Childhood Immunization Schedule: 2026 Updates
The short answer
The childhood immunization schedule is reviewed and updated annually by the CDC's Advisory Committee on Immunization Practices (ACIP), the AAP, and the American Academy of Family Physicians. The schedule may include changes to timing, new vaccine recommendations, or updates to catch-up schedules. Always consult your pediatrician for the most current recommendations, as the schedule is designed to provide the earliest possible protection during the most vulnerable periods.
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By Age
What to expect by age
0-2 months
The immunization schedule begins at birth with the hepatitis B vaccine, given before hospital discharge. At 2 months, babies receive their first doses of several vaccines including DTaP, IPV (polio), Hib, PCV15 or PCV20 (pneumococcal), and rotavirus. These early vaccines are critically important because young infants are most vulnerable to serious infections. New additions to the schedule may include updated RSV prevention recommendations with monoclonal antibodies like nirsevimab or clesrovimab for all infants.
4-6 months
Babies receive second and third doses of many vaccines during this period to build robust immunity. The 6-month visit often includes the first influenza vaccine dose (during flu season) and may include COVID-19 vaccination per current recommendations. Following the recommended schedule closely ensures your baby builds immunity before potential exposure. If your baby has missed doses, a catch-up schedule can be arranged with your pediatrician.
12-18 months
This is a busy vaccination period with first doses of MMR, varicella, and hepatitis A, along with booster doses of several earlier vaccines. The 12-15 month visit is also when the first dose of varicella vaccine is given. Changes to the schedule may affect which combination vaccines are recommended or the timing of boosters. Your pediatrician will follow the most current ACIP recommendations and can address questions about any changes.
4-6 years
Before kindergarten, children typically receive booster doses of DTaP, IPV, MMR, varicella, and the second dose of hepatitis A if not already given. This is an important catch-up opportunity for any missed vaccines. Schedule updates may affect the recommended age for certain boosters or introduce new combination vaccine options. Check with your child's doctor to ensure they are up to date before school entry.
What Should You Do?
When to take action
- Your pediatrician follows the current ACIP-recommended schedule and explains any updates at each visit.
- Your child experiences mild side effects after vaccination such as low-grade fever, fussiness, or injection site tenderness.
- Your child is slightly behind schedule but your pediatrician has created a catch-up plan.
- You have questions about recent changes to the vaccine schedule or new vaccine recommendations.
- Your child has a medical condition that may affect which vaccines are safe or their timing.
- You are unsure if your child is up to date on vaccinations, especially if you have changed pediatricians.
- Your child develops a severe allergic reaction (difficulty breathing, swelling, widespread hives) shortly after receiving a vaccine.
- Your child has a very high fever (over 105 degrees F), seizure, or inconsolable crying lasting more than 3 hours after vaccination.
- Your unvaccinated child has been exposed to a vaccine-preventable disease like measles or pertussis.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
COVID-19 Vaccine Recommendations for Infants: Updates
COVID-19 vaccines have been authorized for children as young as 6 months. Recommendations are updated regularly as new variants emerge and new vaccine formulations are developed. The CDC and AAP recommend that all eligible children receive the most current COVID-19 vaccine to help protect against severe illness and hospitalization. The vaccine schedule for young children may differ from adults. Always consult your pediatrician for the most current guidance.
Chickenpox Outbreaks and Clusters in Children
Chickenpox (varicella) outbreaks continue to occur, particularly in communities with lower vaccination rates. While the varicella vaccine has reduced cases by over 90%, breakthrough infections can occur in vaccinated children, typically with milder symptoms. Chickenpox is most dangerous for infants under 12 months (who are too young for the vaccine), pregnant women, and immunocompromised individuals. Two doses of varicella vaccine remain the best protection.
Clesrovimab: New RSV Prevention for Infants
Clesrovimab is a long-acting monoclonal antibody being developed for the prevention of RSV (respiratory syncytial virus) lower respiratory tract disease in infants. Similar to nirsevimab (Beyfortus), it provides passive immunity against RSV by giving babies ready-made antibodies. This approach is especially important because RSV remains a leading cause of infant hospitalization, and infants under 6 months are too young for active vaccination. Consult your pediatrician about the latest RSV prevention options for your baby.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.