A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen.[2] Vaccines go through multiple phases of trials to ensure safety and effectiveness.

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Example Polish call for vaccination against Diphtheria and Tetanus.
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Global vaccination coverage 1980 to 2019 among one year olds[1]

Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years.[3] Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many new vaccines have been developed.[4]

Some vaccines are recommended only in certain areas (countries, sub national areas, or at-risk populations) where a disease is common. For instance, yellow fever vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease.[5] In developing countries, vaccine recommendations also take into account the level of health care access, the cost of vaccines and issues with vaccine availability and storage. Sample vaccination schedules discussed by the World Health Organization show a developed country using a schedule which extends over the first five years of a child's life and uses vaccines which cost over $700 including administration costs while a developing country uses a schedule providing vaccines in the first 9 months of life and costing only $25.[6] This difference is due to the lower cost of health care, the lower cost of many vaccines provided to developing nations, and that more expensive vaccines, often for less common diseases, are not utilized.

Worldwide

The World Health Organization monitors vaccination schedules across the world, noting what vaccines are included in each country's program, the coverage rates achieved and various auditing measures.[7] The table below shows the types of vaccines given in example countries. The WHO publishes on its website current vaccination schedules for all WHO member states.[8] Additional vaccines are given to individuals more likely to come into contact with specific diseases through work or travel (e.g. military), or after potentially infectious exposure. Examples include rabies, anthrax, cholera and smallpox.[9][10]

More information Country, Required for school ...
Vaccines used for each infection in each country
  Mandatory to all
  Mandatory to specific people
  Recommended to all
  Recommended to specific people
  Neither mandatory nor recommended to anyone
  1. Category B (i.e. not even recommended but for a personal care only) for the elderly. The public insurance partially covers the vaccination cost.
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By country

Australia

The Immunise Australia Program implements the National Immunization Program (NIP) Schedule. All vaccines available under the Australian immunization schedule are free of charge under the Pharmaceutical Benefits Scheme.[16]

More information Infection, Birth ...
Vaccine Schedule for Australia: 1 April 2019[17]
Infection Birth Months Years Preg
Women
2 4 6 12 18 4 12–<13 14–<16 >15 >50 65+ 70
Rotavirus RV RV
Hepatitis A HepA§[lower-alpha 1] HepA§[lower-alpha 1]
Hepatitis B HepB DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib[lower-alpha 2]
Diphtheria Tdap Tdap
Pertussis
Tetanus
Polio DTaP-HepB-IPV-Hib
Haemophilus influenzae
Meningococcus MenACWY MenACWY MenACWY MenACWY[lower-alpha 2]
Pneumococcus PCV13 PCV13 PCV13# PCV13 PCV13[lower-alpha 2]
PCV13§[lower-alpha 1]
PPSV23# PPSV23#§ PPSV23§ PPSV23
Measles MMR MMRV MMRV[lower-alpha 2]
Mumps
Rubella
Varicella
Human papillomavirus HPV x2 HPV x2[lower-alpha 2]
Influenza IIV (yearly) IIV (yearly)
IIV (yearly)#
IIV (yearly)§
Herpes Zoster ZVL
  •   † Recommended ages for everyone.
  •   # Recommended ages for certain other high-risk groups.
  •   ‡ Recommended ages for catch-up immunization.
  •   § Recommended range of additional vaccinations for Aboriginals and Torres Strait Islanders.
  1. All people aged less than 20 years are eligible for free catch up vaccines.
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Austria

Austrian vaccine recommendations are developed by the National Vaccination Board (German: Nationales Impfgremium), which is part of the Federal Ministry of Social Affairs, Health, Care and Consumer Protection.[18]

Children aged 14 and older can be vaccinated without parental consent.[19]

Brazil

All recommended vaccines are provide free of charge by the public health services.

More information Infection, Gestation ...
Brazilian National Vaccination Schedule: 2019[20]
Infection Gestation Birth Months Years
2 3 4 5 6 9 12 15 4 5 9 11 10–59 60+
Tuberculosis BCG
Leprosy
Hepatitis A HepA
Hepatitis B HepB5V5V5V
Diphtheria DTPaDTPDTPdT
Tetanus
Pertussis
Haemophilus influenzae
Polio IPVIPVIPVOPVOPV
Pneumococcus 10v10v10v
Meningococcus MenCMenCMenCMenC
Rotavirus RVRV
Measles MMRMMRV
Mumps
Rubella
Varicella VV
Yellow fever YF
Human papillomavirus HPV x2 (girls)HPV x2 (boys)
Flu IIVIIV (yearly)IIV (yearly)
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Canada

In Canada, publicly funded immunization schedules may vary from province or territory.

Alberta

More information Infection, Months ...
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British Columbia

More information Infection, Months ...
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New Brunswick

More information Infection, Birth ...
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Ontario

Quebec

Finland

More information Infection, Birth ...
Vaccination Schedule for Finland[24][25]
Infection Birth Months Years
2 3 5 6 12 18 3 4 6 11–12 14–15 25 65+
Tuberculosis BCG[lower-alpha 1]
Rotavirus RV RV RV
Diphtheria DTaP DTaP DTaP DTaP Tdap Td (10yearly)[lower-alpha 2]
Tetanus
Pertussis
Polio IPV IPV IPV IPV
Haemophilus influenzae HIB HIB HIB
Hepatitis B HepB
Pneumococcus PCV10[26] PCV10[26] PCV10[26] PCV13 + PPSV23[26][lower-alpha 3]
Measles MMR[lower-alpha 4] MMRV
Mumps
Rubella
Varicella[lower-alpha 5] VV
Human papillomavirus HPV[27]
Influenza IIV3[lower-alpha 6] IIV3
Tick-borne encephalitis TBE[lower-alpha 7]
  1. For specific at risk-groups only (to be given at the earliest age))
  2. Thereafter Td booster every 10 years with or without vaccination against poliomyelitis (IPV) in case of travel to endemic areas and when previous IPV dose was given more than 5 years before
  3. Recommended but not free of charge for those over 65 years.
  4. Vaccination can be given from 6 months of age in case of travel abroad. If vaccination starts before 12 months of age, 2 doses are recommended (14–18 months and 6 years) The temporary recommendation of giving measles at 12 months of age was made a permanent recommendation; ie. now MMR should be given from 12–18 months except if travelling abroad to measles infected countries when it can be given from 6 months on. In case MMR is given at 6–11 months, the child needs a second and third dose to complete the series.
  5. Varicella vaccination implemented from 1 September 2017. Catch-up to all those born on 1 January 2006 or after and with no history of varicella.
  6. One or two doses administered depending on previous influenza vaccination history. Annual vaccination. IIV tri-or quadrivalent used as follows: IIV3 for all those 6–35 months. IIV4 with nonpreferential alternative to all those 24–35 months. IIV3 also recommended to medical risk group children from 36 months up.
  7. TBE vaccination for to those living permanently on the island of Åland
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History
1960: Mumps vaccinations for military recruits.
1975: Measles vaccination for 1 year old children.
1975: Rubella vaccination for 11–13 years old girls and seronegative mothers.
1982: Two doses of MMR vaccination at 14–18 months and 6 years of age were introduced in the national childhood vaccination programme.
2009: Rotavirus vaccine introduced at 2, 3 and 5 months to all children (September 2009)
2010: PCV introduced at 3, 5 and 12 months of age to all children (September 2010).
2013: HPV vaccination of girls introduced
2017: Varicella vaccination introduced (1 September 2017) at 18 months, 6 years + catch-up of all born from 1 January 2006 or after with no history of varicella.
2020: HPV vaccination of boys introduced[28]

France

More information Infection, Months ...
Vaccination Schedule for France
Infection Months Years
0 1 2 4 6 11 12 13 15 16–18 23 2 5 6 11–13 25 45 65+
Tuberculosis BCG BCG#
Diphtheria D D D D D d
Tetanus TT TT TT TT TT
Pertussis acP acP acP acP acp
Polio IPV IPV IPV IPV IPV
Haemophilus influenzae Hib Hib Hib
Hepatitis B HepB HepB HepB HepB HepB
Pneumococcus PCV PCV PCV
Meningococcus MenC
Measles MEAS MEAS
Mumps MUMPS MUMPS
Rubella RUMBE RUMBE
Human papillomavirus HPV
Influenza TIV
Herpes Zoster HZ
  † General Recommendation   # Recommended for specific groups only.   ‡ Catch-up
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Germany

In Germany, a vaccination schedule is developed by the Standing Committee on Vaccination (STIKO), which operates as part of the Robert Koch Institute. The recommendations are generally adopted by the Federal Joint Committee.

More information Infection, Weeks ...
Vaccination Schedule for Germany
Infection Weeks Months Years
6 2 3 4 11 12 14 15 23 2 5–6 9 14 15 17 18–45 59 >60
Rotavirus RV RV RV
Diphtheria D D D D D d d d d
Tetanus TT TT TT TT TT TT TT TT TT
Pertussis acP acP acP acP acP acP acp acp acp
Polio IPV IPV IPV IPV IPV IPV IPV IPV
Haemophilus influenzae Hib Hib Hib Hib Hib Hib
Hepatitis B HepB HepB HepB HepB HepB HepB
Pneumococcus PCV PCV PCV PCV PCV Pnc# PPSV23
Meningococcus MenC MenC
Measles MEAS MEAS MEAS MEAS#
Mumps MUMPS MUMPS MUMPS
Rubella RUMBE RUMBE RUMBE
Varicella VAR VAR VAR
Human papillomavirus HPV HPV
Influenza TIV
Tick-borne Encephalitis TBE#
  † General Recommendation   # Recommended for specific groups only.   ‡ Catch-up
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Hong Kong

In Hong Kong, Department of Health is responsible for providing free vaccinations from newborns up to primary school students.

India

In India, the standard vaccination schedule is recommended by the Indian Academy of Paediatrics(IAP).[29] The latest schedule was the one given in 2016.[30]

Italy

More information Infection, Birth ...
Vaccination Schedule for Italy
Infection Birth Months Years
3 5–6 11 13 15 5–6 11–18 65+
Diphtheria D D D D d
Tetanus TT TT TT TT TT
Pertussis acP acP acP acP acp
Polio IPV IPV IPV IPV
Haemophilus influenzae Hib Hib Hib
Hepatitis B HepB# HepB HepB HepB
Pneumococcus PCV PCV PCV
Meningococcus MenC MenC
Measles MEAS MEAS MEAS
Mumps MUMPS MUMPS MUMPS
Rubella RUMBE RUMBE RUMBE
Varicella VAR
Human papillomavirus HPV
Influenza TIV
  † General Recommendation   # Recommended for specific groups only.   ‡ Catch-up
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Japan

The vaccination schedule in Japan is defined and partially recommended by Immunization Act [ja] (Japanese: 予防接種法) and its related cabinet order [ja] (Japanese: 予防接種法施行令).[14][15] By the combined laws, infections are categorized into two groups: Category A is recommended for vaccination to prevent pandemic whereas Category B is only for a personal care purpose.[31] As of January 2020, fourteen infections are Category A diseases and two are Category B on the legal lists.[14][15] The Act and the Order were enacted for mandatory vaccination in 1948 with punitive clauses, only the clauses were repealed in 1976 and eventually vaccination has become non-mandatory since 1994.[32]

More information Infection, Act/Order (Category) ...
Japan Vaccine Schedule: January 2020[14][15]
Infection Act/
Order
(Category)
Birth Months Years
2 3 6 12 24 36 60 ≧5[lower-alpha 1] 7>[lower-alpha 1] 7.5
(90 mo)
9 11 12[lower-alpha 2] 13> 16[lower-alpha 2] 60–64[lower-alpha 3]
& 65+
Diphtheria Act (A)DTaP-IPVDT
Tetanus Act (A)
Pertussis Act (A)
Polio Act (A)
Measles Act (A)MR (1st)MR (2nd)
Rubella Act (A)
Japanese encephalitis Act (A)Japanese encephalitis (1st)Japanese encephalitis (2nd)
Tuberculosis Act (A)BCG
Haemophilus influenzae Act (A)Hib
Pneumococcus Act (A)Pneumococcal
Order (B)Pneumococcal
Human papillomavirus Act (A)HPV vaccine
Smallpox Order (A)Not specified by the act or the order
Varicella Order (A)Varicella
Hepatitis B Order (A)Hep B
Influenza Order (B)Flu
  1. Vaccines for measles and rubella (MR vaccine) can be received anytime from 5 y/o before 7 y/o, AND the time should be also between one year and one day before the first day of schooling (quote: "五歳以上七歳未満の者であって、小学校就学の始期に達する日の一年前の日から当該始期に達する日の前日までの間にあるもの".
  2. HPV for female students only. Vaccination can be started from the first day of school year within she turns 12, and until the last day of school year within she turns 16 (quote: "十二歳となる日の属する年度の初日から十六歳となる日の属する年度の末日までの間にある女子").
  3. Age 60–64 with certain diseases: heart, kidney or respitory failures, or with an immune-related disorder due to HIV infection.
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Only in the legal term in Japan, citizens get old one day before their birthdays. If a person was born on January 1, 2020, and Immunization Act specifies vaccine against measles could be received from age 12 months to 24 months, vaccination shall be practiced between December 31, 2020, and December 31, 2021 (not between January 2021 and January 2022.)[33][34] Some vaccinations are scheduled in line with the school year system, which starts from April 1 in Japan.[35] As explained, those who born on April 1 and on April 2 get old legally on March 31 and April 1, respectively. Thus, these two people are in different school years and thereby they may take vaccines in different calendar years.

More information Recipients, Birth ...
Legal age counting system in Japan[33][34][35]
Recipients Birth Months Years
2 3 6 12 24 36 60 ≧5[lower-alpha 1] 7>[lower-alpha 1] 7.5
(90 mo)
9 11 12[lower-alpha 2] 13> 16[lower-alpha 2]
Person A[lower-alpha 3] Dec 31, 2019Feb 29, 2020[lower-alpha 4]Mar 30, 2020Jun 30, 2020Dec 30, 2020Dec 30, 2021Dec 30, 2022Dec 30, 2024Apr 1, 2025Mar 31, 2026Jun 30, 2027Dec 30, 2028Dec 30, 2030Apr 1, 2031Dec 29, 2032Mar 31, 2036
Person B[lower-alpha 3] Jan 1, 2020Feb 29, 2020[lower-alpha 4]Mar 31, 2020Jun 30, 2020Dec 31, 2020Dec 31, 2021Dec 31, 2022Dec 31, 2024Apr 1, 2025Mar 31, 2026Jun 30, 2027Dec 31, 2028Dec 31, 2030Apr 1, 2031Dec 30, 2032Mar 31, 2036
Person C[lower-alpha 3] Apr 1, 2020May 31, 2020Jun 31, 2020Sep 30, 2020Mar 31, 2021Mar 31, 2022Mar 31, 2023Mar 31, 2025Apr 1, 2025Mar 31, 2026Sep 30, 2027Mar 31, 2029Mar 31, 2031Apr 1, 2031Mar 30, 2033Mar 31, 2036
Person D[lower-alpha 5] Apr 2, 2020Jun 1, 2020Jul 1, 2020Oct 1, 2020Apr 1, 2021Apr 1, 2022Apr 1, 2023Apr 1, 2025Apr 1, 2026Mar 31, 2027Oct 1, 2027Apr 1, 2029Apr 1, 2031Apr 1, 2032Mar 31, 2033Mar 31, 2037
  1. Vaccines for measles and rubella (MR vaccine) can be received anytime from 5 y/o before 7 y/o, AND the time should be also between one year and one day before the first day of schooling (quote: "五歳以上七歳未満の者であって、小学校就学の始期に達する日の一年前の日から当該始期に達する日の前日までの間にあるもの".
  2. HPV for female students only. Vaccination can be started from the first day of school year within she turns 12, and until the last day of school year within she turns 16 (quote: "十二歳となる日の属する年度の初日から十六歳となる日の属する年度の末日までの間にある女子").
  3. Starts elementary schooling from April 1, 2026
  4. 2020 is a leap year. Person B socially turns 2 months old on March 1, 2004. In the legal term, however, Person B's 2-month birthday is the day before March 1, 2004. Thus, It shall be February 29, 2004. There are no February 30 or 31 in 2020. As a result Person A and Person B have the same 2-month birthday.
  5. Starts elementary schooling from April 1, 2027
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New Zealand

More information Infection, Gestation ...
New Zealand Immunization Schedule: 1 October 2020[36]
Infection Gestation Weeks Months Years
6 3 5 12 15 4 11–12 45 65+
Rotavirus RV RV
Diphtheria Tdap DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-HepB-IPV-Hib DTaP-IPV Tdap Tdap Tdap
Tetanus
Pertussis
Polio
Hepatitis B
Haemophilus influenzae Hib
Pneumococcus PCV10 PCV10 PCV10
Measles MMR MMR
Mumps
Rubella
Varicella VV VV[lower-alpha 1]
Human papillomavirus HPV9
Herpes Zoster HZ
Influenza IIV IIV (yearly)
  1. Only if the person has not previously received the varicella vaccine or had a varicella infection
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History

Major additions, replacements and removals from the New Zealand Immunization Schedule include:[37]

1958: First Schedule: DTwP and DT
1961: Polio (OPV) added
1971: Measles, rubella and tetanus toxoid added
1979: Rubella changed to girls only
1988: HepB added
1990: MMR replaced measles and rubella
1994: HIB added; Td replaced tetanus toxoid
1996: DT dropped
1997: Influenza added
2000: DTaP replaced DTwP
2002: IPV replaced OPV
2006: MeNZB and Tdap added
2008: MeNZB dropped, PCV7 added, HPV4 added for females only
2011: PCV10 replaced PCV7
2014: RV5 added, PCV13 replaced PCV10
2017: HPV9 replaced HPV4 and extended to males, RV1 replaced RV5, PCV10 replaced PCV13, VV added.
2018: HZ added.
2020: Td dropped.

Nigeria

All recommended vaccines are provide free of charge by the Federal Ministry of Health.

More information Infection, Birth ...
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Spain

More information Infection, Birth ...
Vaccination Schedule for Spain
Infection Birth Months Years
2 4 6 12 18 3–4 6 12 14 65+
Diphtheria D D D D d d d
Tetanus TT TT TT TT TT TT TT
Pertussis acP acP acP acP acp
Polio IPV IPV IPV IPV
Haemophilus influenzae Hib Hib Hib Hib
Hepatitis B HepB HepB HepB
Pneumococcus PCV PCV PCV PPSV23
Meningococcus MenC MenC MenC
Measles MEAS MEAS
Mumps MUMPS MUMPS
Rubella RUMBE RUMBE
Varicella VAR
Human papillomavirus HPV
Influenza TIV
  † General Recommendation   # Recommended for specific groups only.   ‡ Catch-up
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United Kingdom

The United Kingdom childhood vaccination schedule is recommended by the Department of Health and National Health Service, and uses combination immunisations where available.

More information Infection, Months ...
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Non-routine vaccinations

Some children may receive vaccines in addition to those listed in the table:

  • BCG vaccine is given at birth to "children born in areas of the country where there are high numbers of TB cases" and "children whose parents or grandparents were born in a country with many cases of TB."[39]
  • Hepatitis B vaccine is given at birth to "babies born to mothers who have hepatitis B".[39]
  • The injected flu vaccine is offered annually to "children 6 months to 17 years old with long-term health conditions".[39]

Adult vaccinations

The five scheduled childhood tetanus vaccinations are thought to generally confer lifelong immunity; thus, no routine booster doses are given in adulthood. Those adults at risk of contaminated cuts (e.g., gardeners) may have booster tetanus vaccination every ten years.[40] Pneumococcus vaccinations (pneumococcal polysaccharide vaccine/PPV) are recommended for those over 65 and for people without a functional spleen (asplenia), either because the spleen has been removed or does not work properly.[41] Flu vaccine is recommended for anyone who is aged 65 years and over, people with certain long-term medical conditions, health and social care professionals, pregnant women, and poultry workers.[42] The shingles vaccine is recommended for those over 70.[39] Additionally, pregnant women are advised to have the pertussis vaccine.[43]

United States

The most up-to-date schedules are available from CDC's National Center for Immunization and Respiratory Diseases. In the US, the National Childhood Vaccine Injury Act requires all health-care providers to provide parents or patients with copies of Vaccine Information Statements before administering vaccines.[44]

More information Infection, Birth ...
Vaccine Schedule for the United States: 2020[45][46]
Infection Birth Months Years
1 2 4 6 9 12 15 18 19–23 2–3 4–6 7–10 11–12 13–15 16 17–18 19–26 27–49 50–64 65+
Hepatitis B HepB HepB HepB HepB HepB HepB x2–3#
Rotavirus RV RV RV
Diphtheria DTaP DTaP DTaP DTaP DTaP DTaP DTaP Tdap Tdap Tdap Td or Tdap (every 10 years)
Tetanus
Pertussis
Haemophilus influenzae Hib Hib Hib Hib Hib Hib Hib# Hib x1–3#
Polio IPV IPV IPV IPV IPV IPV
Pneumococcus PCV13 PCV13 PCV13 PCV13 PCV13 PCV13 PCV13# PCV13# PCV13§
PPSV23# PPSV23 x1–2# PPSV23
Influenza IIV (yearly) IIV or LAIV (yearly)
Measles MMR# MMR MMR MMR MMR MMR x1–2
Mumps
Rubella
Varicella VAR VAR VAR VAR VAR x1–2 VAR 2x#
Hepatitis A HepA# HepA x2 HepA HepA x2–3#
Meningococcus MenACWY# MenACWY MenACWY MenACWY MenACWY MenACWY x1–2#
MenB x2–3#
MenB§
Human papillomavirus HPV# HPV x2–3 HPV HPV HPV§
Herpes Zoster RZV or ZVL
  •   † Range of recommended ages for everyone. See references for more details.
  •   # Range of recommended ages for certain high-risk groups. See references for more details.
  •   ‡ Range of recommended ages for catch-up immunization or for people who lack evidence of immunity (e.g., lack documentation of vaccination or have no evidence of prior infection).[lower-alpha 1]
  •   § Recommended vaccination based on shared clinical decision-making.
  1. CDC provides more detailed information in catch-up immunizations.
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During pregnancy

The CDC recommends pregnant women receive some vaccines, such as the measles, mumps, rubella (MMR) vaccine a month or more before pregnancy. The Tdap vaccine (to help protect against whooping cough) is recommended during pregnancy. Other vaccines, like the flu shot, can be given before or during pregnancy, depending on whether or not it is flu season. Vaccination is safe right after giving birth, even while breastfeeding.[47][48][49][50]

History

In 1900, the smallpox vaccine was the only one administered to children. By the early 1950s, children routinely received three vaccines, for protection against diphtheria, pertussis, tetanus, and smallpox, and as many as five shots by two years of age.[4] Since the mid-1980s, many vaccines have been added to the schedule. In 2009, the U.S. Centers for Disease Control and Prevention (CDC) recommended vaccination against at least fourteen diseases. By two years of age, U.S. children receive as many as 24 vaccine injections, and might receive up to five shots during one visit to the doctor.[4] The use of combination vaccine products means that, as of 2013, the United Kingdom's immunization program consists of nine injections by the age of two, rather than 22 if vaccination for each disease was given as a separate injection.[51]

See also

References

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