Your Baby's Immunizations: All Your Questions Answered!

Most parents already know that babies will undergo a significant amount of immunizations in their first 1-2 years of life. Especially, with a new baby, the scheduling of these can be confusing and overwhelming. . Most parents have nothing to worry about, as your doctor will keep track of the scheduled immunizations for you. Often, you will be given a copy of the vaccine schedule. However, it is a good idea to keep your records, confirming when the shots were received and if your baby had any adverse reactions.

Some parents have concerns beyond scheduling, they want to have a deeper understanding of why vaccines are necessary, if they are safe, or have side effects. First, we will cover these topics by answering common questions and concerns about the nature and purpose of infant vaccinations.

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18 Why does my baby need vaccines?

Vaccines are used to prevent infectious diseases that have previously caused illness or death in great numbers. If your children do not receive these vaccines, they become at risk for illnesses that are capable of causing significant suffering, pain, disability, and possibly even death. Babies and children are vaccinated to provide them immunity early in life. The very young are more susceptible to disease and the consequences of these diseases can be more serious in infants and children.

17 Are flu and chickenpox vaccines really necessary?

The influenza (flu) vaccine is not required, but is highly recommended by the CDC (Center for Disease Control) for children over 6 months of age. Every year, many children get sick with seasonal influenza and the most severe complications are common in children younger than 2 years old. Some children develop severe complications, need hospitalization, and even die from the flu. Children with chronic health problems or who come into contact with people who are high risk for complications, are especially encouraged to receive the vaccination.

Most people believe that chickenpox is a mild disease, but it can actually become quite serious. Many cases of chickenpox are mild, but some cause blisters that become infected, and other cases develop pneumonia. Before the vaccine was available, some children were hospitalized and even died from chickenpox every year. Some schools are now requiring proof that your child has been vaccinated against chickenpox.

16 Why are most vaccines for diseases that are uncommon today?

Some of the diseases that we no longer see in the US are not common because of vaccines. While the diseases may currently be uncommon, they have not been eliminated. If we stop vaccinating, a few cases have the potential to multiply very quickly. It is important to remember that vaccine-preventable diseases may still be prevalent in other countries, even when they are not common here. Even if you and your children do not travel, your family could potentially be exposed to international travelers in your community. If your children have not been vaccinated against diseases that others are carriers for, they are at increased risk for contracting them.

15 Are vaccines safe?

Yes. The Centers for Disease Control and Prevention states that the US currently has the safest, most effective vaccine supply in its history. Any side effects that are commonly experienced are typically very mild. Millions of children are vaccinated safely in the USA every year. Most vaccines have only minor side effects like irritation at the injection site, fussiness, or low grade fevers. These side effects are treatable at home and only last for a few days at most. In the event of a rare but serious reaction, your doctor will be prepared to handle it.

14 Do vaccines cause Autism?

No. There has been speculation over the years, that a component of mercury (thimerosol) found in vaccines given to infants and young children, might cause Autism. Some people also believe that the MMR vaccine might be linked to Autism. Neither of these have any scientific evidence to validate such claims. Countless research and continued observation have revealed that there is no such correlation and that neither causes Autism. The use of thimerosol, in vaccinations for children, was eliminated in 2001. The MMR vaccine is safe, and the possibility of mild side effects far outweigh the potential risk and complications of having  any of the diseases; measles, mumps, or rubella.

13 Can my baby get shots if he/she is sick?

Most children can still get immunized, even when they have mild illnesses like a cold, fever, diarrhea or earache. Mild illness will not affect the body’s responsiveness to a vaccine. Antibiotics do not affect any vaccines being administered, if your child is being treated with antibiotics, she may still receive her shots.

If your child is on antiviral medications, your doctor may recommend delaying her vaccines. Certain antiviral medications could affect the way the body responds to immunizations. Some children with a moderate or serious illness may need to wait to receive some vaccines. Children with chronic health conditions, cancer, weakened immune systems, or with history of an allergic reaction, may not receive certain vaccines. Your doctor will help you to determine which vaccines your child should or should not receive.

12 Do vaccinations vary by State or Country?

Yes. Required vaccinations are determined by each state. Each state decides which vaccinations will be required for enrollment into childcare and school. The requirements and allowable exemptions can sometimes vary by state, and they may be updated or changed on a regular basis. If your child is relocating, you can contact the Department of Health or the State’s Immunization Program for possible variances in the recommended schedule of immunizations for your child. Although requirements may vary by state, they are overseen by a federal organization. This means that the vaccinations are influenced by recommendations from the Centers of Disease Control and Prevention. The majority of vaccinations will be similar from state to state, but there is the possibility of small variances.

Each country determines the need for vaccines and immunizations through their government health regulations. Required vaccinations worldwide can have large variations. The US Federal Government has required vaccinations for non-US citizens who want to live here. Foreign citizen, including internationally adopted children, who are seeking permanent American residency, must be vaccinated before entry into the US.

If your children are moving or traveling out of the US, it is possible and even likely, that there will be additional required vaccinations. You can learn more about these by checking with your health care provider, local health department or travel clinics in your area. You can also check with the International Society of Travel Medicine for travel medicine specialists. You may learn about the health risks and information for locations of interest, by checking the CDC Travel Health Site.  Prepare well in advance, as some vaccinations must be given at authorized vaccination centers, at least 4-6 weeks prior to travel departure.

11 Why are some people against vaccines?

Approximately 10-20% of parents in the US are currently opting out of routine vaccinations. The most common reason that these people choose not vaccinate their children, is because of safety concerns. Despite overwhelming evidence through scientific studies, some people believe that vaccines can cause extensive serious side effects that lead to life altering disabilities and death. Among the biggest misconceptions, is the belief that MMR can cause autism. This misconception arose more than 10 years ago, and more than a dozen studies have debunked the myth. Other concerns include worries about over loading the immune system of babies, and about potentially toxic ingredients, such as mercury, aluminum, formaldehyde, and antifreeze. The truth: the high frequency of shots received in infants, does not overwhelm the immune system. In fact, children who receive all of the routine vaccinations at the scheduled times, don’t typically see any infectious diseases. This would not be the case, if the immune systems were compromised. Secondly, vaccines are mostly water and only contain additional ingredients to stabilize the solution or to increase the vaccines effectiveness. Thimeresol has not been used in children’s vaccines for 15 years. The type of mercury that is used is different than the neurotoxin that is found in fish. The type that is used in vaccinations is a preservative called ethylmercury, and it does not accumulate in the body. The trace amounts of aluminum and formaldehyde, pose no risk, and are given in smaller amounts than exposure from other sources, like fruit and insulation materials. Antifreeze is never used in vaccines, and this confusion has come over a misunderstanding of chemical names that are found within ingredients that are used during the manufacturing process of vaccines.

10 Can I refuse to vaccinate my baby?

Yes. Since 2011, all 50 states have vaccine laws that require proof of certain vaccines, for children to be allowed to attend daycare, middle school, high school, and college. However, most states also give citizens the legal right to opt out. Depending on which state you live in, you may be allowed to refuse vaccinations for your child based on religious exemption, medical exemption, or on personal, philosophical, or conscientious belief exemptions. It will be necessary to provide proof of exemption to your daycares and schools, if you choose to opt out.

9 Am I protected against other people who refuse to vaccinate?

Yes and No. Vaccinating your child, greatly decreases the likelihood that your child will get the same disease if they are exposed to it. However, vaccinations do not guarantee prevention. The current vaccinations are still in place today because the diseases have not been eliminated. One goal of the vaccines is to eventually have success in completely eliminating them. It is not possible to do so, when every person has not been vaccinated. One person can carry a disease that can spread like wild fire in a matter of hours or days. In other words, hopefully, the vaccines that your children have been given will protect them against those who have not had them. Unfortunately, those who choose not to vaccinate, put the rest of the population at increased risk for a new outbreak.

8 What vaccines does my baby need?

Here is a list of the typical immunizations that are scheduled for babies in the US. Your schedule may be altered if your baby misses a dose. Depending on the health of your baby and other variables in your lifestyle, additional vaccines may be necessary. Together, you and your doctor will make the best plan for your child’s needs.

Some doctors recommend giving your baby an appropriate dose of children’s Tylenol, ibuprofen, or similar medications shortly before the shots are administered. Experienced mothers and nurses often recommend nursing or bottle feeding your baby immediately following the shots, after any crying has ceased. This provides comfort and reassurance to your startled and confused infant. It is a good idea to clear your schedule when new immunizations are being administered. There are no guarantees as to how your baby will react. It is important to be prepared for any side effects, regardless of how small or great they may be. Stay close to home, and close to medical care, if possible. Plan to spend the day comforting your baby and be prepared to act in case of an emergency.

7 Immunizations at Birth/1 Month

Birth: Hep B (Hepatitis B Vaccine), typically given within 12 hours of birth, the first of 3 doses

What is it for? The prevention of the serious disease Hepatitis B.It is a virus that attacks the liver and can cause lifelong infection, cirrhosis, cancer, failure of the organ, and death.

Possible Reactions: pain, soreness, redness, swelling at the injection site, irritability, fever, headache, fatigue, sore throat, runny or stuffy nose, nausea, diarrhea, loss of appetite, weakness, and dizziness.

One month: Hep B (Hepatitis B Vaccine), typically given between 1 and 2 months of age, the 2nd of 3 doses.

6 Immunizations at 2 months

  • Rotavirus, 1st of 2 doses

What is it for? The prevention of worldwide cases of acute gastroentitis that occur in children. Gastroentitis causes vomiting and severe diarrhea.

Possible Reactions: small risk of mild diarrhea or vomiting in the week following administration of the vaccine, any severe reactions are very rare.

  •  DtaP (Diphtheria, tetanus, & accelular pertussis), 1st of 5 doses

What is it for? Helps children under the age of 7 to develop immunity to three bacterial diseases: diphtheria, tetanus, and pertussis (whooping cough). Diphtheria is a respiratory disease that can cause difficulty breathing, paralysis, heart failure, and death. It is highly contagious and is spread through sneezing and coughing. Tetanus is caused by a bacteria found in the soil. In the human body, its toxin attacks the nervous system. Untreated, it can cause muscles spasms and death. Pertussis is a highly contagious disease that causes coughing spasms, it can become so severe in infants that it becomes difficult to eat, drink, and breathe. It can develop into pneumonia, seizures, brain damage, and eventually death.

Possible Reactions: fever, redness, swelling, or tenderness at the injection site, or swelling of the entire leg or arm where the shot was given. These reactions are more common after the 4th and 5th doses. Occasionally: fussiness, fatigue, poor appetite and vomiting are present. Symptoms usually appear 1-3 days after administration of the shot.

  • Hib (Haemophilus Influenza type B), 1st of 4 doses

What is it for? Prevents serious bacterial infections that can lead to meningitis, epiglottis, and pneumonia. It is recommended for all children under age 5. Meningitis is an infection of the covering of the spinal cord and brain. Epiglottis is a severe throat infection, and pneumonia is a lung infection.

Possible Reactions: redness, warmth, or swelling at the injection site. These reactions are uncommon and subside 2 or 3 days after the shot is given.

  • PCV13 (Pneumonal Conjugate), 1st of 4 doses

What is it for? Protection against pneumococcal disease, caused by bacteria that spread easily through close contact. Pneumococcal disease can cause serious conditions including pneumonia, blood infections, and meningitis. Children under the age of 2 have an increased risk for serious medical conditions resulting from these bacteria.

Possible Reactions: drowsiness, temporary loss of appetite, redness, swelling, and tenderness at the injection site, mild fever, and fussiness or irritability.

  • IPV (Inactivated Polio Virus), 1st of 4 doses

What is it for? Prevention of a serious viral disease, called Polio. Polio is a virus that lives in the stool of an infected person, but can also be spread through coughing and sneezing. The disease was very common in the USA prior to the introduction of the vaccine in 1955. Most people have no symptoms, but the 1% who do, develop paralysis that can be permanent paralysis. Death is also possible.

Possible Reactions: mild fever, soreness and redness at the injection site. Anything more serious should be reported to your doctor immediately.

No Immunizations required at 3 months, unless up catch up doses are needed.

5 Immunizations at 4 months

  • Rotavirus, 2nd of 2 doses
  • DtaP (Diphtheria, tetanus, & accelular pertussis), 2nd of 5 doses
  • Hib (Haemophilus Influenza type B), 3rd of 4 doses
  • PCV13 (Pneumonal Conjugate), 2nd of 4 doses
  • IPV (Inactivated Polio Virus), 2nd of 4 doses

No Immunizations required at 5 months, unless up catch up doses are needed

4 Immunizations at 6 months

  • Hep B (Hepatitis B Vaccine), typically given between 6-18months of age, the 3rd of 3 doses
  • DtaP (Diphtheria, tetanus, & accelular pertussis), 3rd of 5 doses
  • Hib (Haemophilus Influenza type B), 3rd of 4 doses
  • PCV13 (Pneumonal Conjugate), 3rd of 4 doses
  • IPV (Inactivated Polio Virus) 3rd of 4 doses, to be administered anytime between 6 and 18 months of age. The 4th does is not administered until between the ages of 4-6 years.
  • Influenza (Seasonal Flu Vaccine) not required but recommended 1-2 times annually after 6 months of age.

What is it for? For the development of antibodies to provide protection against infection from the viruses that are contained in the vaccine. The influenza vaccine is different in every season, and is designed to protect against the seasonal flu viruses that will be most common during the upcoming season.

Possible Reactions: redness, soreness, or swelling at the injection site, hoarseness, irritated eyes, cough, fever, and body aches, headache, itching, and fatigue.

No Immunizations required between 7-12 months, unless catch up doses are needed.

3 Immunizations at 12-15 months

12 months: PCV13 (Pneumonal Conjugate), 4th of 4 doses

MMR (Measles, Mumps, Rubella), 1st of 3 doses. Subsequent doses are not administered until after the age of 4 years.

What is it for? Protection against three potentially serious viral diseases: Measles, Mumps, and Rubella. In most states, you must prove that your children have been vaccinated before they are allowed to enter school. Measles is a virus that starts as a fever, cough, runny nose, pinkeye or a rash that starts on the face. If it infects the lungs, it can cause pneumonia. If the virus affects older children, it can cause encephalitis, and an infection of the brain that can cause seizures and brain damage. Mumps is a virus that usually causes swelling below the ears, giving the appearance of chipmunk cheeks. Prior to the vaccine, this disease was the most common cause of meningitis, acquired deafness, and infertility in the U.S. The 3rd virus, Rubella is also known as the German measles. It can cause a mild rash of the race, swelling of the glands behind the ears and sometimes a low grade fever and swelling in the small joints. Most children recover quickly with little or no long term effects. Rubella poses the greatest risk to the unborn children of women who are infected in their first trimester of pregnancy. It can cause significant birth defects, such as blindness, deafness, heart defects, or mental retardation.

Possible Reactions: fever, mild rash, swelling of the glands in the cheeks or neck, occasionally fever related seizures

15 months: Hib (Haemophilus Influenza type B), 4th of 4 doses

2 Immunizations at 18 months

  • DtaP (Diphtheria, tetanus, & accelular pertussis), the 4th of 5 doses. The 5th dose in not administered until between the ages of 4-6.
  • Influenza (Common Flu Vaccine), not required but recommended 1-2 times annually after 6 months of age

1 Immunizations at 24 months

  • Influenza (Common Flu Vaccine), not required but recommended 1-2 times annually after 6 months of age

The recommended schedule of infant immunizations is subject to update and change at anytime. Keep yourself informed by following the activity at the Centre for Diseases Prevention and Control. Always ask you doctor to provide you with any updated information about the prevalence of infectious diseases, and of any new information about the risks of receiving the vaccines that protect against them.


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