Immunizations for children in the U.S

Doctors create immunizations for children’s schedules. It is to protect children from life-threatening infections before and when they are most vulnerable. The recommended plan depends on: 

• The type of vaccination
• The disease for which the vaccine works
• And the age at which it is most effective

Doctors don’t recommend alternative plans since they can leave children at risk. While vaccine schedules may vary from country to country, they have become more uniform.

By the time they start kindergarten, most infants will undergo multiple doses of 10 vaccines. These vaccines can protect them from 14 vaccine-preventable diseases.

Vaccination Schedule for Children

By the time children in the United States start school, they should have had:

• Hepatitis B vaccine: 3-dose sequence at birth, 1 to 2 months and 6 to 18 months
• Rotavirus vaccine: Either oral Rotarix (2-month and 4-month sequence of doses). Or RotaTeq oral (3-dose series at 2, 4, and 6 months).
• Diphtheria, tetanus and pertussis vaccine: 5-dose sequence for 2, 4, 6, 15 to 18 months and 4 to 6 years
• Haemophilus influenza type b vaccine: Option of three or four-dose series: ActHIB, Hiberix or Pentacel at 2, 4, 6. And for 12 to 15 months, or for 2, 4, and 12 to 15 months, PedvaxHIB.
• Pneumococcal vaccine: A four-dose sequence of 2, 4, 6 and 12 to 15 months of Prevnar 13 vaccine. Children with high-risk heart or lung problems also receive Pneumovax 23 (PPSV23) at age 2.
• Polio Vaccine: 4-dose series for 2, 4, 6 to 18 months and 4 to 6 years
• Measles, mumps, rubella vaccination: Two-dose series at 12 to 15 months and 4 to 6 years of age
• Varicella (chickenpox) vaccine: Two-dose sequence of 12 to 15 months and 4 to 6 years
• Hepatitis A vaccine: Sequence of two doses at 12 months and 18 to 23 months
• Influenza vaccine: Yearly starting at 6 months, with two doses split by at least four weeks for infants between 6 months and 8 years of age if they had less than two previous doses of the vaccine. And just one dose if they had two previous doses of the influenza vaccine. Also available as a nasal spray (LAIV) for children 2 years of age or older.

This vaccination schedule is prescribed by:

1. The Centres for Disease Control and Prevention (CDC)
2. The American Academy of Pediatrics
3. The American Academy of Family Physicians
4. The Advisory Committee on Immunization Practices

Doctors recommend further vaccines for 11 to 12 years old

• Tetanus, diphtheria, pertussis vaccine (TDaP). One injection at 11 or 12
• Meningococcal vaccine. A series of two doses of Menactra or Menveo at 11 or 12 and again at 16
• Human Papillomavirus (HPV) vaccine. Two-dose Gardasil 9 series, with at least five months between doses, started between 9 and 14 months

Combination Vaccines

Single vaccinations that protect against multiple diseases can minimize the total number of shots. Combination vaccinations shall include: 

• Pediarix, a combination of DTaP, polio, and hepatitis B vaccine. Doctors deliver this as a three-dose series at 2, 4, and 6 months.
• ProQuad, a combination of MMR and varicella vaccines, can be given from 12 months to 12 years of age. However, it is better to use ProQuad as the second dose in sequence for these vaccines. Use it at the age of 4 to 6 years after the initial vaccine as the first dose.
• Pentacel, a combination of DTaP, polio, and Hib vaccines delivered at 2, 4, 6, and 12 to 15 months of age.
• Kinrix or Quadracel, the mixture of vaccines against DTaP and polio. Doctors deliver this at 4 to 6 years of age to replace the fifth dose of DTaP.

Health experts say that children may delay Immunizations due to disruption of the COVID-19 pandemic. Parents and guardians are important to ensure immunizations for children.

Alternative Schedules

Alternative immunization schedules arose from parents’ concerns. Parents may have concerns over the number of vaccinations that infants receive before age 2 and the safety of many vaccines at one time. They also sought to separate Immunizations for children to resolve these problems. But this is not well regarded by most paediatricians and other health care professionals and specialists. However, two such alternatives continue to be promoted:

• User-friendly vaccination schedule: This schedule delays vaccination until after age 2. And rather than DTap, suggests individual vaccinations for diphtheria, tetanus, and pertussis. 
• Dr. Bob’s alternative vaccine schedule: Paediatrician Robert Sears establish this schedule. This schedule paces injections so that children do not get more than two doses at a time. This ensures they only get monthly shots. It also prevents hepatitis A and hepatitis B vaccines until children are older. Also, it recommends separate measles, mumps, and rubella vaccinations rather than a combined MMR vaccine.

Experts made the recommended schedule of vaccination focusing on when the infant is likely to be affected. They also kept in mind when the immune system is mature enough to respond to the vaccine. Altering this routine can put a child at risk only when they can and should be protected. Many vaccines are completely effective only if given at multiple doses. So, the infant is less safe if you postpone the timetable or if the dosage is missing or delayed.

What’s more, remaining on top of the altered schedule allows a parent to be extremely diligent. Paediatricians who do not support alternate plans may not provide the same reminders they would have on the standard schedule. The altered schedule often means more time spent in the waiting room at the paediatrician’s office. It increases the child’s chance of becoming exposed to infections before they have complete protection.

In an article in Pediatrics, Dr. Paul Offit discusses the numerous flaws in Dr. Bob’s alternate schedule’s logic. Dr. Paul is head of the Infectious Diseases Division at Philadelphia Children’s Hospital.

As long as all parents immunize their children on time, a non-immunized child will not be at risk. However, outbreaks of these diseases have arisen in the U.S. once too many parents have taken the same decision.

The Bottom Line

Experts designed immunizations for children plans to protect the infant from preventable diseases. The recommended schedule prevents diseases that have caused many children to be sick in the past. Live in a society where immunization rates are high, and vaccine schedules are followed to protect all children. Formerly rare diseases can circulate and cause outbreaks when vaccination rates are low. So, these places unvaccinated children in danger.