Infant Vaccines

An important part of many well-child visits in the first year is vaccination. This is a vital way to protect your child against severe illness. Your child’s doctor will discuss vaccines that are recommended for your child during the well-child visit, and can answer any questions you may have. The vaccines covered in this post are those recommended by the CDC (Center for Disease Control) and AAP (American Academy of Pediatrics) to be given during the well-child visits that occur at 2 mo, 4mo, and 6 mo of age. Toddler vaccines (from 12 mo until 2y) and adolescent vaccines will be discussed in separate posts.  

Recommended infant vaccines include the following: 

• DTaP (Diphtheria, Tetanus, acellular Pertussis)
• IPV (Inactivated Polio)
• Hepatits B 
• PCV (Pneumococcal)
• Hib (Haemophilus influenza b)
• Rotavirus

Why should your infant be vaccinated?

Each of these vaccines protects against very serious, sometimes life-threatening diseases. Let’s look at them individually in more detail. 

DIPHTHERIA is caused by the bacteria Corynebacterium diphtheriae. Infection results in a thick coating in the back of the throat, leading to breathing problems, heart failure, paralysis, and death. Diphtheria spreads from person to person through respiratory droplets, such as exposure to an infected person’s cough or sneeze.

TETANUS (Lockjaw) is caused by the bacteria Clostridium tetani. Infection results in painful muscle tightening and stiffness, usually all over the body. If the muscles in the head or neck are involved, it can progress so that you can’t open your mouth, swallow, or sometimes even breathe. Tetanus bacteria enter the body through “dirty” wounds, such as cuts or punctures that are contaminated by the surrounding environment.

PERTUSSIS (Whooping cough) is caused by the bacteria Bordetella pertussis. Infection results in severe coughing spells, which can cause difficulty sleeping, vomiting, and disturbed sleep. In infants it can cause severe difficulty with breathing and even death. Pertussis is a very contagious disease found only in humans. It spreads from person to person through respiratory droplets, such as exposure to an infected person’s cough or sneeze. 

POLIO (poliomyolitis) is caused by the polio virus. Infection causes a disabling and potentially life-threatening disease that affects a person’s spinal cord, causing paralysis (the inability of a muscle to move). If this paralysis affects the muscles that are responsible for breathing, death can occur. The polio virus is very contagious. It is spread via contact with stool (feces) and respiratory droplets. The polio vaccine is very effective, and the US is currently polio free. However, the disease still occurs in other parts of the world and could be easily brought back through travel to another country by an unvaccinated individual. 

HEPATITIS B is caused by the hepatitis B virus. The infection can develop into a chronic disease that causes liver damage, cirrhosis, liver cancer, and death. The virus is spread from person to person via infected blood, semen, or other body fluids. Transmission occurs through birth (from an infected mother), sexual contact, sharing of needles or syringes, sharing of toothbrushes or razors, direct contact with blood or open sores, exposures to accidental needle sticks. Many people are unknown carriers of the hepatitis B virus. This vaccine is first given shortly after birth to protect infants of mothers who have unknown infections.  

PNEUMOCOCCAL disease is caused by the bacteria Streptococcus pneumoniae. This bacteria causes many different types of diseases, some of which can be serious and life-threatening. Infections caused by pneumococcal bacteria include pneumonia, ear infections, sinus infections, meningitis (infection along the lining of the brain), and bloodstream infections. The bacteria is transmitted via contact with respiratory secretions such as saliva. Children under age 2 are at higher risk, along with those who have certain underlying illnesses such as sickle cell disease, diabetes, HIV infection, immunocompromised conditions, or cochlear implants. 

HAEMOPHILUS INFLUENZAE B (Hib) is caused by the bacteria Haemophilus influenzae type B. This bacteria causes invasive disease including meningitis (an infection along the lining of the brain and spinal cord) and life-threatening throat infections. The bacteria is transmitted from person to person via respiratory droplets, such as exposure to an infected person’s cough or sneeze. This infection primarily affects children under the age of 5. 

ROTAVIRUS disease is caused by the Rotavirus virus. This infection causes a severe watery diarrhea, vomiting, fever, and abdominal pain. Often infants become dehydrated because they cannot keep up with fluid intake compared to the diarrhea output. It is easily transmitted via the fecal-oral route, meaning unwashed hands or other objects become contaminated with stool (feces) and then come in contact with a person’s mouth. It can spread rapidly among young children. 

Schedule of vaccines given in the first year:

Vaccine	Number of doses before 12 mo	Recommended ages
DTaP	3	2mo, 4mo, 6mo
IPV	3	2mo, 4mo, 6mo
HEP B	3	Birth, 2mo, and 6 mo
PCV	3	2mo, 4mo, 6mo
HIB	2 OR 3	2mo, 4mo (sometimes 6 mo depending on vaccine manufacturer)
ROTAVIRUS	2 OR 3	2mo, 4mo (sometimes 6 mo depending on vaccine manufacturer)

Please see specific Vaccine Information Statements for more details about each vaccine, including who is recommended to receive vaccines, contraindications to vaccines, possible side effects, and more. The VIS can be found at your healthcare provider’s office or online at https://www.cdc.gov/vaccines/hcp/vis/index.html

What about side effects?

The most common side effects of any vaccine are fevers, soreness at the site of injection, and fussiness. Some infants are more sleepy than usual or do not eat as well. With any vaccine or medication, there is a small risk of severe allergic reaction. Please talk with your child’s doctor about what to expect and what you can do for common vaccine side effects.  

Who should not be vaccinated?

Talk to your child’s health care provider if your child:

• Has had an allergic reaction after a previous dose of any vaccine, or has any severe, life-threatening allergies.
• Has ever had Guillain-Barré Syndrome (also called GBS).
• Has had severe pain or swelling after a previous dose of any vaccine 

People with minor illnesses, such as a cold, may still be vaccinated. People who are moderately or severely ill should usually wait until they recover before receiving vaccinations. 

Further questions?

Though I talk to parents extensively about vaccines at well-checks, I commonly refer parents who still have questions or hesitancies about vaccinations to the CDC’s website. There is a comprehensive list of vaccines, the diseases they protect against, side effects, and more. I also usually recommend the Children’s Hospital of Philadelphia (CHOP) Vaccine Education Center website. It contains great information that is easy to navigate and understand. 

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