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Immunization Schedule, Children (cont.)

Hepatitis B Vaccine

Hepatitis B is a vaccine-preventable disease that can lead to chronic liver disease and cancer. The infection is spread through contact with the blood and body fluids of an infected person.

  • Infants should receive the first dose at birth. The immunization schedule encourages the use of hepatitis B vaccine for all infants before hospital discharge. The second and third doses are usually given at 1-4 months and at 6-18 months of age. (Specific recommendations are available for infants born to mothers who are infected or carriers of hepatitis B.) A fourth dose may be administered when combination vaccines are administered after the birth dose.
  • Unimmunized children younger than 18 years may begin the series at any age.
  • Two one-shot vaccines that protect infants against five different diseases have been approved by the FDA. That means babies may get six fewer shots during their first few years of life. The combination vaccine (Pediarix) contains hepatitis B vaccine along with DTaP (diphtheria, tetanus, and acellular pertussis vaccine) and inactivated poliovirus vaccine (IPV). Pediarix is recommended to be given as a three-dose primary series to infants at about 2, 4, and 6 months of age. Pediarix should not be given to infants before 6 weeks of age and therefore is not indicated for infants born to mothers who are infected with hepatitis B or whose hepatitis B status is unknown. Another combination vaccine (Pentacel) contains protection against DTaP, polio, and Hemophilus influenzae type B (Hib). Using this protocol requires a separate hepatitis B vaccine injection. Pentacel is routinely administered at 2, 4, 6, and 15-18 months of age.

Diphtheria, Tetanus, Pertussis Vaccine

This combination vaccine (DTaP) is composed of vaccines against diphtheria, tetanus (lockjaw), and pertussis (whooping cough). The use of the acellular pertussis (aP) vaccine is now recommended because it is associated with fewer side effects compared to the previous vaccine.

  • This vaccine is usually given at 2, 4, and 6 months of age. A fourth dose is usually given between 15-18 months of age, as long as it has been six months since the third dose. If the child has received doses one through four before 4 years of age, a booster dose is given before entering kindergarten (4-6 years of age).
  • An adolescent preparation of the tetanus, reduced diphtheria, and acellular pertussis (Tdap) vaccine is recommended for children 11-12 years of age.
  • Subsequent booster shots of tetanus and diphtheria (Td) are recommended every 10 years.
  • Some children may have a fever and injection site pain and swelling after this vaccine. To reduce this discomfort, one may give a child acetaminophen for 24–48 hours after their injection.
Medically Reviewed by a Doctor on 11/10/2015

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