As a new parent, your highest priority is ensuring your baby’s health and safety. Vaccinations are a crucial part of this process, protecting your little one from various serious illnesses. Having a clear understanding of the recommended vaccine schedule can help you make informed decisions about your baby’s health. We’ve compiled a detailed guide to the U.S. vaccine schedule for babies, including which vaccines are most recommended, which are optional, and opinions on a delayed vaccine schedule.
The Recommended Vaccine Schedule – A Lifetime Of Protection
The Centers for Disease Control and Prevention (CDC) has a comprehensive immunization schedule for children in the United States. Here’s a breakdown of the recommended vaccines for babies from birth to 18 months, the diseases they protect against, and why they are essential.
BIRTH
Hepatitis B (HEPB)
Facts: Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). It is a serious disease that can lead to chronic liver damage, liver cancer, and even death. Infants infected with hepatitis B are at high risk of developing chronic hepatitis B, which can lead to long-term health issues or death.
How it is transmitted: The hepatitis B virus (HBV) is spread through contact with infectious body fluids, such as blood and semen, from an infected person and from mother to child during childbirth. Young children can contract this from bites from other toddlers, which can be common in daycare settings.
Vaccine Schedule: Three doses
Birth, 2 months, 6 months
TWO MONTHS
Repeat vaccines: Hep B (2nd dose)
Rotavirus (RV) Oral vaccine
Facts: Rotavirus causes severe diarrhea and vomiting, leading to dehydration, which is especially dangerous in infants and young children. Rotavirus can lead to hospitalization and, in severe cases, death.
How it is transmitted: Rotavirus is spread through contact with contaminated hands, surfaces, and objects. Quickly spreads among babies and toddlers because they frequently put objects in their mouths as a part of normal development.
Vaccine Schedule: Three doses
2, 4 and 6 months
Diphtheria, Tetanus, and Pertussis (DTaP)
Diphtheria
Facts: Diphtheria is caused by the bacterium Corynebacterium diphtheriae. A bacterial infection that causes a thick covering in the back of the throat, leading to breathing problems, paralysis, heart failure, and death.
How it is transmitted: spread through respiratory droplets from coughing or sneezing.
Vaccine Schedule: Four doses
2, 4, 6 and 12 months
Tetanus (Lockjaw):
Facts: Tetanus is a serious, sometimes fatal, disease caused by a toxin released by the bacteria Clostridium tetani. The infection causes painful muscle spasms and stiffness, especially in the jaw. In severe cases, tetanus can lead to breathing problems, broken bones, and even death.
How it is transmitted: The bacteria is found in soil, dust, and animal manure and enters the body through wounds, such as deep cuts, puncture wounds, burns, or even seemingly minor injuries. Tetanus is not spread from person to person; it’s contracted through exposure to the bacteria and its toxin.
Vaccine Schedule: Four doses
2, 4, 6 and 12 months
Pertussis (Whooping Cough):
Facts: Pertussis is an infection caused by the bacterium Bordetella pertussis, which is a highly contagious bacterial infection of the respiratory system. Begins with cold-like symptoms, progressing to prolonged fits of coughing that end in a “whooping” sound as the person gasps for air, vomiting after coughing, redness in the face, fatigue, and fever. Complications include pneumonia, seizures, brain damage, and death.
How it is transmitted: The bacteria are spread through respiratory droplets when an infected person coughs or sneezes. Whooping cough is most common in children under 5 years of age. People with whooping cough are contagious for up to 3 weeks after starting antibiotic treatment.
Vaccine Schedule: Four doses
2, 4, 6 and 12 months
Haemophilus Influenzae Type B (Hib):
Facts: Hib is a severe bacterial infection that occurs mainly in infants and children under 5, including meningitis (infection of the brain and spinal cord coverings), pneumonia, and epiglottitis (severe throat infection). Hib can lead to lifelong disabilities or death if not treated promptly.
How it is transmitted: Caused by the bacterium Haemophilus influenza type b, spread through respiratory droplets. Hib can lead to lifelong disabilities or death if not treated promptly.
Vaccine Schedule: Four doses
2, 4, 6 and 12 months
Polio (IPV)
About Polio: Polio is a viral disease that can attack the brain and spinal cord, causing paralysis and can lead to death. Initial symptoms can include fever, fatigue, headache, vomiting, stiffness of the neck, and pain in the limbs.
How it is transmitted: spread through contact with infected feces or, less commonly, through sneezing or cough droplets. Although polio has been eradicated in most parts of the world, it can still be a threat due to international travel and unvaccinated populations.
Vaccine Schedule: Four doses
2, 4, and 6 months
Pneumococcal Conjugate (PCV13)
Facts: This vaccine protects against 13 strains of Streptococcus pneumoniae bacteria, which can cause serious illnesses like pneumonia and meningitis, and bloodstream infections. Young children are particularly vulnerable to serious illness and death from pneumococcal infections.
How it is transmitted: Pneumococcal bacteria, the cause of pneumococcal disease, spread through direct contact with respiratory secretions like saliva or mucus, often from asymptomatic carriers. People can carry the bacteria in their noses and throats and spread the bacteria without feeling sick.
Vaccine Schedule: Four doses
2, 4, 6 and 12 months
Meningococcal B Vaccine (MenB):
Facts: MenB is a rare but serious bacterial infection that can cause meningitis (inflammation of the brain and spinal cord lining) and septicemia (blood infection). MenB has a high risk of rapid progression and severe outcomes. Babies are at higher risk because their immune systems are not fully developed and they haven’t yet been exposed to the bacteria. Meningococcal disease can be life-threatening, and even with treatment, it can lead to serious complications like hearing loss, brain damage, or limb loss.
How it is transmitted: It is spread by respiratory droplets through close contact with an infected person, such as through sharing saliva, kissing, or using shared utensils.
Vaccine Schedule: Three doses
2, and 4 and 12 months
FOUR MONTHS
Repeat vaccines: Rotavirus, DTap, Hib, Polio, PVC, MenB
SIX MONTHS
Repeat vaccines: Rotavirus, DTap, Hib, Polio, PVC
Influenza (Flu)
Facts: Influenza viruses, which come in different strains, are highly contagious respiratory illnesses and are the primary cause of the flu. In young babies, complications can include pneumonia, bronchitis, respiratory failure, and heart problems.
How it is transmitted: The flu is spread through respiratory droplets released when an infected person coughs, sneezes, or talks. These droplets can be inhaled directly or land on surfaces that can then be touched by others.
Vaccine Schedule: Two initial doses
Six months, then repeat 4 weeks later. One dose is given annually every year following.
COVID19
Facts: COVID-19 most often causes respiratory symptoms that can feel much like a cold, the flu, or pneumonia. Babies under age one might be at higher risk of serious illness with COVID-19 than older children.
How it is transmitted: COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. Other people can breathe in these droplets and particles, or these droplets and particles can land on others’ eyes, nose, or mouth
Vaccine Schedule: Two initial doses
Six months, then repeat 4 weeks later. One dose annually every year following.
TWELVE MONTHS
Repeat vaccines: DTap, Hib, PVC
Measles, Mumps, and Rubella (MMR)
Measles
Facts: Measles is a highly contagious viral infection that causes fever, cough, and a characteristic rash. It can lead to severe complications like pneumonia, encephalitis (brain swelling), and death.
How it is transmitted: Measles is spread through direct contact with respiratory droplets from an infected person or by inhaling airborne virus particles. The virus can remain suspended in the air for up to two hours after an infected person leaves a room. The virus can survive on surfaces for up to several hours. Touching an infected surface and touching your eyes, nose, or mouth can spread the virus.
Vaccine Schedule: Two doses
12 months, 2nd dose between 2-6 years of age
Mumps
Facts: Mumps is a viral infection that causes swelling of the salivary glands and can lead to complications like meningitis, encephalitis, and hearing loss.
How it is transmitted: Mumps is spread through infected droplets of saliva that can be inhaled or picked up from surfaces and transferred into the mouth or nose. A person is most contagious a few days before the symptoms develop and for a few days afterward.
Vaccine Schedule: Two doses
12 months, 2nd dose between 2-6 years of age
Rubella (German Measles)
Facts: Rubella is a viral infection that causes mild symptoms but can lead to serious birth defects if a pregnant woman is infected. It can cause severe complications in pregnant women, known as Congenital Rubella Syndrome (CRS). CRS can lead to birth defects, such as deafness, blindness, heart defects, and intellectual disability, miscarriage, stillbirth.
How it is transmitted: Rubella spreads through direct or droplet contact with respiratory secretions from infected individuals and can also be transmitted from mother to fetus during pregnancy. Infants with CRS may shed the virus for up to a year, posing a risk to susceptible contacts.
Vaccine Schedule: Two doses
12 months, 2nd dose between 2-6 years of age
Varicella (Chickenpox)
Facts: Varicella is a highly contagious disease caused by the varicella-zoster virus (VZV), resulting in an itchy, blister-like rash. It spreads through airborne respiratory droplets and direct contact with the rash or blisters. Complications include bacterial skin infections, pneumonia, encephalitis (brain inflammation), bloodstream infections, bones or joints, and even death.
How it is transmitted: Varicella is transmitted through direct contact with the infected person or their secretions. Inhaling respiratory droplets containing the virus can be released when an infected person coughs, sneezes, or talks. Touching objects contaminated with the virus, such as towels, bedding, or toys.
Vaccine Schedule: Two doses
12 months, 2nd dose between 4-6 years of age
Hepatitis A (HepA)
Facts: Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus (HAV), that causes inflammation of the liver. Symptoms can include fever, fatigue, nausea, abdominal pain, loss of appetite, and jaundice (yellowing of the skin and eyes).
How it is transmitted: The virus is primarily transmitted through the fecal-oral route, meaning it spreads when someone ingests contaminated food or water or through close contact with an infected person. The virus can spread through contact with contaminated surfaces, such as doorknobs, countertops, or toys
Vaccine Schedule: Two doses
12 months, 2nd dose given at 6 months after the first
Opinions on Delaying the Recommended Vaccine Schedule
Some parents are concerned about multiple vaccines being administered at once, fearing it’s too much for a baby’s immune system. The CDC’s recommended vaccine schedule is based on extensive research, and there is limited evidence supporting the safety or efficacy of delayed schedules. When parents spread out the schedule, it takes longer before the child is protected, leaving babies vulnerable to these diseases. The risk of a complication of the disease is always higher than the risk of the vaccine, an important fact that sometimes gets lost in the vaccine discussion. A delayed schedule also requires more visits to the pediatrician’s office, which requires more time off work for parents and more exposure to sick children in the office.
Making the Best Decision for Your Baby
It’s important to discuss any concerns about the recommended vaccine schedule with your pediatrician. They can provide personalized advice based on your baby’s health needs and help you understand the benefits and risks associated with both the recommended and delayed vaccine schedules. If you have specific concerns, prepare a list of questions to ask during the visit.
Vaccinating your baby according to the recommended schedule is one of the most effective ways to protect them from serious illnesses.
