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Vaccine Information
for Children

Birth – 6 Years

At a glance

Most parents choose to vaccinate their children according to the recommended schedule, but many parents may still have questions about the vaccines recommended for their child.

Vaccine Safety

Are vaccines safe?

Yes. Vaccines are very safe. The United States’ long-standing vaccine safety system ensures that vaccines are as safe as possible. Currently, the United States has the safest vaccine supply in its history. Millions of children safely receive vaccines each year. The most common side effects are very mild, such as pain or swelling at the injection site.

What are the risks and benefits of vaccines?

Vaccines can prevent infectious diseases that once killed or harmed many infants, children, and adults. Without vaccines, your child is at risk for getting seriously ill and suffering pain, disability, and even death from diseases like measles and whooping cough.

The main risks associated with getting vaccines are side effects, which are almost always mild (redness and swelling at the injection site) and go away within a few days. Serious side effects after vaccination, such as a severe allergic reaction, are very rare and doctors and clinic staff are trained to deal with them.

The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children. The only exceptions to this are cases in which a child has a serious chronic medical condition like cancer or a disease that weakens the immune system, or has had a severe allergic reaction to a previous vaccine dose.

Is there a link between autism and vaccines?

No. Scientific studies and reviews continue to show no relationship between vaccines and autism.

Side Effects

What are common side effects of vaccines?

Vaccines, like any medication, may cause some side effects. Most of these side effects are very minor, like soreness where the shot was given, fussiness, or a low-grade fever. These side effects typically only last a couple of days and are treatable. For example, you can apply a cool, wet washcloth on the sore area to ease discomfort.

Can vaccines overload my baby's immune system?

No, Vaccines do not overload the immune system. Every day, a healthy baby’s immune system successfully fights off thousands of germs. Antigens are parts of germs that cause the body’s immune system to go to work to build antibodies, which fight off diseases.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Even if babies receive several vaccinations in one day, vaccines contain only a tiny fraction of the antigens they encounter every day in their environment. Vaccines give your child the antibodies they need to fight off serious vaccine-preventable diseases.

Why do vaccines start so early?

The recommended schedule protects infants and children by providing protection early in life, before they come into contact with life-threatening diseases. Children receive vaccinations early because they are susceptible to diseases at a young age.

Should my child get shots if she is sick?

Talk with your child’s doctor, but children can usually get vaccinated even if they have a mild illness like a cold, earache, mild fever, or diarrhea. If the doctor says it is okay, your child can still get vaccinated.

Should I delay some vaccines or follow a non-standard schedule?

Children do not receive any known benefits from following schedules that delay vaccines. Infants and young children who follow immunization schedules that spread out or leave out shots are at risk of developing diseases during the time you delay their shots.

Why can't I delay some vaccines if I'm planning to get them all eventually?

Young children have the highest risk of having a serious case of disease that could cause hospitalization or death. Delaying or spreading out vaccine doses leaves your child unprotected during the time when they need vaccine protection the most. For example, diseases such as Hib or pneumococcus almost always occur in the first 2 years of a baby’s life. And some diseases, like hepatitis B and whooping cough (pertussis), are more serious when babies get them.

If I'm breastfeeding, do I vaccinate my baby on schedule?

Yes, even breastfed babies need to be protected with vaccines at the recommended ages. The immune system is not fully developed at birth, which puts newborns at greater risk for infections.

Breast milk provides important protection from some infections as your baby’s immune system is developing. For example, babies who are breastfed have a lower risk of ear infections, respiratory tract infections, and diarrhea. However, breast milk does not protect children against all diseases. Even in breastfed infants, vaccines are the most effective way to prevent many diseases. Your baby needs the long-term protection that can only come from following CDC’s recommended schedule.

Can I wait to vaccinate my baby since he isn't in child care?

No, even young children who are cared for at home can be exposed to vaccine preventable diseases, so it’s important for them to get all their vaccines at the recommended ages. Children can catch these illnesses from any number of people or places, including from parents, brothers or sisters, visitors to their home, on playgrounds or even at the grocery store. Regardless of whether your baby is cared for outside the home, your baby comes in contact with people throughout the day, some of whom may have a vaccine-preventable disease.

Many of these diseases can be especially dangerous to young children, so it is safest to vaccinate your child at the recommended ages.

Can I wait until my child goes to school to catch up on immunizations?

No, Before entering school, young children can be exposed to vaccine-preventable diseases. Children under age 5 are especially susceptible to diseases because their immune systems have not built up the necessary defenses to fight infection.

Why do adolescents need vaccines?

Vaccines are recommended throughout our lives to protect against serious diseases. As protection from childhood vaccines wears off, adolescents need vaccines that will extend protection. Adolescents need protection from additional infections as well, before the risk of exposure increases.

Why are multiple doses needed for each vaccine?

Getting every recommended dose of each vaccine provides your child with the best protection possible. Depending on the vaccine, your child will need more than one dose to build high enough immunity to help prevent disease or to boost immunity that fades over time. Your child may also receive more than one dose to make sure they are protected if they did not get immunity from a first dose, or to protect them against germs that change over time, like flu. Every dose is important because each protects against an infectious disease that can be especially serious for infants and very young children.

Schedule for Vaccines

Vaccination schedule

The Centers for Disease Control and Prevention (CDC) sets a recommended vaccine schedule for both children and adults, which is shown in the table below.

If you didn’t receive some of your childhood vaccines, it’s still possible to get them as an adult. However, depending on the vaccine, the dosing schedule may be different. You can ask your doctor what to expect.

Key

ALL children should be immunized at this age.

SOME children should get this dose of vaccine or preventive antibody at this age

Vaccine or Preventive Antibody	Birth	1 Month	2 Months	4 Months	6 Months	7 Months	8 Months	12 Months	15 Months	18 Months	19 Months	20–23 Months	2-3 Years	4-6 Years
RSV antibody	Depends on mother’s RSV vaccine status						Depends on child’s health status
Hepatitis B	Dose 1	Dose 2			Dose 3
Rotavirus			Dose 1	Dose 2	Dose 3
DTaP			Dose 1	Dose 2	Dose 3				Dose 4					Dose 5
Hib			Dose 1	Dose 2	Dose 3			Dose 4
Pneumococcal			Dose 1	Dose 2	Dose 3			Dose 4
Polio			Dose 1	Dose 2	Dose 3									Dose 4
COVID-19					At least 1 dose of the current COVID-19 vaccine
Influenza/Flu					Every year. Two doses for some children
MMR								Dose 1						Dose 2
Chickenpox								Dose 1						Dose 2
Hepatitis A								2 doses separated by 6 months

Many vaccines are given in a group or series. It may seem like your child is getting a lot of vaccines all at once.
But according to the CDC, there’s no data that supports spacing out childhood vaccines. In fact, delaying a child’s vaccinations can do more harm than good, leaving them vulnerable to pathogens that can cause serious illness or complications.

Protection from Diseases

Do infants have natural immunity?

Babies may get some temporary protection from mom during the last few weeks of pregnancy, but only for diseases to which mom is immune. Breastfeeding may also protect your baby temporarily from minor infections, like colds. These antibodies do not last long, leaving your baby vulnerable to disease.

Haven't we gotten rid of most of these diseases in this country?

Some vaccine-preventable diseases, like pertussis (whooping cough) and chickenpox, remain common in the United States. On the other hand, other diseases vaccines prevent are no longer common in this country because of vaccines. If we stopped vaccinating, the few cases we have in the United States could very quickly become tens or hundreds of thousands of cases. Even though many serious vaccine-preventable diseases are uncommon in the United States, some are common in other parts of the world. Even if your family does not travel internationally, you could come into contact with international travelers anywhere in your community. Children who don’t receive all vaccinations and are exposed to a disease can become seriously sick and spread it through a community.

Combination Vaccines

What to know?

Combination vaccines reduce the number of shots your child needs while protecting against the same number of serious diseases.

Fewer shots, but same protection

Combination vaccines take two or more vaccines that could be given individually and put them into one shot.

At a doctor's visit, your child may only get two or three shots to protect him from five diseases, instead of five individual shots.

Several vaccines are so common that they are generally known by their initials: MMR (measles, mumps, and rubella) and DTaP (diphtheria, tetanus, and pertussis). Each protect your child against three diseases. However, today these two particular vaccines are not considered true combination vaccines because in the United States, you cannot get separate vaccines for all of the diseases that MMR and DTaP protect against.

Common combination vaccines for children

Vaccine Name	Combination and Protection From
Pediarix	DTaP + Hep B + IPV Diphtheria, tetanus, pertussis, hepatitis B, and polio
Pentacel	DTaP + IPV + Hib Diphtheria, tetanus, pertussis, polio, and Hib (Haemophilus influenzae type b)
Kinrix Quadracel	DTaP + IPV Diphtheria, tetanus, pertussis, and polio
Vaxelis	DTaP + IPV +Hib +HepB Diphtheria, tetanus, pertussis, polio, hepatitis B, and Hib (Haemophilus influenzae type b)
ProQuad	MMR + varicella Measles, mumps, rubella, and varicella

Did you know?‎
Combination vaccines have been in use in the United States since the mid-1940s.

Benefits of combination vaccines

Combining vaccines into fewer shots may mean that more children will get recommended vaccinations on time. And that means fewer delays in disease protection.

Benefits for Children Benefits for Parents

Fewer shots Fewer visits to doctor

Less pain and discomfort Less hassle and cost with fewer visits

On-time protection Less time off from work or family activity

Safety and effectiveness

Before a combination vaccine is approved for use, it goes through careful testing to make sure the combination vaccine is as safe and effective as each of the individual vaccines given separately. And, just as with individual vaccines, there are systems in place to watch for any rare reactions to combination vaccines that can be detected only after the vaccine is used widely.

Side effects

Side effects from combination vaccines are usually mild. They are similar to those of the individual vaccines given separately.

Sometimes combination vaccines cause slightly more pain or swelling where the shot was given. But if your child got the shots individually, he or she might have pain or swelling in two or three spots, instead of just one.

If your child has moderate or serious side effects from a combination vaccine, tell your child's doctor. If the separate vaccines are available, the doctor may be able to give additional doses of certain vaccines separately.
Side effects from combination vaccines are usually mild.

Growing future for combination vaccines

As scientists develop and test new vaccines to protect children against more diseases, more combination vaccines may become available. This will allow children to get additional protection with fewer shots.

Recommendations for the MMRV vaccine‎

The MMRV vaccine combines the MMR (for measles, mumps, and rubella) vaccine with the chickenpox vaccine.

Some children who get the first MMRV shot at 12 through 23 months of age may have a higher chance of a seizure caused by fever after the shot. But this is not common.

These "febrile" seizures are scary for parents, but they are not harmful to children. Because of this slightly higher risk of seizures, the Centers for Disease Control and Prevention recommend that children under 4 years old get the first dose of MMR and chickenpox vaccines separately.

What diseases do these vaccines protect against?

Vaccine-Preventable Disease	Disease Complications
RSV (Respiratory syncytial virus) Contagious viral infection of the nose, throat, and sometimes lungs; spread through air and direct contact	Infection of the lungs (pneumonia) and small airways of the lungs; especially dangerous for infants and young children
Hepatitis B Contagious viral infection of the liver; spread through contact with infected body fluids such as blood or semen	Chronic liver infection, liver failure, liver cancer, death
Rotavirus Contagious viral infection of the gut; spread through the mouth from hands and food contaminated with stool	Severe diarrhea, dehydration, death
Diphtheria * Contagious bacterial infection of the nose, throat, and sometimes lungs; spread through air and direct contact	Swelling of the heart muscle, heart failure, coma, paralysis, death
Pertussis (Whooping Cough) * Contagious bacterial infection of the lungs and airway; spread through air and direct contact	nfection of the lungs (pneumonia), death; especially dangerous for babies
Tetanus (Lockjaw) * Bacterial infection of brain and nerves caused by spores found in soil and dust everywhere; spores enter the body through wounds or broken skin	Seizures, broken bones, difficulty breathing, death
Hib (Haemophilus influenzae type b) Contagious bacterial infection of the lungs, brain and spinal cord, or bloodstream; spread through air and direct contact	Depends on the part of the body infected, but can include brain damage, hearing loss, loss of arm or leg, death
Pneumococcal Bacterial infections of ears, sinuses, lungs, or bloodstream; spread through direct contact with respiratory droplets like saliva or mucus	Depends on the part of the body infected, but can include infection of the lungs (pneumonia), blood poisoning, infection of the lining of the brain and spinal cord, death
Polio Contagious viral infection of nerves and brain; spread through the mouth from stool on contaminated hands, food or liquid, and by air and direct contact	Paralysis, death
COVID-19 Contagious viral infection of the nose, throat, or lungs; may feel like a cold or flu. Spread through air and direct contact	Infection of the lungs (pneumonia); blood clots; liver, heart or kidney damage; long COVID; death
Influenza (Flu) Contagious viral infection of the nose, throat, and sometimes lungs; spread through air and direct contact	Infection of the lungs (pneumonia), sinus and ear infections, worsening of underlying heart or lung conditions, death
Measles (Rubeola) † Contagious viral infection that causes high fever, cough, red eyes, runny nose, and rash; spread through air and direct contact	Brain swelling, infection of the lungs (pneumonia), death
Mumps † Contagious viral infection that causes fever, tiredness, swollen cheeks, and tender swollen jaw; spread through air and direct contact	Brain swelling, painful and swollen testicles or ovaries, deafness, death
Rubella (German Measles) † Contagious viral infection that causes low-grade fever, sore throat, and rash; spread through air and direct contact	Very dangerous in pregnant women; can cause miscarriage or stillbirth, premature delivery, severe birth defects
Chickenpox (Varicella) Contagious viral infection that causes fever, headache, and an itchy, blistering rash; spread through air and direct contact	Infected sores, brain swelling, infection of the lungs (pneumonia), death
Hepatitis A Contagious viral infection of the liver; spread by contaminated food or drink or close contact with an infected person	Liver failure, death

*DTaP protects against tetanus, diphtheria, and pertussis
†MMR protects against measles, mumps, and rubella

This easy-to-read schedule is recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), and American Academy of Family Physicians (AAFP).