What is the childhood vaccine schedule? A look at immunizations by age

WASHINGTON - Starting at birth, U.S. children are recommended to get vaccinations to protect against diseases on a schedule set by the U.S. Centers for Disease Control and Prevention. 

The immunization schedule protects against 14 potentially serious diseases before a child’s second birthday, based on how their immune system responds to vaccines at various ages, and how likely a baby is to be exposed to a particular disease. 

Who sets the vaccination schedule?

The CDC publishes written recommendations for vaccinating U.S. children and adults to protect against vaccine-preventable diseases.

Dig deeper:

Medical and public health experts review available data on newly-licensed and existing vaccines. The vaccine experts, as well as scientists, doctors, and public health professionals, form what’s called the Advisory Committee on Immunization Practices (ACIP). This committee meets three times a year to discuss recommendations and to consider the following:

• How safe and effective the vaccine is when given at a specific age
• The severity of the disease that the vaccine prevents
• How many people get the disease if there is no vaccine
• How well the vaccine helps the body produce immunity to the disease

The final vaccine recommendations include the number of doses of each vaccine, the timing of each dose, the age when infants and children should receive it, and precautions, as well as information on who should not receive the vaccine.

Based on the ACIP’s recommendations, the CDC sets the immunization schedules.

Big picture view:

Childhood vaccine science was a recent topic of discussion during Robert F. Kennedy Jr.'s confirmation hearings to lead the Department of Health and Human Services. The role oversees vaccine research, approval and recommendations, as well as food safety and health insurance programs. 

Kennedy, the son of Attorney General Robert F. Kennedy and nephew of President John F. Kennedy, is a prominent vaccine skeptic and has earned a formidable following with his views on food, chemicals and immunizations. He took over the anti-vaccine group Children’s Health Defense and built it into a juggernaut during the pandemic.

His ascension to HHS secretary has prompted mixed reactions, with all Democrats voting against his nomination, as did Kentucky Sen. Mitch McConnell, who had polio as a child. While recent polling shows that many Americans disagree with some of Kennedy’s controversial health stances — including vaccine skepticism and changing guidelines around fluoride in drinking water — some of his other stances, like reformulating processed foods, are broadly popular. 

After being sworn in, Kennedy said that he would launch a stronger program to more closely monitor vaccine side effects.

What diseases do the recommended vaccinations protect against?

• Hepatitis B (HepB): Chronic liver infection, liver failure, liver cancer, death.
• RSV antibody (Nirsevimab): Pneumonia, bronchiolitis.
• Rotavirus (RV5, RV1): Severe diarrhea, dehydration, death.
• Diphtheria, tetanus, and acellular pertussis (DTaP): Heart muscle swelling, heart failure, coma, paralysis, seizures, broken bones, trouble breathing, pneumonia, death.
• Haemophilus influenzae type B (Hib): Brain damage, hearing loss, limb loss, death.
• Pneumococcal conjugate (PCV15, PCV20): Pneumonia, blood poisoning, meningitis, death.
• Inactivated poliovirus (IPV): Paralysis, death.
• COVID-19: Pneumonia, blood clots, liver damage, heart damage, kidney damage, long COVID, death.
• Influenza (IIV): Pneumonia, sinus infection, ear infection, worsened underlying conditions (heart or lung), death.
• Measles, mumps, rubella (MMR): Brain swelling, pneumonia, swollen testicles or ovaries, deafness, death.
• Varicella (VAR) for chickenpox: Infected sores, brain swelling, pneumonia, death.
• Hepatitis A (HepA): Liver failure, death.
• Tetanus, diphtheria, and acellular pertussis (Tdap): Heart muscle swelling, heart failure, coma, paralysis, seizures, broken bones, trouble breathing, pneumonia, death.
• Human papillomavirus (HPV): Genital warts, cancer (including cancer of the cervix, mouth and throat). Note: The HPV vaccine is recommended by the CDC for routine vaccination at age 11 or 12 years, although vaccination can be started at age 9.
• Meningococcal (MenACWY): Limb loss, deafness, seizures, death. Note: A MenACWY vaccine is recommended for all 11- to 12-year-old adolescents, according to the CDC, and a booster at age 16 since protection wanes.

Childhood vaccine schedule

Timeline:

Here’s a look at the recommended immunizations by age through age 6, according to the CDC.