Vaccines for

4 to 6 months of age

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Are my child's vaccines up to date?

Schedule of Check-ups and Immunizations

  Travel
Hepatitis B DT / DPT / aDPT
Hib Polio
Pneumococcus  

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.
  6. When traveling is mentioned, it is considered as traveling to an area at high risk for exposure.

Hepatitis B

About the Hepatitis B vaccine
Doses received so far Up to Date? Next dose due from last one
3 Yes *
2 and low risk of exposure Yes 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 >1 months 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 6 to 12 months, NOT < 6mo
2 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
2 Yes 2 months
1 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
1 Yes unless 2nd >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 and 3rd dose  on or after 4th birthday Yes Finished
3 and no doses after 4th birthday No After 4th birthday
2 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
2 Yes 2 months
1 and traveling soon Yes unless 2nd >4 weeks ago 4 weeks
1 Yes unless 1st >2 months ago 2 months
none No As soon as possible

* If the 3rd dose was given after the 4th birthday, then the series is considered complete.


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
3 Yes after the 1st birthday
2 regardless of travel Yes if used PedvaxHIB after 1st birthday
2 and traveling soon No if didn't use PedvaxHIB 4 weeks
2 No if didn't use PedvaxHIB 2 months
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

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. Those starting the doses between 1 and 2 years of age get 2 doses 2 months apart, while those starting after 2 years of age only get one dose. As of 4/2000, those above 2 years of age should be evaluated on risk factors for Pneumococcal disease and given the vaccine accordingly. High risk is: caycare attendance within the last 3 months, any immune deficiency, frequent infections, most chronic diseases (asthma, kidney disease, cystic fibrosis).

About the Pneumococcus vaccine
Doses received so far Up to Date? Next dose due
1 on or after the 2nd birthday Yes  
2 or more total doses given after the 1st birthday Yes  
1 dose after the 1st birthday and 3 before the first birthday and the last 2 doses at least 2 months apart Yes  
1 dose after the 1st birthday and 2 given between 6 and 12 months and the last 2 at least 2 months apart Yes  
All others No As soon as possible

TRAVEL

If your child may have a high risk of exposure, then as many vaccines as possible will be given before travel.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.