of age. Shot number four is given before 18 months of age. The last in the series should not be administered until after the child is four years old. Tetanus and diptheria boosters (Td) are necessary again by age 12 and every ten years after to maintain immunity. However, the vaccine for pertussis should not be administered to anyone over 7 years of age.

Haemophilus influenzae type b (Hib)—This immunization protects against the bacteria that can cause meningitis, pneumonia and other serious infections in children. Beginning at 2 months of age, your child will receive four shots before he or she is 15 months old. This vaccine is manufactured by various companies, so individual instructions may differ slightly.

Pneumococcal vaccine (PCV)—Also used to prevent meningitis and other blood infections, this immunization is administered at 2 months and repeated three more times before the age of 15 months. Some at-risk children may also receive a similar vaccine after reaching 2 years of age.

Polio (IPV)—This vaccine is given first at 2 months and again at 4 months. Subsequent doses should be given between 6 and 18 months of age and again between 4 and 6 years of age. While previously available as a liquid that could be swallowed, the polio vaccine is now only recommended to be given via an injection.

Influenza (flu)—A yearly inactivated flu vaccine is recommended for children between 6 months and 5 years (this vaccine should never be given to anyone under 6 months of age). It is also recommended for children older than 2 years if they have a particular medical condition that puts them at increased risk, such as asthma, HIV, diabetes or cardiac disease.

Rotavirus—2007 guidelines recommend that all infants receive a vaccine against rotavirus, which is the leading cause of severe diarrhea in infants and young children.

12 Months and Older
Measles, mumps and rubella (MMR)—This immunization is given once between 12 and 18 months and again between 4 and 6 years. If the second dose is missed, it should be given before 12 years of age.

Chickenpox (varicella)—If your child is a year old and has not had chickenpox yet, he or she should be immunized against the disease by 18 months and can be effectively immunized with one dose until 13 years of age. The newest guidelines recomend a second dose of the chichenpox vaccine between the ages of 4 and 6. However, if this immunization has not been given by this point, it can be given any time up to 18 years of age, but 2 doses spaced 4-6 weeks apart are needed. Be aware that some schools require proof of immunization against chickenpox.

Hepatitis A (HepA)—This immunization is given in two doses at least six months apart after age 2. However, it is only recommended for people who are at increased risk of the disease, either because they live in a particular region of the country which has a high incidence of the disease or because of travel outside the United States.

HPV—2007 guidelines recommend that all girls between the ages of 11and 12 receive the HPV vaccine, which greatly reduces the risk of cervical cancer. it is also recommended that girls between the ages of 13 and 18 received this vaccine who have not.

Other Tips
While your child's pediatrician will keep a record of immunizations on file in the office, it is a good idea to keep a personal copy at home. This way, if you need to change physicians or if your child becomes ill, you know what he or she has been protected against. Additionally, having a copy of you child's records will ease the process of applying to a new school or child care program.

Keep an immunization calendar on hand to keep track of the recommendations.

A printable version can be found here: http://www.cdc.gov/nip/recs/child-schedule-fourpages-print.pdf

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