Vaccines for

1 to 4 years of age

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All of the following assume your child is at least 12 months old and under 4 years of age.

Please print out this page
Travel Schedule of Check-ups and Immunizations
Are my child's vaccines up to date? Special Situations
   
  Chicken Pox
DT / DPT / aDPT Hib
Hepatitis B MMR
Pneumococcus Polio

Instructions:

  1. Read the boxes below to see if your child's vaccine are up to date.
  2. If your child's vaccine are not up to date, follow the directions on when to get the next vaccines.
  3. You may get your vaccines at your pediatrician's office or at the local health department.
  4. Please recognize that your pediatrician may not follow this schedule exactly for a very good reason in your particular child's case. At the same time though, please be very resistant to letting your pediatrician defer your child's vaccines unless there is a very good reason. Having a minor illness is NOT a reason to defer any vaccine.
  5. All vaccines should be given at a scheduled check up unless their is a specific reason to give them early. If a vaccine has to be deferred because of an illness (this should be rare), then get the vaccines at the follow up visit for that illness.

Hepatitis B

About the Hepatitis B vaccine
Doses received so far Up to Date? Next dose due from last one
4 Yes having 4 is not harmful
3 Yes *
2 and low risk of exposure Yes if 2nd <12 months ago 6 to 12 months
2 and high risk of exposure Maybe 2 months*
1 and low risk of exposure Yes unless 1st >2 months ago 1 to 6 months
1 and high risk of exposure Yes unless 1st> 4 weeks ago 1 month
none and low risk of exposure No Next check up
none and high risk of exposure No As soon as possible

High risk of exposure: Infants born to a mother whom is a carrier for Hepatitis B, health care workers and chronic health care facility patients, hemodialysis patients, patients whom receive blood products, household contacts of those with carriers, international travel, intravenous drug users, prisoners. Low risk is everyone else.

* The 3rd dose may be given as early as 2 months from the 2nd if there is a high risk of exposure, but some may then give a 4th dose a year later. This should be discussed with your pediatrician.


DT / DPT / aDPT

This schedule applies regardless of which of the above are used. For example, if your child had a DPT and then a DT, then this would count as 2 of this vaccine. Should your child only get the DT and then latter get the Pertussis part, then a special schedule will have to be made by your pediatrician.

About the DT / DPT / aDPT vaccines
Doses received so far Up to Date? Next dose due from last one
3 Yes if last <6 months ago 6 to 12 months, NOT < 6mo
2 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
2 Yes unless last >2 months ago 2 months
1 and traveling soon Yes unless 1st >4 weeks ago 4 weeks
1 Yes unless last >2 months ago 2 months
none No As soon as possible

Polio

This schedule applies regardless of whether the IPV or OPV was used. For example, if your child had 1 IPV and 1 OPV then they have had 2 vaccines. The OPV is recommended if traveling to an endemic area, but this should be discussed with your pediatrician. As of late 1999, the Oral Polio vaccine is not recommended for routine use in the USA due to the small risk of getting a form of poilio from that version of the vaccine. There is no risk of this from the IPV. Only the IPV is routine used now

About the Polio vaccine
Doses received so far Up to Date? Next dose due from last one
3 Yes after the 4th birthday
2 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
1 and traveling soon Yes unless 1st >4 weeks ago 4 weeks
1 Yes unless 1st >2 months ago 2 months
none No As soon as possible

Hib

This applies regardless of what brand of vaccine was used. If it appears that your child does not have enough of this vaccine, then check which DPT shot was given. The Hib vaccine may have been combined with the DPT in a product called Tetramune or Acel-immune. Most nurses whom fill in your shot record will write down the brand name Tetramune or Acel-immune in the DPT vaccine space AND write down that a Hib vaccine was given also, but some may not. There are no DT / aDPT and Hib vaccines available in this country commercially yet. The currently available brands are: PedvaxHIB (PRP-OMP), HIBTITER (HbOC), ActHIB (PRP-T), OmniHIB(PRP-T) and ProHIBit (PRP-D). The ProHIBit (PRP-D) brand should not be used below 12 months of age, if it was used notify your pediatrician. The same brand should be used for all doses given below 12 months and any brand may be used as the booster.

About the Hib vaccine
Doses received so far Up to Date? Next dose due from last one
1 after 15 months of age regardless of earlier doses Yes Finished with series*
2 and both after 1st birthday regardless of earlier doses Yes Finished with series
4 and 1 was after 1st birthday Yes Finished with series
3 and none after 1st birthday No 2 months then finished
3 and 1 after 12 month birthday If 1st 2 were PedvaxHIB and 3rd> 2months after 2nd, then yes, else no 2 months, then finished with series
2 and 1st before 1st birthday and 2nd after 1st birthday No 2 months, then finished
2 and none after 1st birthday No 2 months, then possibly finished, see 2 boxes above
1 after 1st birthday and <15mo No 2 months, then finished
1 before 1st birthday and child is now <15 months old No 2 months, see 3 boxes above
1 before 1st birthday and child now >15 months old No Now, then finished
none No As soon as possible, if given after 15 months old, then finished*, if not need 2 separated by 2 months then finished

* If only 1 dose was given and it was after 15 months, then 1 more may be required if the child has a high risk condition (mainly altered immune systems, no spleen, sickle cell disease).


MMR

About the MMR
Doses received so far Up to Date? Next dose due from last one
3 and last 2 given after 1st birthday and >1 month apart Yes Finished with series
2 and both given after 1st birthday and >1 month apart Yes Finished with series
2 and 1 dose after1st birthday Yes after 4th birthday or as soon as 1 months after 1st and high risk
1 before 1st birthday No 1 month and after 1st birthday
1 after 1st birthday Yes after 4th birthday or as soon as 1 months after 1st and high risk
None No As soon as possible

Chicken Pox

This vaccine is currently not required for school entrance, but probably will be within the next few years. Most pediatricians, including myself, do recommend this vaccine. I personally gave my daughter this vaccine just after her 1st birthday. The vaccine can be given with all other vaccine but in a separate syringe except the DPT because the Chicken Pox vaccine may not work as well (the DPT will work fine). If the Chicken Pox vaccine is not given at the same time as the MMR, then they should not be given within 1 month of each other. There is currently a MMR and Chicken Pox combined vaccine in trials and will be released "soon".

About the Chicken Pox vaccine
Doses received so far Up to Date? Next dose due from last one
1 Yes Finished with series
None No As soon as possible

Pneumococcus

The first dose can be given as early as 6 weeks of age and the first 3 can be given as close as 4 weeks apart. The forth dose should be greater than 2 months from the 3rd and on or after the first birthday. The total amount of doses depends on the age of the child.

About the Pneumococcus vaccine
Doses received so far Up to Date? Next dose due
4 Yes Provided 4th dose after 1st birthday and >= 2 months from the 3rd dose
3 and 3rd dose after 1st birthday and >= 2 months from the 2nd Yes  
3 and 3rd dose before 1st birthday No Final dose on or after 1st birthday and >= 2 months from the 3rd dose
2, first dose was after 12 months of age Yes provided the doses were 2 months apart If the 2 doses were not 2 months apart, then you may need a third dose 2 months from the 2nd
2, first dose was after 6 months of age, but before 12 months of age No >= 2 months from 2nd dose
2, first dose was before 6 months of age No As soon as possible, but >=  2 months from last 2nd dose
1 and 1st dose after 2nd birthday Yes  
1 and first dose on or after first birthday No As soon as possible, but >= 2 months from the 1st dose
1 and first dose before 1st birthday No As soon as possible, but >= 4 weeks from the 1st dose
0 No As soon as possible

SPECIAL SITUATIONS

My child or a close family member has heart disease, asthma or other lung disease, some immune deficiencies or suppressions, sickle cell disease or other hemoglobinopathies, diabetes, chronic kidney disease, or is on long term aspirin therapy.

You child should then receive the Influenza vaccine. If a close family member has one of the above, then your child needs the vaccine to protect the family member not your child. Since the vaccine is not 100% effective, all close contacts should have the vaccine for the best protection. The flu vaccine may be given as early as 6 months of age. Should the child be less than 9 years of age and this is the 1st dose of vaccine given, then a 2nd dose is required 1 month later (every year thereafter only one dose is needed).

My child is over 2 years of age and has frequent ear infections, no spleen, has heart or lung disease.

Your child should have the Pneumovax vaccine. Only one vaccine should be required, but occasionally a 2nd dose is given a few years later.


TRAVEL

If your child has not completed the series of vaccines outlined above, then your child will need a special schedule to update them before travel. Certain countries also require special vaccines.See the other section on travel. This definitely requires consultation with your physician.


DISCLAIMER

This web site is designed to provide accurate and authoritative information in regard to the subject matter covered. In providing this site, the author is not engaged in rendering medical or any other professional service. Individual conditions may vary and the information contained herein should not be relied upon for the diagnosis and/or treatment of any particular individual. If medical advice or other expert assistance is required, the services of a competent professional should be sought.

Copyright 2005 Joe Matusic, MD. This document may be freely copied and distributed, providing there is no charge for duplication or the material and this copyright notice remains affixed.