A parent-friendly guide to the recommended childhood vaccination schedule from birth through age 6, including what to expect at each visit, managing side effects, and keeping accurate records.
Hepatitis B (HepB) — first dose given within 24 hours of birth
This is typically administered in the hospital before discharge. The vaccine protects against a liver infection that can become chronic if contracted in infancy. Over 90% of infected newborns develop chronic hepatitis B without vaccination.
Request a copy of the hospital vaccination record before discharge
Ask the nurse for the official Vaccination Information Statement (VIS) and the lot number of the vaccine given. Store this with your baby's medical records since you will need it for every future pediatrician visit.
2-Month Vaccines
DTaP (diphtheria, tetanus, pertussis) — first dose
This is one of the most important early vaccines. Pertussis (whooping cough) hospitalizes about 50% of infants under 1 year who catch it. The 5-dose DTaP series provides strong protection by age 4-6.
IPV (inactivated polio vaccine) — first dose
Four doses are given by age 4-6. The inactivated version used today cannot cause polio, unlike the older oral vaccine. Side effects are minimal, usually just soreness at the injection site.
Hib (Haemophilus influenzae type b) — first dose
Before this vaccine, Hib was the leading cause of bacterial meningitis in children under 5, affecting about 20,000 kids per year in the U.S. Cases have dropped by over 99% since routine vaccination began.
PCV15 or PCV20 (pneumococcal conjugate) — first dose
Protects against pneumococcal disease that can cause meningitis, blood infections, and ear infections. The newer PCV20 covers 5 additional strains compared to the older PCV13.
RV (rotavirus) — first dose given orally
This is a liquid vaccine given by mouth, not an injection. Rotavirus causes severe diarrhea and vomiting in young children. Before the vaccine, it led to about 55,000-70,000 hospitalizations per year in the U.S.
HepB — second dose (if not given at 1-month visit)
The second hepatitis B dose can be given anytime between 1 and 4 months. Your pediatrician will time it based on your baby's visit schedule. There is flexibility in the exact timing.
4-Month and 6-Month Boosters
4-month boosters: DTaP, IPV, Hib, PCV, and RV second doses
This visit mirrors the 2-month series. Your baby may receive 3-4 injections plus the oral rotavirus dose. The booster doses strengthen the immune response started at 2 months.
6-month vaccines: DTaP, PCV, and HepB third doses
By the 6-month visit, your baby will have completed the primary hepatitis B series. Some combination vaccines reduce the total number of injections. Ask your pediatrician about combo options.
6-month flu vaccine: first dose if during flu season (September-March)
Babies 6 months and older need a flu vaccine every year. The first time, they require 2 doses given 4 weeks apart. After that first year, only 1 annual dose is needed each flu season.
RV — third dose at 6 months (if receiving the 3-dose RotaTeq series)
There are two rotavirus vaccines: a 2-dose series (completed by 4 months) and a 3-dose series (completed by 6 months). Your pediatrician chose one at the 2-month visit and will stay consistent.
12-15 Month Vaccines
MMR (measles, mumps, rubella) — first dose at 12-15 months
One dose of MMR is about 93% effective against measles. A mild rash or low-grade fever may appear 7-12 days after vaccination, which is a normal immune response and not contagious.
Varicella (chickenpox) — first dose at 12-15 months
One dose prevents about 85% of chickenpox cases and 100% of severe cases. Before the vaccine, chickenpox caused about 4 million cases, 10,000 hospitalizations, and 100-150 deaths annually in the U.S.
HepA (hepatitis A) — first dose at 12 months, second dose 6 months later
This is a 2-dose series with the second dose given 6-18 months after the first. Hepatitis A spreads through contaminated food and water. Two doses provide protection that lasts at least 20 years.
Hib and PCV booster doses
These boosters complete the Hib and pneumococcal series started at 2 months. After these doses, your child has strong protection that lasts through early childhood.
4-6 Year Boosters (Pre-Kindergarten)
DTaP — fifth and final dose before kindergarten entry
Most states require proof of the 5th DTaP dose for school enrollment. Check your state's requirements at least 6 months before kindergarten registration to allow time if catch-up doses are needed.
IPV — fourth and final polio dose
The final polio dose must be given on or after the 4th birthday, with at least 6 months since the third dose. This completes the series and provides lifelong protection.
MMR — second dose
Two doses of MMR are 97% effective against measles. This second dose catches the roughly 7% of children who did not develop full immunity after the first dose.
Varicella — second dose
Two doses are 98% effective at preventing chickenpox. Without the second dose, breakthrough cases can still occur, though they are usually mild with fewer than 50 lesions.
Record Keeping and Side Effect Management
Keep a physical and digital copy of the immunization record card
Take a photo of the card after every visit and store it in a secure cloud folder. Schools, daycares, and camps will request copies throughout childhood. A lost record requires contacting every previous provider.
Register with your state's immunization information system (IIS)
Most states maintain a digital registry that tracks all vaccinations. Ask your pediatrician if they report to the state IIS automatically. This serves as a backup if you lose the paper card.
Know how to manage common side effects after vaccination
Injection site soreness, low-grade fever (under 101°F), and fussiness are normal for 1-2 days. Infant acetaminophen (Tylenol) can be given after 2 months of age at 10-15 mg/kg per dose, but check with your doctor for exact dosing.
Understand when to call the doctor after a vaccination
Call if your child has a fever over 104°F, continuous crying for 3+ hours, seizures, or severe swelling beyond the injection site. These reactions are rare, occurring in fewer than 1 in 10,000 doses.
Frequently Asked Questions
How many vaccines does a child get from birth to age 6?
Children receive approximately 24-26 vaccine doses by age 2 and about 30-35 by age 6, covering 14 diseases. This sounds like a lot, but combination vaccines (like Pediarix, which covers DTaP, polio, and hepatitis B in one shot) reduce the actual number of injections to about 16-20 by age 6. The vaccines protect against serious diseases including measles, whooping cough, polio, hepatitis, and meningitis — many of which were common childhood killers just 50 years ago.
Is it safe to give multiple vaccines at the same time?
Yes. The CDC and AAP confirm that combination vaccinations are safe and well-studied. A baby's immune system encounters thousands of antigens (bacteria, viruses, proteins) every day — the antigens in all childhood vaccines combined represent a tiny fraction of what the immune system handles naturally. Studies involving over 1 million children show no increased risk of adverse events from receiving multiple vaccines at one visit. Delaying or spreading out vaccines leaves children unprotected during the period when they are most vulnerable to serious illness.
What are the most common vaccine side effects in children?
The most common side effects are mild and temporary: soreness, redness, or swelling at the injection site (affecting 25-50% of children), low-grade fever under 101 degrees F (10-25%), fussiness or decreased appetite for 1-2 days (20-30%), and mild drowsiness. These reactions mean the immune system is responding as expected. Serious side effects (like allergic reactions) are extremely rare — about 1 in 1 million doses. Give acetaminophen or ibuprofen (age-appropriate dose) for discomfort, and apply a cool cloth to the injection site.
What happens if your child misses a scheduled vaccine?
The CDC has catch-up schedules for every vaccine, and it is never too late to get back on track. You do not need to restart a vaccine series — pick up where you left off regardless of how much time has passed between doses. Your pediatrician can create an accelerated schedule to get your child caught up in 2-4 visits. Most schools require up-to-date vaccinations for enrollment, so catching up before kindergarten entry (age 5) is important. Contact your pediatrician's office to schedule a catch-up visit.
Are vaccine exemptions available for school enrollment?
Medical exemptions (for children with specific allergies or immune conditions) are accepted in all 50 states. Religious exemptions are available in 44 states. Philosophical or personal belief exemptions are accepted in 15 states. Five states (California, New York, West Virginia, Mississippi, and Maine) allow only medical exemptions. Exemption requirements and processes vary by state — check your state's department of health website for specific forms and documentation requirements. Non-vaccinated children may be excluded from school during disease outbreaks.