By: Edith Bracho-Sánchez, MD, FAAP
Have you ever wondered why babies get vaccines starting from the day they're born? One big reason: the youngest of us need the protection the most. It's also the time in your child's development that their immune system works best with the vaccine.
Childhood vaccination is essential because it helps provide immunity before kids are exposed to potentially life-threatening diseases. Of all the age groups, babies are more often hospitalized, and sometimes die, from the diseases we can prevent with vaccines. That's why most of the childhood vaccines are recommended during your baby's first 12 to 18 months of life.
Did you know? By the time a child is old enough to start school, they will be protected from 14 diseases! From birth to age 6, infants and children get vaccines to protect them from hepatitis A and hepatitis B, rotavirus, diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, polio, pneumococcal disease, measles, mumps, rubella, varicella and influenza.
Immunization schedule for babies & young kids
The Centers for Disease Control and Prevention, the American Academy of Pediatrics and other medical groups, have all agreed on a schedule for immunizations for kids. This
recommended schedule is based on research showing us the best timing for each vaccine dose.
Your pediatrician keeps track of your child's vaccines. They make sure your child is protected at the right time.
Baby's first vaccine
Hepatitis B is the first vaccine most babies receive. It is given within 24 hours of birth. Your baby will get a second dose of hepatitis B vaccine when they are 1 month to 2 months old and the third dose when they are 6 months to 18 months old.
Why do we give the first dose so quickly? More than 1 million people in the U.S. have long-term hepatitis B infections. And people who are infected with hepatitis B as a baby have a 90% chance of developing serious, chronic conditions like liver cancer in their lifetime. And because people may not know they are infected, they may spread the virus if they come in close contact with your baby. The vaccine is a safe, very effective way to eliminate that risk right away by protecting babies from infection.
2 months old
The first doses of the vaccines given at two months of age protect babies from 7 diseases. Their names may look like a jumble of alphabet letters. But the letters stand for the diseases that used to cause serious infections in children.
Diphtheria, tetanus and acellular pertussis (DTaP) vaccine
Children get 5 doses of DTaP vaccine. The vaccine prevents serious illness from three diseases:
Diphtheria: A serious throat infection that can cause breathing problems and heart failure. Before the vaccine, diphtheria killed one-fifth of the kids who got infected.
Tetanus: A deadly bacteria that lives in the soil and is found everywhere in the earth. It can get into your body through a rusty nail or any kind of cut on your skin. If the germ gets in, it produces a deadly toxin that causes muscle paralysis.
Pertussis: Also called "whooping cough," it causes violent coughing fits that make it hard to breathe. Babies with pertussis may need hospital care and are at risk of death. Often, pertussis is spread to the baby by an adult who has not had the Tdap vaccine.
Haemophilus influenzae type B (Hib) vaccine (4 doses) prevents several types of illness, including ear infections, pneumonia and meningitis. Infections can be life threatening. If babies have not been vaccinated and have symptoms, they may need a spinal tap to test for the bacteria.
Polio vaccine (4 doses) prevents a disease that causes death and paralysis. The polio virus is still circulating outside the United States, and unvaccinated children are at risk.
Pneumococcal vaccine (4 doses) prevents disease caused by bacteria called
Streptococcus pneumoniae. When these bacteria invade the lungs, they cause pneumonia. When they invade the bloodstream, they can cause an overwhelming infection called sepsis. When they invade the brain, they cause meningitis. They can also cause ear infections—which most parents know can be painful and frequent. Since we have had this vaccine, the number of kids suffering all of these illnesses has dropped dramatically.
Rotavirus vaccine (2 or 3 doses) stops the main cause of diarrhea in children. This virus spreads very easily—on your hands, dirty diapers or toys, and through the air. Rotavirus infections cause severe, watery diarrhea, vomiting, fever and abdominal pain. Sometimes the virus causes children to become so dehydrated that they need hospital care.
6 months old
flu vaccine is recommended for everyone starting at 6 months of age. The first time your child gets the flu vaccine, they will also need a second dose 4 weeks later. Even healthy kids can develop severe complications that send them to the hospital. Flu viruses change from year to year, so everyone needs to get a flu shot each year. Annual flu shots keep children from severe disease.
12 to 18 months old
At your child's first birthday
checkup (or soon after), they will get shots that protect them from 5 more diseases. They also may get second, third or fourth doses of the vaccines they started during the first year.
Measles-mumps-rubella (MMR) vaccine
Children get 2 doses of MMR vaccine. Most people who are vaccinated with MMR will be protected for life. The vaccine prevents serious illness from three diseases:
Measles can cause fever, cough, runny nose, and red, watery eyes, commonly followed by a rash that covers the whole body. It can lead to seizures (often associated with fever), ear infections, diarrhea, and pneumonia. Rarely, measles can cause brain damage or death.
Mumps can cause fever, headache, muscle aches, tiredness, loss of appetite and swollen and tender salivary glands under the ears. It can lead to deafness, swelling of the brain and/or spinal cord covering, painful swelling of the testicles or ovaries and, very rarely, death.
Rubella can cause fever, sore throat, rash, headache and eye irritation. It can cause arthritis in up to half of teenage and adult women. A pregnant person who gets rubella could have a miscarriage or the baby could be born with serious birth defects.
Varicella vaccine (2 doses) prevents "chickenpox," which used to infect 4 million people in the United States every year. More than 10,000 were hospitalized, and more than 100 died. A mild case can cause a child to miss school for a week or more.
Hepatitis A vaccine (2 doses) gives lifelong protection from a serious liver disease. The disease can spread through food or by contact with an infected person—even someone who doesn't show any symptoms.
Fun fact: Vaccines protect babies before birth!
It's true. Babies get antibodies during pregnancy from some vaccines their mothers have had. For example, the baby is protected for a short time after they are born if their mother has had the measles vaccine.
However, this protection moms give their babies during pregnancy starts to wear off at around 1 year of age. That's why, when they are 12 months to 18 months old, babies get a shot to keep them protected from measles and two other diseases (the MMR vaccine). Then, a second dose of MMR vaccine is recommended when kids are 4 years old. The second dose acts like a reminder for your child's immune system. Research shows the MMR vaccine is incredibly effective when given at these ages.
We know from decades of research, in millions of children, that the vaccines work best at these ages, and with this spacing between doses. And we know they are safe when given on this schedule.
The immunization schedule helps children develop life-long immunity and protect them and others from serious diseases. Finally, if you have questions, talk with your pediatrician. We are here to partner with you to help your child stay healthy—and thrive.
About Dr. Bracho-Sánchez
Edith Bracho-Sánchez, MD, FAAP, is a primary care pediatrician and the director of the pediatric telemedicine program at Columbia University Irving Medical Center. She was born and raised in Caracas, Venezuela, obtained her medical degree from New York University and trained in pediatrics at The Children’s Hospital of Philadelphia. She lives in New York City with her husband and son. Follow her on Twitter