Immunizations (Vaccines)

Older children and teenagers must continue an immunization schedule to remain healthy. They may require boosters for some vaccine-preventable diseases. Older children are also susceptible to additional illnesses and require new immunizations.

The teenage years are a good time to catch up on any missed vaccinations such as the:

• Tetanus, Diphtheria, Pertussis (Tdap) vaccine
• Hepatitis B vaccine
• Hepatitis A vaccine
• Polio vaccine
• Measels, Mumps, Rubella (MMR) vaccine
• Chickenpox (varicella) vaccine

Children with certain health problems who are at high risk for serious disease may require extra vaccines to stay healthy, including the:

• Pneumococcal Vaccine (PCV)
• Meningococcal Conjugate Vaccine (MCV4) between ages 7 and 10

At Riley at IU Health, we follow the evidenced-based guidelines and recommendations for immunizations from the Centers for Disease Control and Prevention. Our doctors work with you to provide the vaccines your child needs at the right time to maintain optimal health.

Recommended Vaccines

Chickenpox (Varicella) Vaccine

• Immunization given: between 12 months and 15 months old, with a booster between 4 and 6 years of age

Varicella is always present in the community and is highly contagious. Before the chickenpox vaccine became available in 1995, the virus had infected almost every adult in the United States. Chickenpox was responsible for an estimated 4 million illnesses, 11,000 hospitalizations and 100 deaths each year. Chickenpox is usually mild but may be severe. Complications such as bacterial infections, loss of fluids (dehydration), pneumonia and infections of the central nervous systems can occur. Furthermore, even after the chickenpox infection has healed, the inactivated virus remains in the body and can cause shingles. Shingles is a painful rash that occurs when the inactive virus living in a nerve becomes active. It affects about 300,000 people each year. Only people who have had chickenpox can get shingles.

Diphtheria, Tetanus, Acellular Pertussis (DTaP) Vaccine

• Immunization given: at 2 months, 4 months and 6 months old, between 15 and 18 months old and again between 4 and 6 years of age
• Booster immunization given: between 11 and 12 years of age and at 16 to 18 years of age—the booster vaccine given for this disease is Tetanus, Diphtheria, Acellular Pertussis (Tdap)

Diphtheria is a serious bacterial infection that can lead to heart and nerve problems. The death rate is 5 percent to 10 percent, with higher rates (up to 20 percent) in infants. In the 1920s, diphtheria was a major cause of illness and death for children in the United States. Although diphtheria is now rare in the U.S., it is still a threat. Diphtheria is common in other parts of the world.

Tetanus is a severe, often fatal disease. The bacteria that cause tetanus are widely distributed in soil and street dust, are found in the waste of many animals and are resistant to heat and germ-killing cleaners. People who get tetanus suffer from stiffness and spasms of the muscles. The larynx (windpipe) can close, causing breathing difficulties. Muscle spasms can be so severe that they cause bone fractures. In extreme cases, people can become comatose and even die. Approximately 30 percent of people who develop tetanus die worldwide.

Pertussis (whooping cough) is most severe during the first year of life. Newborns with whooping cough may have apnea (stop breathing) and die. Even in older children, it can cause prolonged coughing spells that last for many weeks. These spells make eating, drinking and breathing difficult. When the coughing spells cause vomiting, infants lose weight and become dehydrated. Other complications of pertussis include pneumonia, seizures, infections of the central nervous system and rarely death.

Haemophilus Influenzae (Hib) Vaccine

• Immunization given: at 2 months, 4 months and 6 months old and between 12 and 15 months old

Before the Hib vaccine became available in 1985, Haemophilus influenzae was the most common cause of bacterial meningitis in infants and children, affecting about 16,000 children in the United States each year. Prior to 1985, 1 in 20 children with Haemophilus meningitis died. Twenty percent to 30 percent of survivors were left with permanent brain damage.

Hepatitis B Vaccine

• Immunization given: at birth, between 1 month and 2 months old and again between 6 months and 18 months old

Hepatitis B is a serious liver disease caused by a virus. The hepatitis B virus is spread by contact with blood or other body fluids of an infected person. Hepatitis B can enter the bloodstream, attack the liver and cause severe illness and, in extreme cases, death. Infants and children who become infected with the hepatitis B virus are at the highest risk of developing lifelong infection, which often leads to death from liver disease and liver cancer. Approximately 25 percent of children who become infected with lifelong hepatitis B virus die of related liver disease as adults.

Influenza (Flu) Vaccine

• Immunization given: yearly starting at 6 months old

Influenza is highly contagious and is carried in the air and by direct contact. Symptoms include fever, muscle pain, sore throat, cough and extreme fatigue. A complication of flu is pneumonia. Studies show that the flu vaccine reduces the risk of flu illness by between 50 percent and 60 percent among the overall population during seasons when most circulating flu viruses are like the vaccine viruses. During the flu seasons of 2010 to 2012, the flu vaccine reduced children’s risk of flu-related pediatric intensive care unit admissions by 74 percent. The flu vaccination also helps protect pregnant women and their babies for up to six months after birth. Giving the flu vaccine to pregnant women is 92 percent effective in preventing hospitalization of infants for flu. The flu vaccine is believed to have prevented 67,000 flu-related hospitalizations in the 2014-2015 season, during which 40 million people contracted the flu.

Measles, Mumps, Rubella (MMR) Vaccine

• Immunization given: between 12 and 15 months old and between 4 and 6 years of age

Before the measles vaccine was available, nearly everyone in the United States got measles (seven-day measles). There were approximately 3 million to 4 million cases each year. As many as 20 percent of people with measles required hospitalization, and almost 10 percent suffered complications such as diarrhea, ear infections and pneumonia. When the virus infects the brain, permanent damage to brain function occurs. Measles is one of the most infectious diseases in the world. More than 90 percent of people who are not immune will develop measles if they are exposed to the virus. In 1998, most cases of measles were associated with international visitors or United States residents who were exposed to the measles virus while traveling abroad. With more parents refusing immunizations for their children, there is an increase in measles cases in the U.S.

Before the mumps vaccine was introduced, mumps caused deafness in about 1 in every 20,000 reported cases in children. Mumps is usually a mild viral disease. However, rare conditions, such as swelling of the brain, nerves and spinal cord, can lead to serious side effects such as paralysis and seizures. Serious side effects of mumps are more common in adults than in children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 20 percent to 50 percent of men who become ill with mumps. An increase in miscarriage has been found among women who develop mumps in the first three months of their pregnancy.

Rubella (German measles or three-day measles) is usually mild in children and adults, but up to 90 percent of infants born to mothers who become infected with rubella in the first three months of pregnancy will develop congenital rubella syndrome, resulting in heart defects, cataracts, mental retardation and deafness.

PCV Vaccine

• Immunization given: at 2 months, 4 months and 6 months old and between 12 and 15 months old

Pneumococcal infections include ear infections, sinusitis, pneumonia and meningitis. All of these diseases can have serious complications, such as respiratory failure and bacteria in the blood. Pneumococcal disease kills about 40,000 people in the world each year.

Inactivated Poliovirus Vaccine (IPV)

• Immunization given: at 2 months and 4 months old, between 6 months and 18 months old and again between 4 and 6 years of age

Poliovirus can cause minor infections that heal after a few days, or it can cause rapidly progressive, serious infections that are complicated by paralysis, permanent physical disability and even death. Before the polio vaccine was available in the United States, 13,000 to 20,000 cases of paralytic polio occurred each year. These annual epidemics left thousands of victims—mostly children—in braces, crutches and wheelchairs for life.

Rotavirus Vaccine

• Immunization given: at 2 months, 4 months and 6 months old

Rotavirus spreads by the mouth and is most often contracted by infants and young children. It causes inflammation of the stomach and intestines (gastroenteritis). This leads to diarrhea, fever, vomiting and abdominal pain. The diarrhea can be severe and can cause dehydration. The rotavirus vaccine was introduced in 2006. In 2008, rotavirus caused an estimated 453,000 deaths worldwide in children younger than 5 years of age. Each year, the vaccine prevents an estimated 40,000 to 50,000 hospitalizations among U.S. infants and young children.

Hepatitis A Vaccine

• Immunization given: at 12 months of age and again at 18-24 months of age

Hepatitis A is an infection in the liver caused by the hepatitis A virus. The virus spreads from person to person orally from contact with objects, food or drinks contaminated by the feces (stool) of an infected person. Symptoms include fever, fatigue, loss of appetite, nausea, abdominal discomfort, dark urine and jaundice (yellowing of the skin and eyes). An infected person may have no symptoms, may have mild illness for a week or two or may have severe illness for several months that requires hospitalization. About 100 people in the U.S. die from hepatitis A each year.

Human Papillomavirus (HPV) Vaccine

• Immunization given: between 9 and 12 years of age

Human papillomavirus is a common virus. HPV is most common in people in their teens and early 20s. It is the major cause of cervical cancer in women and genital warts in women and men. The strains of HPV that cause cervical cancer and genital warts are spread during sex. The vaccine is recommended for boys and girls. Every year, about 17,600 women and 9,300 men are affected by cancers caused by HPV. For HPV vaccines to be effective, they should be given before sexual activity begins. There is no reason to wait until a teen is having sex to offer HPV vaccination. Preteens should receive all three doses of the HPV vaccine series long before they begin any type of sexual activity and are exposed to HPV. The HPV vaccine produces a higher immune response in preteens than it does in older teens and young women.

Meningococcal Conjugate Vaccine (MCV4)

• Immunization given: between 11 and 12 years of age
• Booster immunization given: at 16 years of age

Meningococcal disease is caused by bacteria and is a leading cause of bacterial meningitis (infection around the brain and spinal cord). The bacteria are spread through the exchange of nose and throat droplets, such as when coughing, sneezing or kissing. Symptoms include nausea, vomiting, sensitivity to light, confusion and sleepiness. Meningococcal disease also causes blood infections. About 1 in every 10 people who get the disease dies from it. Survivors of meningococcal disease may lose their arms or legs, become deaf, have hearing or vision loss, become developmentally disabled or suffer seizures or strokes. The disease is most common in infants and adolescents between the ages of 16 and 23. In 2013, there were 550 reported cases in the U.S.

Serogroup B Meningococcal (MenB) Vaccine

• Immunization given: at age 16 (two doses given at least one month apart)

There are different serogroups of bacteria that cause meningococcal disease. Serogroup B is one of five groups that cause most infections. Meningococcal disease causes meningitis and infections of the blood (bacteremia or septicemia). It can easily spread among people who live together, such as college students living in a dorm, by sharing food and utensils, coughing, sneezing and kissing. Even when treated, meningococcal disease kills 10 to 15 infected people out of 100. Among those who recover, about 10 to 20 out of every 100 will suffer disabilities such as hearing loss, brain damage, amputations, speech loss and vision loss or severe scars from skin grafts.

Recommended Immunization Schedule

Your child’s doctor will talk with you about the best time to give all of the immunizations your child needs to stay healthy. The schedule below is recommended by the American Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease Control and Prevention.

Birth

• Hepatitis B #1

1 month old

• Hepatitis B #2

2 months old

• DTaP #1
• Polio (IPV) #1
• Hib #1
• Pneumococcal Vaccine (PCV) #1
• Rotavirus

4 months old

• DTaP #2
• Polio (IPV) #2
• Hib #2
• Pneumococcal Vaccine (PCV) #2
• Rotavirus

6 months old

• DTaP #3
• Hib #3
• Pneumococcal Vaccine (PCV) #3
• Hepatitis B #3
• Polio #3
• Rotavirus

12 months old

• MMR #1
• Varicella vaccine
• Hepatitis A #1

15 months old

• Hib #4
• Pneumococcal Vaccine (PCV) #4
• DTaP #4

18 months old

• Hepatitis A

4-6 years old

• DTaP #5
• Polio (IPV) #4
• MMR #2
• Varicella booster

Ages 9-12

• Tdap
• HPV (three doses)
• MCV4

Age 16

• MCV4 booster
• MenB (two doses)

Yearly starting at 6 months old

• Influenza vaccine

The following vaccines should be given again if previously recommended doses were missed or given earlier than the recommended age:

• Hepatitis B
• MMR
• Varicella vaccine

Printable Resources

• Recommended Immunizations for Infants and Children Up to 6 Years Old–Riley at IU Health
• Recommended Immunizations for Children Ages 7-18–Riley at IU Health
• Vaccine-Preventable Diseases and the Vaccines That Prevent Them–Riley at IU Health

Online Resources

View the trusted Web pages below from the Centers for Disease Control and Prevention to learn more about vaccine-preventable childhood diseases.

• Chickenpox (Varicella)
• Diphtheria
• Haemophilus Influenzae (Hib)
• Hepatitis A
• Hepatitis B
• Human Papillomavirus
• Influenza
• Measles
• Meningococcal Disease
• Mumps
• Pertussis
• Polio
• Rotavirus
• Rubella
• Serogroup B Meningococcal
• Tetanus