Every year, the Centers for Disease Control and Prevention (CDC) publishes recommended childhood vaccination schedules. Why are schedules created? Because the timing and spacing of immunizations are really important for the best possible protection against preventable diseases.

Kids’ immune systems are more vulnerable to illness and disease, and vaccination schedules are scientifically designed by top infectious disease experts and doctors with this in mind. The goal is to protect kids from vaccine-preventable diseases as early and as safely as possible.

Below, we cover how many vaccines are recommended for children and when, changes to the current schedule, and a list of vaccine recommendations by age group. We also answer questions around COVID-19 vaccines for children and teens.

How many vaccines do kids get if the immunization schedule for children is followed?

There is a wide range of vaccines – some requiring multiple doses at specific ages and times – that are recommended from birth to 18 years old. Recommended vaccines include:

*Number of doses recommended depends on your child’s age and type of COVID-19 vaccine used.
**The American Academy of Pediatrics recommends giving HPV as early as 9. Please discuss with your clinician.

Updated Immunization schedule: What changes have been made to the childhood vaccine schedule?

The pediatric immunization schedule has been updated to include COVID-19 vaccines for kids and teens, and dengue vaccination recommendations for children living in areas with high rates of dengue fever (such as Puerto Rico and American Samoa) who have previously caught it. The schedule was also updated to include the latest recommendations for the MMR, varicella and hib vaccines. In addition, information about “special situations” was added for the hep B, HPV and MenACWY vaccines. If you have specific questions about schedule updates and how they relate to your child’s vaccination schedule, talk with your child’s doctor.

The CDC’s Advisory Committee on Immunization Practices (ACIP) meets three times a year to review the latest scientific research and make any necessary changes to the child vaccination schedule. The CDC officially sets the schedule based on ACIP’s recommendations, and organizations like the American Academy of Pediatrics (AAP) and the American Association of Family Physicians (AAFP) also approve the schedule.

The CDC’s childhood vaccination schedule: A list of immunizations by age

The flu shot: An annual immunization for children starting at 6 months old

The flu vaccine – or influenza vaccine – may be the most well-known of all immunizations. That’s because it’s one of the longest-running vaccines in the United States, with the first of its kind being approved for widespread use in 1945.

While influenza viruses circulate year-round, flu cases peak in the fall and winter months nearly every year. Flu vaccinations help protect against the types of influenza viruses that research indicates will be most common that season. That’s why the CDC recommends annual flu shots for everyone by the end of October – including kids 6 months and older.

When children receive their first flu vaccination, the vaccine is delivered in two doses, given at least one month apart. After that first pair of doses, just one vaccination is needed each year.

Flu vaccinations are available in mist and shot form, and work to protect your child against the flu in the same way. Speak to your doctor to determine which form of the vaccination is right for your child and what timing works for their first vaccinations.

Newborn baby and infant vaccine schedule: Recommended immunizations for children ages 0 to 18 months

When do babies get their first shots? Staying on track with childhood immunizations starts early, with immunizations beginning at birth and coinciding with baby and child wellness schedules.

Remember, baby and child vaccination schedules are made with young immune systems in mind. If you have specific questions about when or why specific childhood vaccines are recommended for your newborn baby, infant or toddler, talk with your child’s doctor.

An overview of immunizations for newborns to 18 months old

• Hep B – Many new parents wonder what vaccines are given at birth, and just one "newborn vaccine" is recommended right away: the first dose of hepatitis B. The first dose is recommended early on in case mothers are knowingly or unknowingly hepatitis B positive. The hep B vaccine schedule requires three doses in total. The second dose is recommended when your child is between 1-2 months old, and the third dose is recommended between 6-18 months.
• RSV antibody – For infants under 8 months old who were born during or who are entering their first RSV season (late fall through the spring), it’s recommended they receive a single dose of the RSV preventive antibody to help protect their young immune systems. Timing on when they should receive it is dependent on when they’re born. However, most infants whose mothers or birthing parent received the RSV vaccine don’t need this antibody treatment, too.
• Rotavirus – Depending on the manufacturer of the vaccine, your child may need two or three doses of the rotavirus vaccine, with the first dose being given at 2 months old and the second at 4 months old. If needed, the third dose is given at 6 months old. It’s important to note that some forms of the vaccine cannot be given after 4 months of age, so following the recommended schedule is especially important to ensure your child is protected.
• DTaP – The diphtheria, tetanus and pertussis vaccine requires five doses. The first four are recommended at 2 months, 4 months, 6 months and between 15-18 months old.
• Hib – Depending on the manufacturer of the vaccine, your child may need three or four doses of the haemophilus influenzae type b vaccine. If three doses are needed, shots are given at 2 months, 4 months and between 12-15 months old. If four doses are needed, kids also receive a dose at 6 months old.
• PCV – The pneumococcal vaccine is a series of four doses taking place at 2 months, 4 months, 6 months and between 12-15 months old.
• IPV – The poliovirus vaccine is another four-dose series. The dosing schedule for the polio vaccine recommends the first three shots occur at 2 months, 4 months and between 6-18 months old.
• COVID-19 – The first dose of the COVID-19 vaccine is given at 6 months old. The total number of doses to complete the first series will depend on the type of COVID-19 vaccine that’s used.
• MMR – The measles, mumps and rubella vaccine is given in two doses. The dosing schedule for the MMR vaccine recommends the first shot be given between 12-15 months old.
• Varicella – The chickenpox vaccine is also given in two doses, with the first shot taking place between 12-15 months old.
• Hep A – The hepatitis A vaccine requires two doses. The first dose is recommended at 12 months old.

Recommended childhood vaccines for ages 4 to 6 years old

The recommended shots for kids between the ages of 4-6 years old are often called “kindergarten vaccines.” That’s because kids are usually required to be up to date on their immunizations to start attending elementary school. No new vaccines are introduced at this time, but oftentimes vaccines are given as combinations.

For example, DTaP and IPV can be given in a single shot. MMR and varicella vaccines can also be combined into a single immunization. These vaccines are just as effective when given together, and it cuts down on the number of shots kids need.

An overview of immunizations for kids ages 4 to 6 years old

• DTaP – The fifth and final diphtheria, tetanus and pertussis vaccine is recommended when your child is between 4-6 years old.
• IPV – The poliovirus vaccine is a four-dose series. The fourth dose should occur sometime between 4-6 years old.
• MMR – The measles, mumps and rubella vaccine is given in two doses. The second dose should be given between 4-6 years old.
• Varicella – The second and final dose of the chickenpox vaccine is also recommended when your child is between 4-6 years old.

Recommended childhood vaccines for ages 11 to 12 years old

The immunizations that are recommended at this age (“middle school shots”) are for diseases that teens and young adults are at higher risk for – plus one booster dose to strengthen immunity for three diseases. Your child’s annual wellness visit or back-to-school checkup is the perfect time to get these vaccines.

An overview of immunizations for kids ages 11 to 12 years old

• Tdap – At this age, this immunization is what’s commonly referred to as a “booster shot” because it boosts your child’s tetanus, diphtheria and pertussis immunity. While related to the DTaP vaccine kids receive during childhood, this vaccine is formulated for adolescents and adults. After this shot, the recommended dosing schedule for Tdap boosters is every 10 years.
• MenACWY – The first of two meningococcal vaccine doses is recommended sometime between 11-12 years old. This vaccine protects against the most common types of meningococcal bacteria (often the cause of meningitis) that affect adolescents.
• HPV – While in some cases doctors may recommend the human papillomavirus vaccine as early as age 9, this vaccine is routinely recommended to begin between 11-12 years old. If the initial vaccination is completed before age 14, just two doses are needed. The second dose should be completed 6 to 12 months after the first dose. (If the initial vaccination is completed at age 15 or older, three doses are needed at specific intervals.)

Recommended immunizations for teens ages 16 to 18 years old

Between the ages of 16 and 18, there is one regularly recommended immunization and one immunization that may be recommended under certain circumstances.

An overview of immunizations for teens ages 16 to 18 years old

• MenACWY – The second and final meningococcal vaccine shot is recommended at 16 years old.
• MenB – The meningococcal B vaccine is recommended under specific circumstances, specifically if a college or university requires students to have this vaccination, or if a bacterial meningitis outbreak has occurred. The vaccine is given in two doses between the ages of 16 and 18. Once the first dose is given, the timing of the second dose is dependent on the manufacturer of the vaccine.

When are COVID-19 vaccines recommended for children and teenagers?

Everyone 6 months old and older can get the COVID-19 vaccine, and it’s recommended that all eligible kids and teens get vaccinated. The number of doses your child needs will vary based on their age, vaccination status and type of vaccine that’s used. Talk to your child’s doctor about which COVID-19 vaccine is best for your child.

What should I do if my child is behind on their vaccination schedule?

Don’t worry. There are catch-up recommendations in place. But since each vaccine has its own guidelines, talk with your child’s doctor to make a plan for getting back on schedule. They can talk with you about your child’s medical and immunization history, give you more information on specific vaccines and catch-up guidelines, and discuss any concerns or questions you may have.

Are there any reasons not to vaccinate my child?

Yes. There are times when some children should not get certain vaccines, or they should wait. For example, if:

• Your child has any severe, life-threatening allergies
• They’ve had an allergic reaction after a previous dose of vaccines
• They’re moderately or severely ill

Their doctor may recommend not getting or delaying a specific vaccination.

Questions about when and why to vaccinate your child? Talk with a doctor.

If you have questions, we have answers. We have a team of family medicine doctors and pediatricians who are experts in kids’ health. They can talk with you about specific vaccines, walk you through the vaccination schedule, make recommendations based on your child’s medical and immunization history, and more.

If your child is due for their next round of shots or you need to get them caught up, make an appointment at a HealthPartners or Park Nicollet clinic near you.

For more about childhood vaccine disparities and how building trust and relationships with both patients and parents can help close the gap, listen to the discussion Dr. Andrea Singh had with Dr. Kari Haley and Dr. Steven Jackson on our Off the Charts podcast.