Pediatric Immunizations Overview

Pediatric Immunizations

Immunizations have been one of the single greatest advances in preventive medicine. Throughout Northwestern Medicine, we believe immunizations are an essential part of well-child care. Our providers follow the standard Centers for Disease Control and Prevention (CDC) guidelines for immunizations for all of our patients.

We keep up to date with the newest vaccine products, recommendations, and take our immunization practice seriously. We discourage alternative vaccine schedules. We also participate in the Vaccines for Children Program, a government sponsored program providing federally funded vaccines for children whose insurance doesn’t cover the cost of vaccines. Types of immunizations include:

DTaP/Tdap: The DTaP vaccine is a "three-in-one" vaccine that protects against diphtheria, tetanus, and pertussis. DTaP immunization is usually a series of injections given to children at ages two months, four months, six months, fifteen months and four years. DTaP is recommended unless there is a reason that the child should not receive the pertussis vaccine (such as allergic reaction), in which case the DT should be given. After the initial series of immunizations, a booster of Tdap vaccine should be given.

Tdap: Tetanus, diphtheria and acellular pertussis booster. This vaccine was licensed in 2005 and is recommended as a booster dose at the 10-11 year exam. It is similar to the tetanus booster of the past, however, it has the additional whooping cough (Pertussis) component that boosts immunity to this bacterial illness. Waning immunity through the late childhood years has allowed older siblings and parents to be the main source of spreading this serious illness to younger infants and children. By boosting your ten-year-old’s immunity to this illness, we are not only providing immunity to them, but also decreasing the spread of infection to younger children who are more vulnerable. Parents should talk to their physician about obtaining their booster as well.

MMR: The MMR vaccine is a "three-in-one" vaccine that protects against measles, mumps and rubella—all of which are potentially serious diseases of childhood. The MMR is one of the recommended childhood immunizations. The first shot is recommended at 12 months. A second MMR is recommended prior to school entry at four years or prior to entry into junior high at 11-13 years. Some states require a second MMR at kindergarten entry.

HiB: This vaccine prevents childhood Haemophilus influenza B infections, which can cause a severe and potentially fatal illness. Haemophilus B conjugate vaccine is one of the recommended childhood immunizations. Generally, states require proof that a child has received the vaccine prior to entry into daycare or preschool. Infants and toddlers should receive injections of the vaccine at two months, four months, six months, and fifteen months of age.

Prevnar: This vaccine provides immunization against Streptococcus pneumoniae, a bacterium that frequently causes meningitis and pneumonia in the elderly and in people with chronic illnesses. It effectively prevents illnesses caused by Streptococcus pneumoniae in children under the age of two years old and adults at risk. Pneumococcal pneumonia accounts for 10 to 25 percent of all pneumonias. It is a four-dose series.

Hepatitis B: This immunization protects against Hepatitis B, a serious disease which causes inflammation and damage to the liver and may lead to cirrhosis of the liver, chronic liver disease and liver cancer. The Hepatitis B vaccine is one of the recommended childhood immunizations. Hepatitis infection is spread through contact with the blood and body fluids of an infected person. It can also be passed from mother to baby in pregnancy. Hepatitis B vaccine is given as a series of three injections. The first shot is given to infants shortly after birth. All three doses are necessary for the most effective and longest lasting immunity.

Hepatitis A: This immunization protects against Hepatitis A, a serious disease that causes inflammation and damage to the liver. The Hepatitis A vaccine is one of the recommended childhood immunizations. Hepatitis A is transmitted by contaminated food or water, or contact with the blood and body fluids of an infected person. The first shot is given to infants at 15 months.

IPV: Polio immunization protects against a severe, paralyzing disease caused by poliomyelitis. Polio vaccination is one of the recommended childhood immunizations and vaccination should begin during infancy. In most parts of the United States, polio immunization is required before a child can start school. Children should receive four doses of IPV: one dose each at ages two months, four months, six months and four years. Children who have received three doses of IPV before age four should receive a fourth dose before or at the time of school entry. The fourth dose is not needed if the third dose is given on or after the fourth birthday.

Varicella: This vaccine (Varivax) protects against chickenpox, a disease caused by the varicella-zoster virus. Chickenpox is characterized by a rash that forms blisters and is generally mild. However, some children can develop serious, even life-threatening, complications from chickenpox. The American Academy of Pediatrics (AAP) and the CDC recommend the chickenpox vaccine for children at age 12 months and a booster dose is given at four years. People 13 and older who have not received the vaccine and have not had chickenpox should get two doses four to eight weeks apart. Children who receive the vaccine before age 13 only need to receive one dose.

Menactra: This vaccine protects against some strains of bacterial meningitis. Acute bacterial meningitis is a true medical emergency, and requires immediate hospital-based treatment. Bacterial strains that cause meningitis include Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitis (meningococcus), Listeria monocytogenes and many other types of bacteria. This vaccine does not protect against all strains of bacterial meningitis, however, the protection received from this vaccine is important especially for college-age students living in dorms. This vaccine is recommended for children at age 11. 

Influenza: This vaccine is now recommended for all children aged six months and older. For children under nine years, the first time they receive the flu shot, they will need a series of two vaccines, one month apart. Subsequent years, they will only need one vaccine. For children older than two years, we offer the FluMist® vaccine—a modified live viral vaccine. This vaccine is administered through the nose and does not involve a shot. Talk to your provider about which product is best for your child. We have flu clinics on Saturdays in the winter, and at times we are able to offer the vaccine to parents as well.

Rotavirus: This vaccine protects people from contracting rotavirus, which is the leading cause of gastroenteritis in children and can also occur in adults exposed to children with the virus. Rotavirus causes severe gastroenteritis in infants and young children. Severe dehydration and death can occur in the young age group. It is responsible for up to 50 percent of the hospitalizations of children with diarrhea. Outbreaks may also occur in geriatric settings such as nursing homes. This vaccine is an oral series that starts at two months of age.

HPV: Human papillomavirus (HPV) is a sexually transmitted infection that can lead to genital warts and/or cancer. Because HPV can lead to cancer, it is important to prevent it.

The HPV vaccine (Gardasil 9) protects against nine types of HPV types. It helps prevent cancers such as:

• Cervix
• Vagina
• Vulva
• Anus
• Penis
• Oropharynx (throat)

Gardasil 9 is given as a two-dose or three-dose series of vaccinations. The CDC recommends that children between 11 and 12 get vaccinated against HPV. However, children as young as 9 can get vaccinated.

If a child gets the first vaccination in the series before they turn 15, two doses are recommended. The second dose is typically given six to 12 months after the first one.

People who start the vaccine series at between age 15 through 26 need to get three doses.

Even though Gardasil 9 is given to children, teens and young adults, it helps protect them against HPV for their entire life.