Every year, the Centers for Disease Control and Prevention (CDC) publishes recommended childhood vaccination schedules. Why are schedules created? Because the timing and spacing of immunizations are really important for the best possible protection against preventable diseases.
Kids’ immune systems are more vulnerable to illness and disease, and vaccination schedules are scientifically designed by top infectious disease experts and doctors with this in mind. The goal? Protect kids from vaccine-preventable diseases as early and as safely as possible.
The 2021 vaccination schedule isn’t too different from the 2020 schedule, but some updates and clarifications have been made. Below we cover how many vaccines are recommended for children and when, an overview of the 2021 schedule changes, and list vaccine recommendations by age group. We also answer questions around COVID-19 vaccines for kids and teens.
How many vaccines do children get if the schedule is followed?
Currently, 16 vaccines – some requiring multiple doses at specific ages and times – are recommended from birth to 18 years old. Recommended vaccines include:
- Influenza (annual flu shot)
- Diphtheria, tetanus and pertussis (DTaP)
- Tetanus, diphtheria and acellular pertussis (Tdap “booster” for adolescents)
- Poliovirus (IPV)
- Measles, mumps and rubella (MMR)
- Varicella (Chickenpox)
- Pneumococcal (PCV)
- Haemophilus influenzae type b (Hib)
- Hepatitis B (Hep B)
- Hepatitis A (Hep A)
- Human papillomavirus (HPV)
- Meningococcal (MenACWY)
- Meningococcal B (MenB)**
**MenB is recommended for specific populations only. If you have questions, ask your child’s doctor.
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What changes were made to the immunization schedule in 2021?
The CDC’s Advisory Committee on Immunization Practices (ACIP) meets three times a year to review the latest scientific research and make any necessary changes to the child vaccination schedule. The CDC officially sets the schedule based on ACIP’s recommendations, and the schedule is also approved by organizations like the American Academy of Pediatrics (AAP) and the American Association of Family Physicians (AAFP).
In 2021, no major changes were made. But the schedule was updated to include the latest guidance on catch-up vaccinations for Hib and HPV vaccines. New information about “special situations” was also added for several immunizations. If you have specific questions about 2021 updates and how they relate to your kid’s vaccine schedule, talk with your child’s doctor.
The CDC 2021 vaccination schedule: A list of immunizations by age
The flu shot: An annual immunization for children starting at 6 months old
The flu vaccine – or influenza vaccine – may be the most well-known of all immunizations. That’s because it’s one of the longest-running vaccines in the United States, with the first of its kind being approved for widespread use in 1945.
While influenza viruses circulate year-round, flu cases peak in the fall and winter months nearly every year. Flu shots help protect against the types of influenza viruses that research indicates will be most common that season. That’s why the CDC recommends annual flu shots for everyone by the end of October – including kids 6 months and older.
When children receive their first flu shot, the vaccine is delivered in two doses, given at least one month apart. After that first pair of doses, just one shot is needed each year.
Recommended immunizations for children ages 0 to 18 months
When do babies get their first shots? Staying on track with childhood immunizations starts early, with immunizations beginning at birth and coinciding with baby and child wellness schedules.
Remember, child vaccination schedules are made with young immune systems in mind. If you have specific questions about when or why specific vaccines are recommended for your newborn baby, infant or toddler, talk with your child’s doctor.
An overview of immunizations for newborns to 18-month-olds
- Hep B – Many new parents wonder what vaccines are given at birth, and just one "newborn vaccine" is recommended right away: the first dose of hepatitis B. The first dose is recommended right away in case mothers are knowingly or unknowingly hepatitis B positive. Three doses are needed in total. The second dose is recommended when your child is between 1 and 2 months old, and the third dose is recommended between 6 and 18 months.
- Rotavirus – Depending on manufacturer of the vaccine, your child may need two or three doses of the rotavirus vaccine, with the first dose being given at 2 months old and the second at 4 months old. If needed, the third dose is given at 6 months old. It’s important to note that this vaccine cannot be given after 8 months of age, so following the recommended schedule is especially important to ensure your child is protected.
- DTaP – The diphtheria, tetanus and pertussis vaccine requires five doses. The first four are recommended at 2 months, 4 months, 6 months, and between 15 and 18 months old.
- Hib – Depending on the manufacturer of the vaccine, your child may need three or four doses of the haemophilus influenzae type b vaccine. If three doses are needed, shots are given at 2 months, 4 months, and between 12 and 15 months old. If four doses are needed, kids also receive a dose at 6 months old.
- PCV – The pneumococcal vaccine is a series of four doses taking place at 2 months, 4 months, 6 months, and between 12 and 15 months old.
- IPV – The poliovirus vaccine is another four-dose series. The first three are recommended at 2 months, 4 months, and between 6 and 18 months old.
- MMR – The measles, mumps and rubella vaccine is given in two doses. The schedule recommends the first MMR vaccine dose be given between 12 and 15 months old.
- Varicella – The chickenpox vaccine is also given in two doses, with the first shot taking place between 12 and 15 months old.
- Hep A – Like several other important vaccines, the hepatitis A vaccine requires two doses. The first dose is recommended at 12 months old.
Recommended immunizations for children ages 4 to 6 years old
The shots recommended between ages 4 and 6 are often called “kindergarten vaccines” because kids are often required to be up to date on their immunizations to start attending elementary school. No new vaccines are introduced at this time, but oftentimes vaccines are given as combinations.
For example, DTap and IPV can be given in a single shot. MMR and varicella vaccines can also be combined into a single immunization. These vaccines are just as effective when given together, and it cuts down on the number of shots kids need.
An overview of immunizations for kids ages 4 to 6 years old
- DTaP – The fifth and final diphtheria, tetanus and pertussis vaccine is recommended when your child is between 4 and 6 years old.
- IPV – The fourth and final poliovirus vaccine is recommended when your child is between 4 and 6 years old.
- MMR – The second and final dose of the measles, mumps and rubella vaccine is also recommended when your child is between 4 and 6 years old.
- Varicella – The second and final dose of the chickenpox vaccine is also recommended when your child is between 4 and 6 years old.
Recommended immunizations for children ages 11 to 12 years old
The immunizations that are recommended at this age (a.k.a. middle school shots) are for diseases that teens and young adults are at higher risk for – plus one “booster” dose to strengthen immunity for three diseases. Your child’s annual wellness visit or back-to-school checkup is the perfect time to get these vaccines.
An overview of immunizations for kids ages 11 to 12 years old
- Tdap – At this age, this immunization is what’s commonly referred to as a “booster shot” because it boosts your child’s tetanus, diphtheria and pertussis immunity. While related to the DTaP vaccine kids receive during childhood, this vaccine is formulated for adolescents and adults.
- MenACWY – The first of two meningococcal vaccine doses is recommended sometime between 11 years old and 12 years old. This vaccine protects against the most common types of meningococcal bacteria (often the cause of meningitis) that affect adolescents.
- HPV – While in some cases doctors may recommend the human papillomavirus vaccine as early as age 9, this vaccine is routinely recommended to begin between 11 and 12 years old. If the initial vaccination is completed before age 14, just two doses are needed. The second dose should be completed 6 to 12 months after the first dose. (If the initial vaccination is completed at age 15 or older, three doses are needed at specific intervals.)
Recommended immunizations for teens ages 16 to 18 years old
Between the ages of 16 and 18, there is one regularly recommended immunization and one immunization that may be recommended under certain circumstances.
An overview of immunizations for teens ages 16 to 18 years old
- MenACWY – The second and final meningococcal vaccine shot is recommended at 16 years old.
- MenB – The meningococcal B vaccine is recommended under specific circumstances, specifically if a college or university requires students to have this vaccination, or if a bacterial meningitis outbreak has occurred. The vaccine is given in two doses between the ages of 16 and 18. Once the first dose is given, the timing of the second dose is dependent on the manufacturer of the vaccine.
Are COVID-19 vaccines recommended for children and teenagers?
While the CDC has not added COVID-19 vaccines to their official childhood or adolescent vaccinations schedules, they’re encouraging all eligible kids, teens and adults to be vaccinated as soon as they can.
If you have concerns about vaccinating your child, talk with your child’s doctor or read this resource on COVID-19 vaccines for kids and teens where we answer questions such as:
- Should my child get the COVID-19 vaccine or other recommended vaccines first?
- Can my child receive the COVID-19 vaccine alongside other vaccines?
- How do I talk to my kid or teen about getting a COVID-19 vaccine?
If your child is ready to get the vaccine, call any of our primary care clinic locations and we’ll help you schedule an appointment at a vaccination site near you.
What should I do if my child is behind on their vaccination schedule?
Don’t worry. There are catch-up recommendations in place. But since each vaccine has its own guidelines, talk with your child’s doctor to make a plan for getting back on schedule. They can talk with you about your child’s medical and immunization history, give you more information on specific vaccines and catch-up guidelines, and discuss any concerns or questions you may have.
Does your child need catch-up vaccinations? Don’t delay.
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Are there any reasons not to vaccinate my child, especially during the COVID-19 pandemic?
Yes. There are times when some children should not get certain vaccines or they should wait. For example, if your child has any severe, life-threatening allergies, they’ve had an allergic reaction after a previous dose of vaccines, or they’re moderately or severely ill, their doctor may recommend not getting or delaying a specific vaccination.
When it comes to the COVID-19 pandemic, you don’t need to delay the immunizations or care your child needs – unless of course you, your child or someone in your household is experiencing COVID-19 symptoms.
While staying on track with all immunizations is important, making sure your child has their annual flu shot will be especially important this year. As the pandemic continues, so too will the high amounts of time we spend at home and indoors – where flu viruses can thrive during cold and dry winter weather. Flu shots are typically available starting in late August, and this year HealthPartners and Park Nicollet is offering both shot and FluMist options.
We’ve taken rigorous steps to make our hospitals and clinics as safe as possible for everyone, including the expansion of video visits to make sure people have access to care while reducing visitor traffic. Plus we’ve made specific accommodations like kids-only appointment hours to make bringing your child in for their shots quick, easy and comfortable.
Questions about when and why to vaccinate your child? Talk with a doctor.
If you have questions, we have answers. We have a team of family medicine doctors and pediatricians who are experts in kids’ health. They can talk with you about specific vaccines, walk you through the vaccination schedule, make recommendations based on your child’s medical and immunization history, and more.
If your child is due for their next round of shots or you need to get them caught up, make an appointment at a HealthPartners and Park Nicollet clinic near you.