Immunizations save lives. They are the best way to help protect you or your child from certain infectious diseases. They also help reduce the spread of disease to others and prevent epidemics. Most are given as shots. They are sometimes called vaccines, or vaccinations.
In many cases when you get a vaccine, you get a tiny amount of a weakened or dead form of the organism that causes the disease. This amount is not enough to give you the actual disease. But it is enough to cause your immune system to make antibodies that can recognize and attack the organism if you are ever exposed to it.
Sometimes a vaccine does not completely prevent the disease, but it will make the disease much less serious if you do get it.
Some immunizations are needed only one time. Others require several doses over time to help your body be able to fight the disease (build immunity).
If you are a woman who is planning to get pregnant, talk to your doctor about what immunizations you have had and what you may need to protect your baby. And if you live with a pregnant woman, make sure your vaccines are up-to-date.
Traveling to other countries may be another reason to get immunized. Talk with your doctor months before you leave, to see if you need any shots.
Ask your doctor what shots your child should get. The immunization schedule includes vaccines for:
Immunizations start right after birth, and many are given throughout a baby's first 23 months. Booster shots (the later doses of any vaccines that need to be repeated over time) occur throughout life.
Fewer immunizations are needed after age 6. But older children and teens need shots too (such as those for bacterial meningitis and for tetanus, diphtheria, and whooping cough). Some shots are also given during adulthood (such as a tetanus shot).
It is important to keep a good record, including a list of any reactions to the vaccines. When you enroll your child in day care or school, you may need to show proof of immunizations. Your child may also need the record later in life for college, employment, or travel.
Talk to your doctor if you or your child plans to be in a group living situation, like a college dormitory or summer camp. You may want certain shots, like those for meningitis.
The vaccines you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans but also on who you are in close contact with and what vaccines you had as a child.
Talk to your doctor about which vaccines you need. Common adult vaccines include:
In some states, pharmacists can give some of these shots.
Most side effects from vaccines are minor, if they occur at all. Ask your doctor or pharmacist about the reactions that could occur. They may include:
Serious reactions, such as trouble breathing or a high fever are rare. If you or your child has an unusual reaction, call your doctor.
False claims in the news have made some parents concerned about a link between autism and the shot for measles, mumps, and rubella. But studies have found no link between vaccines and autism.
Some parents question whether mercury-containing thimerosal (used as a preservative in vaccines) might cause autism. Studies have not found a link between thimerosal-containing vaccines and autism. Today, all routine childhood vaccines made for the U.S. contain either no thimerosal or only trace amounts.
Two major government agencies, along with vaccine makers and other groups, watch for, study, and keep track of adverse events that occur after vaccines are given.
The U.S. Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians recommend a specific childhood immunization schedule each year. Immunizations are recommended, because they protect against diseases (give immunity) or make a disease less severe if your child does get it. The schedule outlines the immunizations and booster shots needed from birth through age 18, as well as when catch-up immunizations should be given.
The schedule for a premature infant is the same as for a full-term infant. But sometimes the hepatitis B vaccine is delayed.
Many immunizations require more than one dose, given at varying intervals. Although your child does not need to restart the series if a scheduled dose is missed, the immunization should be given as soon as possible.
This schedule outlines the immunizations recommended for children younger than 11 years of age.
This shot protects against chickenpox.
Who should get it?
The combination MMRV shot can be given in place of the chickenpox vaccine. The vaccines for chickenpox, measles, mumps, and rubella are all in this one shot.
This shot (immunization) protects against diphtheria, tetanus, and whooping cough (pertussis).
Who should get it?
This immunization helps protect against the flu. Flu viruses are always changing, so the flu vaccines are updated every year.
Who should get it?
There are different ways to get a flu vaccine. Ask your child's doctor what is right for your child. For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.
This shot protects against bacteria that can cause an infection in the lungs (pneumonia) or the covering of the brain (meningitis), skin and bone infections, and other serious illnesses in young children. It does not protect against viral influenza (flu).
Who should get it?
This shot protects against hepatitis A disease.
Who should get it?
This shot protects against hepatitis B disease.
Who should get it?
This shot protects against measles, mumps, and rubella.
Who should get it?
There is a measles, mumps, rubella, and varicella (MMRV) shot that also protects against chickenpox (varicella). Talk to your child's doctor about the pros and cons of the MMRV shot. It can be given to children ages 12 months to 12 years.
This shot (called PCV13) protects against a bacteria that causes meningitis, blood infections (sepsis), and ear infections.
Who should get it?
This shot protects against polio.
Who should get it?
This immunization protects against rotavirus infection, which causes severe diarrhea.
Who should get it?
This immunization is swallowed rather than given as a shot. Without this vaccine, most children will get infected by the time they are about 5 years old.
Your child's doctor may suggest other shots if your child is at higher risk than other children for certain health problems. These may include:
This shot protects against a bacteria that causes meningitis and blood infections (sepsis).
Who should get it?
Children who remain at high risk need routine booster shots starting a few years after their first doses of meningococcal shots. Ask your doctor if your child has a high risk of getting infections from bacterial meningitis and whether booster shots are needed.
This shot does not necessarily reduce the risk of getting pneumonia. But it can prevent some of the serious complications of pneumonia, such as blood infections (sepsis).
Who should get it?
Combination vaccines are usually preferred to separate shots because they reduce the number of needle pricks.
It is important to keep accurate records of immunizations, including any reactions to the vaccines. When you enroll your child in day care or school, you may need to show proof of immunizations. Also, your child may need the record later in life for college, employment, or travel.
You may worry that immunizations are dangerous if given when your child has a cold or other minor illness. Talk to your child's doctor if you have concerns about the timing of immunizations. Immunizations can usually still be given during a mild illness, while medicines are being taken, and in other situations where a child may not be in perfect health. Also, getting several vaccines at the same time is as safe as getting one shot at a time.footnote 6 There are very few reasons for which doctors suggest that a person postpone or not get an immunization.
Some parents fear that the measles-mumps-rubella (MMR) vaccine may cause their child to develop autism. Misleading stories about the MMR shot and autism have circulated through websites, the media, and word of mouth. But scientific studies have found no connection between autism and the vaccine.footnote 7
For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.
Adolescents need certain immunizations and booster shots for ongoing protection (immunity) against diseases. Consult your doctor or public health department if your child missed an immunization or if you need to find out whether your child needs a certain one.
The U.S. Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians recommend a specific immunization schedule for children and adolescents each year.footnote 8 This schedule outlines the immunizations and booster shots needed during adolescence and also when catch-up immunizations should be given.
This immunization helps protect against the flu. Flu viruses are always changing, so the flu vaccines are updated every year. Protection lasts up to a year for each flu vaccine type.
Who should get it?
There are different ways to get a flu vaccine. Ask your doctor what is right for your child.
For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.
The HPV (human papillomavirus) vaccine protects against HPV. HPV is a common sexually transmitted infection (STI). There are many types of HPV. Some types of the virus can cause genital warts. Other types can cause cervical or oral cancer and some uncommon cancers, such as vaginal and anal cancer. The HPV vaccine protects against the most common HPV types that can cause serious problems.
Who should get it?
If your child already has HPV infection, talk with your doctor about whether to get your child immunized. The shot has not been shown to help existing HPV infection, but it may protect your child from other HPV infections.
This shot protects against a bacteria that causes meningitis and blood infections (sepsis).
Who should get it?
People who have a damaged or missing spleen or who have certain immune system problems need a booster dose every 5 years.
This booster shot protects against tetanus, diphtheria, and whooping cough (pertussis).
Who should get it?
Some adolescents may need or want additional immunizations for situations that increase a person's risk for exposure to disease, such as being in group living situations (when attending college or summer camp) or traveling to other countries. They may have missed shots when they were younger. Or a vaccine may not have been offered when they were younger. These immunizations may include:
This is important if your child never had chickenpox or never got this shot.
This shot protects against chickenpox.
Who should get it?
Chickenpox infection can be very serious when it occurs after childhood.
This shot protects against hepatitis A disease. Two doses are needed over at least 6 months.
Who should get it?
This is important if your child never got this shot.
This shot protects against hepatitis B disease.
Who should get it?
This is important if your child never got this shot.
This shot protects against measles, mumps, and rubella. There is a measles, mumps, rubella, and varicella (MMRV) shot that also protects against chickenpox (varicella). It can be substituted for either or both doses of MMR in children ages 12 months to 12 years.
Who should get it?
This shot does not necessarily reduce the risk of getting pneumonia. But it can prevent some of the serious complications of pneumonia, such as blood infections (sepsis).
Who should get it?
Most side effects from vaccines are minor, if they occur at all. The doctor may have your child stay in the office for up to 15 minutes after the shots are given, to watch for any reactions.
You may worry that immunizations are dangerous if they are given when your child has a cold or other minor illness. Talk to your child's doctor if you have concerns about the timing of shots. But keep in mind that shots can usually still be given during a mild illness, while medicines are being taken, and in other situations where a child may not be in perfect health. There are very few reasons for which doctors suggest that a person postpone or not get an immunization.
For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.
Your need for immunizations does not end when you reach adulthood. The specific shots (injections) you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans but also on who you are in close contact with and what vaccines you had as a child. Tetanus and diphtheria shots need to be repeated every 10 years throughout adulthood in order to keep your immunity.
Each year the U.S. Advisory Committee on Immunization Practices (ACIP), the American College of Obstetrics and Gynecologists, the American College of Physicians, the American Academy of Family Physicians, and the American College of Nurse-Midwives recommend a specific adult immunization schedule. Your doctor will consider your medical and immunization history (and documentation) when deciding which shots you need.
This list outlines an adult immunization schedule.
This immunization helps protect against the flu. Flu viruses are always changing, so the flu vaccines are updated every year. Protection lasts up to a year for each flu vaccine type.
Who should get it?
There are different ways to get a flu vaccine. Ask your doctor what is right for you.
Adults ages 65 and older can get a high-dose flu shot.footnote 10 Studies are being done to see if the high-dose shot protects older adults better than the standard-dose shot.
For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.
This shot protects against hepatitis A disease.
Who should get it?
This shot protects against hepatitis B disease. Three doses are needed over at least 4 months.
Who should get it?
Adults who have not had this vaccine series need this shot when occupation, travel, health condition, or lifestyle increases their risk of exposure.
A hepatitis combination vaccine is recommended for those who are at risk for both hepatitis A and hepatitis B. This vaccine is approved in the United States only for those 18 years of age or older.
This shot does not necessarily reduce your risk of getting pneumonia, but it can prevent some of the serious complications of pneumonia, such as infection in the bloodstream (bacteremia) or throughout the body (septicemia).
Your doctor can help you choose between the pneumococcal polysaccharide vaccine (PPSV23) or the pneumococcal conjugate vaccine (PCV13).
Who should get it?
This vaccine may help prevent shingles or make it less painful if you do get it.
Who should get it?
Ask your doctor or pharmacist about the shingles vaccine. Shingles: Should I Get a Shot to Prevent Shingles?
The Tdap shot protects against tetanus, diphtheria, and whooping cough (pertussis). The Td shot does not protect against pertussis.
Who should get it?
It's important to get the Tdap shot at least 2 weeks before having close contact with a baby.
You may need or want additional immunizations if certain situations raise your chance for exposure to disease. Or you may have missed shots when you were younger. Or a vaccine may not have been offered when you were younger. These immunizations may include:
This is important if you never had chickenpox or never got this shot.
This shot protects against chickenpox. Chickenpox infection can be very serious when it occurs after childhood.
Who should get it?
Pregnant women and people with immune system problems should not get this shot.
This is important if you never got this shot.
The HPV (human papillomavirus) vaccine protects against HPV. HPV is a common sexually transmitted infection (STI). There are many types of HPV. Some types of the virus can cause genital warts. Other types can cause cervical or oral cancer and some uncommon cancers, such as vaginal and anal cancer. The HPV vaccine protects against the most common HPV types that can cause serious problems.
Who should get it?
If you already have HPV infection, talk with your doctor about whether to get immunized. The shot has not been shown to help existing HPV infection, but it may protect you from other HPV infections.
This is important if you never got this shot or never had these diseases.
This shot protects against measles, mumps, and rubella.
Who should get it?
Women should avoid becoming pregnant for 28 days after getting the MMR shot. Women who are known or suspected to be pregnant and people who have impaired immune systems should not get this shot.
These shots protect against a bacteria that causes meningitis and blood infections (sepsis).
Who should get them?
This shot protects against polio.
Who should get it?
Routine polio immunization is not recommended for adults (ages 18 and older) who live in the United States.
Consult your doctor or public health department if you missed an immunization or to find out whether you need a specific immunization. For more information about each vaccine, see the topic Vaccine Information Statements.
Before you become pregnant, discuss your immunization history with your doctor. Your immunity protects both you and your baby. Some vaccines (such as the ones for flu and Tdap) can be given during pregnancy. Some vaccines need to be given before or soon after pregnancy.
If you are pregnant, your children should still get their immunizations on schedule. You do not need to speed up or delay your other children's immunizations.
You may worry that immunizations are dangerous if they are given when you have a cold or other minor illness. Talk to your doctor if you have concerns about the timing of shots. But keep in mind that shots can usually still be given during a mild illness, while medicines are being taken, and in other situations where you may not be in perfect health. There are very few reasons for which doctors suggest that a person postpone or not get an immunization.
For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.
Talk with your doctor months in advance of a trip to find out whether any immunizations are recommended. Certain things, such as your age and health, where you are going, and the length of your stay, affect your risk of disease and your need for immunization.
Your age and health
People with certain medical conditions, such as immune system problems, may have different immunization recommendations than healthy people. Also, young children who are traveling may need to receive their routine immunizations sooner than normally scheduled.
Where you travel
In most developed countries (including Canada, Australia, New Zealand, Japan, and western and northern European countries), the risk of exposure to serious diseases is generally no greater than it is in the United States.
The risk of exposure to serious disease may be much higher in developing countries (such as those in most parts of Africa and Asia and many parts of South and Central America) than it is in most developed countries. This is especially true for areas with poor sanitation (for example, poor water and food handling). For example:
The need for travel immunizations depends on your immunization history, the specific area you plan to visit, the time of year, and whether any outbreaks of disease have recently occurred.
How you travel and types of activities
Certain activities or modes of travel increase your risk of exposure to disease. These include:
Length of stay
The longer you stay in a country, the more exposure you have to local pathogens that could cause harm.
You can get information about travel immunizations by:
For more information on immunizations and health related to travel, see the topic Travel Health.
The United States government has developed plans on how to respond to possible bioterrorism threats.
A 2007 law called the Pandemic and All-Hazards Preparedness Act ("Bioshield II") will help companies make more vaccines and drugs that protect against bioterror agents.footnote 12
Certain diseases have been identified that pose the greatest threat to the U.S. public. At this time, there is a supply of anthrax and smallpox vaccines only. These immunizations are not currently available to or recommended for the general public. But the government has advised immunization for people at high risk of exposure to anthrax or smallpox, such as health care workers specifically designated to respond to a bioterrorism emergency. Some of these recommendations are listed below.
This shot protects against anthrax.
Who should get it?
Five shots are given over 18 months. And booster shots are needed every year for continued protection (immunity).
This shot protects against smallpox.
Who should get it?
This shot is given once as several quick punctures on the upper arm, using a special prong device. Immunity after a first-time immunization is likely to be 3 to 5 years. If you have been immunized in the past, successful revaccination may extend your immunity.
The United States has enough smallpox vaccine to vaccinate Americans in an emergency.footnote 13
More information about these immunization recommendations can be found on the Centers for Disease Control and Prevention (CDC) website at www.bt.cdc.gov/bioterrorism. For general information about bioterrorism issues, see the topic Terrorism and Other Public Health Threats.
Call 911 or other emergency services if you or your child develops any of the following symptoms:
Call your doctor if:
If a fever develops after an immunization and you need to find out if you should call your doctor, see:
Talk with your doctor about whether you need special immunizations because you:
Many immunizations are given as shots (injections). Your child may experience brief pain as the needle penetrates the skin or muscle. Some vaccines cause more discomfort than others. In general, you can help decrease your child's discomfort by making sure that he or she is physically comfortable and well rested before getting immunized. You can use home treatment measures to help relieve some of the common minor reactions to immunizations.
You can help relieve some of the common, temporary, mild reactions to immunizations with basic home care.
For more information about reactions to immunizations, see When to Call a Doctor.
Citations
- Demicheli V, et al. (2008). Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews (4).
- Parker SK, et al. (2004). Thimerosal-containing vaccines and autistic spectrum disorder: A critical review of published original data. Pediatrics 114(3): 793–804.
- Centers for Disease Control and Prevention (2011). Vaccine safety: Thimerosal. Available online: http://www.cdc.gov/vaccinesafety/Concerns/thimerosal.
- Taylor LE, et al. (2014). Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccines, 32(29): 3623–3629.
- Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.
- Centers for Disease Control and Prevention. (2011). Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book), 12th ed. Washington, DC: Public Health Foundation. Also available online: http://www.cdc.gov/vaccines/pubs/pinkbook/index.html.
- Demicheli V, et al. (2008). Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews (4).
- Centers for Disease Control and Prevention (2014). Advisory Committee on Immunization Practices recommended immunization schedules for persons aged 0 through 18 years—United States, 2014. MMWR, 63(Early Release): 1–2. http://www.cdc.gov/mmwr/pdf/wk/mm63e0203a1.pdf. Accessed February 4, 2014.
- Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.
- Centers for Disease Control and Prevention (2010). Licensure of a high-dose inactivated influenza vaccine for persons aged ?65 years (Fluzone high-dose) and guidance for use—United States, 2010. MMWR, 59(16): 485–486. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5916a2.htm?s_cid=mm5916a2_e.
- Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.
- Mitka M (2007). Bioterror vaccine production: Take 2. JAMA, 297(6): 575–576.
- Centers for Disease Control and Prevention (2016). Smallpox fact sheet: Vaccine overview. http://emergency.cdc.gov/agent/smallpox/vaccination/facts.asp. Accessed April 5, 2016.
Current as of: August 31, 2020
Author: Healthwise Staff
Medical Review:John Pope MD - Pediatrics & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine
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