American Medical Association Family Medical Guide - American Medical Association [158]
Recommended Schedule of Childhood Vaccinations
The following schedule is a general recommendation for the timing of vaccinations during childhood. Children usually receive the vaccinations during their regular well-child visits to the doctor.
Recommended Schedule of Childhood Vaccinations
Age Vaccination
Birth-2 months Hepatitis B (1st dose)
1-4 months Hepatitis B (2nd dose)
2 months DTaP, Hib, IPV, PCV
4 months DTaP, Hib, IPV, PCV
6 months DTaP, Hib, PCV
6-18 months Hepatitis B (3rd dose), IPV
6 months-18 years* Influenza (yearly)
6 months-23 months† Influenza (yearly)
12-15 months Hib, MMR (1st dose), PCV
12-23 months Chickenpox (varicella)
15-18 months DTaP
2 years-18 years* PPV, hepatitis A series
4-6 years DTaP, IPV, MMR (2nd dose)
11-16 years Td
2-18 years Hepatitis B series, chickenpox (if not given previously)
11-18 years MMR (2nd dose, if not given previously)
*Recommended for children who have risk factors such as asthma, heart disease, sickle cell disease, HIV or AIDS, or diabetes.
† Recommended for all healthy children.
Key
DTaP Diphtheria and tetanus toxoids and acellular pertussis vaccine
Hib Haemophilus influenzae type b conjugate vaccine
IPV Inactivated poliovirus vaccine
PCV Pneumococcal vaccine
PPV Pneumococcal polysaccharide vaccine
MMR Measles, mumps, and rubella vaccine
Td Tetanus and diphtheria toxoids
Common Childhood Screenings and Tests
At routine visits to the doctor throughout childhood, screening tests are given to children for a number of disorders, including high blood pressure (see page 574) and lead poisoning (see page 425). Early detection of these disorders enables the child to be treated before symptoms develop.
Blood Pressure
The doctor will check your child’s blood pressure at each annual checkup starting at age 3. The measurement is compared against the average healthy range for children of the same age and sex. If your child has high blood pressure, the doctor will want to find the cause and will recommend treatment if necessary. High blood pressure can be a sign of a serious disorder such as kidney disease, heart disease, or thyroid disorders. It can also result from being overweight. If your child is overweight, the doctor will recommend a weight-loss program that will include a healthy diet and an increase in exercise; weight loss can significantly lower blood pressure.
Blood Tests
All children are given a blood test at one time or another, either to diagnose a disorder such as an infection or to screen for disorders such as anemia.
Complete blood cell count
A complete blood cell (CBC) count measures the major components of blood, including red cells (which deliver oxygen to cells), white cells (which fight infection), and platelets (which help blood to clot). A CBC count can detect disorders such as anemia (see page 610), which results from a low level of red blood cells, leukemia (see page 621), which affects white blood cells, or the presence of an infection.
Hemoglobin test or hematocrit test
A hemoglobin test measures the level in the blood of the oxygen-carrying protein hemoglobin. A hemocrit test measures the percentage in the blood of red blood cells, which contain hemoglobin. Both tests can be used to screen for anemia. Children usually are given a test at some time in their first year of life and then periodically throughout childhood and adolescence.
Cholesterol
A cholesterol test, which measures the levels of various types of fats in the blood, can help evaluate a child’s risk of developing heart disease. Some doctors recommend that all children have a cholesterol screening test at age 6 and a follow-up test at age 8. All doctors recommend a cholesterol test for children who are overweight, who have a parent with a total cholesterol level above 240 milligrams per deciliter (mg/dL), or who have a close relative (parent, grandparent, aunt, or uncle) who developed heart disease or had