Your Child’s Immunization Timeline

Your child needs to stay up-to-date on a number of different immunizations throughout their childhood. And while your child’s health-care provider will keep track of their immunization records, it’s a good idea for you to keep track, too. Childhood vaccines are a safe and important step in protecting your child (and the community) from preventable illnesses that can be very serious. Here’s what you should know about each of your child’s recommended vaccines, as well as how many doses of each they’ll need at various points of their childhood.

Why Does My Child Need Vaccines?

Ensuring that your child stays on a schedule of routine vaccines from birth through 6 years of age covers children for 14(!) potentially life-threatening diseases. Missing these critical vaccines can put a child at life-long risk of contracting serious illnesses such as whooping cough, measles, polio, hepatitis, and others. Vaccines also work to strengthen your child’s immune system by safely developing their body's protection against these diseases.

Are Vaccines Required for My Child to Attend School?

Yes. Children must have all required immunizations within the first five days of the school year. Unless excused for medical reasons, religious beliefs, or strong philosophical/moral or ethical convictions, Pennsylvania law requires the immunizations outlined below. If you aren't sure whether your child's immunizations are up to date, or have specific questions about a vaccine, check with your child’s provider.

Here’s a handy list that can help you to follow and understand your children’s recommend vaccines, from birth through adulthood. Unless otherwise indicated, all are given as injections.

Hepatitis B (Hep B)

The Hep B vaccine protects your child from this liver disease that can cause mild sickness lasting a few weeks, all the way to serious lifelong illness.

• Birth: 1st Dose
• 1-2 months: 2nd dose
• 6-18 months: 3rd dose

Rotavirus

Rotavirus spreads quickly among children, with infection leading to severe diarrhea, vomiting, and dehydration. This vaccine is given through a series of 2 or 3 oral drops, depending on the brand of vaccine used.

• 2 months: 1st dose
• 4 months: 2nd dose
• 6 months: 3rd dose (depending on vaccine used)

Diphtheria, Tetanus & Pertussis (DTaP/Tdap)

This vaccine offers protection against three separate viruses. Diphtheria is an infection spread by the transfer of bacteria person to person, and can cause difficulty breathing, swelling of the heart muscle, and paralysis. Tetanus, or “lock jaw,” is an infection that enters the body through broken skin and can cause painful stiffening of the muscles. Pertussis, or whooping cough, is a contagious respiratory disease that can cause violent coughing, and lead to pneumonia, convulsions and possible brain damage.

Children under the age of 7 receive the vaccine known as DTaP:

• 2 months: 1st dose
• 4 months: 2nd dose
• 6 months: 3rd dose
• 15-18 months: 4th dose
• 4-6 years: 5th dose

Children over the age of 7 receive a different formulation of this vaccine, known as Tdap:

• 11-12 years: 1st Dose

Haemophilus Influenza Type B (Hib)

Prior to the creation of this vaccine, Hib disease was the leading cause of bacterial meningitis, an infection of the lining covering the brain and spinal cord, among young children.

• 2 months: 1st dose
• 4 months: 2nd dose
• 6 months: 3rd dose (depending on brand)
• 15-18 months: 3rd or 4th dose (depending on brand)

Pneumococcal Conjugate (PCV13)

Pneumococcal disease refers to any illness caused by the bacteria pneumococcus, which can range from mild infections in the sinus and ears, to serious infections such as pneumonia, meningitis and even blood infections.

• 2 months: 1st dose
• 4 months: 2nd dose
• 6 months: 3rd dose
• 12-15 months: 4th dose (depending on brand)

Inactivated Poliovirus (IPV)

The IPV vaccine protects against polio, a contagious virus spread through sneezing, coughing, or the stool of an infected person. Polio can cause flu-like symptoms, the whole way to severe lifelong weakness or paralysis if infection occurs. 

• 2 months: 1st dose
• 4 months: 2nd dose
• 6-18 months: 3rd dose
• 4-6 years: 4th dose

Measles, Mumps, Rubella, Varicella (MMRV)

This combination vaccine protects against four different diseases. Measles can cause fever and a cough, followed by a rash that covers the whole body. It can potentially lead to seizures, diarrhea and pneumonia. Mumps can lead to deafness, brain swelling, and swelling of the testicles or ovaries. Rubella can cause arthritis in up to half of teenage and adult women. Varicella, or chickenpox, causes an itchy rash that can lead to shingles years later.

• 12-15 months: 1st dose
• 4-6 years: 2nd dose

Hepatitis A

This contagious liver infection can range from a mild illness lasting a few weeks, to a severe months-long illness. Hepatitis A spreads through close personal contact with an infected person. 

• 12-24 months: 1st and 2nd doses, 6 months apart

Meningococcal ACWY

This vaccine protects against meningococcal disease that can cause meningitis and blood infections. While meningococcal disease is rare and instances have declined in the United States, even when treated this disease can lead to severe disabilities or even mortality.

• 11-12 years: 1st dose
• 16 years: 2nd dose

Human Papillomavirus (HPV)

While not mandatory for school attendance in Pennsylvania, this vaccine is routinely recommended for children as they enter their teenage years, as well as those under the age of 26 years old. HPV is spread through sexual contact, and is associated with cervical pre-cancers in women.

• 11-12 years: 2 or 3 dose series depending on age at first vaccination

Meningococcal ACWY and Meningococcal B

These vaccines protect against meningococcal disease that can cause meningitis and blood infections. While meningococcal disease is rare and instances have declined in the United States, even when treated this disease can lead to severe disabilities or even mortality.

• 11-12 years: 1st dose of ACWY vaccine
• 16 years: 2nd dose of ACWY vaccine, 1st dose of B vaccine (with 2nd and final dose in 1 or more months)

Influenza

Although not required under Pennsylvania law, it is recommended that children 6 months of age and older also get an annual flu shot. Influenza is responsible for hundreds of pediatric hospitalizations and more than 100 deaths each year. The first time your child is vaccinated against the flu, they will receive two vaccinations one month apart. Following the first vaccine, your child may receive the flu shot yearly to provide the greatest immunity.

COVID-19

The Centers for Disease Control recommends COVID-19 vaccination for everyone 6 months of age and older to help protect against COVID-19, though it is not required for school attendance. Even if you’ve already had COVID-19, getting a vaccine after recovery provides added protection against the infection. Here’s how to schedule your child’s COVID-19 vaccine with a Penn Medicine Lancaster General Health provider.  

If you have any questions or concerns about the vaccines recommended for your child, it’s important to contact your child’s provider. They will be able to address any concerns you may have, and can assess any reasons to delay or modify your child’s vaccine schedule based on their health history. Staying up-to-date on your child’s immunizations is one of the most important things you can do for their own health, as well as those around them.