10 Things to Know About Your Baby’s Vaccination and Immunization Schedule

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10 Things to Know About Your Baby’s Vaccination and Immunization Schedule

The Flu.Pneumonia.COVID-19
Carina Fung, PharmD, BCPPS
By Carina Fung, PharmD, BCPPS
Aug 21, 2020
10 Things to Know About Your Baby’s Vaccination and Immunization Schedule

The CDC recommends that all healthy babies stick to an annually revised vaccination and immunization schedule. If this schedule is followed from birth, your baby will have begun receiving a series of vaccines necessary to prevent illnesses such as polio, rotavirus, Hepatitis A and B, diphtheria, pertussis, tetanus, measles, mumps, rubella, varicella, pneumococcal disease, and influenza (flu) by the time they turn 18 months old.

However, if you started late with vaccinating your baby, or have fallen behind on your baby’s vaccination schedule for any reason, including the COVID-19 pandemic, don’t panic. The CDC offers a convenient catch-up chart if you are late for your baby’s vaccines.

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What vaccines does my baby need?

Babies are born with newborn immunity, which is passed to them from their mother during the third trimester of pregnancy. Because this newborn immunity is only temporary and begins to decrease after the first few weeks or months, your baby will need many vaccines during their first year of life. Fortunately, manufacturers have bundled many of the recommended vaccinations together, to reduce the number of shots infants have to get.

The first vaccination your baby will ever receive is the first dose of Hepatitis B (Hep B), which is given almost immediately after birth. This vaccine is given to all newborns because the mother may unknowingly expose the baby to Hepatitis B during the birthing process. There is no cure for Hepatitis B which can cause liver disease, bleeding disorders, and other long term consequences.

Vaccines at 2 Months

Many pediatricians advise parents to keep their babies away from crowded places for the first few months because their baby’s immune system is not mature yet. When they are 2 months old, babies should begin receiving the first in a series of vaccines to protect them from multiple diseases.

At 2 months, all healthy babies should have already received their second dose of the Hepatitis B vaccine. They should also receive their first rotavirus (RV) vaccine, to prevent disease symptoms and complications including diarrhea, fever, vomiting, and dehydration.

Healthy babies should also receive their first inactivated poliovirus (IPV) vaccination when they are 2 months old. The polio vaccination is available as a stand-alone vaccine, although it is also included in several DTaP combination vaccines.

At 2 months, babies should also receive their first vaccination for Haemophilus influenzae type B (Hib). The Hib vaccine protects babies from this potentially deadly bacteria which can cause meningitis (an infection of the brain and spinal cord), pneumonia, and other life-threatening conditions.

2-month-old babies should receive the combination DTaP vaccine, which prevents diphtheria, tetanus, and acellular pertussis. There are a few combination variations of the DTaP vaccine. For example, Pediarix is a DTaP vaccine bundled with vaccines for Hepatitis B and polio (DTaP-HepB-IPV). Pentacel is a DTaP combination vaccine that also includes polio and Hib vaccines (DTaP-IPV/Hib).

Finally, the pneumococcal 13 (PCV13) vaccine should first be given to a baby when they are 2 months old. This vaccine protects against Streptococcus pneumoniae bacteria, which can cause meningitis and a blood infection known as bacteremia.

Coupons for Vaccines

RxSaver may be able to help you save significantly off the retail price of the vaccine. Be sure to check with your local pharmacy to ensure the pharmacy can administer the vaccine before going.

Here is a breakdown of vaccines at 2 months for babies which RxSaver offers coupons:

Vaccines at 2 Months RxSaver Price at Major Retail Pharmacies Starts at:
Rotarix $133.42
Rotateq $92.59
IPOL Inactivated IPV $77.98
ACTHIB $23.77
Hiberix $17.52
PedvaxHIB $59.76
Pediarix $174.38
Pentacel $107.69
Prevnar $417.06

Vaccines at 4 Months

Your baby’s vaccination schedule includes several second dose vaccines when they are 4 months old. Vaccines given at 4 months may include:

  • RV (2nd of 2 shots total for Rotarix, or 2nd of 3 shots total for RotaTeq)
  • Hib (2nd of 4 shots total for ActHIB, Hiberix, or Pentacel, or 2nd of 3 shots total for PedvaxHIB)
  • DTaP (2nd of 5 shots total)
  • PCV13 (2nd of 4 shots total)
  • IPV (2nd of 4 shots total, which can be given alone as IPOL, or as a combination vaccine with DTaP)

Vaccines at 6 Months

Babies should receive a series of shots when they are 6 months old to maintain their vaccination schedule. Healthy babies should receive their first annual influenza vaccine (IIV) at six months to prevent the flu. During the first year of your baby receiving their first flu vaccine, a second dose is required at least 4 weeks after the first dose. At 6 months old, your baby may also receive their next shots in the vaccine series for:

  • Hep B (3rd of 3 shots total)
  • RV (3rd of 3 shots total for RotaTeq only)
  • Hib (3rd of 4 shots total for ActHIB, Hiberix, or Pentacel)
  • DTaP (3rd of 5 shots total)
  • PCV13 (3rd of 4 shots total)
  • IPV (3rd of 4 shots total, which can be given alone as IPOL, or as a combination vaccine with DTaP)

Vaccines at 1 Year Check-Up

By the time healthy babies turn 12 months old, they should be well on their way towards completing many of the vaccines recommended by the CDC. Between 12-18 months old, they will receive their final shot in the Hib vaccine series. They will also receive their last shot in the PCV13 vaccine series. Babies should receive their fourth DTaP shot before they turn 18 months old.

At their 1 year check-up, known as a “well-baby” check-up, healthy babies may receive a second dose of the flu shot if they have not received it already. They may also receive their last dose of the Hepatitis B vaccine during this appointment with the pediatrician. Your baby will also begin receiving new vaccinations such as the measles, mumps, and rubella (MMR) vaccine.

Healthy babies may also receive a varicella vaccination at their well-baby check. The varicella vaccine is designed to protect against chickenpox.

The third new vaccine given to babies 12 months or older is to prevent Hepatitis A (Hep A). Hepatitis A can lead to liver failure, blood disorders, and/or disorders of the pancreas and the kidney.

Here is a breakdown of RxSaver coupons for new vaccines your 1-year-old baby may require:

Vaccines at 1 Years Old RxSaver Price at Major Retail Pharmacies Starts at:
M-M-R-II $86.37
Varivax $144.81
Havrix $79.43
Vaqta $74.17

Flu Vaccines for Babies

Generally, babies should continue to receive an annual flu shot after their first year of receiving the 2 dose series. This is especially true amid the COVID-19 pandemic. The flu can be very dangerous for babies and children, and can trigger asthma attacks in those with asthma. Given the large numbers of children who have asthma, it is strongly recommended for babies and children to be vaccinated against the flu.

Baby Vaccinations During COVID-19

The COVID-19 pandemic forced some medical offices to temporarily close, operate with limited hours, or postpone many appointments. However, it is very important to resume your baby’s vaccination schedule as soon as possible.

Across the country, pediatricians have implemented new protocols to keep you and your baby safe when taking them to the doctor. Some of the measures being employed to keep you safe during doctor visits include:

  • Limiting the number of patients in the waiting area
  • Recommending patients wait in their cars until called in by the medical staff
  • Seeing healthy babies during certain times of the day, and sick babies during other times of the day
  • Limiting the baby to one guardian for all appointments
  • Offering telemedicine appointments through HIPAA compliant apps

If you believe for any reason that you or your baby have been exposed to COVID-19, or if anyone in your family is showing symptoms of coronavirus, call your doctor before you take your baby into the office.

How long can vaccines be delayed?

Although there are minimum intervals between when your baby can safely receive vaccinations, there are no maximum intervals that would prevent you from receiving a necessary vaccine. It is always better to get a vaccination late than to never complete the vaccination series. . This is particularly true during the COVID 19 pandemic when it is more important than ever that healthy babies receive their recommended vaccinations.

What vaccinations can pharmacists administer?

Traditionally, the vaccines you may be able to receive from a pharmacist varied on a state-by-state basis because unlike the practice of medicine, pharmacy is a state-specific practice. In some states, pharmacists may only administer specific vaccines to adults. In other states, pharmacists may be able to administer all vaccines, even to children.

But recently, the U.S.Department of Health and Human Services (HHS) amended the Public Readiness and Emergency Preparedness Act (PREP Act) in response to the CDC's concern of dropping childhood vaccination rates.

This act allows pharmacists nationwide to provide greater access to care. It outlines specific guidelines and training requirements for all licensed pharmacists to immunize children 3 years old and up according to the CDC vaccination schedule. It may not be much longer before your local pharmacist can begin administering childhood vaccines, if they were not able to do so before.

You’ll need to speak with your local pharmacist to determine which vaccines your baby may be able to receive from them.

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Should all babies be vaccinated?

It is recommended for healthy babies without underlying conditions to be vaccinated on a schedule that aligns with CDC guidelines. Parents of babies with underlying medical conditions should defer to their physician or team of physicians to provide clinical decisions related to the appropriateness and timing of vaccines.

Some babies may need to have vaccines delayed, or may not be healthy enough for vaccines, because they are fighting other severe illnesses. This makes it all the more important for all healthy babies and children to maintain their vaccination and immunization schedule or to catch up, if they have fallen behind due to COVID-19.

Rotarix: 10e6/ml / 1 vial

Rotateq: 2 ml / 1 tube

IPOL Inactivated IPV: 40-8-32 / 0.5 vials

ACTHIB: 10 mcg/0.5 / 1 vial

Hiberix: 10 mcg/0.5 / 1 vial

PedvaxHIB: 7.5mcg/0.5 / 1 vial

Pediarix: 10-25-25 / 1 syringe

Pentacel: 15-20-5-10 / 1 kit

Prevnar: 0.5 ml / 1 syringe

M-M-R-II: 12500/0.5 / 1 vial

Varivax: 1350 unit /1 vial

Havrix: 1440/ml / 1 syringe

Vaqta: 25/0.5 ml / 1 syringe

*Lowest online price at national pharmacy chains Costco, CVS, RiteAid, Walgreens and Walmart as of 8/13/2020. Prices vary by location and pharmacy, see RxSaver.com for actual pricing in your area.

Carina Fung, PharmD, BCPPS

Carina Fung, PharmD, BCPPS

Carina Fung, PharmD, BCPPS., is a pharmacist who earned her PharmD from St. John’s University in Queens, NY. She maintains an active practice, serving as a Board-Certified Pediatric Pharmacotherapy Specialist at a large metropolitan teaching hospital in New York City. Carina has also published in pharmacy journals and works as a consultant reviewing medical articles for publication.

The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.

If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.