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Childhood Immunization Record

My child's name is __________________________. My child's birthday is _________________.

My child's doctor is __________________________. The doctor's phone number is _____________________.

Age Immunization Dose Notes Date given
Birth Hepatitis B (HepB) 1 of 3
Respiratory syncytial virus (RSV) 1 of 1
1 to 2 months Diphtheria, tetanus, and pertussis (DTaP) 1 of 5
Haemophilus influenzae type b (Hib) 1 of 4
Hepatitis B (HepB) 2 of 3 Can be given from 1 to 2 months of age
Pneumococcal (PCV) 1 of 4
Polio (IPV) 1 of 4
Rotavirus 1 of 2 or 3
4 months Diphtheria, tetanus, and pertussis (DTaP) 2 of 5
Haemophilus influenzae type b (Hib) 2 of 4
Pneumococcal (PCV) 2 of 4
Polio (IPV) 2 of 4
Rotavirus 2 of 2 or 3
6 months Diphtheria, tetanus, and pertussis (DTaP) 3 of 5
Haemophilus influenzae type b (Hib) 3 of 4
Hepatitis B (HepB) 3 of 3 Can be given from 6 to 18 months of age
Pneumococcal (PCV) 3 of 4
Polio (IPV) 3 of 4 Can be given from 6 to 18 months of age
Rotavirus 3 of 3, if needed
COVID-19 Discuss with doctor
6 months and older Flu (influenza) Yearly One dose each year. Some children may need 2 doses depending on when they started getting this yearly vaccination.
12 months Chickenpox (varicella) 1 of 2 Can be given from 12 to 23 months of age
Haemophilus influenzae type b (Hib) 4 of 4 Can be given from 12 to 23 months of age
Hepatitis A (HepA) 1 of 2 Can be given from 12 to 23 months of age
Measles, mumps, and rubella (MMR) 1 of 2 Can be given from 12 to 23 months of age
Pneumococcal (PCV) 4 of 4 Can be given from 12 to 23 months of age
Diphtheria, tetanus, and pertussis (DTaP) 4 of 5

Can be given from 12 to 23 months of age

Can be given from 12 months of age if at least 6 months after the 3rd dose

18 months Hepatitis A (HepA) 2 of 2 Given at least 6 months after the 1st dose
4 years Chickenpox (varicella) 2 of 2

Given at 4 to 6 years of age

Can be given earlier if at least 3 months after the 1st dose

Diphtheria, tetanus, and pertussis (DTaP) 5 of 5 Can be given from 4 to 6 years of age
Measles, mumps, and rubella (MMR) 2 of 2 Can be given from 4 to 6 years of age
Polio (IPV) 4 of 4 Can be given from 4 to 6 years of age
11 years and older Human papillomavirus (HPV) 1, 2, or 3 Given at 11 or 12 years of age. Two doses are given within 6 months. A 3-dose series is given at 15 years or older.
Meningococcal 1 and 2 Preferred given at 11 or 12 years of age. There are a few types of vaccines, so discuss vaccines and schedule with doctor.
Tetanus, diphtheria, pertussis (Tdap) 1 of 1 Given at 11 or 12 years of age. Teens who haven't had the shot can get it as soon as possible.

Other shots

Depending on where you live and your child's health, your doctor may talk with you about other shots.

Age Immunization Notes
2 years and older Hepatitis A (HepA)

Your child may need this shot if they have not already had the vaccination series and:

  • Hepatitis A is found in your area.
  • You and your child travel to countries with a high rate of hepatitis A. These include Mexico and countries in Central or South America, the Caribbean, Asia (except Japan), Africa, and eastern Europe.
  • Your child needs medicine to help the blood clot.

Others at risk for hepatitis A include people who inject drugs, men who have sex with men, and people who work with animals that have the disease or who work with the hepatitis A virus in a lab. If your child has contact with these groups of people, your child may also be at risk.

Two shots are given. The two shots must be at least 6 months apart.

2 years and older Pneumococcal (PPSV)

Your child may need this pneumococcal shot when older than age 2 if they:

  • Have sickle cell disease.
  • Have a damaged spleen or have had the spleen removed.
  • Have a disease or condition that affects the immune system, such as diabetes or HIV.
  • Take medicine that affects the immune system, such as chemotherapy or corticosteroids.
  • Have a long-lasting disease, such as heart disease, lung disease, kidney disease, or diabetes.
6 weeks to 10 years Meningococcal

Your child may need at least 2 shots before age 11 if they:

  • Are in an area where an outbreak has occurred.
  • Have a damaged spleen or have had the spleen removed.
  • Have certain immune system problems.
  • Travel or live in areas of the world where meningococcal disease is common, such as certain parts of Africa or Saudi Arabia during the Hajj.

Talk to your doctor about whether booster shots are needed.

Missed doses: If your child has missed any shots, talk to your doctor about the best way to make them up.

Travel: If you are traveling or if you live outside of the United States, your child may get other shots. Talk to your doctor several months before your trip.

Availability: Shots may sometimes not be available or may be in short supply. In this case, talk with your doctor about the best thing to do for your child.

Reactions: List any reactions your child has had to vaccines.

Print out a copy of your child's schedule and keep it up to date. It is very important to keep accurate records of your child's shots. When you enroll your child in day care or school, you may need to show proof of vaccinations. Also, your child may need the record later in life for college, employment, or travel. Take the schedule with you when you visit your doctor. Your doctor may need to change the schedule based on your child's special needs. Keep the record in a safe place with other important documents, and never throw it away. It is an important part of your child's lifelong medical records.

Put notes on your calendar to remind you when a shot is coming up. You also may want to ask your doctor to send you notices when shots are due.

This information is based on the immunization schedule prepared by the Advisory Committee on Immunization Practices (ACIP) and other medical organizations. It is based on your child's birth date. See the schedule on the U.S. Centers for Disease Control and Prevention's website at www.cdc.gov/vaccines/imz-schedules/index.html to learn more.

Some diseases or treatments for disease affect the immune system. For children with these diseases or children receiving these treatments, the schedule may need to be modified. Your child's health, environment, and lifestyle may also affect the shot schedule. Always talk to your doctor about the best schedule for your child.

This information does not replace the advice of a doctor. Ignite Healthwise, LLC, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

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