Suggested Pediatric Immunizations

Immunizations have come a long way since the first vaccine was discovered for smallpox by Edward Jenner in 1796. It took a little more than 100 years to pass before Dr. Louis Pasteur was able to prove that disease could be prevented by infecting humans with weakened germs when he used a vaccine to successfully prevent rabies in a boy bitten by a rabid dog. By the mid-20th century, Dr Jonas Salk and Dr. Albert Sabin developed the inactivated polio vaccine and live polio vaccine, respectively. With that and subsequent ones developed, vaccines have prevented the spread of serious childhood infectious diseases, which has saved countless lives and has prevented children from having to live with long-term health issues such as blindness, deafness, loss of limbs, or paralysis that may occur with some of these childhood infections.

Pediatric immunizations are vital to the health of a child. Following is a chart that lists common pediatric immunizations. The chart is formatted in chronological order from birth to 18 years of age and lists the recommended immunization for each age group. It also lists what the immunization protects against and the possible sequelae if the child is not immunized. Last, the chart also provides nursing considerations that include how the bacteria or virus is spread, which is helpful when teaching parents and caregivers preventative measures to keep children healthy, and important information that pertains only to a specific immunization. Monitor all pediatric patients for common reactions that may occur after the immunization has been given. These reactions are usually mild and resolve quickly such as local reactions at the injection site (burning, itching, pain, redness, or swelling) or a mild fever.

Age	Immunization	Protection Against	Dangers Of Not Being Vaccinated	Nursing Considerations
Birth	RSV antibody (Respiratory syncytial virus)	Contagious viral infection of the nose, throat, and sometimes lung	RSV infection is especially dangerous in infants and young children. Can cause severe inflammation of the airways and lungs possibly requiring hospitalization and mechanical ventilation	Spread through air and direct contact Depends on mother's RSV vaccine status: CDC recommends a single dose of RSV vaccine for pregnant women during wk 32 to wk 36 of pregnancy to prevent RSV in infants less than 6 mo. If mother did not receive RSV vaccination during pregnancy, infant may receive preventive antibodies in the form of the vaccine.
	HepB (Hepatitis B vaccine)—first dose	Contagious viral infection of the liver	Can cause chronic liver infection, liver failure, or liver cancer and possibly death	Spread through contact with infected body fluids Given within 12 to 24 hr of birth Low-birth-weight infants given at 1 mo or when discharged from hospital If child never received immunization, first dose of HepB can be given at any age.
1–2 mo	HepB (Hepatitis B vaccine)—2nd dose	See HepB above	See HepB above	Second dose should be given 1 to 2 mo after the first dose.
2 mo	DTaP (Diphtheria, tetanus, and acellular pertussis vaccine)—1st dose	Contagious bacterial infection of the nose, throat, and sometimes lungs (diphtheria), lungs and airway (pertussis), and brain and nerves possibly causing lockjaw (tetanus)	Diphtheria may cause swelling of the heart muscle, heart failure, coma, paralysis, and death. Tetanus may cause seizures, broken bones, difficulty breathing, and death. Pertussis may cause infection of the lungs and is especially dangerous for infants.	Diphtheria and pertussis spread through air and direct contact. Tetanus spreads through spores found in soil and dust everywhere that enter body through broken skin.
	Hib (Haemophilus influenzae type b vaccine)	Contagious bacterial infection of the brain, lungs, spinal cord, or bloodstream	Depends on body part infected but may cause brain damage, hearing loss, loss of extremity, or death	Spread through air and direct contact
	IPV (Inactivated poliovirus vaccine)	Contagious viral infection of nerves and brain	Causes paralysis and possibly death	Spread through the mouth from stool on contaminated hands, food, or liquid, and by air and direct contact
	PCV (Pneumococcal conjugate vaccine)	Bacterial infection of ears, sinuses, lungs, and blood stream	Depends on body part infected but may cause lung infection, septicemia, infection of the lining of the brain and spinal cord, and possibly death	Spread through direct contact with respiratory droplets like saliva or mucus Can be given to older children ages 2 and older who have immune deficiency disorders such as asplenia or HIV infections or other conditions such as chronic heart or lung disease or who has a cochlear implant
	RV (Rotavirus vaccine)	Contagious viral infection of the intestines	Causes severe diarrhea and dehydration and possibly death	Spread through the mouth from hands and food contaminated with stool
4 mo	DTaP—2nd dose	See DTaP above	See above	See above
	Hib—2nd dose	See Hib above	See Hib above	See Hib above
	IPV—2nd dose	See IPV above	See IPV above	See IPV above
	PCV—2nd dose	See PCV above	See PCV above	See PCV above
	RV—2nd dose	See RV above	See RV above	See RV above
6 mo	DTaP—3rd dose	See DTaP above	See DTaP above	See DTaP above
	Hib—Possible 3rd dose	See Hib above	See Hib above	3rd dose may be needed based on brand of vaccine given in previous Hib immunizations.
	PCV—3rd dose	See PCV above	See PCV above	See PCV above
	RV—Possible 3rd dose	See RV above	See RV above	3rd dose may be needed based on brand of vaccine given in previous RV immunizations.
	Influenza (Flu vaccine)	Contagious viral infection of the nose, throat, and sometimes lungs	May cause infection of the lungs, sinus and ear infections, worsening of underlying heart or lung conditions, and possibly death	Spread through air and direct contact Recommended every year for children 6 mo and older Children younger than 9 yr receiving flu vaccine for the first time or given only 1 dose before July 2023 will require 2 separate doses at least a month apart.
				Children younger than 9 yr receiving flu vaccine and have had at least 2 doses of flu vaccine before July 2023 will require only 1 dose. Given by injection or nasal spray. Nasal spray is only for healthy children and should NOT be given for children with weak immune systems or presence of chronic health conditions such as asthma, heart problems, diabetes, HIV, or sickle cell disease.
6 mo–18 yr	COVID-19 vaccine	Contagious viral infection of the nose, throat, or lungs that may feel like a cold or flu	May cause lung infection; blood clots; liver, heart, or kidney damage; long-term COVID-19; and possibly death	Spread through air and direct contact Recommendations varies with manufacturer but first dose recommended to be initiated at 6 mo of age Number of doses dependent on if either unvaccinated or have had received previous doses of a particular manufacturer The updated 2023–2024 COVID-19 vaccine protects against the most common variants.
6–18 mo	HepB	See HepB above	See HepB above	See HepB above
	IPV	See IPV above	See IPV above	See IPV above
12–15 mo	Hib	See Hib above	See Hib above	See Hib above
	MMR (Measles, mumps, rubella) vaccine	Contagious viral infection that causes high fever, cough, red eyes, runny nose and rash (measles and rubella), and fever, tiredness, swollen cheeks, and tender swollen jaw (mumps)	Measles may cause brain swelling, infection of the lungs, and possibly death	Spread through air and direct contact Sometimes given together with varicella and is called MMRV
			Rubella (German measles) is very dangerous in pregnancy as it can cause miscarriage or still birth, premature delivery, and severe birth defects. Mumps can cause brain swelling, painful and swollen testicles or ovaries, deafness, and possibly death.	May be given to infants as young as 6 mo if they will be traveling internationally. A second dose may be given as soon as 4 wk after the first dose if they are still traveling and are at risk. However, they should still be revaccinated at 12–15 mo and 4–6 yr of age.
	PCV	See PCV above	See PCV above	See PCV above
	Varicella (chickenpox) vaccine	Contagious viral infection that causes fever, headache, and an itchy, blistering rash	May cause infected sores, brain swelling, lung infection, and possibly death	Spread through air and direct contact
12–23 mo	HepA (Hepatitis A vaccine)	Contagious viral infection of the liver	May cause liver failure and possibly death	Spread through contaminated food or drink or close contact with an infected person Given as 2 injections at least 6 mo apart May be given as early as 6 mo to infants who will be in a place where hepatitis A is common. However, the child will still need to be revaccinated after their first birthday.
15–18 mo	DTaP	See DTaP above	See DTaP above	See DTaP above
4–6 yr	DTaP	See DTaP above	See DTaP above	See DTaP above
	MMR	See MMR above	See MMR above	See MMR above
	IPV	See IPV above	See IPV above	See IPV above
	Varicella	See Varicella above	See Varicella above	See Varicella above
9–16 yr	Dengue vaccine	Contagious viral infection	Most cases are mild and are resolved in about a week on their own. Severe cases can cause serious bleeding, shock, and possible death.	Spreads from mosquitoes to people Given in 3 doses to children who already had dengue fever and live in areas where it is common (American Samoa, Puerto Rico, U.S. Virgin Islands)
11–12 yr	HPV (Human papillomavirus) vaccine	Contagious viral infection	Can cause some types of cancer Causes genital warts	Spread most commonly during anal or vaginal sex. It may also spread through close skin-to-skin touching during sex. Given as 2 injections over a 6- to 12-mo period Can be given as early as age 9 For teens and young adults ages 15 to 26, given as 3 injections over 6 mo
	TDaP (Tetanus, diphtheria, and pertussis booster)	See TDaP above	See TDaP above	See TDaP for how disease is spread. Tetanus, diptheria, and pertussis booster
	MenACWY (Meningococcal vaccine for types A, C, W, and Y)	Contagious bacteria infection of meningococcal bacteria types A, C, W, and Y	Causes infection of the brain and spinal cord as well as blood infections May result in permanent disability (deafness, brain damage, loss of limbs, or seizures) and possibly death	Spread through throat and respiratory secretions from coughing or coming into close or lengthy contact with a person who carries the bacteria by kissing, sharing drinks, or living together with the infected person A booster dose is recommended at age 16. Recommended for all children May be given as early as 8 wk old (depending on vaccine brand) in infants and young children who are at risk for a meningococcal infection such as presence of some immune disorders, live or travel to countries where meningitis is common, or during an outbreak
16–18 yr	MenB (Meningococcal vaccine for type B)	Contagious bacteria infection of the meningococcal bacterium type B	May cause infection of the membrane of the brain and spinal cord as well as septicemia	Spread through throat and respiratory secretions from couging or coming into close or lengthy contact with a person who carries the bacteria by kissing, sharing drinks, or living together with the infected person Given to children and teens in 2 to 3 doses depending on the brand Only recommended as routine for children ages 10 and older who have conditions that weaken the immune system, or during an outbreak

Data from Centers for Disease Control and Prevention. (2024). Child and adolescent immunization schedule by age, United States, 2024. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html;

Data from Centers for Disease Control and Prevention. (2024). What diseases do these vaccines protect against? Retrieved from https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html;

Data from Centers for Disease Control and Prevention. (2024). What disease do these vaccines protect against? Retrieved from https://www.cdc.gov

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